The Countess of Mar moved Amendment No. 35:
After Clause 7, insert the following new clause—
"CIVIL AVIATION OCCUPATIONAL AND ENVIRONMENTAL MEDICAL MONITORING AND
ACTION CENTRE
(1) There shall be an independent organisation to be known as the Civil Aviation
Occupational and Environmental Medical Monitoring and Action Centre
(CA-OEMMAC).
(2) CA-OEMMAC is to have the functions conferred on it by or under this or any
other Act.
8 Dec 2005 : Column GC130
(3) Schedule (CA-OEMMAC: Supplementary) makes further provision about
CA-OEMMAC."
The noble
Countess said: I have warned the Minister that I shall not be brief and perhaps
I ought to warn noble Lords as well. This is a vital issue and it should be
addressed fully. In moving Amendment No. 35 and speaking to Amendment No. 49, I
am following up my remarks at Second Reading with what I hope the Minister will
find are constructive suggestions that will overcome my concerns and those of
many others in the industry about the health of air crew, passengers and ground
staff.
The amendments, including the proposed new
Schedule, lay out the bones of a holistic approach to aviation, occupational
and environmental medicine that I believe is the only way in which a proper
medical and scientific examination of all the many unknowns in this field may
be conducted and resolved.
Currently, problems are dealt with in a piecemeal
way and because all the threads have never been pulled together at the same
time, there has never been a satisfactory outcome. I am sure that by now
Members of the Committee will be aware that my primary concern is with the
quality of cockpit and cabin air in aircraft. I will elaborate the major points
of my concerns in this field and how I expect the acceptance of these
amendments to go a long way towards resolving them soon.
There is no point in looking at just one aspect of
occupational or environmental medicine in isolation. That leads to a waste of
effort and resources. For example, as recently as 1 August 2005, the CAA issued
a guidance-on-good-practice booklet, entitled Occupational Health and Safety
on-board Aircraft. It deals with the legal obligations of the CAA and of
employers of aircraft crew members. Regulation 6 of the CAA working time
regulations 2004 is quoted in full. It states:
"An employer shall ensure that each crew
member employed by him is at all times during the course of that employment
provided with adequate health and safety protection and prevention services or
facilities appropriate to the nature of his employment".
The booklet provides advice on manual handling;
burns and scalds in the aircraft cabin; slips, trips and falls guidance; and
incident reporting and investigation. Nowhere is there any mention of air
contamination incidents when, by any stretch of the imagination, these can have
serious health and safety implications for both crew and passengers. Surely, if
we are talking about health and safety responsibilities of the CAA, it is only
sensible that all aspects should be considered under one umbrella.
There is also a crying need for an incident
reporting system that is totally independent of the CAA. A major survey of
pilots conducted by BALPA demonstrated that there is serious under-reporting of
contaminated air incidents. The Minister, in a reply to me on 23 November 2005,
stated that this survey included events that were not safety-related. The
pilots reported signs and symptoms that while they did not, at the time they
occurred, prevent the pilots from fully
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carrying out their duties, could well be an indication that sub-clinical
neurological damage that is known to be cumulative was occurring.
Incidentally, for those with knowledge of reported
signs and symptoms described by sheep farmers and some Gulf veterans, the
pilots' reports bear a remarkable similarity. The very fact that pilots know
that the Air Accident Investigation Branch will take its prompts from the CAA's
mandatory occurrence reporting system and ignore reports other than where
aircrews are incapacitated inhibits pilots from reporting incidents—a point
made by the Swedish Air Accident Investigation Branch, investigating a BAe 146
incident four years ago. It stated in its final report that,
"an international database is established
with factual information from flights where suspicion of polluted cabin air
exists".
Whose safety are we talking about? Does not the
CAA have a responsibility to ensure that the pilots' working environment—the
flight decks—are free from health hazards? Do not the aircrew and passengers need
to be protected? Even the Government recognise that aircrew, passengers and
ground staff health matters fall between two stools. In their consultation
document, Giving Aviation Health Policies a Better Focus, they
acknowledge that the HSE, the organisation normally responsible for employee
health and safety matters,
"has limited relevant experience in dealing
with health issues specifically affecting aircrew (both issues which arise from
carrying out their duties on board aircraft and those affecting their ability
to carry them out)".
