THE AIRLINER CABIN ENVIRONMENT AND THE HEALTH OF PASSENGERS AND CREW -- Copyright -- OTHER REPORTS OF THE BOARD ON ENVIRONMENTAL STUDIES AND TOXICOLOGY -- Preface -- Contents -- The Airliner Cabin Environment and the Health of Passengers and Crew -- Summary -- THE CHARGE TO THE COMMITTEE -- THE COMMITTEE'S APPROACH TO ITS CHARGE -- THE COMMITTEE'S EVALUATION -- Aircraft Systems -- Exposures on Aircraft -- Health Considerations -- Findings -- RECOMMENDATIONS -- 1 Introduction -- EXPOSURES ON AIRCRAFT -- REGULATORY ASPECTS OF CABIN AIR QUALITY -- HISTORY OF PREVIOUS CABIN AIR-QUALITY STUDIES -- ORGANIZATION OF THE REPORT -- REFERENCES -- 2 Environmental Control -- ENVIRONMENTAL CONDITIONS -- Pressure -- Contamination -- Contaminants Originating in the Cabin -- Contaminants Originating Outside the Cabin -- Transient Response of Cabin Environmental Conditions -- Reactive Contaminants -- Temperature Control -- Air Distribution and Circulation -- Recirculation -- Relative Humidity -- ENVIRONMENTAL CONTROL SYSTEMS -- Bleed-Air Supply -- Auxiliary Power Unit -- Air-Conditioning Packs -- Air Distribution System -- Ground-Based Systems -- ALTERNATIVE ENVIRONMENTAL CONTROL SYSTEMS -- ENVIRONMENTAL CONTROL SYSTEM DESIGN AND OPERATIONAL STANDARDS -- CONCLUSIONS -- RECOMMENDATIONS -- REFERENCES -- 3 Chemical Contaminants and Their Sources -- CONTAMINANTS WITH EXTERNAL SOURCES -- Ground-Level Pollution -- Pollution During Ascent and Descent -- Ozone During Cruise -- Atmospheric Ozone Concentrations -- Ozone Chemistry -- Methods of Controlling Ozone in Aircraft -- Measurements of Ozone in Aircraft -- CONTAMINANTS WITH INTERNAL SOURCES -- Passengers and Belongings -- Aircraft Component Materials -- Cleaning Materials and Dust -- Pesticides -- Disinsection Procedures -- Composition of Pesticide Sprays -- Pesticide Exposure -- CONTAMINANTS FROM AIRCRAFT SYSTEMS.

CONCLUSIONS -- RECOMMENDATIONS -- REFERENCES -- 4 Biological Agents -- GENERAL INFORMATION ON BIOAEROSOLS -- Biological Agents in Outdoor Air Near the Ground -- Biological Agents in Outside Air in Flight -- People -- Arthropods, Pets, and Service Animals -- Arthropods -- Pets and Service Animals -- Settled Dust -- Microbiological Growth -- Contaminated Fluids -- Other Reservoirs of Potential Infectious Agents -- ENVIRONMENTAL SAMPLING ON AIRCRAFT -- Sampling for Culturable Bacteria and Fungi -- Sampling for Allergens -- Evaluation of Available Information on Bioaerosols -- Microorganisms Sampled in Cabin Air -- Other Biological Agents -- Bacterial Endotoxin -- Fungal Toxins -- Microbial Volatile Organic Compounds (MVOCs) -- Recommended Sampling for Biological Agents -- NIOSH-Sponsored Review -- Allergens -- Infectious Agents -- HEALTH EFFECTS OF EXPOSURE TO BIOAEROSOLS -- Hypersensitivity Disease -- Infectious Disease -- Influenza -- Influenza and Air Travel -- Public-Health Measures Related to Influenza and Travel -- Measles -- Measles and Air Travel -- Public-Health Measures Related to Measles and Travel -- Tuberculosis -- Tuberculosis and Air Travel -- Public-Health Measures Related to Tuberculosis and Travel -- Meningococcal Disease -- Meningococcal Disease and Air Travel -- Public-Health Measures Related to Meningococcal Disease and Air Travel -- CONTROL OF EXPOSURES TO BIOLOGICAL AGENTS -- Hypersensitivity Diseases, Toxins, and Nuisance Agents -- Infectious Agents -- Immunization against Infectious Diseases -- Recognition of Potential Infection During or Shortly After Flight -- Postexposure Prophylaxis (PEP) -- Cabin Ventilation and Exposure to Bioaerosols -- Ventilation Rate and Air Movement -- Recirculation of Cabin Air and Exposure to Infectious Agents -- Treatment of Recirculated Air and Exposure to Infectious Agents -- CONCLUSIONS.

