Aviation Health Working Group minutes: 10 June 2004

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Aviation Health Working Group Meeting

10 June 2004, DfT, Great Minster House

Present

   

Chair

Ann Godfrey

DfT/CAD

Secretary

Robert Baker

DfT/CAD
 

Peter Smith

DfT/CAD
 

Dr Annette Ruge

CAA/AHU
 

Tom Hamilton

CAA/SRG
 

Alison Tingle

DoH
 

Roger Wiltshire

BATA
 

James Fremantle

AUC
 

Peter North

BAR UK
 

George Blundell-Pound

Thomas Cook Airlines

Apologies

   
 

Dr Bill Maton-Howarth

DoH
 

Simon Evans

AUC
 

Dr Nigel Dowdall

BATA
 

Steve James

CAA/SRG
 

Dr Tony Evans

CAA/SRG
 

Philip Stables

DfT/CAD
 

Greame Henderson

HSE

Item 1: Minutes of the previous inclusive meeting (16 January 2004)

  1. At the previous Inclusive meeting Dr Ruge had mentioned "entertainment boxes" (music and video players) in aircraft. Following up she said that she had recently visited Virgin Airlines to see their boxes, these are placed under the seats and are either 7 or 2 inches wide. Dr Ruge said that she did not consider these to be a health hazard.

Item 2: Chair's introductory remarks

  1. The Chair welcomed James Fremantle from the AUC and Alison Tingle from DoH.
  2. The Chair reported that John Smith MP and the Victims of Air Related DVT Association (VARDA) on 5 May delivered a petition in support of his Aviation Health Bill to No. 10. Tony McNulty had replied saying that he believed the existing legal framework establishing liability to be satisfactory and that the Government had now ratified the Montreal Convention, which will come into force on 28 June.
  3. The Chair said that David Kidney MP recently wrote to the Minister requesting that a representative from VARDA attend the AHWG. Tony McNulty had replied saying that if circumstances arise where the views of another organisation are required by the group the officials would be pleased to consider inviting VARDA to a future meeting. Tony McNulty had recently responded to two Parliamentary Questions from Damian Green MP, about the implementation of the European Civil Aviation Conference Working Paper on Air Passenger Health Issues and the guidance provided to UK airlines on the provision of medical emergency kits.
  4. The Chair expressed the opinion that the AHWG appeared to be gaining a higher profile with Ministers on health issues.

Item 3: Update of the work of the Aviation Health Unit current Issues

BMA Report on Flying and Passenger Health

  1. Dr Ruge reported that Dr Evans and Dr Dowdall had contributed to the medical part of the report. However, they did not have editorial control of the document. They were therefore surprised to have been credited as authors. In addition Dr Maton-Howarth and Dr Ruge reviewed the report. None of the AHWG members who helped in the preparation of the report were consulted about changes made to the report.
  2. The BMA press release gave the wrong impression of the contents of the report, it indicated that the report was focused on missing requirements for medical kits and training of cabin crew in first aid. However, it is actually a guide for GPs. The press release was also critical of the UK Government, and made no mention of the AHWG or AHU.
  3. Dr Ruge said that she became aware of the report on the 28 May when she was asked to prepare a statement for the CAA. On the 31 May, the day of publication, she handled media enquires from the BBC. Dr Graham Cresswell from the BMI also took part. It was felt that the media response was balanced and that the BMA had missed an opportunity to present some good news on aviation health.
  4. Roger Wiltshire said that his principle concern about the press release was the impact on international relations, in particular the incorrect statement, about the United States Federal Aviation Authority (FAA). Peter North suggested a high level complaint to the BMA.

Action: It was agreed that DfT would co-ordinate a reply to the BMA letter with DoH.

JAA Cabin Air Quality Adhoc Working Group "Healthy Cabin Air"

  1. Dr Ruge said that she had joined the adhoc working group on cabin air standards, which is acting as a link between the AECMA Stan WG CabinAir (5th European Framework) and the JAA. The aim of the WG is to assist these groups. As part of its terms of reference it has considered the definitions for safety, health, and comfort.

JAA Sub-Group on Medical Kits

  1. Dr Ruge said that the ECAC Manual on Air Passenger Health Issues contains proposals for the content of First Aid Kits and Emergency Medical Kits. JAR-OPS 1 is implemented in most JAA Member States and also contains requirements and guidance material for medical kits. The ECAC recommendations will be discussed in the JAA Medical Group (LSST(M)) with the aim to harmonise the ECAC and JAA standards. However, ECAC has higher standards than JAR-OPS as a result Dr Graham Cresswell has disagreed on the justification for the provision of more sophisticated Medical Kits. The JAA is also to review the ECAC recommendations on cabin crew training. The ECAC training syllabus would provide more detail than the existing syllabus, listing the steps to be taken by cabin crew.

