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6.26 The Committee is convinced that aircraft operators recognise that there exists a possibility that individual aircrew can and do reach a 'saturation' level of cumulative exposure to chemicals. Such a possibility should be recognised and further investigated.
6.27 The Committee is also convinced that there is sufficient evidence before this inquiry to justify further examination of the following factors:
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the effects on human health of the introduction into the aircraft cabin and cockpit of engine oil, by-products of engine oil combustion and other compounds as a result of leaking seals and bearings; and

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the cumulative physical effect of exposure to these substances which can affect particular individuals.

Air safety
6.28 The Committee has carefully considered all evidence put before it during this inquiry, and has also given consideration to the current safety regulatory structure imposed on air operators of aircraft, such as the BAe 146, by CASA under the Civil Aviation Act 1998.
6.29 A principal statutory function of CASA in relation to the oversight and maintenance of safe regulation and safe flying operations for civil aircraft in Australia is to:
.  conduct comprehensive aviation industry surveillance, including assessment of safety related decisions taken by industry management at all levels for their impact on aviation;
Submission 6, British Aerospace, p 6
.  conduct regular reviews of the system of civil aviation safety in order to monitor the safety performance of the industry to identify safety related trends and risk factors and to promote the development and improvement of the Australian aviation system.5
6.30 As a further statutory requirement, CASA is required to:
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foster an awareness in industry management and within the community generally of the importance of aviation safety;

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promote full and effective consultation and communication with all interested parties on aviation safety issues; and6

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ensure that the Civil Aviation Regulations covering Australian airspace are complied with.

Committee Conclusions
6.31 The Committee believes that CASA erred in rejecting the finding of Occurrence Brief No. 199702276 dealing with the incident involving Captain Kolver, published in September 1999. The Committee was not provided with a substantive reason for this action by CASA. The Committee believes that CASA should now accept the BASI/ATSB recommendations and develop an action plan for implementing them.
6.32 In its Occurrence Brief of September 1999, BASI recommended that:
The Civil Aviation Safety Authority, in conjunction with the aircraft manufacturer, British Aerospace Plc, address deficiencies that permit the entry of fumes into the cockpit and cabin areas of BAe146 aircraft. These deficiencies should be examined by the regulatory authority as part of its responsibilities for initial certification and continued airworthiness of the BAe 146 aircraft.7
　
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