Challenging questions demanded candid answers from presenters and workshop leaders in February 2008 when the Southern California Safety Institute (SCSI) brought flight attendants and other airline safety, health and security specialists together for the International Aircraft Cabin Safety Symposium (CSS) in Montreal.
People who manage, train and/or compose today’s cabin crews increasingly see themselves as agents of change in the aviation safety community, according to Sharon Morphew, SCSI’s manager of the CSS, and other symposium organizers. Among the most safety-oriented highlights of the symposium, which also included a number of security-oriented presentations and workshops, were the following messages.
Merlin Preuss, director general of civil aviation in Canada, said that the introduction of safety management systems — and a counterpart for airline security — urgently requires research, open dialogue and global harmonization of solutions for various cabin safety problems. “There will be a rapid increase in the number of seniors in the next five years. … The baby-boomer generation will be traveling more than any other generation,” Preuss said. “Cabin crews then can expect to encounter 10 percent of seniors with health issues affecting their mobility or agility or causing pain; 4 percent with hearing impairments; and 3 percent with vision impairments.”
Paulo Alves, M.D., medical director of MedAire, said that the aging population will affect the quality and quantity of in-flight medical events. “[The percentage of] people living beyond age 100 is increasing, and not because we are more healthy but because we are surviving our diseases,” Alves said. The reason flight attendants must train for rare events — heart attacks, for example — is the extremely short time available to make a difference in the outcome. “The chance of surviving decreases 10 percent every minute; after 10 minutes [without any first aid], you can forget it. … Even if you are over an airport, you will have to wait about 20 minutes before landing — so the responsibility to respond is on flight attendants, nobody else. … [Physician-passengers typically] are not trained to handle out-of-hospital emergencies.”
Craig Hoskins, assistant chief pilot of JetBlue Airways, invited the audience to recognize both healthy and negative aspects of tension among crewmembers during a flight. “Conflict is very natural and very healthy,” Hoskins said. “I have often said that if there is an aircrew without conflict, they are looking for a place to crash, because it is unhealthy not to question what is going on, to check [present reality against] our expectations.”
Beyond baseline alertness, however, conflict becomes detrimental and safety deteriorates. “If you are in the first stage of conflict … you are concerned about yourself, the situation and the other person or persons,” he said. “After a period of time, if the conflict is not resolved, you will think about yourself and the situation. If not resolved at the [final fight-or-flight] stage, you could care less about the situation or the other person; all you are caring about is self-preservation. … Factors within your sphere of interest are your integrity, your [trustworthiness], being accountable, and having loyalty and respect for one another.”
Robert Matthews, Ph.D., senior safety analyst in the U.S. Federal Aviation Administration (FAA) Office of Accident Investigation, discussed why the federal transportation policy says lap infants would be significantly safer occupying a secured child restraint system in an airliner cabin, yet the government stops short of requiring parents or guardians to buy extra airline tickets for them. The FAA’s position is that the average U.S. family — asked to spend 45 percent more to fly instead of driving a typical highway trip of 480 mi (772 km) — would choose highway travel rather than far-safer airline travel. The FAA argues that a net increase in fatalities would occur — at least 60 more infants killed in motor vehicles compared with one infant traveler’s life saved by a child restraint system over 10 years.
Colette Hilliary, program manager of cabin safety training, FlightSafety International, said that the industry has been reassessing cabin crew training since the investigation of the Helios Airways Boeing 737 decompression accident in Greece in August 2005. One improvement for some airlines has been to ensure that every portable oxygen bottle is preassembled for instant use.
Others have introduced flight attendant mixed-gas hypoxia-awareness training, which does not involve a conventional hyperbaric chamber. The training prepares crewmembers to recognize early-onset symptoms and their first/predominant individual symptom, such as tunnel vision or numbness; to observe/hear subtle indications in the cabin; and to take immediate corrective action before losing mental acuity because of hypoxic degradation.
“The sensations are different from anything you have ever felt unless you have had hypoxia-awareness training,” Hilliary said. “Rapid decompression occurs in one to three seconds, and slow/insidious decompression occurs over more than three seconds. … In a slow/insidious decompression, [flight attendants] may or may not hear whistling near the doors or window seals, the cabin may become cool or appear hazy [but these signs] may be slight. What is the first indication of a slow decompression that we have typically? It is the masks dropping out of the passenger service unit.”