That is relevant to the previous amendment tabled
by the noble Lord, Lord Clinton-Davis.
The document says about the CAA,
"As a specialist UK safety regulator,
the Authority might be the best place to manage the interface between safety
and health, but it would need to guard against the possible knock-on effects on
its safety role.".
"the Authority would need to ensure
that [its constructive working relationship] would not be put at risk should
developing policies on aviation health impose unwelcome burdens on the
industry. Conversely, there could be problems if the public or aviation workers
perceive the authority to be too close to the industry to exercise effective
oversight of health concerns".
As the Bill stands, responsibility for health
matters is with the Secretary of State and the CAA. We must not lose sight of
the source of the CAA's funding; nor must we forget what is the perception of
those who must avail themselves of the health and safety provision by the CAA.
Current approaches to occupational and
environmental medicine in this field are more theoretical than practical.
In their response to the report of the House of
Lords Select Committee on Science and Technology on air travel and health,
dated 15 November 2000, the Government gave an assurance that they would:
"work closely with passenger
organisations, medical experts and the industry to ensure that the range of
issues the committee has identified receive the attention they merit".
In their response to recommendation 19 on air
quality, the Government accepted the recommendation that air quality standards
should be extended beyond those for carbon dioxide, carbon monoxide and ozone.
The Select Committee noted at paragraph 5.4 of its report:
"Until around 1980, aircraft cabins
were ventilated entirely with fresh air. One of the ways aircraft manufacturers
found to meet the commercial and environmental pressures to reduce oil
consumption"—
it must have meant fuel consumption—
"which arose at this time was to
reduce the amount of outside air taken from the engines, maintaining overall
air supply by re-circulating some of the air already present in the cabin. As
Boeing noted, the resulting air quality was more than adequate for respiratory
needs, but the air needed to be filtered for satisfactory contaminant
control".
The committee did not address the fact that
so-called outside air is not fresh air as your Lordships and I know it. In
older aircraft such as the Boeing 707, outside air was indeed taken directly
into dedicated turbo-compressors which provided cabin conditioning. The
breathing air supply is now passed through a jet engine and is delivered into
the aircraft cabin unfiltered. They seem to have missed the point that there
can be chemical as well as bacteriological contaminants in air, and that
sterilisation might get rid of bacteria, but it does not deal with chemicals. I
believe that the real culprit is the bleed air from the main engines or the
auxiliary power unit—itself a small jet engine. I described the process by
which bleed air becomes contaminated at Second Reading, so I shall not burden
the Committee with repetition.
Even the manufacturers of the oils that produce
the contaminants with which we are concerned acknowledge that one of the most
frequently used jet engine oils,
"contains Tricresyl Phosphate.
Swallowing this product can cause nervous system disorders including paralysis.
Prolonged or repeated breathing of the oil mist or prolonged skin contact can
cause nervous system effects".
The NTP Chemical Repository data for TCP show:
"ACUTE CHRONIC HAZARDS: This compound
is toxic by inhalation, ingestion or by absorption through the skin. It is an
irritant to the skin and eyes. It is also an irritant to the mucous membranes
and the respiratory tract. When heated to decomposition it emits toxic fumes of
phosphorus oxides".
Another synthetic jet engine oil Material Safety
Data Sheet states:
"Toxic fumes may be evolved on
burning or exposure to heat".
The organophosphate TCP is present in these
synthetic jet engine oils and can be simply broken down into three sub-groups:
the -meta, -para and -ortho isomers of TCP. I am afraid that I shall be very
technical for a minute. The -ortho isomers, which may be the most toxic and
make up some 0.2 per cent of the TCP, are broken down into three isomers known
as tri-ortho-cresylphosphate or TOCP, mono-ortho-cresylphosphate or MOCP and
di-ortho-cresylphosphate or DOCP. Thank goodness I have got all those off my
chest.
The CAA air quality paper of 2004 makes several
references to TOCP, but never mentions anywhere anything about MOCP or DOCP. As
TOCP makes up
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a tiny amount of these isomers, referring to it alone is very misleading,
especially when you learn that MOCP and DOCP are five and 10 times more toxic
than TOCP and make up 99 per cent of the -ortho isomers present in TCP.
