My first recorded fume event was on the 29 November1991. During the take-off run having passed V1 (a speed at which the aircraft was committed to becoming airborne) the aircraft flight deck filled instantly with hot acrid fumes. The Captain and myself were blinded, unable to view instrumentation or gain any visual reference, our skin was burning and we could not breathe.
As the handling pilot I allowed the aircraft to accelerate for several seconds prior to becoming airborne. The Captain (a highly experienced pilot with many years experience on this specific aircraft type) with no visual reference, but by feeling this way along the instrument panel located and then opened the dump valve (This valve in effect lets air out of the aircraft). Within about 3 seconds the fumes cleared. The incident lasted for about 15 seconds.
For those 15 seconds we were blinded, unable to breathe and accelerating in excess of 160 mph. Oxygen masks were activated, emergency drills actioned and an emergency declared to Air Traffic Control. An emergency landing was made and the aircraft evacuated. Both the Captain and myself were employed by and trained by the aircraft manufacturer. One wonders how a less experienced crew would have managed. The aircraft and documentation were subsequently exported to Russia.
My last recorded fume event occurred in 2004. The Captain (a recently retired United Kingdom Civil Aviation Authority Flight Operation Inspector) was the handling pilot. During a fume event he had the aircraft descend to within 500 feet above the city of Amsterdam not established on any published instrument approach and with no visual reference to the runway. The only time it is ever safe to be this low is during takeoff and landing. What is even more concerning is that I too failed to intervene. I can still recall the oily smell on the flight deck! At 500ft and confused we instigated a climb to 1500 feet. I still do not understand how this situation occurred.
The next day enroute to Italy, Swiss air traffic control gave a re-routing over Switzerland. Both I and the Captain were unable to process the information being given! That was my last ever flight before I resigned. Why did I resign? Because I could not and indeed still cannot think clearly enough to fly.
Aircrew worldwide know what is causing their neurological, respiratory, neuropsychological, psychiatric conditions. Many are afraid to come forward in fear of losing their livelihood, particularly given the powerful Government and Aerospace industry opposition to this issue.
In the Swiss Air Accident Investigation Bureau report into a serious incident involving the Avro 146 RJ 100 registration HB-IXN on the 19 April 2005 the medical examination of the co-pilot after the flight showed that during the flight toxic exposure took place.
What I cannot understand is why in my own personal experience consultant psychiatrists declined and failed to view the 2003 AOPIS DVD “Aircraft Air Contamination” when both the British Airline Pilots Association (BALPA) and the Independent Pilots Association sent this DVD out to it's members presumably to prevent misdiagnoses.
My personal experience is well documented, medically misdiagnosed and with three Court of Protection Medical Certificates CP3s issued but never registered by the Official Solicitor. With other solicitors and doctors denying their existence, I was held as a captive mental patient for almost 18 months with most of my assets disposed of.
So, heavily medicated, misdiagnosed by psychiatrists, unable to take care of myself, simply because psychiatrists failed to eliminate any organic cause that could be related to aircraft fumes. Psychiatrists must consider the possibility of physical causes if there is a clinical reason for doing so. Thankfully the fifth psychiatrist did and I regained my mental capacity.
Only after a circuit judge allowed me access to records were the Court of Protection Medical Certificates located. (Following representation by Members of Parliament to the Secretary of State Rt Hon Jack Straw, Ministry of Justice), has the definitive response been given that it was the responsibility of the certificate holder to ensure that these certificates were registered. One questions how many others have, are, or will suffer a similar fate?
BALPA's Medical Officer directed my General Practitioner to refer me to Professor XXXX a CAA approved psychiatrist (whose team did view the AOPIS DVD). I have no doubt I would have continued to be misdiagnosed. Thankfully BALPA arranged for myself and a few others to have specialist blood tests for which I will always be grateful. The test identified chemical induced nervous system injury.
During my flying training little did I realise how in later years I would come to rely on the Cockpit Resources Management Training (CRM) and Human Factors Training I had received. “Mr Lawrence I see that you have been exposed to TCP - that's an antiseptic”. “No doctor TCP stands for tricresyl phosphate - an organophosphate”. There was silence!
I continued to receive treatment from a hospital that has and continues to provide specialist treatment. I now know the nature of the beast that I am fighting - tricresyl phosphate. How many have still to identify their possible current psychiatric misdiagnosis to that of an organic cause?
A professor of Psychiatry wrote “Dear Len, I think that Dr XXXX at the Hospital is intending to follow you up by pursuing neurological investigations. I think it's very likely that we are pursuing the same problems but through a different line the psychological and behavioural line. There is a point where psychological issues meet up with physical issues and I think that is what's happening here.
