MRS DAWN PRIMAROLO, MR JIM FITZPATRICK, MRS SANDRA WEBBER, DR RAY JOHNSTON

17 JULY 2007

  Q225Chairman: Welcome Ministers, Dr Johnston and Mrs Webber. Thank you very much for coming to talk to us this morning. This is the Select Committee of Science and Technology's inquiry into air travel and health. I am the Chairman of the Committee. Welcome to members of the public. There is an information note outside, if you have not already collected it. It is there for your purposes. Perhaps we could start by the Members giving evidence introducing themselves, please, and then, if you wish, making an opening statement.

  Jim Fitzpatrick: Thank you, Lord Broers. May I make the introductions on behalf of my colleagues and also add a couple of very brief comments? To my right, obviously, my ministerial colleague, Dawn Primarolo, Minister of State for Public Health, on my left, Sandra Webber, head of Civil Aviation Division in the Department for Transport and Chair of the Aviation Health Working Group, and to Ms Primarolo's right, Dr Ray Johnston, Head of the Aviation Health Unit at the Civil Aviation Authority. Sir, your report in 2000 was announced, raising the profile of aviation health. Of course, shortly after came 9/11 and passenger safety has been a priority for both ministers and the aviation industry. Nonetheless, I can say confidently that the Government, the Civil Aviation Authority and the airlines have responded actively to your recommendations, and to demonstrate this we can present to the Committee an update on your Lordships' recommendations from 2000 and the current position which, obviously, you can study as part of your deliberations in due course, which could prove helpful after today.

  Q226  Chairman: Thank you very much. Shall we get into the questions then? The first question really restates what you were talking about, but let me ask it formally. What progress has been made in improving flying conditions for passengers and crew since 2000?

  Jim Fitzpatrick: Structurally we have made important changes. We have amended the law. The Civil Aviation Act 2006 charges the Secretary of State with "the general duty of organising, carrying out and encouraging measures for safeguarding the health of persons on board the aircraft". The functions of the CAA were also amended to include the health of persons on board the aircraft. This change is a world first, as far as we know, and was obviously welcomed in Parliament. We have also brought in the Civil Aviation Working Time Regulations 2004, which gave effect to the European Union Council Directive 2000/79 on the working time of mobile workers in civil aviation. To complement those regulations we set up the Aviation Occupational Health and Safety Working Group to look at certain aspects of crew health and safety in the cabin environment. The group is chaired by the CAA with membership drawn from airline unions. The group has been instrumental in producing guidance on good health and safety practice in the aircraft cabin and its work has been widely welcomed. In direct response to your recommendations in 2000, we have set up the Aviation Health Working Group, which has brought industry and government agencies closer together, not just through meetings but by embedding day-to-day contact as part of the working culture. The AHWG has adopted an approach based on openness and information-gathering to underpin policy. We have established in December 2003 an Aviation Health Unit in the CAA to act as a focal point for aviation health issues in the UK. Also, I would like to mention very briefly three important research initiatives which I know we will have a chance to discuss in more detail later on in this session. We have funded major work on deep vein thrombosis co-ordinated by the World Health Organisation, we have begun innovative research work to investigate concerns about potential contaminants in cabin air—again a world first—and we are actively participating in the EU-led Ideal Cabin Environment (ICE) project.

  Q227  Chairman: Thank you very much. There are several examples you gave of what has happened. Were they the result of discussions in the Aviation Health Working Group?

  Jim Fitzpatrick: May I invite Mrs Webber to respond to that question, sir.

  Mrs Webber: Following up the recommendations of this Committee last time, we took that as the agenda. The Aviation Health Working Group has co-ordinated taking forward the various examples of research, and we started from the recommendations which the Committee made last time and we also commissioned a first piece of research from the BRE to look at what other priorities there might be for research just to make sure that we had got the programme worked out, and then those priorities were identified as things to do with the cabin environment, both the regular cabin environment and the cabin environment in the case of fume events and also DVT.

  Q228  Chairman: They would be your top three priorities for the Committee?

  Mrs Webber: They have been the top three priorities, yes, in the first period that the Committee has been operating.

  Q229  Chairman: Could you repeat them again? There is the environment in the cabin, there is DVT and what was the other?

  Mrs Webber: There were the two aspects of the cabin environment, there was the normal cabin environment—that is the normal situation that people experience every time they fly—and then there is the particular aspect of fume events, which obviously happen relatively rarely, maybe about half a per cent of occasions.

