URGENT: Complete this section immediately upon detection of any cabin air quality event. All timestamp entries must be in UTC. Fields marked mandatory are required for initial incident notification.
Aircraft Tail Number
Aircraft Type and Model
Flight Number
Departure Airport ICAO Code
Destination Airport ICAO Code
Alternate Airport ICAO Code (if flight diverted)
Date of Incident (UTC)
UTC Time of First Detection
UTC Time of Incident Resolution
Phase of Flight at Time of Detection
Pre-flight/Ground Operations
Pushback/Taxi
Takeoff Roll
Initial Climb
Cruise
Descent
Approach
Landing Roll
Post-flight/Parking
Altitude at Detection (feet)
Total Flight Deck Crew Members on Board
Total Cabin Crew Members on Board
Total Passengers on Board
Captain's Full Name
First Officer's Full Name
Purser/Lead Cabin Crew Member Name
Initial Incident Timeline Narrative (provide sequential description of events)
Detailed Event Timeline Log
Time (UTC) | Event Description | Location in Aircraft | Personnel Involved/Witness | |
|---|---|---|---|---|
Document all observable characteristics of the cabin air contamination and any resulting exposures. This data is critical for determining toxicity and health risk assessment.
Was a fume, odor, or visible smoke detected inside the cabin?
Rate the intensity of the odor/contamination (1 = barely detectable, 10 = overwhelming)
Select all locations where fumes/odors were detected
Flight Deck/Cockpit
Forward Entry Door Area
First Class Cabin
Business Class Cabin
Forward Economy Cabin
Mid Economy Cabin
Aft Economy Cabin
Aft Galley
Forward Galley
Lavatory Compartments
Crew Rest Area
Cargo Bay (if accessible)
Unknown/Throughout Aircraft
How was the contamination initially detected?
Crew member smell/irritation
Passenger complaint
Flight deck warning light
Visual smoke/haze
Automatic air quality sensor
Medical symptom onset
Estimated Duration of Exposure (minutes)
Number of Passengers Reporting Symptoms or Discomfort
Number of Crew Members Reporting Symptoms or Discomfort
Symptom and Exposure Tracking Matrix
Affected Person Category | Count of Affected Individuals | Reported Symptoms (e.g., headache, nausea, dizziness) | Severity Rating (1-5) | |
|---|---|---|---|---|
Passengers (Economy) | 0 | |||
Passengers (Premium) | 0 | |||
Cabin Crew | 0 | |||
Flight Deck Crew | 0 | |||
Was in-flight medical attention or first aid provided?
Were any passengers or crew relocated to different seats or areas?
Upload photographic evidence of smoke, haze, or contamination sources (if visible and safe to photograph)
Were cabin air quality monitoring devices deployed or readings taken?
Were passenger complaints formally logged?
Provide complete technical data on aircraft environmental control systems, bleed air sources, and filtration status at time of incident. This section must be completed by qualified maintenance personnel or flight crew with systems knowledge.
Was the Auxiliary Power Unit (APU) running during the incident?
Was HVAC Pack 1 operational and supplying conditioned air?
Was HVAC Pack 2 operational and supplying conditioned air?
Which bleed air source was active for the packs during the incident?
APU Bleed
Engine 1 Bleed
Engine 2 Bleed
Mixed Engine Sources
Unknown/Automatic Switching
Bleed Air Temperature at Source (°C)
Bleed Air Pressure (psi)
Cabin Pressure Differential (psi)
Were recirculation fans operational?
Is a HEPA filtration system installed and configured?
Date of Last Pack/ECS System Maintenance
Upload Technical Logbook pages showing recent ECS/APU maintenance entries
List any ECAM, EICAS, or system fault codes recorded during the incident
Was a pre-flight bleed air contamination check completed?
Was a physical inspection of ducting and vents performed after the incident?
Document all post-incident ground actions including decontamination procedures, medical evaluations, and crew fitness-for-duty assessments. This section ensures aircraft airworthiness and personnel safety before return to service.
Has the aircraft been formally grounded pending decontamination and investigation?
Has professional decontamination been initiated?
Have specialized decontamination contractors or teams been notified?
Select all chemical agents or methods used during decontamination
Aircraft-approved disinfectant
Ozone generator
Hydrogen peroxide vapor (HPV)
Quaternary ammonium compounds
Isopropyl alcohol wipes
HEPA filter replacement
Cabin air flushing/ventilation
Select all areas that underwent decontamination treatment
Flight deck/cockpit
Forward galley
Aft galley
All lavatories
All passenger seats
Carpets and soft furnishings
Overhead bins
Crew rest areas
Entire cabin interior
Duration of Decontamination Process (hours)
Was post-decontamination air quality testing performed?
Is formal medical evaluation required for exposed cabin crew before next flight duty?
Number of Cabin Crew Members Medically Evaluated
Number of Cabin Crew Members Cleared for Return to Duty
Number of Cabin Crew Members Placed on Medical Hold
Select all symptoms reported by crew that require medical monitoring
Headache/migraine
Nausea/vomiting
Dizziness/vertigo
Respiratory irritation/cough
Eye irritation/vision changes
Fatigue/weakness
Cognitive impairment
Skin rash/irritation
No symptoms reported
Post-Incident Medical Monitoring Period (days)
Select all ground support equipment used during response
Ground air conditioning cart
Ground power unit
Pneumatic air cart
Decontamination equipment
Air quality monitors
Medical support equipment
Has a decontamination certificate or airworthiness release been issued?
Final authority approvals and incident classification. This section must be completed by designated supervisory personnel before aircraft release or formal investigation closure.
Incident Severity Classification
Minor (localized, no injuries, resolved)
Significant (multiple crew affected, medical evaluation required)
Major (passenger injuries, aircraft grounding, regulatory notification)
Critical (severe health effects, emergency landing, potential systemic failure)
Is a formal safety investigation required?
Has regulatory notification been made or is it required?
Flight Safety Director Full Name
Flight Safety Director Digital Signature
Flight Safety Director Approval Timestamp (UTC)
Lead Aircraft Maintenance Engineer Full Name
Lead Aircraft Maintenance Engineer Digital Signature
Lead Aircraft Maintenance Engineer Approval Timestamp (UTC)
Is the aircraft cleared for return to service?
Final Comments and Additional Actions Required
Attach Final Incident Report and Supporting Documentation