The senior toxicologist of Mobil, in a 1999 paper
entitled Evaluation of the hazards of industrial exposure to TCP: A review
and interpretation of the literature concluded that,
"one might incorrectly imply that
TOCP standards are adequately protective for products containing TOCP. However,
TCP consists of a mixture of isomers . . . This calls into question the adequacy
of . . . exposure standards of the tri-o-isomer of TCP in the atmosphere. It is
possible that the standard promulgated by the US OSHA has been based upon the
assumption that the tri-o-isomer was primarily or solely responsible for the
neurotoxic properties of TCP".
In response to the Select Committee, the
Government established the inter-departmental Aviation Health Working Group in
2001. Among other things, the AHWG was tasked to act as a focal point for
examination of relevant issues and to be able to provide soundly based advice
to Ministers. Four years old, as far as I can ascertain, no soundly based
advice has been provided to Ministers on the question of contaminated air in
aircraft. Despite the two key recommendations of the Select Committee
identified by the AHWG to the Building Research Establishment for its client
report, Extending cabin air measurements to include older aircraft types
utilised in high volume short haul operation, of October 2003, there is
still no regular monitoring of cabin air quality. The recommendations stated:
"We recommend that airlines collect,
record and use at least some of the basic cabin environment data being
continuously monitored, not only to give authoritative substance to their
refutation of the common allegations, but also to provide a better basis for
public confidence in these matters. Indeed we are surprised that they do not
already do so . . . We recommend airlines to carry out simple and inexpensive
cabin atmosphere sampling programmes from time to time, and to make provision
for spot sample collection in the case of unusual circumstances. This would be
helpful to passengers and staff and also benefit the airlines themselves."
Recent Written Answers given by the Minister to my
Questions have elicited the fact that there is no monitoring and no filtration
on aeroplanes. The only time that an aircraft is monitored is when it is
commissioned. That is a horrendous thought. Why, five years after the Select
Committee made those simple, inexpensive recommendations, has nothing been done
to implement them? I am told that an efficient filtering system costs a few
thousand pounds—peanuts when compared with the cost of an aircraft, the cost of
sick leave for a crew or, worse still, the loss of an aeroplane full of passengers.
We have a situation with which I am only too
familiar. Concerns are expressed by a group of employees or the public about
exposure to environmental or occupational toxins that appear to be causing
health problems. An expert committee is set
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up purportedly to investigate the problem. At this stage, it would not hurt for
me to repeat observations I made on 27 June 1997 at column 1559. I said:
"These expert committees are often
required to make decisions upon incomplete evidence, so the only verdict they
can give is that of "not proven". This cannot be an impartial
response if the resources allocated to field and clinical investigations are
inadequate and the evaluators do not qualify their findings accordingly. They
rely upon what may be called "constructive ignorance" by being
content to rule on the evidence which is before them and avoid a search for
information that may lead them to a different decision. That is not being
impartial.
Of course, there is also an inherent bias
in that human nature decrees that arbiters tend to favour their own judgment
and resist the opposite view. The Cairns Committee in its review of the
authority which both licensed aircraft as airworthy and was responsible for
investigating aircraft accidents coined the phrase "intellectual
corruption"—[Official Report, 24/6/97; col. 1558–9.]
The Cairns Committee reported in, I think, 1966.
Shopenhauer, the philosopher, is attributed with the belief that most ideas go
through three phases: first they are laughed at; secondly they are violently
attacked; and thirdly they are accepted as common sense. In view of the
defences being put up by the Minister and his advisors, I think we may just
about have reached the second stage.
Dr Ruge, a member of the AHWG, in referring to the
UK Government and CAA-initiated and sponsored research paper Cabin Air
Quality published in 2004, stated:
"The results did not suggest that
there is a health risk for passengers, including infants, and crew".
A look at that paper reveals that:
"The research described in this
report addresses the effect of cabin air contamination on the pilot's ability
to safely fly and land an aircraft. The CAA decided to conduct this research
following a small number of events where flight crew effectiveness was reduced,
possibly due to oil products present in the cabin air. Although some references
are made concerning long term health effects, the scope of this research did
not attempt to determine the extent of any such risk".
It makes no reference to passengers or infants.
