Even minor events are important to track. According to Abou-Donia, Westgate was never exposed to a single, overwhelming “fume event” during his career. His exposure was chronic, and probably dated back to his first days as a professional pilot in 1996. Westgate didn’t begin to feel ill and show symptoms of organophosphate poisoning until 1999 -- a gap of three years that Abou-Donia says is consistent with the chemical-induced sicknesses he observed while studying Gulf War Syndrome. “Every time you are on the plane and you are exposed, it accumulates,” he explained. Given how much they fly, crew members are at far greater risk than passengers from the steady, day-to-day accumulation of chemicals in their systems.
So why aren’t more airline crew members coming down with symptoms like Westgate's? According to Abou-Donia, genetic differences account for how an individual will react to organophosphates (stress levels are also a critical determinant). Based on population studies of the enzymes in question, about 20 percent of the population will experience some symptoms, while about .01 percent will experience the very worst effects. Westgate probably belonged to the latter group.
The problem is that very few studies of this phenomenon exist, and those few that do are hampered by the small number of subjects. As a result, even quality studies that find a correlation between cabin air and organophosphate poisoning, such as a 2009 report by Australia’s Civil Aviation Safety Agency, have to concede “insufficient evidence at present to confirm or deny" that crew members were poisoned by the air around them.
Westgate's case should add to pressure for more extensive studies. “We know that there’s something there,” said Abou-Donia. “But to confirm it we need to do it with a very large number of subjects and controls.” Airlines and airplane manufacturers would seem to have an incentive -- not to mention a moral obligation -- to fund such investigations. But fear of the results, and the likely litigation to arise out of them, makes that highly unlikely.
Instead, government agencies with an interest in worker health and safety need to take the lead. In the U.S., responsibility should fall on the Federal Aviation Authority, the National Institutes of Health and the National Institute for Occupational Safety and Health. More than half a century after airplane manufacturers recognized the problem of air bleed, it’s time to find out just how deadly it is -- and then to do something about it.
Adam Minter is an American writer based in Asia, where he covers politics, culture, business and junk. He is the author of Junkyard Planet: Travels in the Billion Dollar Trash Trade, a bestselling and critically acclaimed account of his decade writing and reporting in the world's scrap yards. His work has been published in a range of publications, including the Atlantic, Bloomberg Businessweek, the Los Angeles Times and Time.