FUME EVENTS: Exposure to aircraft bleed air contaminants among airline workers

A guide for health care providers

SUMMARY: The outside air supplied to the cabin/flight deck on commercial aircraft ("bleed air") may sometimes be contaminated with pyrolyzed engine oil and/or hydraulic fluid. As a result of this contamination, airline workers may develop acute and/or chronic health effects and seek attention from health care providers. This document provides information about the health effects that may result after exposure to aircraft bleed air contaminants, and makes recommendations regarding treatment methods. The information in this document is largely based on information that has been published in the medical and scientific literature, and also relies on the clinical experience of one of the authors (Robert Harrison, MD, MPH) who has diagnosed and treated airline workers with contaminated bleed air exposure. A more detailed discussion on the toxicity of tricresylphosphate (TCP) engine oil additives can be found in Attachment 1. For more information, web links to additional resources and detailed references are provided at the end of the document.