The research paper relies heavily on a BAe "Commercial—in confidence"
paper by Marshman and neither paper has been peer-reviewed nor published in a
scientific journal, and yet they seem to be accepted as gospel.
Just prior to the publication of the recent Royal
Commission report on environmental exposure to chemicals, there appeared in the
Observer of 18 September an article that with a began:
"Britain's leading poison experts
united last week to denounce pressure groups for mounting a 'hysterical,
scaremongering' campaign about dangerous chemicals in the environment".
The report includes a quotation from Professor
Alan Boobis who, as a member of the Committee on Toxicity, will be reviewing a
great deal of the evidence submitted by BALPA to the AHWG. In relation to a
recent statement by the WWF, he stated:
"These compounds can cause diseases
but not at the levels found in these [blood] tests".
As for the chemical cocktail effect, he stated:
"There is simply no evidence it exists".
There is an ever increasing body of scientific
literature from around the world that indicates that some chemicals are giving
rise to adverse health effects.
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Even the royal commission accepts that there is clear evidence of ill-health
which may be attributable to exposure to small quantities of toxic chemicals. I
remind the Committee that Toyber said that the absence of evidence is not
evidence of absence. I continue to find it extraordinary that our so-called
experts exhibit so little scientific curiosity. Their objective seems to be to
maintain the status quo and dismiss out of hand any hypotheses others may
propose. Their pronouncements in the face of so much contrary evidence do not
tend to engender public confidence.
I could go on giving examples. I could comment on
the complacency of Written Answers that I have received in recent weeks to my
Questions about cabin air quality. I could be justifiably angry that sick
people are being ignored—as long as they are fit enough to fly an aeroplane, no
one is responsible for how they feel or the conditions under which they are
expected to work. Neither the aviation regulators nor the airlines seem to
consider that occupational health and safety are their business. They are currently
using the excuse of waiting for the Government's advisory committee to report
after the Department of Health's Committee on Toxicity has reported to them and
then, presumably they will be waiting for legislation or regulation. I have
seen it all before.
John Woodley, the Australian former Senator who
chaired his government's inquiry into this subject is reported to have said:
"Some people in the industry and some
of the regulators seem to think they are God and so can take risks with the
lives of their employees and customers, but they are not God and this is not a
joke. It is time they got serious, stopped mucking about and started to play
the game seriously".
I most earnestly ask the COT to heed his words.
The Minister knows what I think about stand-alone
epidemiological studies. As another eminent scientist whom I know said to one
of my correspondents just the other day:
"In the final analysis data trumps
models. Why on earth won't they measure?"
The answer that he gave is that they really do not
want to know"
To be constructive, we need to get down to
practicalities. I have given the reasons for my amendments and have given some
indication as to why I believe the current system of dealing with occupational
health and safety in this field is unsatisfactory for everyone. My proposal is
that there is established a small, preferably independent, organisation called
the Civil Aviation Occupational and Environmental Medical Monitoring and Action
Centre. That is a big mouthful, and perhaps we can find a shorter title for it.
Instead of the currently scattered activities of medical and research providers
and institutions, that centre would provide a multi-faceted approach to all of
the occupational and environmental health problems of aircrew, passengers and
ground staff and people living in the grounds of airports, not just those
concerned with contaminated
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air incidents. For example, it could deal with pilot fatigue, jet lag and deep
vein thrombosis as well as more minor things such as burns and scalds.
I have listed the functions I would like to see
carried out by centre staff at paragraph 5 of the new schedule. I think they
are clear and will not elaborate, unless of course, any Member of the Committee
would like me to. I understand that I have the support of most, if not all of
the unions representing aircrew and staff in the UK for the proposals.
What is needed is a small, independent, expert
organisation that has the trust of aircraft manufacturers, airlines and employees.
Trust is the most important thing. Without trust, we might as well forget
Clause 7 and go on as before.
I hope that the Minister will give serious
consideration to accepting my proposals and that if they need a little tweaking
we can do it at Report. I beg to move.
Lord Clinton-Davis: The whole Committee is indebted to the noble Countess, Lady Mar, for her expertise on the issue. I shall be very brief, which the Committee will welcome. One thing is vital: these are very important issues which should be dealt with at an international level—first, perhaps, in Europe and, secondly, worldwide. While having regard to what has been said, I await my noble friend's comments with interest.