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Bugs Fly on Planes Too

Medically Reviewed by Jacqueline Brooks, MBBCH, MRCPsych
From the WebMD Archives

Nov. 21, 2000 -- Thanksgiving is just around the corner, but in this heavy travel season, groups representing airline employees are working hard to ensure that turkey is not the only bird on the minds of Americans.

In the past few days, these groups have managed to highlight several issues, all of which they say represent a potential risk to the health of both airline passengers and workers alike.

Among these is the potential for the passengers to fall ill as a result of poorly filtered ventilation systems. And also there's the potential for passengers to get sick because of poor sanitary practices of the nation's largest airline laundry service.

According to the Union of Needle Trade and Textile Employees, or UNITE, Royal Airline Laundry does not wash blankets or pillows used by passengers, but simply repackages them for reuse. Royal Airline Laundry is responsible for cleaning airline linens for more than 150 carriers at 20 airports. UNITE said at a press conference Monday that they were concerned about this practice in at least two facilities.

UNITE is the nation's largest apparel and textile union. It represents over 25,000 workers, including 200 Royal Airline employees that have also accused the Inglewood, N.Y.-based company of running a sweatshop. But these latest allegations follow two television stories, in which laboratory analysis of blankets, pillowcases, and headsets from several airlines found the presence of at least two known germs.

"Certainly that occurrence of bacteria is an indication of a problem," Eric Furman, director of UNITE's Department of Occupational Safety and Health, tells WebMD. "The fact that the blankets aren't clean raises questions."

But some experts say UNITE, along with other airline employee-based organizations, might just be creating a problem where one doesn't exist.

Although for esthetic reasons alone it would be nice to have a clean blanket, odds are against the blankets being able to transmit disease, says Russell Rayman, MD, executive director of the Aerospace Medical Association. The association is the world's largest of medical specialists in the fields of aviation, space, and environmental medicine.

Anything is possible, Rayman says, but considering that both bacteria and viruses need hosts to survive, even if the blankets and pillows were not cleaned, they probably would not be capable of transmitting an infectious disease, Rayman tells WebMD.

Moreover, Royal Airline Laundry "categorically denies the baseless allegations" from UNITE. They write in a statement that they provide the "highest level of hygienically cleaned linen and blankets." They add that their laundry is constantly monitored by state-of-the-art equipment and the allegations are UNITE's ploy to force its union into parts of the company that are currently non-union

Still, UNITE has found a powerful ally. Joining UNITE at the press conference was the Association of Flight Attendants, or AFA.

"What we are hoping is that the airlines do the right thing," says AFA President Patricia Friend. "We are hoping that pressure from customers will cause them to do what they need to do," she tells WebMD.

The AFA gives UNITE a powerful voice. They have been running a successful media campaign since 1984 asking for high-grade air filters on all commercial jets.

That campaign has received media attention thanks to an engineering group that has been studying cabin air quality, in part, as result of the AFA members' complaints. The filters already are used voluntarily on most commercial jets. But the recommendation by the cabin air committee of the American Society of Heating, Refrigerating and Air-conditioning Engineers has given it a boost.

The organization's members design and maintain airline heating and air systems. The committee includes plane makers, pilots, flight attendants, and airline officials, whose past recommendations have led to binding rules.

Yet, once again, researchers say that while high-grade filters are a nice touch, odds are that the cabin air itself is not responsible for getting people sick.

"The risk of contracting an infectious disease from the aircraft itself is minimal," says Jolanda Janczewski, PhD, MPH, president of Consolidated Safety Service, an independent consulting firm. Janczewski's firm has now conducted two studies into the issue.

"Those studies found that the levels of circulating bacteria and fungus were much lower than other places with circulated air, such as an office building," she tells WebMD. Janczewski adds that the flight attendants claims are probably not unfounded -- but most likely do not represent a distinct risk to passengers.

"Sitting in close proximity to another sick passenger seems to be the largest risk," she tells WebMD.

But the AFA is seeking more evidence. In 1994, the group successfully lobbied Congress to mandate a long-term study into infectious disease and air quality. More recently, it has petitioned Congress to also mandate a short-term study to be conducted by the National Academy of Sciences, upon which new regulations could be based.

Still, "there is nothing to date to demonstrate the presence of pollutants on an aircraft that can adversely affect a passenger's health," Les Dorr, a spokesman for the Federal Aviation Authority, tells WebMD. Dorr adds that the FAA will not take action unless such a danger can be demonstrated. "We, as a regulatory agency, have to base our rules on hard data," he says.

That bodes badly for UNITE, who would like to pressure the FAA and Department of Transportation to also regulate the airlines' laundry service. But unlike the flight attendants, the union of laundry workers does not even have a pending study on which to pin their hopes.

However, that lack of evidence does not mean airline passengers are completely out of the woods, cautions Rayman. Research has shown that the increase in air pressure and dry air in the cabin may be contributing to medical complications, from which passengers and workers are both at risk. Research has also shown that crowding passengers might place them at risk for things like rare, but serious, blood clots in the leg, Rayman notes.

But the vast majority of passengers do reach their destination none the worse off, Rayman adds. This means, he tells WebMD, that it might prove impossible to change the status quo.

Nevertheless, passengers could take some proactive actions to at least reduce the risk of transmitting disease, Janczewski points out. For example, the common courtesy of using a Kleenex while sneezing would go a long way toward preventing the spread of disease. Airlines could also take proactive action by training their workers in sanitation, and perhaps allowing flight attendants to wear gloves, she tells WebMD.

After all, Janczewski notes, "No one can design a safety system that's going to prevent the spread of disease from someone in close proximity to you, and that seems to be the real problem."

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