Introduction Since the 1950s pressurised aircraft cabin air has been drawn unfiltered from turbine jet engines as ‘bleed air’. Therefore emissions from engine oil seals leads to contamination of the breathable cabin air. The synthetic oils include a wide range of hazardous substances including the organophosphates, and a complex pyrolysed mixture. Oil seals are reported to produce a noticeable cabin fume event in 1% of flights.¹ However, to function oil seals ‘weep’ lubricant at varying stages of normal engine operation,² so there is always low level air contamination which crew and frequent flyers are cumulatively exposed to for 100 s of hours annually. Reports of adverse effects specifically related to the aircraft environment have continued since the early 1950s.^3,4 Short and long-term effects, termed ‘Aerotoxic Syndrome’, primarily involve irritant, sensitising, neurological, neuropsychological, respiratory, cardiovascular and other general effects.⁴

Methods A review of the various actions undertaken by the aviation manufacturer’s, airlines regulators, governments and independent studies will be outlined. A selection of incident and accident reports and bureau of air safety recommendations will be highlighted. The implications for both aircrew, frequent flyers and susceptible individuals will be discussed.

Result The aviation industry has inadequately addressed this long-standing problem, despite it being a clear threat to flight safety, occupational health and safety, occupational and public health. There is a need for further research to be undertaken to help address this important problem relevant to anyone who flies in aircraft as crew or as a passenger.

Discussion In view of the need to prevent incidents and accidents related to aircraft contaminated air supplies and the subsequent occupational and public health issues, there is a clear need for action to be taken to assess the scale of the problem and highlight the need for preventative actions.