  Q230  Chairman: So there is fume events, there is the normal atmosphere and then there is DVT.

  Mrs Webber: Those would be the top priorities, yes.

  Q231  Chairman: Why is the Independent Pilots Association not represented on the Aviation Health Working Group when they have some 1,500 members?

  Mrs Webber: The Aviation Health Working Group reviewed its membership and its mode of operation at its meeting in April this year, including a request from the IPA. The group decided that it had operated well and made progress because it was relatively small, and that it already had a substantial representation of pilots from BALPA (obviously the major pilots union) and also from cabin crew through the Transport General Workers Union, and decided not to include a further trade union but felt that the one gap it identified in its membership was the construction and manufacture of aircraft and if it were, therefore, going to enlarge its membership it would like to have somebody to fill that gap.

  Q232  Lord Patel: My question is properly addressed in the first instance to you, Dr Johnston, and it relates to the written evidence that you supplied, which says that the Aviation Health Unit was set up within the CAA "to act as a focal point for aviation health issues in the United Kingdom". Are you able to tell us, since the unit was set up, what in practical terms have been the advantages for air passenger health?

  Dr Johnston: The unit was set up in December 2003 and I have been in post since April 2006. I think it provides accessible reference data on aviation health matters to a wide range of stakeholders, it monitors and encourages research and keeps abreast of international knowledge of aviation health, and that involves myself contributing research papers to major medical meetings in the aviation environment, such as the Aerospace Medical Association, the International Academy of Aviation and Space Medicine, responding to a number of queries from both the general public and from crew and other stakeholders.

  Q233  Lord Patel: Can you give examples of what areas of health, let us say two or three different areas of health, that you are concerned about with respect to air travel?

  Dr Johnston: Specifically I carried out some research, which I presented at the seminar, on defibrillators, co-ordinating information from a number of UK carriers on the outcome of defibrillation on board aircraft. It was a very emotive subject and there was a suggestion that defibrillation should be mandated on aircraft, and the evidence from our study would suggest that the outcome is rather different in the aviation environment than it is in public places such as football stadia or, indeed, main railway stations, and that is probably due to the fact that the underlying heart rhythm upset that we see in the aviation population is rather different from what we see out in the general public and it is not responsive to the same degree to electrical reversal.

  Q234  Lord Colwyn: I do not understand that. A defibrillator reverses ventricular fibrillation and it is the same, surely, whether you are in a football ground, in the Palace of Westminster or at 36,000 feet?

  Dr Johnston: In fact, one would think that, but if you look at the prevalence of ventricular fibrillation and ventricular tachycardia, which are the two remedial rhythms, if one does a study in the general population, it appears to be of the order 70% of all cases. In the aviation population the data from the airlines I have to date, and I am still receiving further information, would suggest this is of the order of 30 to 40%. Many of the individuals in the aviation environment have other morbidity and illness and do not have a rhythm which is remedial to electrical reversal.

  Q235  Lord Colwyn: But that means some are.

  Dr Johnston: Some are, indeed, yes.

  Q236  Lord Patel: What other examples are there?

  Dr Johnston: The other examples I would give are people who telephone with medical conditions looking for advice in relation to travel (for example cardiac or respiratory conditions), often from the individual themselves or the physician, who may be an expert in cardiology or respiratory medicine but would like to understand the aviation environment a little more closely to help them understand the interaction with the patient's condition and travel, and I speak to both the patient or passenger who is travelling and the specialist physician and direct them to a number of sources of information, including our own website.

  Q237  Lord Patel: So if the passenger felt that, following air travel, they had caught some illness, are they able to approach this unit?

  Dr Johnston: Yes, I have been approached. Normally they approach the airline directly. I would note their concerns and liaise with the airline to get further detail.

  Q238  Lord Patel: Have you known lots of passenger to do this?

  Dr Johnston: I think increasingly our website, which we have recently revamped, has an increased number of hits—1,200 in the last month—and the awareness of the Aviation Health Unit has increased in the past year and certainly, by the number of calls and emails I get, I think people are aware of it but I am actively working to improve the visibility of the Aviation Health Unit for the travelling public.

  Q239  Lord Patel: What effect would the European Aviation Safety Agency, when it is set up in 2008, have on the plans that you have just now or the Aviation Unit has?

  Dr Johnston: I think that would depend on what their interest in aviation health is, and myself and my colleague Sandra Webber are going to visit EASA to discuss a number of topics, including that particular area.