Aircraft fires, smoke toxicity, and survival

In-flight fires in modern aircraft are rare, but post-crash fires do occur. Cabin occupants frequently survive initial forces of such crashes but are incapacitated from smoke inhalation. According to an international study, there were 95 fire-related civil passenger aircraft accidents worldwide over a 26-yr period, claiming approximately 2400 lives. Between 1985 and 1991, about 16% (32 accidents) of all U.S. transport aircraft accidents involved fire and 22% (140 fatalities) of the deaths in these accidents resulted from fire/smoke toxicity. Our laboratory analyses of postmortem blood samples (1967-93) indicate that 360 individuals in 134 fatal fire-related civil aircraft (air carrier and general aviation) accidents had carboxyhemoglobin saturation levels (> or = 20%), with or without blood cyanide, high enough to impair performance. Combustion toxicology is now moving from a descriptive to a mechanistic phase. Methods for gas analyses have been developed and combustion/animal-exposure assemblies have been constructed. Material/fire-retardant toxicity and interactions between smoke gases are being studied. Relationships between gas exposure concentrations, blood levels, and incapacitation onset are being established in animal models. Continuing basic research in smoke toxicity will be necessary to understand its complexities, and thus enhance aviation safety and fire survival chances.