8Airline employee health

Publication Details

The risk of TB among cabin crew members is similar to that of the general population. Mandatory routine or periodic screening is not indicated for cabin crew.

Available data about transmission of M. tuberculosis on aircraft do not suggest an increased risk for cabin crew resulting from their work, and thus routine and periodic tuberculin screening of all flight crew is not indicated.

Crew members are not generally considered to be close contacts of an infected passenger due to the nature and limited contact between individual passengers and crew. Exceptionally, if a cabin-crew member is assigned during a flight to look after an ill passenger who is subsequently diagnosed with infectious or potentially infectious TB, this crew member may be considered to be a close contact on the basis of the risk assessment.

When the infectious source is a crew member (cabin or flight crew), an assessment of individual work assignments should be made. All other crew with a cumulative exposure of 8 hours or longer during the period when the crew member with TB was potentially infectious should be informed of their exposure and advised to seek medical evaluation. Crew members would be considered close contacts if they were exposed to the infectious source while working, travelling and socializing together. The risk assessment should also consider whether any other work colleagues would also meet the criteria for close contact.

If evaluation of crew members with a cumulative exposure of less than 8 hours is required due to exceptional circumstances, the public health authority investigating contacts of the case will, in cooperation with the airline occupational health department where this exists, advise the relevant crew members.

Cabin crew should receive training about potential exposure to communicable diseases during flights. Cabin crew should also be trained in first aid and in the use of universal precautions when there may be exposure to body fluids (29). Airlines should ensure that gloves, surgical masks and biohazard bags are readily available. Airline cleaning staff should be prepared for appropriate cleaning of the aircraft after potentially contagious passengers have disembarked.