Gaps in research
3.23. There remain gaps in research. In 2000
we recommended an "exploration of the ways different aspects
of the aircraft cabin environment may interact, particularly on
those in less than average health".
This recommendation is even more relevant today. Phase I of the
WRIGHT Project found that "the more pronounced risk increase
observed after air travel compared to ground travel for some of
these risk factors may suggest an effect of flight-related factors,
which are absent during travel by other modes of transport".
We expect that the ICE Project may address some of the issues,
but it is imperative that we find what these "flight-related
factors" are and what effects they have on passengers and
in particular on those with existing medical conditions. For instance,
the Anthropometric Study to Update Minimum Aircraft Seating Standards
recommended that "studies investigate any specific relationships
between seating parameters and thromboembolic disease".
No such studies have taken place. It is essential that the WRIGHT
Project addresses this issue.
3.24. We also recommended in 2000 that researchers
should be enabled to extract "maximum value from available
and improved medical records of aircrew concerning any long-term
effects from exposure to the aircraft cabin environment".
The CAA's study into mortality and cancer rates is a good start
and we will follow with interest the publication of the preliminary
results. However, we heard at our seminar of the difficulties
that the CAA encountered in carrying out this study. Section 23
of the Civil Aviation Act 1982 restricts the CAA on how they can
use information from pilots' medical examinations for research
purposes. When we put this issue to Jim Fitzpatrick MP he
told us that the Government "have not made judgment on it
yet" but that it is "something that we are prepared
to consider in due course".
3.25. Stage 2 of the Study of possible effects
on health of aircraft cabin environments highlighted jet lag
as a high priority area in need of research, and in particular
the inclusion of jet lag as a confounding effect in the study
of DVT, cabin air quality and infection risk. Also highlighted
was the need to study the long-term effects of jet lagthe
physiological condition resulting from alterations to the circadian
rhythm (the body's internal clock) due to transmeridian traveland
shift working patterns on air crew. Such issues are increasingly
relevant today given the expansion of long haul flights. But to
our knowledge little has been done in this area.
3.26. At its meeting on 6 October
2006 the AHWG decided not to support a research proposal from
Dr Jane Zuckerman from the Royal Free Hospital to carry out
research into the transmission of respiratory infections by or
in air travel. However the Group agreed that "there were
potential issues, which good quality research could tease out".
It is interesting to note how the travelling public have come
to accept that at times they may contract a cold after a flight
and this is assumed to be a "side effect" of air travel.
Written evidence submitted to the original inquiry included personal
accounts from passengers complaining of contracting respiratory
infections following a flight. We concluded in 2000 that the re-circulation
of air in aircraft does not in fact aid infection transmission.
However, given the public's perception on this issue it is worth
investigating specifically whether any aspect of the flying experience,
such as jet lag or psychological factors, makes us more susceptible
to contracting respiratory diseases.
3.27. We recommend that the Government fully
support Phase II of the WRIGHT Project including investigations
on flight-related factors which may increase the risk of VTE,
the relationship between seating and VTE, and effective preventive
3.28. We recommend that the Government bring
forward an amendment to Section 23 of the Civil Aviation Act 1982
which regulates the use of information from air crew medical records,
so that anonymised data can be extracted and used to carry out
epidemiological research projects.
3.29. We recommend that jet lag should be
studied as a confounding effect of DVT as part of Phase II of
the WRIGHT Project. Other research projects, such as FACE should
include jet lag in their studies. We also recommend that the CAA,
as the body responsible for the health and safety of air crew
while on board an aircraft, commission a study into the possible
long-term health effects that jet lag may have on air crew.
3.30. We recommend that in addition to contributing
to international research projects, the Government and the Research
Councils explore ways to increase the research capacity in aviation
health that exists within the United Kingdom. A strong research
base in this country is essential if awareness and understanding
of aviation health are to be increased across the wider medical
3.31. We find surprising and frustrating the
number of EU-led research projects that have not published their
reports. We recommend the Government should take an interest in
these projects and if possible expedite the publication of their