In a Belgian newspaper (Het Laatste Nieuws), earlier this month, it was reported that neurophysiologist and psychologist, Daniel Dumalin, had started analysing brain damage in ‘(ex-) cabin crew members and (ex-) pilots’, amid concerns of so-called ‘aerotoxic syndrome’.[i]
In the last edition of BC Disease News (here), we reported that 94 claimants, including relatives of the deceased British Airways (BA) pilot, Richard Westgate, were seeking to obtain an order for collective case management of occupational ‘aerotoxic syndrome’ claims, known as the ‘Aircraft Cabin Air Litigation’.
Defendant counsel for BA, David Platt QC, argued before Senior Master Barbara Fontaine, at the High Court, that this litigation must be ‘viewed as weak and speculative, given that it challenges a technical, scientific and industry consensus’.
If claimants are to be successful at future trials of liability, they will need to prove that contaminants in aircraft cabin air cause neurotoxic injury – a connection that has not been consistently established in medical literature to-date (see our Collection of Articles for comprehensive analysis of what is known about the condition).
Nevertheless, Mr. Dumalin’s research may add weight to the claimant’s arguments on medical causation.
The Belgian scholar has publicly compared the current position of the aviation industry with the problems that the asbestos and tobacco industries faced in the 1960’s and 1970’s, respectively; they were no-longer able to continue ‘playing down the health risks’ once the ‘scientific evidence became overwhelming’.[ii]
It can be inferred, therefore, that Mr. Dumalin is a proponent of ‘aerotoxic syndrome’. His investigation should therefore be observed with a critical eye, given the risk of positive bias.
Ultimately, his research looks to measure brain damage following ‘repeated exposure to low doses of toxins in the air’.
Where previous studies, e.g. Christiansson et al. (2008)[iii] and Strid et al (2014)[iv] (these were referred to in a European Aviation Safety Agency report[v]), used biomonitoring techniques, such as blood analysis, to measure the health impact of aircraft cabin air ingestion, Mr. Dumalin is analysing the neurotoxic effects of aircraft cabin air by comparing quantitative electroencephalograph (QEEG) scans of ‘(ex-) cabin crew members and (ex-) pilots’ against ‘healthy people’.
QEEG scanning can identify the amplitude, location and normalcy of brainwaves, as well as the coherence (quality of communications), phase (thinking speed) and network integration of neural pathways – all of these factors are crucial for the optimal operation of mental functioning.[vi]
For completeness, Mr. Dumalin has assured that:
‘If a test person had previous MRI- or PET- scans ... [he] ... will include those for a thorough analysis’.
Based on his preliminary examination of 7 airline employees, Mr. Dumalin has described his findings as ‘remarkable’, as each scan has shown evidence of brain damage resembling the type of damage commonly seen in individuals exposed to organophosphates (the alleged exposure source in ‘aerotoxic syndrome’ claims).
‘[The damage] relates to damage in brain areas that control cognitive processes. This causes e.g. concentration disorders, memory problems or a hypersensitivity to trigger signals. Even more striking is that in people who haven’t been flying any more for over 10 years, the damage is as evident as in people who flew recently’.
Mr. Dumalin considers it to be ‘too early to draw conclusions’ from his initial study results, but plans to submit another 4 airline employees to the same method of examination in the coming weeks. In total, he is aiming to inspect the neural activity of 50 individuals:
‘At that point the conclusions would be rather solid. And besides, after that one could repeat the same research in other countries’
He has further emphasised that a ‘big advantage’ of QEEG testing is that it is more cost-effective than MRI-research.
‘Thus, in a few years’ time and on a world wide scale, we could acquire a large number of test persons in a relatively simple and cheap way. That would only reinforce the evidence’.
We will continue to follow the progress of this Belgian study with interest.
However, it is important to highlight that, even though this study could show that organophosphates are a definitive cause of neurotoxicity, it will not pinpoint organophosphates as the definitive exposure source of ‘aerotoxic syndrome’. This preserves the assertion that ‘toxic air from the engines enters cabin and cockpit via the air conditioning system’ of aircraft with ‘bleed-air systems’ as an as-yet uncredited association. John Leahy, Chief of Operations at Airbus, previously referred to the possibility of aircraft cabin contaminants as ‘absurd’.
[i] André Orban, ‘Study reveals permanent brain damage among pilots and cabin crew’ (16 April 2019 Aviation24.be) <https://www.aviation24.be/airlines/study-reveals-permanent-brain-damage-among-pilots-and-cabin-crew/> accessed 23 April 2019.
[ii] ‘Research Dumalin into Brain damage’ (8 April 2019 Fly Aware) <https://www.flyaware.nl/wp-content/uploads/2019/04/Article-Dumalin-Research.pdf> accessed 17 April 2019.
[iii] A. Christiansson, L. Hovander, I. Athanassiadis, K. Jakobsson, A. Bergman, Polybrominated diphenyl ethers in aircraft cabins--a source of human exposure?, Chemosphere 73 (2008) 1654–1660 <https://www.ncbi.nlm.nih.gov/m/pubmed/18786695/> accessed 23 April 2019.
[iv] A. Strid, G. Smedje, I. Athanassiadis, T. Lindgren, H. Lundgren, K. Jakobsson, A. Bergman, Brominated flame retardant exposure of aircraft personnel, Chemosphere 116 (2014) 83–90 https://www.ncbi.nlm.nih.gov/pubmed/24745557> accessed 23 April 2019.
[v] EASA Final Report EASAREP_RESEA_2014_4 Research Project: CAQ Preliminary cabin air quality measurement campaign (EASA) <https://www.easa.europa.eu/system/files/dfu/EASA%20CAQ%20Study%20Final%20Report_21.03.2017.pdf> accessed 23 April 2019.
[vi] ‘QEEG BRAIN MAPPING’ (Brain Works) <https://brainworksneurotherapy.com/qeeg-brain-mapping> accessed 23 April 2019.