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Study Says Jetliner Air Quality Poses Health Risks: CUPE Takes On Airline Industry With Findings Of Survey

By David South

Now Magazine (Toronto, Canada), March 11-17, 1993

Canada’s troubled airline industry is about to face some more turbulence, as the union representing more than 6,000 flight attendents presses its concern that many of its members’ health problems are related to poor air quality in jets.

The Canadian Union of Public Employees (CUPE) says its locals have compiled data that paints a fairly stale profile of in-flight air quality and its relationship to altitude, passenger load and length of flight. As part of the survey, the union recorded flight crews’ complaints of chest pains and lack of oxygen, as well as other work-related problems like back injuries, hearing loss and high incidence of colds and flu.

Of more interest to frequent fliers might be the opinion of some experts that even the more common jet lag may be caused by excess carbon dioxide, ozone and radiation. More than half the air in many aircraft is recirculated, “stale” air that is high in carbon dioxide and may be carrying bacteria and viruses, according to some experts.

CUPE health and safety chair Tracy Angles says the union now has enough evidence to at least pressure the carriers to undertake more comprehensive air quality studies. CUPE represents workers at Air Canada, Canadian, Nationair, Air Transat and some smaller feeder carriers.

While the union’s study is the first of its kind in Canada, a survey by the US department of industrial relations found, among other things, that flight attendents had 20 times the expected frequency of respiratory illness.

Flying mines

“Flight attendants have been equated with coal miners in terms of the bad air they have to breathe,” says Angles. “But this is not something the companies want to study.”

However, spokespeople for Air Canada and Canadian Airlines say they have not heard of such health problems. Jerry Goodrich of Canadian simply says, “It’s not an issue.”

However, while earlier-model jets supplied the cabin with 100 per cent fresh air, increasing fuel costs led to some modification. Modern jets mix fresh air – expensive to produce – with stale air from inside the cabin, which is passed through filters. The percentage of recirculated air in some aircraft, such as the popular Boeing 747-400, could be as high as 52 per cent, Boeing’s figures show.

Boeing’s Tom Cole says air circulation in Boeing’s jets is better than in an average office building, and that the passengers are “washed” with air to eliminate carbon dioxide and other hazards.

Critics like Georgia doctor William Campbell Douglass, publisher of the health newsletter Second Opinion, charge that the high rates of recirculated air, and the reliance on passengers’ own breath and perspiration to humidify the dry air, provide a perfect environment for bacteria and viruses. Douglass even speculates that planes could transmit serious diseases like tuberculosis. He suggests jet leg could be “nothing more than CO2 intoxification and oxygen starvation.”

“There is no doubt if you are in a confined space, you are at greater risk,” says University of Toronto microbiologist Eleanor Fish. “Aircraft filter systems aren’t sophisticated enough to filter out all the bacteria and viruses. But I’d be hard pressed to believe that you are at greater risk traveling on airplanes than on elevators.”

It is difficult for public health authorities to pin down the health risks of airplane travel because passengers disperse immediately after a flight. However, medical journals have documented two cases where virus transmission could be established because the passengers were easily traceable.

In 1977, 38 of the 54 passengers on a plane grounded in Alaska for a four and a half hours came down with the same strain of flu.

“We consistently hear complaints about certain aircraft,” says Angles. “The Airbus 320 is one of the worst.”

Angles says many airlines exacerbate the problem by over-crowding planes and flying them longer and farther than they were designed for.

Cut corners

“With deregulation, they have more people in there than was ever planned on. Nationair is a good example. A normal class Air Canada 747 carries about 420 people. In the all-economy configuration the load is upwards of 496.”

Angles also says airlines have been known to cut corners by turning down air flow to save money. In their 1990 book The Aircraft Cabin: Managing the Human Factors, Mary and Elwin Edwards cite a study indicating a 1 per cent saving on a fuel bill can be achieved by reducing the ventilation rate in a McDonnel-Douglas DC-10.

ORCID iD: https://orcid.org/0000-0001-5311-1052.

© David South Consulting 2021

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Cut Services To Elderly, Says Doctors’ Survey… But Leave Our Salaries Alone!

“With a guaranteed income and job security, I don’t know one doctor who has suffered in the recession…”

By David South

Today’s Seniors (Canada), January 1993

If the results of a nation-wide survey of doctors are right, Canadian physicians love medicare but abhor government attempts to make them accountable for its costs. It also suggests that doctors are more willing to talk about cutting services to seniors and people with “unhealthy lifestyles” than to discuss cutting their own wages to save money. 