The Civil Aviation Safety Authority (CASA) of Australia, recognizing industrywide advances in cabin safety and relevant risk assessment, in 2007 accepted safety cases from five airlines for permanently reducing their operating cabin crew complements for their 737-800 and Airbus A320 operations from five to four. Previously, this reduction was permissible only for specified operational contingencies such as last-minute crew sickness, but CASA now can accept reductions case-by-case through a five-phase application process — including an evacuation demonstration with four flight attendants and eight passengers using half the available exits — where advanced airline risk-management programs are equivalent to or exceed regulatory requirements.
Among CASA requirements is ensuring that two able-bodied passengers are at every “self-help” overwing exit and are given enhanced exit-row briefings, with each passenger verbally acknowledging understanding of emergency duties, to bolster their self-sufficiency in four-crew evacuation, said Grant Howard, an air safety inspector for CASA. The 46-year-old regulation requires one flight attendant per 36 passengers on aircraft of this capacity; proposed new regulations have been published for comment.
In the wake of random testing of drinking water systems by the U.S. Environmental Protection Agency (EPA) in 2004 that led to findings of noncompliance with existing regulations, some flight attendants have reported concerns about current airline practices, according to Dinkar Mokadam, a public safety specialist for the Association of Flight Attendants–Communications Workers of America. At present, 44 U.S. airlines are operating under administrative orders on consent — agreements specifying how each airline implements regular monitoring, disinfection and reporting protocols for its entire fleet for a period of two years. The orders, in effect, supersede regulations until the completion of EPA rulemaking on aircraft drinking water supplies, and a final rule is expected in 2009, he said.
“Many flight attendant duties require running water that is potable to be available on board the aircraft,” Mokadam said. “Hand washing is mandatory before and after food preparation … beverage service and following lavatory use, and recommended following trash pickup, medical emergencies and spill cleanup. … Liquid antiseptic is acceptable on hands that are not visibly soiled or contaminated with organic material.”
Flight attendants have voiced other concerns: placarding of lavatory faucets with words or pictographs indicating that the water should not be consumed; routine operation of aircraft without running water, with premoistened wipes, hand sanitizer or bottled water in lavatories; and nonpotable water in galleys for cleaning/rinsing purposes, he said.
Les Bennett, Ph.D., a nuclear engineer, professor at the Royal Military College of Canada and Queen’s University, and vice president of special projects for PCAire, outlined results from an experimentally validated method to assess the occupational exposure of aircraft crews to two sources of ionizing radiation by applying a predictive code. These sources are galactic cosmic radiation, the high-energy subatomic particles originating from exploding stars in space and from their collisions with atoms in Earth’s atmosphere, and solar energetic particles, which originate from solar flares and the sun’s coronal mass ejections.
Exposure to a high dose of radiation causes cancer, but current studies show that flight crews do not have a significant occupational risk, Bennett said. To put ionizing radiation in perspective, exposure to 1 sievert (Sv) — a measure of potential harm from ionizing radiation — typically is associated with a 5 percent increased risk of fatal cancer. Earth’s inhabitants at sea level typically receive from all natural sources an annual effective dose of about 3 millisievert (mSv) — three-thousandths of that amount.
“It is estimated that about 25 percent of the [U.S.] population will develop fatal cancer from all causes,” he said. “For a person receiving a 6-mSv exposure [annual dose] — including radiation on the ground — over a career of 30 years [as a flight crewmember], it works out to be less than one percent added on to the 25 percent, so relatively speaking, the exposure is not that dangerous. … We are quite sure that we do not need to badge all the aircraft or badge [all] the individuals in an aircrew [to monitor the dose].”
At a typical cruise flight level of about 35,000 ft, exposure to galactic cosmic radiation is about 50 percent more than on the ground, Bennett said. On such a flight at latitudes between 50 degrees north or south latitude and the respective poles, the exposure is two to three times greater than it would be at the equator.
Several other factors also affect exposure in the same scenarios. As the sun’s activity decreases to its lowest level during the 11-year solar cycle — the situation for the rest of 2008, for example — galactic cosmic radiation temporarily increases about 20 percent, Bennett said. Fluctuations in the level of solar energetic particles from time to time can increase the normal in-flight exposure by 50 percent.
Predictive codes available as software for personal computers, however, enable scientists, airlines and crewmembers to determine with acceptable accuracy how galactic cosmic rays, solar energetic particles, latitude, altitude and durations of these occupational exposures contribute to the effective dose received. National governments issue alerts to airlines when the environmental conditions warrant.
The U.S. Federal Aviation Administration currently recommends the following limits for aircrew exposure to ionizing radiation: a five-year average effective dose of 20 mSv per year with no more than 50 mSv in a single year; and an equivalent dose for the conceptus of a pregnant crewmember of 1 mSv, with no more than 0.5 mSv in any single month after the pregnancy has been reported to airline management.