AIRCREW SAFETY & HEALTH

Exposure to Pesticides on Aircraft

Some countries require that in-bound flights be treated with pesticides to prevent the spread of insects, or diseases carried by insects, like malaria or Zika. The process of applying pesticides to kill insects is called disinsection. Here air and ground crew can learn more about aircraft disinsection, related health problems, and what you can do to reduce your exposure.

What is disinsection?

• Aircraft disinsection is allowed under international law, but not all countries require it. The U.S. Environmental Protection Agency (EPA) has not currently approved any pesticides for use in passenger cabins on commercial aircraft.¹ The U.S. Department of Transportation provides information on which countries require disinsection on inbound flights.
• The only pesticides recommended by the World Health Organization (WHO) for aircraft disinsection are synthetic pyrethroids (permethrin, d-phenothrin, and 1R-trans-phenothrin).² Other pesticides, including DDT (dichlorodiphyltrichloroethane), were used to disinsect aircraft several years ago but are no longer used.
• Disinsection methods can include spraying the aircraft cabin with an insecticide (either before or after passengers board, or while in flight) or treating the aircraft’s inside surfaces (while passengers are not on board) with an insecticide that can be effective at killing insects for up to 8 weeks.^2,3

What air and ground crew should know

• Crewmembers have reported illness from exposure to pesticides on aircraft, including headaches, dizziness, nausea, respiratory symptoms, skin and eye irritation, and other symptoms.^3,4
• Flight crew, ground crew, and passengers may be exposed to pesticides used for disinsection:
  • Flight attendants may spray a pesticide in the aircraft cabin after the aircraft leaves the gate and/or before it lands.^2-3
  • Ground crew (including maintenance or cleaning staff) may treat surfaces inside the aircraft with a pesticide prior to air crew and passengers boarding. Additionally, ground crew might enter an aircraft shortly after disinsection and before treated surfaces have dried.^2-4
  • Crew and passengers can be exposed to pesticides during aircraft disinsection or from contact with treated surfaces within the aircraft (fuselage).^2-4 Pesticide exposure may also occur when eating or drinking products that have come in contact with surfaces treated with pesticides.
• Aircrew can unknowingly be exposed to insecticides even when they are on flights that don’t require disinsection (including flights within the continental United States) because aircraft that have been treated with insecticides can be used on multiple flight routes.
• There is no single set of standards for how aircraft disinsection is performed. It is unknown whether all aircraft disinsection adheres to the WHO guidelines regarding disinsection, label directions, and good occupational hygiene practices. Pesticides should always be used according to their label directions and following good hygiene practices.

What can air crew do to reduce or eliminate exposure?

• Talk with your employer or employee representative about concerns you have with pesticide exposure.
• Avoid skin contact with surfaces that are still wet with pesticide.
• Follow up with your supervisor and healthcare provider if you have concerns about your potential pesticide exposure. Make sure your doctor knows that you work as a crewmember.

Research gaps

• It is unknown whether long-term exposure to the chemicals used in aircraft disinsection might cause health effects in air and ground crew.
• Pesticides used for aircraft disinsection are mixtures including solvents, propellants, surfactants, and synergists. Research on the health effects of exposure to these mixtures, as well as possible combined effects with other chemicals present in aircraft environments, are needed.
• Although pyrethroid pesticides are generally not believed to cause allergy or asthma symptoms, allergic sensitization, asthma symptoms, and anaphylaxis (a sudden and severe allergic reaction) have been reported related to exposure to commercial aircraft disinsection products.^3,5-7 Additional research is needed to clarify the relationship between disinsection and asthma/allergy.
• Reports from passengers and air crew suggest that there are major differences in how disinsection is performed. Better understanding of current practices is needed.
• Further studies of aircraft surfaces and air crew are needed to evaluate whether repeated applications of insecticides in a cabin, or improper application of pesticides in aircraft, might cause increased exposure.
• Some insects are resistant to the pesticides used in aircraft disinsection. Research to evaluate the usefulness of chemical disinsection, as well as non-chemical and engineering controls that can be used as an alternative, is needed.

Resources

• The Agency for Toxic Substances and Disease Registry (ATSDR): pyrethrins and pyrethroids including toxicological profile
• The Agency for Toxic Substances and Disease Registry (ATSDR): DDT, DDE, and DDD including tox profile
• World Health Organization: Chemicals for Aircraft Disinsection
• 2005 World Health Organization report: Safety of Pyrethroids for Public Use
• American Journal of Industrial Medicine: Pesticide Illness Among Flight Attendants Due to Aircraft Disinsection
• State of California Health and Human Services Agency: Occupational Illness Among Flight Attendants Due to Aircraft Disinsection
• CDC Technical Statement on the Role of Disinsection in the Context of Zika Outbreaks
• Airliner Cabin Environment Research Center
• The Association of Flight Attendants-CWA