Dr Sarah Mackenzie Ross a clinical neuropsychologist from University College London has undertaken research on 18+ pilots said to be exposed to oil fumes on the BAe 146 & B757 & found a pattern of abnormal cognitive deficits in all 18. It was the same pattern to similar research undertaken by another psychologist (Leonie Coxon) in Australia testing another group of pilots also said to have been exposed to oil fumes.
Leonard Lawrence,
medically retired pilot HS125, BAe146 and B757
27 February 2009
Len Lawrence has written this article for the Brain Injury Rehabilitation trust (BIRT) telling how they have helped rehabilitate him following his brain injury due to contaminated cabin air. These are Len’s own words, although we have tidied some of the text up.
I previously worked as an Airline Pilot flying the Boeing 757 and the BAe146. Unfortunately doctors now tell me that I have been exposed to toxic fumes that had entered into the aircraft cabin via the cabin air supply system. This I understand caused my brain injury, a condition known as Aerotoxic Syndrome.
In May 2009 the house I rented burnt down and I thought things could not get any worse.
Shortly after the house fire a social worker called Lorraine came to see me and carried out an NHS 1990 Community Care Assessment and suggested a referral to The Brain Injury Rehabilitant Trust.(BIRT). A short time later Dr Fussey and Martin Wood from BIRT came to see me. Dr Fussey was able to take a very complex history extending five years and summarised it in a short paragraph.
“Mr. Lawrence has aerotoxic syndrome, a brain injury due to organophosphate poisoning. However, this has only recently been diagnosed, as the onset of his symptoms were thought to indicate an underlying psychiatric condition. Early cognitive problems included short term memory deficits, particularly with absent mindedness. It is thought likely that Leonard sustained his aerotoxic poisoning while working as a pilot, being exposed to organophosphate in the cockpit of the various aircraft that he flew. It would appear that the development of what are now thought to be organic signs and symptoms but then judged to be psychiatric. I believe he does have capacity to consent to the Brain Injury Rehabilitation Trust’s services. It should be recognized that this is an extremely complicated case, with probable psychological overlay of an organic disorder.” Dr Fussey, Consultant Psychologist Brain Injury Rehabilitation Trust.
BIRT are a group who take people seriously. Accordingly they get things done that others simply talk about. Devon County Council aided the funding and BIRT became a reality.
An NHS Neuropsychology assessment was arranged. The Neuro-psychologist from Torquay Hospital was extremely thorough and saw me on about five occasions for testing. Part of her report can be read below.
“Aero-toxicity is a relatively new area of neuro-psychological research. Leonard clearly has had difficult experiences in the past with healthcare professionals not taking his concerns seriously. This pressure undoubtedly affects his performance in neuropsychological testing and has led to a complex interplay of neurological factors, particularly around memory. It is important for all those involved in his care to be understanding of Leonard's difficulties whilst encouraging him to regain confidence in his own abilities.”
The Neuro-psychologist devised a coping strategy to aid cognitive and short term memory issues that I have as a result of my brain injury. With the help of Dave and Anna we set about addressing the coping strategy. From a food timer to a notice board, informing people when necessary of my problems life has greatly improved matters. The most noticeable change since BIRT involvement has been with the healthcare professionals!!
Before becoming a pilot I had worked as an expert witness for various Trading Standards departments in the Home Counties. I was also a Member of the Institute of Domestic Heating and Environmental Engineers, Executive Council and Consultant Group Committee.
As a result of my brain injury, the cognitive and short term memory issues make it impossible to work as a pilot. I’m also unable to work as an engineer. However, I still have a lot of long term knowledge of domestic and industrial mechanical engineering which I would like to focus on.
With Dave, my designated carer with BIRT, we have been watching recordings of the Channel 4 programs “Put Me Together Again”, about life in BIRT units. This has been a great help and has helped me to understand my condition and issues. I have lost count at the number of times (20 or more) Dave and I have viewed the programme, but what is invaluable is the one to one discussion we then have about the many issues these documentary identify.
Likewise we recently watched Sir Stirling Moss being interview by Richard Hammond regarding brain injury. Stirling Moss made the statement:
“What has changed is, what I used to do was automatic, now with a conscious thought everything has to be thought-out. What was once second nature, is now a conscious, tiring and slower effort.”
This reflects what I now experience with my own injury!
In the last nine months, with the help of the Brain Injury Rehabilitation Trust, I have been able to renew qualifications. The report I had from Dr Ian Fussey enabled me to take part of my exams orally instead of written paper. I was also allowed extra time for the examinations.
I know that, for safety reasons, I can never work as a engineer again, but at BIRT’s suggestion, I might be able to become a mentor/assessor to people who are currently training or who wish to become mechanical engineers. I have recently tutored a family friend at home and have successfully aided him in gaining a full time plumbing course at college. BIRT has recently introduced me to the St Loydes Centre were it is hoped this goal can progress.
26 July 2010
