Air and Toxic Fumes testing protocols. April 8 th

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1 Air and Toxic Fumes testing protocols. April 8 th At Pro Health Medical we have the following protocols already in operation. All is running well but nevertheless we see that patient (read client) information we receive at our offices and lab is either incomplete or incorrect in some aspects. It is very important that the patient/client knows the protocols before submitting clothing, SamplerCards and/or blood for analysis. Of course have Client can call to ask what the options are and how to act. At that time we make an assessment at which stage client is informational wise and help them how to proceed. Because we speak about national and international clients including (frequent flyer) passengers, pilots and cabin crew these groups generally speak and understand English. There for we have written the protocols in English only. It is important that all of the information will remain uniform, but also that the correct request forms are used to handle the applications and analysis requests. Like this we keep control what goes where and what should be done. General Company and Lab information: All requests are to be sent in with a application form (accept Air and samples are to be sent to: Pro Health Medical - Pro Health Medical and Pro Health Research are divisions of Laboratorium Pro Health BV., The Netherlands (EU). Extra information: Pro Health BV. is registered with the Chamber of commerce in the City of Roermond, also in The Netherlands. Our registration number is : Pro Health BV s Tax. nr. in the Netherlands is : B.01. If you should have any more questions, please do not hesitate to contact us or on You are also welcome to call us from Monday through Friday from 8:30am to 17:00pm dialling your international access code followed by Press 2 and you will be connected to the support team to help you further with any questions you might have. Please remember that we are and work on Central European time (CET). Nb.: DID you know that there is an App especially designed with information on TCP and fume event info and issues. You can download the Aerotoxic App for Apple Iphone/Ipad/Ipod through the App-Store. Payments for all tests can be made to: Company name : Pro Health Medical Address : Schoutlaan 4a Postal Code : 6002 EA City : WEERT Country : The Netherlands Bank account Information: IBAN : NL53ABNA BIC : ABNANL2A Bank ABN/AMRO :

2 Exposure to impure cabin air; Risk of neurological symptoms. Scientific research shows that bleed air, used to pressurize and renew cabin air in turboprop and jet aircraft is contaminated-by-design (Michaelis). Neuro toxic components from the engine oil do enter the cabin, among them TriCresylPhosphate (TCP). Neurological symptoms may arise for those that are DNA-compromised (1-2%) and not able to detoxify these compounds properly. This may give rise to acute or chronic health issues varying from, but not excluding: nausea, tremors, headaches, balance disorders, memory impairment, palpitations, fatigue etc. (Exposure to Aircraft bleed air Contaminants among airline workers, a guide for healthcare providers). TCP DNA detox gen panel Several enzymes are known and described in the literature, involved and required in the metabolic breakdown of organophosphates. After consulting several colleagues it was suggested to check the whole Detox Phase 1 and 2 panel. But, realizing this would bring enormous costs to the client, we formulated a special TCP-detox gen panel. Aero toxic antibody profile When debris of cells after breakdown induced by toxins remain in the brain, antibodies can develop and could be responsible for more damage to neurons. This is in the process of development but can be requested already. Air Sampler Card* SamplerCard* This SamplerCard* is made of laboratory grade absorbent material and individually numbered. Research has shown the presence of Organophosphates, a neuro-toxic compound, to be often an integral part of cabin air in jet aircraft using bleed air. It allows for both professional aircrew and passengers to sample their own particular flight. 2

3 What do you need to send in? 5ml of EDTA blood / heparin blood. No cooling required. (if antibody profile is requested, send in also 1 tube (9 ml) of clotted blood. Send it in by FedEx or other postal arrangement in a padded envelope. There is no time limit for this kind of diagnostic test. It is now also possible to do a TCP analysis on clothing (White (piece of) Shirt/Blouse/Underwear) worn during the flight. Certain conditions do apply. An important factor of the conditions to do so is that it must be a white clothing piece. This because coloured or better said dyed clothing could have an adverted affect on the measurement. Equally as important is that the clothing has not been washed after the event or chemically treated in any way such as Dry cleaning, Deodorant, Sprayed etc.. It can then be send and delivered to us in a (sealed) plastic bag. Pro Health Medical provides the blood extraction as well as the sending of the clothing piece to the research lab to be tested on TCP. Please make sure you always call Pro Health Medical. Like this you will received the most current information, protocols and request forms. For more information an to get to know how to get a SamplerCard test kit, feel free to contact us through at or by dialling your country s international access code followed by our phone number which is for more information. We will be glad to help you any way we can. This research is done in collaboration with Aviation Medical Consult Solutions in monitoring, diagnoses and treatment. The office address of the Aviation Medical Consult (AMC) is Karbouwstraat VC BUSSUM - The Netherlands

