Passenger Health

Passenger Health Information for OST 05-01 Dr. Annette Ruge Aviation Health Unit, CAA UK

International ActivitiesICAO • Assembly Resolution A35-12: • The Assembly • Declares that the protection of the health of passengers and crews on international flights is an integral element of safe air travel and that conditions should be in place to ensure its preservation in a time and cost-effective manner;

International ActivitiesICAO • Assembly Resolution A35-12: • The Assembly 3. Requests the Council to establish suitable institutional arrangements to coordinate efforts by contracting States and other members of the civil aviation community aimed at protecting the health of passengers and crews;

International ActivitiesICAO • Assembly Resolution A35-12: • The Assembly • Urges all contracting States, in the meantime, to ensure the implementation of existing SARPs related to passenger health and crews; • Requests the Council to support further research on the consequences of air transport on the health of passengers and crews;

International ActivitiesEASA • The Preamble of Regulation (EC) 1592/2002 (3): In order to respond to increasing concerns over the health and welfare of passengers during flights, it is necessary to develop aircraft design which better protects the safety and health of passengers.

International ActivitiesECAC • Manual on Passenger Health Issues • 2004 adopted by Directors General • Content concerning JAR-OPS • First aid kits • Emergency medical kits • Training of cabin crew in first aid and emergency medical assistance on board

Activities UKHouse of Lords Report • House of Lords Report (published Nov 2000) • inquiry into the health effects of travelling in commercial aircraft • found evidence that air travel is NOT a health risk to the majority of passengers • stated a lack of governmental responsibility for those passengers who do experience adverse effects of flying

Activities UKAviation Health Unit • was established on 1 December 2003 • is hosted and managed through the SRG Medical Division • presently funded by the Department for Transport

Aviation Health Unit Objectives • Provide informed advice and information about aviation health issues to: • UK Government • Passengers • General Practitioners • Flight Crew & Cabin Crew • Media

Aviation Health UnitObjectives • Engage in a dialogue about passenger health issues with • European Organisations • e.g. ECAC, JAA, EASA • International Organisations • e.g. ICAO, WHO • Associations • e.g. BATA, BALPA, ITF

Aviation Health UnitObjectives • Collate existing research on aviation health • Identify the need for future research • Manage and/or support future research activities

Aviation Health Unit • Passenger and crew health concerns • Cabin environment • Cabin air (contamination) • Cabin ventilation (recirculated air) • Temperature • Humidity • Seating arrangements • Medical equipment (medical kits) • Implementation of occupational health policy

ICAO State Letter • adequate regulations should be in place for the in-flight protection of the health of passengers and crew: • limitation of number and weight of carry-on luggage • minimum pitch between passenger seats • provision of advice on medical precautions to be taken by passengers with pre-existing medical conditions

ICAO State Letter • provision of advice on exercises to be carried out while seated on board • a suitable format of for reports on medical incidents during flight • guidelines for cabin crew on the reporting of in-flight medical incidents

ICAO State Letter • guidelines for the content of first aid and medical kits carried on board; • guidelines on the training of the crew in the use of such equipment and the use of telecommunication for medical purposes; • guidelines on training of the crew in CPR and the use of automated external defibrillators, if carried on board;

ICAO State Letter • requirements or recommendations for aircraft design and cabin layout to accommodate a sick passenger • provisions for emergency medical care on board by a volunteering passenger/doctor in response to a crew call, with adequate insurance and legal protection of the volunteering doctor

Medical Kits • ICAO Annex 6 (6.2.2 and Attachment B) • ECAC Manual on Air Passenger Health Issues • JAR-OPS 1.745 & 1.755 • IEM OPS 1.745 & 1.755 • (FAA Part 121)

First Aid Kits • Carriage of FAK is a requirement • Number of FAK to be carried is a requirement in JAA and FAA • Content of FAK: • ICAO: Recommendation • JAA: Guidance Material • FAA: Rule

First Aid Kits • JAA: • amount of material for treating injuries is not specified • contains medications • does not contain splints • medical incident report form and biohazard disposal bags proposed to be added

First Aid Kit • ICAO: • needs updating • no protective gloves • no biohazard disposal bags • no medical incident report form • some medication not needed for first aid, eg insect repellent, sunburn cream • some medication should be used by health professionals only, eg coronary vasodilator

First Aid Kit • FAA: • no medications required • very detailed rules on quantity of material for treating injuries • non-inflatable splints for arm and leg required • 10 ammonia inhalants required

Emergency Medical Kits • FAA: • Carriage of one EMK on all flights where a flight attendant is required is a rule • Automated external defibrillator on these flights is a rule • Medications: mostly tablets, some injectable medication • quantity of medication very detailed

Emergency Medical Kit • ICAO: • Carriage of EMK recommended on flights with more than 250 passenger seats installed • recommended content very basic • automated external defibrillator not mentioned

Emergency Medical Kit • JAA: • to be carried on all flights with more than 30 seats installed and flight time to next suitable airport is more than 60 minutes • Content is proposed to be amended (no deletions) in view of the ECAC Manual on Air Passenger Health Issues (will be presented for approval during OST 05-02)

JAA Emergency Medical Kit • Proposed additions: • Urinary catheter • Bag valve masks • Scalpel (ICAO recommendation) • Basic delivery kit

JAA Emergency Medical Kits • New approach for some proposed additions: • medications and equipment to be considered according to the size of aircraft (>30 seats, >60 min from an aerodrome with qualified medical assistance) and the conclusions of a risk assessment by the operator

Equipment and medications after risk assessment by the operator: • Thermometer – non mercury • Forceps • Intubation set • Aspirator • Blood glucose testing equipment • iv-fluids • Acetylsalicyl Acid • Antiarrhythmic • Antihypertensive medication and ......

Equipment and medications after risk assessment by the operator: • and ...... • Automated external defibrillator .....

Enjoy the discussions

Passenger Health