Respiratory symptoms of flight attendants during high-altitude flight: Possible relation to cabin ozone exposure

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Abstract
The smaller size and lighter weight of the Boeing 747SP aircraft, introduced into passenger service in 1976, permitted higher-altitude flight than older commercial aircraft and thus potentially greater ozone exposure, for those on board. Concerned flight attendants distributed questionnaires relating to symptoms experienced on the Boeing 747SP and/or conventional 747 aircraft to Los Angeles- and New York-based flight attendants. Respondents reported symptoms by frequency and severity and by in-flight and after-flight occurrence. Based on the assessment of three health scientists as to ozone-relatedness, the frequency of “definite” and “probable” ozone-related symptoms of any severity reported by both groups of attendants was significantly associated with 747SP flights (chi-squares: P<0.05). After-flight symptoms significantly associated with 747SP experience, although fewer in number than in-flight symptoms, were all in the scientists' “definite” category. In 21 flight attendants who complained of moderate to severe symptoms during 747SP flights, a battery of pulmonary function tests performed approximately two weeks after their last 747SP flight failed to reveal abnormalities. The symptom questionnaire results are consistent with possible exposure of cabin attendants to toxic levels of ozone during the higher-altitude flights of the Boeing 747SP compared to conventional 747 aircraft.