Action: Dr Ruge to prepare paper showing what the ECAC recommendations are and the actions outstanding. Dr Ruge to contact Dr Graham Cresswell, Dr Simon Janvrin and Dr Tony Evans.

ECAC Air Passenger Health Issues APHI/3 and APHI/4

  1. Dr Ruge and Dr Evans attended both meetings. ECAC have prepared a manual on air passenger health issues which has been agreed by DGCAs, it will be presented as a information paper to the ICAO General Assembly in September.

Action: Dr Ruge will prepare a paper for July for discussion at the next Inclusive meeting to highlight which of the recommendations, if any, need implementing in the UK.

Visit to DSTL

  1. Dr Ruge and Dr Evans recently visited the Defence Science and Technology Laboratory (DSTL) at Porton Down. The visit was aimed at gaining an understanding of the research undertaken into the study of organophoshates for the CAA paper 2004/4 on cabin air quality.

Long Term Health Issues (Paper: AHWG 24-2)

  1. Dr Ruge said that a policy paper 'Responsibility for long term health in the cabin environment' had been prepared by the CAA in order to clarify the responsibilities of AHU and HSE. The responsibility of the AHU regarding long term health is to provide advice to the government via AHWG.

Item 4: Research

The use of Aspirin for DVT (DH)

  1. Alison Tingle said that as a result of previous research into public perceptions of DVT and a paper on Aspirin. DoH had agreed to undertake further studies to quantify the extent to which Aspirin is actually used by the public for the prevention of DVT in long-haul air passengers.
  2. ISIS have been commissioned to undertake the research, interviews will be undertaken by BAA and should take place in the next few months they will involve ten minute interviews focused on health awareness. The results should available by the end of the year.

Update on WHO Wright Project

  1. Peter Smith said that he and Dr Maton-Howarth had attended a meeting at WHO on 28 April. The DVT studies are on target to be finished by the end of the year. The results should be ready by the start of next year.
  2. Peter Smith said that DfT had agreed contracts with Leiden and Leicester universities for the work set out in the WRIGHT Protocol, including specific agreements in relation to intellectual property rights. A Memorandum of Understanding between WHO and the universities is desirable, however, there may be aspects that cannot be resolved due to the separate legal agreements they have entered into with DfT. If this is not resolved it could result in the withdrawal of WHO involvement.

Other research Issues

  1. Dr Ruge said that Dr Jane Zuckerman from the Royal Free Hospital was interested in undertaking research into symptoms of colds and flu after flights. She will arrange to meet Dr Zuckerman in July to develop the project.
  2. Dr Ruge said that BRE are looking to undertake the EU Project on internal cabin environment (ICE). Dr Ruge has been invited to chair the medical group for this project, which will be funded by the EU and BRE.

Item 5: AOB

  1. The Chair said that British Airways had enabled the possibility of an appeal decision from the House of Lords on DVT related incidents by promising to waive costs if they won the case. This had generated some press interest. The appeal process will be in two stages, in the first stage the judges will determine if they are going to consider the appeal. The second stage will be the appeal.
  2. Dr Ruge said that she has recently replied to several passenger queries about sanitation and cleanliness of aircraft. She wanted to know if it was actually the responsibility of the AHU to deal with these queries. Tom Hamilton said that it was really an issue for the airline. James Fremantle said that there were no regulations for airlines on sanitation.
  3. Dr Ruge had attended a meeting by the All Party Parliamentary DVT Awareness Group. She remarked that only one MP was present; the remainder being mainly lobbyists, notably VARDA.
  4. Dr Ruge commented adversely on a booklet by Rachel Briggs (DEMOS) on travel health. Although there were incorrect references to air travel, she decided it was not worth pursuing them.
  5. Dr Ruge said that the AHU website would primarily consist of links to other established websites.

Action: BATA to check about whether or not it would be possible to include a link from the AHU to BA travel health page.

  1. George Blundell-Pound said that the BBC were planning to make a TV programme entitled 'Should I be worried about DVT?' Dr John Scurr who advises Thomas Cook Airways, is planning to carryout before and after examination of passengers on a long-haul flight. Dr Ruge said there would need to be a control group.

Dates of next meetings:

Exclusive - 3 September
Inclusive - 15 October
Exclusive - 3 December
Inclusive - 11 February 2005
Exclusive - 18 March 2005

CAD June 2004