I am a 30 year flight attendant with a major US carrier who has flown numerous types of aircraft both short haul and long, domestic and international. I have never had any medical issues as a result of my occupation.

On November 5, 2008 and December 10, 2008, I was exposed to what I believe to be tricresylphosphate (TCP) while working 4 short haul flights of approximately one hour and thirty minutes. I have records indicating that on the first flight there was a leak in the Auxiliary Power Unit (APU) and after repeated attempts to keep the aircraft in service it was grounded and the APU was replaced. On the second occurrence on December 10, 2008, a maintenance log entry indicated an odor of "smelly feet" in the cabin, (characteristic of TCP), following our flights.

During the first exposure the entire crew experienced burning eyes, upper respiratory, breathing difficulties and "headachy" symptoms. Not knowing what we were experiencing, we carried on with additional flights on a different aircraft.

On the second exposure, being a little more sensitized to the smell, but still not aware what it was, I, along with the other F/As were very concerned and experienced the above symptoms again. This time it was a more intense smell and I felt a somewhat loss of normal balance on walking in the aisle, tripping twice, and stuttered with one of my announcements. The smell was reported to the pilots during flight. We flew with the smell for 1+30 minutes during this segment. On the ground no maintenance was called and the captain indicated that if we reported it, "We would be staying for the night (other than our home base) and the plane would probably be grounded." He said that he had experienced this before (he was the same captain on my first exposure on November 10, 2008, coincidentally). We flew that plane back to base with less of a smell, yet present and intensified near landing.

"I would encourage anyone facing this struggle not to give in to scepticism" 

My exposures were real as the records indicate conclusively on the first occasion and the second by the maintenance log entry. Following the second exposure I realized that something was wrong with me physically and I began to do some research about TCP. Realizing that this neurotoxin is very harmful if aerosolized, I immediately saw my PCP the next day. She examined me, did the basic physical, neurological exam and could not find any observable problems or symptoms. I even told her that I did not feel horrible, just in a fog, "hung over like," slowed down and with a dull headache. She ordered that my blood be sent to a researcher (my request) to see if there was presence of TCP, both of us knowing full well that the test was not perfected yet. Four days later I returned to my PCP still feeling foggy, and not right. I asked that basic blood work be done to see if there were any abnormal readings and that the plasma cholinesterase test be done, recommended by our Union Safety specialist. This test could indicate that there are enzymes in my blood fighting some foreign substance like TCP. Despite the fact that I gave my PCP a specific article entitled "Exposure to Aircraft Bleed Air Contaminants Among Airline Workers, A Guide for Health Care Providers", I was still looked at with scepticism. I now realize that I was truly in a fog and could not really define my symptoms during these visits.

My Workers Compensation claim was denied, I can only assume because of my airline and their insurance company being unwilling to acknowledge exposure and responsibility and my doctor's report of "non-specific" symptoms. I had requested of my PCP a referral to a neurologist and she told me by phone during that week to wait until our next visit in one week. During this time, I had muscle and gait issues, sleep disturbances, heightened smell sensitivity to everything and especially petroleum based products (gas fill ups, neighbors oil delivery, being on a bus), memory lapses, fine motor skill issues, writing difficulty, continued fogginess and persistent dull headaches. This is not to mention being anxious about the uncertainty of my health and how I could possibly return to this environment to work.

I sought a therapist who works a lot with PTSD, and Occupational Issues. I have kept a diary of my day to day activities and symptoms since December 10, 2008. On my third visit to my PCP, I noted a lot of my symptoms and brought them with me, and this time my PCP "got it." She had read the information that I sent her and put into the record more accurately all of my symptoms and referred me to a neurologist. That visit reassured me that no apparent neurological symptoms exist, and he told me that I needed to see a toxicologist, and I told him that my PCP had referred me to one. Coincidentally his referral was with the same practice. That visit with an Environmental Health Clinic proved very unproductive. I had sent the Practitioners Guide to the Clinic and when I was evaluated, it was apparent that the doctor had not read any of the literature I had sent, nor had no knowledge of TCP exposure, and was rather dismissive of the phenomenon. My main concern of this visit was to ascertain from a specialist whether repeated exposures to TCP could have long range effects on me. He disputed all examples of exposure that I presented and told me that they were anecdotal and that no long range studies showed a causal relationship between these symptoms (short term memory being the example I used) and TCP. I told him about pilots who have lost their FAA licenses to fly and flight attendants unable to return to work and perform their inflight duties and passengers exposed not able to return to their normal routines and he told me anyone could say that they can't remember something and fail a test or report odd symptoms after flying. That was enough for me.

I am credible, and my exposure was real. I will return to work on January 13, 2009, reluctantly. I still have concerns about re-exposure, anxiety about returning to an environment that might put me in jeopardy, and many unanswered questions. I will continue to research this issue, seek professionals who understand the phenomenon and not give up on this uphill battle. I would encourage anyone facing this struggle not to give in to scepticism and to persevere in their search for professionals who understand that the symptoms they present are real. Someday soon the airlines will wake up and have their day of reckoning. The simple solution might be a detector similar to a smoke or radon detector.

I am thankful that I can return to work and that my symptoms are not so severe that I cannot perform my job. Unfortunately more severe symptoms and complete disability would have proved more effective in my quest for acknowledgement. Thank goodness I can share what I know.

Sincerely hoping this helps someone and the cause for a more healthy aircraft atmosphere.