gms | German Medical Science

Introduction: Apron workers belong to the airport ground personnel, which is in charge of tasks such as aircraft fuel tanking, aircraft parking or baggage handling. Due to their presence on the apron, these workers are exposed to a complex mixture of air pollutants, which is considered to be potentially harmful for human health [1]. Major concern is related to the exposure to ultrafine particles from aircrafts (UFP, defined as particles less than 100 nm in diameter) [2]. Toxicological studies suggest that UFP exert a higher toxicity per mass unit than larger particles and may possibly contribute to the development and progression of various diseases [3], [4], such as cancer, heart disease, mental disease, and respiratory symptoms, thereby increasing the risk of serious work-related illness and premature death [5].

Methods: A scoping review on occupational health hazards due to air pollution among apron workers at civil airports was conducted. We searched PubMed (until 03/2020) and also the reference lists of original articles and reviews.

Results: Three studies were identified. Although we did not perform a systematic review according to the criteria of PRISMA, to our best knowledge no further studies are published.

Two cross-sectional studies investigated the effect of occupational exposure to aircraft fuel and jet exhaust on respiratory and pulmonary function among workers of the Birmingham International Airport [6] and of Taiwan Kaohsiung International Airport [7]. Workers were classified on the basis of official job titles into exposure categories depending on their likely exposure to aircraft fuel or jet stream. Chronic respiratory symptoms were significantly more prevalent among the exposed group compared to low exposed personnel.

A large Danish register-based cohort study with Copenhagen Airport workers considered men in unskilled jobs employed at Copenhagen airport between 1990-2012. The exposed group included baggage handlers or other outdoor workers on the apron. A reference cohort considered men in unskilled positions working indoors at Copenhagen Airport and men working in the greater Copenhagen area [8]. An individual exposure estimation for UFP was performed. The cohort was linked with national registries to identify potential health effects for each individual: incident cancer, cardiovascular disease, respiratory disease, musculoskeletal disorders and mortality data. Overall, the investigators found no associations between cumulative apron-years and incidence of ischemic heart disease or cerebrovascular disease during a mean follow-up of 14.4 years [9].

Discussion: Up to now, little attention has been given to occupational exposures towards aircraft-related UFP, although aircraft engines have high emissions of UFP, which are orders of magnitude higher than environmental exposure. Currently, reliable information on UFP-exposure and comprehensive scientific evidence on a possible health impact of jet exhaust among civil airport apron workers is not available. Only three studies have been published. Two of them are cross-sectional by design and limited by a small sample size and lack of quantitative exposure data. Only one sizeable cohort study performed an elaborated exposure measurement of UFP. In summary, insufficient epidemiological data regarding UFP-related workplace hazards at civil airports demands future epidemiological studies.

The authors declare that they have no competing interests.

The authors declare that an ethics committee vote is not required.