Date: 201304
Local time of day: 0601-1200
Location: ZZZ.Airport, US
Flight conditions: VMC
Light: Daylight
Aircraft: A321
Operator: Air Carrier
Operating under: Part 121
Flight plan: IFR
Mission: Passenger
Flight phase: Cruise
Airspace: Class A ZZZ
ATC / advisory: Center ZZZ
Reporter organization: Air Carrier
Reporter function: Captain
Reporter qualification: Flight Crew Air Transport Pilot (ATP)
Human factors: Physiological - Other; Communication Breakdown
Second reporter function: Flight Attendant (On Duty)
Anomaly: Aircraft Equipment Problem Critical; Deviation / Discrepancy - Procedural Published Material / Policy; Flight Deck / Cabin / Aircraft Event Smoke / Fire / Fumes / Odor
Detector: Person Flight Attendant; Person Passenger
When detected: In-flight
Result: Flight Crew Diverted; Flight Crew Landed in Emergency Condition; Flight Crew Took Evasive Action; General Declared Emergency; General Physical Injury / Incapacitation; General Maintenance Action
Contributing factors: Aircraft; Human Factors; Procedure
Primary problem: Ambiguous

Narrative: At level off I was advised by flight attendants of fumes in the cabin we did all necessary procedures QRH; etc. I then notified Dispatch and then asked flight attendants if any change. I was told no better maybe worse and that were all getting sick. At that point I diverted. Persons involved all of crew and some passengers.


Second narrative: We were flying a scheduled ferry flight which was made into a live flight at the last minute. Seven passengers were boarded. Five non-rev and two paying passengers. All passengers were seated in the first class cabin. After takeoff three flight attendants were sitting in Row 23. We were approximately 20 minutes into the flight when an unbearable odor and haze took over the cabin. Two of us got up and ran to the back of the cabin and the third Flight Attendant ran to the front to try and escape the odor. When he reached the galley he called the flight deck and told them what was happening in the cabin. I covered my mouth and went forward to follow. Another Flight Attendant headed toward the back of the cabin to see what was happening. When she reached the lav at Row 22 she vomited. The flight deck called to tell us we were making an emergency landing. The odor was causing us to be dizzy; have a headache; irritation in the throat; nausea; pressure in our chest and stomach; weakness and confusion. When we landed we were taken to the boarding area to have our vital signs checked by the fireman. All of our vitals were normal. The fireman strongly recommended we go in the ambulance to the hospital. The Captain said I just want all of my crew to remain together. An In-flight Supervisor was on the phone with upper management and she said the company wanted us to go to the clinic so we wouldn't have to wait 5 hours in the hospital. She was asking if the clinic would be able to provide blood work to check for carbon monoxide (CO) and she said yes. We as a crew said that was fine as long as blood work could be done. When we arrived at the clinic I was on the phone with a Union Safety Representative. She wanted me to get the fax number to the clinic so she could fax a document to the doctors on the recommended blood work that should be done when exposed to fumes on the aircraft. The clinic said they did not do blood work. A woman from Risk Management showed up and asks; 'What the problem was.' We said we needed to get to the hospital to have a time sensitive blood work done. The woman from Risk Management said; 'it isn't something the company requires. It is something your union suggests.' We said we want to get to the hospital now. She was of no help to us. She asked us what hospital we wanted to go to. How would we know? The girl at the front desk said to take us to a local hospital. When we arrived at the hospital the clerk gave us the fax number and the papers were faxed to the Doctor. We were all taken back and put on oxygen and all had blood work to test for carbon monoxide. My blood work was done and after being on oxygen approximately 30 minutes. My results came back higher than the normal level. The Doctor said it needed to work its way out of our system and everyone's system is different. Told us to follow up with your Primary Care Physician (PCP). First Officer's level was still very high and he needed to stay behind and receive more oxygen. The Captain was told to call management and she would make all of our arrangements to get us home. He called three times with no response. He called the Chief Pilot to get his crew home and I called my base in-flight services. While on my flight home I noticed my joints were all starting to hurt. I was a little short of breath walking to the car and when I got in the car and started it I couldn't figure out how to clean the windows. I sat for a few minutes looking at the dash like I had never been in the car I have owned for six years. When I got home I couldn't figure out which of the 3 keys I have opened the door. I went to bed hoping to feel better this morning. When I woke up I had a headache. All still symptoms of CO exposure. After speaking with my PCP today he said I should not have been put on a plane so soon after the exposure unless I was tested again and my levels were normal. The cabin altitude could have caused me to have the symptoms I was having after I got home.The company and the mechanics need to listen to us when we are telling them there is a smell or we are having effects from the aircraft. The company is more worried about getting the plane off the gate on time than about our health. If we wouldn't have had an odor we could have all died; because the flight deck didn't have any indication of a problem. There needs to be some type of program in place that when an incident does happen the crew should be taken to the hospital not a clinic. Your vitals will always be fine with CO exposure unless you are near death or dead. Don't treat these fumes as a joke and that the crews are just looking for something to complain about. It is a very serious matter. You may not think so till it happens to you or your loved one. Now questions I have 1) We were told the night before that there were no parts in the US to fix the problem with the aircraft and the parts needed to come from a foreign country. The Mechanic was trying to get a maintenance ferry certificate. We were called in the morning and told we were doing a ferry flight. 2) How did they come up with the parts they didn't have to fix the aircraft to make it a live flight? 3) Can a ferry flight be made into a live flight with numbers?

Second callback: The Reporter stated that she is feeling normal now; but was not well for several days after the event. Elevated CO levels were confirmed by the hospital and she heard the First Officer is not back at work five days after the event. One Flight Attendant had extremely high blood pressure upon arrival at the hospital.

Synopsis: An A321 diverted after an unbearable odor was detected in the cabin making the entire crew ill and requiring hospital emergency care treatment because of carbon monoxide poisoning.