4 Air Sampler Card Protocol: Air_Sampler_Card* SamplerCard* This SamplerCard* is made of laboratory grade absorbent material and individually numbered. Research has shown the presence of Organophosphates, a neuro-toxic compound, to be often an integral part of cabin air in jet aircraft using bleed air. It allows for both professional aircrew and passengers to sample their own particular flight. To see if there has been an actual exposure to toxic chemicals. In certain cases it may indicate a fume event. The compounds that we will look for are called TCP* (*TriCresylPhosphate). They appear in the same composition on the card as in the actual oil of the turbine engines itself (Gas Chromatograph Mass Spectrometer fingerprint). Analysis is done by a validated and certified process. Advise is to use this Card either on one long haul flight or separate exposures during short haul flights on the same aircraft. This to allow levels to reach above detection limits. Air_Sampler_Card* Request procedure 1. A request to receive a SamplerCard* can be made by sending an to or to specifying: - Amount of Cards requested - Applicant name and initials - Full Address (if different please disclose both billing and delivery address) - Country of citizenship - Contact phone number 2. Receipt of a request with all needed details in place will result in an invoice being drawn up and send back to the address used for request. 3. An AMC Air Sampler Card for Air sampling during flights costs 210 euro. After having received and processed payment of requesting applicant, the ordered items shall be shipped. All SamplerCards * are numbered. The Applicants name is Linked to the card number(s) send to applicant. Payments for all tests can be made to: Company name : Pro Health Medical Address : Schoutlaan 4a Postal Code : 6002 EA City : WEERT Country : The Netherlands Bank account Information: IBAN : NL53ABNA BIC : ABNANL2A Bank ABN/AMRO : When card returns to laboratory it will be processed and analyses will start. 5. As soon as analyses is completed results will be ed back to the address used for original request/application. PRO Health Medical, Aviation Medical Consult and partners ensure that all details disclosed will be kept safe and privet under the Dutch privacy law. PRO HEALTH MEDICAL Working Together Towards Bettering Medicine! 4

5 Nb.: The Air testing strips themselves, differ from these informational cards. Please fill out both sides of the request slip. 5

6 6

7 Clothing tests: We leggen uit wanneer, hoe en waar het kleding stuk verzonden moet worden. TCP Analyses in Exposed Material - costs 341,= - WHITE (piece of) Shirt/clothing in a Sealed plastic bag (see protocol and request form). It is now also possible to do a TCP analysis on clothing (White (piece of) Shirt/Blouse/Underwear) worn during the flight. Certain conditions do apply. An important factor of the conditions to do so is that it must be a white clothing piece. This because colored or better said dyed clothing could have an adverted affect on the measurement. Equally as important is that the clothing has not been washed after the event or chemically treated in any way such as Dry cleaning, Deodorant used on it, Sprayed etc.. It can then be send and delivered to us in a (sealed) plastic bag. It is very important that we have all your details collected. Please use the request form for this. Please send the packaged material with the completely filled out request form to our offices. The address is: Pro Health Medical Schoutlaan 4a 6002 EA WEERT THE NETHERLANDS Pro Health Medical provides the blood extractions or extracted blood samples as well as the sending of the clothing piece to the research lab to be tested on TCP. If you do not have a request form, please call , us or request details through the Aerotoxic Iphone App. (Download it free thru the App-store). WARNING: It is very important we have all your personal details such as name, family name(s), complete address, phone number and when available address to be sure the communication with you goes accordantly every step of the way. 7

8 Blood testing: Blood samples tests: There are two different Blood Sample test available at this point. One is the DNA test and the other the Auto Antibody profile. (1) The DNA TEST for TCP - costs 380,= This includes a medical advice from AMC. For this test the laboratory needs one EDTA tube at least ¾ filled with a blood sample (1 purple stopper tube - see protocol and request form). (2) The Neuronal Auto - Antibody profile (extended) Under development Or Auto-Antibody profile USA costs (3) Neuronal Auto Anti-body profile * T.B.A. (to be announced) This includes a medical advice from AMC. For this test the laboratory needs one SERUM tube at least ¾ filled with a blood sample (1 red stopper tube - see protocol and request form). When requesting a test, we ask that the standard request form is filled out completely without fail. If you should have questions which test you should best do, we will then connect you to a Medical Doctor (AMC MD) to walk you through any questions you might have. He or she will then give you the information you need to fill out the request form that you can then mail back to us with the blood sample attached. If you are in the Netherlands, we can provide you with a standard kit especially designed for the test(s) you would like to request. Pro Health Medical provides the blood extractions or extracted blood samples as well as the sending of the clothing piece to the research lab to be tested on TCP. If you do not have a request form, please call , us or request details through the Aerotoxic Iphone App. (Download it free through the App-store). WARNING: It is very important we have all your personal details such as name, family name(s), complete address, phone number and when available address to be sure the communication with you goes accordantly every step of the way. 8

9 Pro Health Medical Working Together Towards Bettering Medicine! 9

10 10

11 Questionnaire (Part 1 of 2): Please fill out the questionnaire completely and provide us with as much information as you possibly can. Especially a contact phone number & address. 11

12 Questionnaire (Part 1 of 2): Please continue to fill out the questionnaire completely and provide us with as much information as you possibly can. Especially a contact phone number & address. 12

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