However, according to some doctors, physicians’s anger with the provincial government is founded on ignorance and poor analysis of the larger forces affecting health care. 

The survey, Breaking the Wall of Silence: Doctors’ Voices Heard at Last, was commissioned by The Medical Post, a national newspaper for doctors. It sent questionnaires to 12,000 doctors, receiving 3,087 responses. The Post also conducted in-person interviews to better gauge the mood of doctors. 

The survey’s title is somewhat misleading, considering that doctors have been making noise over a number of issues this year; targets included proposed right-to-treatment legislation, cuts to the Drug Benefit Plan, capping of yearly billings at $450,000, and inquiries into charges of sexual abuse by doctors. And most significantly, the last conference of the Canadian Medical Association passed a resolution calling for a two-tier health system in which those with money can hop the queue. 

Post editor Diana Swift says the poll shows fairly strong support for limiting services to the elderly, although the survey question is short on details: “I feel it is reasonable that access to high-cost services such as transplants should be rationed according to such parameters as the patient’s age and/or unhealthy habits.”

Yet just under 70 per cent of doctors opposed any capping of their salaries, despite 56 per cent of the public supporting this measure according to a 1991 Globe and Mail-CBC poll. 

When questioned, Health Minister Francis Lankin expressed surprise that doctors felt so strongly, and denied the government is considering rationing services to seniors. Lankin feels the volatile mood of doctors is a reaction to the rapid changes taking place in health care. 

Dr. Michael Rachlis, health care critic and author of the book Second Opinion, says the survey’s low response rate means that the answers reflect “redneck physicians, who are more likely to respond.” Swift admits to a high response rate from young male physicians, who since the 1986 doctors’s strike in Ontario, have been considered the profession’s most militant. 

One response which some may find alarming was towards the “Oregon model.” In that American state, medical procedures are rationed to seniors and individuals covered by medicare. Anybody needing uncovered emegency treatment has to pay for it themselves. A disturbing 65 per cent of survey respondents supported such a move. 

Dr. Gerry Gold, associate registrar at the College of Physicians and Surgeons of Ontario, feels that some doctors lack perspective. “The complaints are a reflection of frustration with increasing involvement of government. But if physicians understood the role of the government in the U.S., they would realize they, along with insurance companies, intervene far more.”

Gold says doctors have had the same complaints ever since the beginnings of medicare. “Many front-line doctors lack the information to make informed comment,” he says. “They aren’t being consulted or informed by the government.”

Rachlis says many doctors fail to realize how privileged they are. “Canadian physicians don’t realize medicare has protected their autonomy more than in the U.S.,” he says. “Doctors are always angry because they have large chips on their shoulders from being brutalized in their training. They don’t realize the government has given them a privileged monopoly over health services. With a guaranteed income with job security, I don’t know one doctor who has suffered in this recession.”

Gold doesn’t foresee strikes or job actions by doctors, but predicts further government cuts, and more services being de-insured by OHIP. A recent example involved removing coverage for third-party medical exams such as those requested by employers or insurance companies. As medical procedures end up outside of OHIP, Gold foresees physicians charging whatever they like. 

A perennial idea is the user fee. This is one of the few ideas that gathers support from a majority of doctors and the general population alike. But Rachlis feels these measures are meanspirited and avoid the real problems plaguing health care. “When Saskatchewan introduced user fees for physician and hospital care in 1968,” he says, “health costs remained the same and it discouraged the elderly, the poor and people with large families from seeking service. 

“When providers are allowed to charge users for care, as in the United States, where more than 20 per cent of health care costs are paid our of pocket, overall costs go up.” 

More from Canada’s Today’s Seniors

Feds Call For AIDS, Blood System Inquiry: Some Seniors Infected

Government Urged To Limit Free Drugs For Seniors

Health Care On The Cutting Block: Ministry Hopes For Efficiency With Search And Destroy Tactics

New Seniors’ Group Boosts ‘Grey Power’: Grey Panthers Chapter Opens With A Canadian Touch

Seniors Falling Through The Health Care Cost Cracks

ORCID iD: https://orcid.org/0000-0001-5311-1052.

© David South Consulting 2021