Aerotoxic syndrome

Aerotoxic syndrome: what is that?

Commercial jet aircraft use air from the engines not only for propulsion purposes, but also to refresh the aircraft’s cabin air. This air is unfiltered when vented into the cabin. A small amount of oil generally leaks past the oil seals of the aircraft’s turbine engines. Tricresyl phosphate (TCP), an organophosphate compound, is released from that oil and ends up, along with metal shavings from the turbine blades, via the high pressure compressor, in the air destined for the cabin’s air conditioning. The flight crew and passengers inhale those burnt oil fumes as well as the toxic substances they contain. 

Occasionally, a so-called 'fume event' occurs on board an aircraft. That is when more oil than usual suddenly leaks into the air, potentially causing, as the name indicates, a thin smoke screen to develop. This phenomenon occurs in one in roughly every 2000 flights, particularly during take-off and landing when more engine power is required.

Exposure to cabin air, whether polluted or not, is associated with certain health risks. This phenomenon is known as the aerotoxic syndrome, as explained in a recent article published by neurologist Gerard Hageman. The symptoms are diverse, consisting predominantly of fatigue and mild cognitive impairment. 

Aerotoxic syndrome: the role of epithelial tissue

The brain is enclosed within three protective membranes (meninges). The brain itself is a gelatinous substance. The meninges (blood-brain barrier) consist of the same tissue as the small intestine (intestinal barrier), the so-called epithelial tissue. The pores in this tissue absorb nutrients as well as excrete waste materials, including toxic substances. Toxic substances that cause aerotoxic syndrome can get into the bloodstream via the lungs (lung barrier) as well as via the intestines or the skin, resulting in inflammation of the pores of the epithelial tissue. When inflamed, the pores widen, thus letting more toxic substances through.

Aerotoxic syndrome: diverse symptoms

Not everyone has symptoms; depending on the severity of the pollution and on the individual, the health effects may become apparent after just one flight or they may develop after repeated exposure to the harmful substances.

Symptoms related to aerotoxic syndrome include: 

• Memory impairment
• Headaches
• Dizziness
• Nausea
• Disorientation
• Balance problems
• Tightness in the chest
• Breathing problems
• Vomiting
• Burnout symptoms
• Shortness of breath
• Fatigue
• Coughing
• Reduced vision
• Palpitations
• Lung irritation
• Diarrhoea
• Tinnitus (ringing in the ears)
• Cognitive problems
• Irritated eyes
• Trembling
• Increased heart rate
• Cardiac arrhythmias
• Trouble walking
• Changed personality
• Feeling of unease
• Strong emotions and crying spells

The contaminants that cause aerotoxic syndrome: TCP and TOCP 

The potentially detrimental health effects of the aerotoxic syndrome are attributed, among other things, to tricresyl phosphate (TCP), which is an organophosphate. TCP is used as an additive in turbine engine oil to increase the engine’s flash point, allowing higher running temperatures and, by extension, higher efficiency. TCP consists of 10 isomers, including tri-ortho-cresyl phosphate (TOCP). This is the only isomer for which a maximum level has long been regulated. This maximum level was stipulated in 1930 in a torpedo factory in the United Kingdom. So nowadays, the oil contains virtually none of this particular isomer. Conversely, a maximum level has never been stipulated for the other isomers. The afore-mentioned toxic substances can enter the bloodstream through the lungs, intestines or skin and inactivate the human nervous system. 

Aerotoxic syndrome: how to prevent it

1. If you suffer from serious jet lag symptoms, i.e., aerotoxic syndrome, travel by other means than by plane.

2. Book flights on a Boeing 787 Dreamliner. This is currently the only plane that does not emit any toxic substances from the engines into the cabin. 

3. Wear a special mask (P3 A2) in flight. This mask filters 95% of toxic substances from the air. Given that more toxic substances are vented into the cabin during take-off and landing, those are the times to wear a mask.

4. Drink bottled water

The drinking water system on board the aircraft is pressurised with the same contaminated air and is often treated with chemicals. So think twice about drinking coffee, tea and water. Preferably drink soft drinks, fruit juice or bottled water instead. 

5. Have your symptoms diagnosed as soon as possible

If you repeatedly experience symptoms attributed to the aerotoxic syndrome, have them diagnosed within the shortest possible time frame.

Aerotoxic syndrome: a time bomb

The aerotoxic syndrome developed into an issue reaching almost mythical proportions in 2019. In the Netherlands, an estimated 35,000 people suffer from aerotoxic syndrome and approximately one million people are affected across Europe. Considering there are some 700,000 frequent flyers in the Netherlands alone (people who fly at least six times a year), just think what proportions this problem can assume in the future. Physician and former KLM pilot Michel Mulder estimates that 10% to 15% of all airline employees suffer the effects of aerotoxic syndrome. 

Aerotoxic syndrome: therapeutic treatment

In order to ensure effective treatment of the aerotoxic syndrome, it is important not to muddle along for too long, but to have a professional diagnose the symptoms as soon as possible. The Functional Neurology Institute specialises, among other things, in diagnosing the aerotoxic syndrome as well as in the therapeutic treatment of the syndrome. 

Eye therapy

Because 80% of the brain depends on the functioning of the eyes, the health of the brain can largely be determined by the way the eyes function. We provide appropriate forms of eye therapy based on any abnormalities detected in certain eye movements.

Gyrostim (three-dimensional balance chair)

This high-tech computer-controlled chair can rotate around its axis in three different ways and helps significantly to restore neurological functions. The professional specialist sets up a movement profile based on your complaints, the results of the diagnostic tests and your progress during the five-day treatment programme. This movement profile comprises the speed at which the three-dimensional balance chair moves as well as the rotation of the chair around its axis. While sitting in the rotating chair, you will be asked to target fixed points in the housing around the chair with a laser pen. You will also be asked to perform specific tasks, such as reading or writing, while sitting in the moving three-dimensional balance chair. 

Neuro supplements

It is quite possible that your body does not get sufficient amounts of certain nutrients. This can be due to your diet, but it can also be traced back to hereditary factors. Certain nutrient deficiencies can keep certain brain functions from functioning as well as they should. You might also lack specific neurotransmitters and/or polyunsaturated fatty acids. 60% of the brain is made up of polyunsaturated fatty acids, which are essential for keeping your brain, a gelatinous substance, flexible. These fatty acids are located particularly in the cell walls, which determine the extent to which the brain can absorb nutrients and dispose of waste products. The treatment plan can therefore prescribe replenishing these possible deficiencies with specific high-quality neuro supplements. These supplements have been developed by the Neurology Functional Institute and are produced on the institute’s own account. 

We constantly monitor your progress by means of such diagnostic tests as the CAPS test and the Saccade test.