Aeroallergens, Toxins, and Biological Irritants -- Infectious Agents -- RECOMMENDATIONS -- Aeroallergens, Toxins, and Biological Irritants -- Infectious Agents -- REFERENCES -- 5 Health Considerations Related to Chemical Contaminants and Physical Factors -- FLIGHT ENVIRONMENT -- Cabin Pressure -- Relative Humidity -- CHEMICAL CONTAMINANTS OF CONCERN -- Ozone -- Engine Oils and Hydraulic Fluids -- Tricresyl Phosphate Esters -- Other Phosphate Esters -- Carbon Monoxide -- Formaldehyde -- Deicing Fluids -- Pyrethroid Pesticides -- Aldehydes -- Carbon Dioxide -- Particulate Matter -- OTHER HEALTH CONSIDERATIONS -- Physiological Stressors -- Multiple and Interactive Factors -- Susceptibility Factors -- CONCLUSIONS -- RECOMMENDATIONS -- REFERENCES -- 6 Health Surveillance -- STUDIES OF AIRCRAFT CABIN AIR QUALITY -- General Air-Quality Surveys -- The "Aerotoxic Syndrome" -- Disinsection Studies -- Transmission of Infectious Agents -- Influenza Virus -- Measles Virus -- Mycobacterium tuberculosis -- Cabin Air Pressure and Health Risks -- OTHER SOURCES OF HEALTH EFFECTS INFORMATION -- CURRENT HEALTH-RELATED DATA COLLECTION SYSTEMS -- CONCLUSIONS -- RECOMMENDATIONS -- REFERENCES -- 7 Air-Quality Measurement Techniques and Applications -- OZONE -- Available Technology -- Application to Aircraft Cabin -- CARBON MONOXIDE -- Available Technology -- Application to Aircraft Cabin -- CARBON DIOXIDE -- Available Technology -- Application to Aircraft Cabin -- RELATIVE HUMIDITY -- Available Technology -- Application to Aircraft Cabin -- PARTICULATE MATTER -- Continuous Monitoring for Fine Particles -- Available Technology -- Application to Aircraft Cabin -- Integrated Monitoring of Particulate Matter -- Available Technology -- Application to Aircraft Cabin -- PESTICIDES -- OTHER MONITORING METHODS -- SAMPLING LOCATIONS -- DATA PROCESSING -- Cockpit Indicators.

Logging and Storage of Data -- Available Technology -- CONCLUSIONS -- RECOMMENDATIONS -- REFERENCES -- 8 Surveillance and Research Programs on Cabin Air Quality -- AIR-QUALITY SURVEILLANCE -- HEALTH SURVEILLANCE -- AIR-QUALITY RESEARCH -- Ozone -- Cabin Pressure and Oxygen Partial Pressure -- Outside-Air Ventilation -- Air-Quality Incidents -- Pesticide Exposure -- Relative Humidity -- Fine Particulate Matter -- STAGING -- Feasibility Demonstration of Air-Quality Monitoring Program -- Development of Standard Monitoring Package -- CONCLUSIONS -- RECOMMENDATIONS -- REFERENCES -- Appendixes -- Appendix A Biographical Information on the Committee on Air Quality in Passenger Cabins of Commercial Aircraft -- Appendix B Building-Related Symptoms -- CHARACTERIZATION OF BUILDING-RELATED SYMPTOMS -- INVESTIGATIONS OF BRS -- ANALOGIES WITH PASSENGER AIR CABINS -- Cabin Crew -- Passengers -- Comparisons of Contaminant Levels in Aircraft and Buildings -- CONCLUSIONS -- REFERENCES -- Appendix C Relevant Federal Aviation Regulations -- SEC. 25.831 VENTILATION. -- SEC. 25.832 CABIN OZONE CONCENTRATION. -- SEC. 25.841 PRESSURIZED CABINS. -- SEC. 121.219 VENTILATION. -- SEC. 121.578 CABIN OZONE CONCENTRATION. -- SEC. 125.117 VENTILATION. -- Appendix D Additional Monitoring Techniques -- ELEMENTAL DETECTORS -- Phosphorus -- Sulfur -- HYDROCARBON DETECTORS -- PARTICLE DETECTORS -- BIOLOGICAL INDICATORS -- REFERENCES -- Appendix E Glossary.