Date: 201907
Local time of day: 1201-1800
Location: ZZZZ.ARTCC, FO
Flight conditions: VMC
Aircraft: B767 Undifferentiated or Other Model
Operator: Air Carrier
Operating under: Part 121
Flight plan: IFR
Mission: Passenger
Flight phase: Cruise
ATC / advisory: Center ZZZZ
Reporter organization: Air Carrier
Reporter function: Captain; Pilot Flying
Reporter qualification: Flight Crew Multiengine; Flight Crew Instrument; Flight Crew Air Transport Pilot (ATP)
Human factors: Situational Awareness
Anomaly: Aircraft Equipment Problem Less Severe; Flight Deck / Cabin / Aircraft Event Illness / Injury; Flight Deck / Cabin / Aircraft Event Smoke / Fire / Fumes / Odor
Detector: Person Flight Attendant
When detected: In-flight
Result: Aircraft Equipment Problem Dissipated; Flight Crew Became Reoriented
Contributing factors: Aircraft
Primary problem: Aircraft

Narrative: Approximately 20 minutes after takeoff; the Purser contacted the First Officer asking if we were making a very steep turn. She had felt some dizziness and vertigo. We told her it was a normal autopilot 20 degree bank turn. Almost an hour after departure; she called again and said that she and the other 2 fwd cabin flight attendants were feeling lightheaded; some tightening in their chest; headache and ear pressure. One of the flight attendants working in economy said she had felt some of the same symptoms. I asked if they could smell any fumes of any kind or if any passengers or anyone else in the cabin was feeling the same symptoms; she said no. At one point; the [Relief Pilot] got up from his crew rest and contacted me to see if he could help. I asked him to walk through the cabin and see if he could see anything unusual or smell anything. He said that he got a brief scent of alcohol wipes or hand sanitizer type smell as he walked toward the first 4 rows of economy; but that it quickly dissipated. In the flight deck; we donned our oxygen masks and looked over the smoke; fire; and fumes checklist. We ran some of the steps and advised the crew that we would be removing power to the galleys. They made an announcement about a momentary interruption to the entertainment systems. As we were trying to find a possible cause of their symptoms; I instructed the flight attendants to take their jump seats and breathe some oxygen to see if their symptoms would improve. I initiated a Satcom call with Dispatch and [Maintenance Control] initially to troubleshoot possible causes. We agreed that keeping the power off to the recirculate fans and galleys was no longer necessary and re-powered the systems. There was no change in cabin air or flight attendant symptoms. The Purser then asked if there was a doctor on board and he came to the forward galley area and examined the flight attendants. I had Dispatch get Medlink for us and they gave us instruction to have the doctor check the oxygen levels of the flight attendants. He verified that they all had normal oxygen levels. At this time; I decided to bring the [Relief Pilot] off break to be in the flight deck so that I could assess everything in the cabin. I went back for 3 hours. The Dispatcher ended the satellite call with us and Medlink because they were doing a shift change and we needed to get more information from the cabin crew to give to Medlink. For the first hour I was in the cabin; I had the Purser lie down in our crew rest seat because she was unable to relax and breathe the oxygen. I then brought [Flight Attendant] XX_27 up from the aft cabin and designated him as the Purser while she was incapacitated. I made sure we had 4 fully capable flight attendants at that point to handle any duties necessary. One of the flight attendants who initially felt some symptoms said that the oxygen had helped and she was able once again to perform duties. This gave us 5 working flight attendants for minimum staffing. The service had been completed and the flight attendants started taking their rest breaks; allowing the ones who were not feeling well to rest first. I walked through the cabin speaking to some passengers and checking for any odors or signs of poor air quality. Everyone was fine and no irregularities were detected. I made sure the sick crew members were doing alright and then I instructed the First Officers to contact Dispatch and have him give all updated statuses to Medlink and that the flight attendants were not requesting medical care upon arrival. I sat down and rested for 2 hours while still being accessible to the crew if anything changed and we needed to make another plan. When the flight attendants got up from resting; they were able to eat something and were drinking water. They felt better but somewhat flu like. By the time I got off break; they felt able to do their duties and I went back to the flight deck. The First Officer came back for his normal break and no other issues occurred through descent and landing. When we arrived at gate there was emergency equipment standing by and they came to the door to test for air quality. They then said they would take the flight attendants up the jetway to make sure they were OK. We had a representative and an Inflight Supervisor to stand at the doors while we deplaned for minimum crew onboard.I stayed onboard until all the flight attendants came back and let me know they were ok and chose not to go to hospitals. The flight attendant representatives walked out through customs with them as well. We thanked all of the emergency personnel and went to clear customs.I still am not sure what may have caused their symptoms. The lengthy delay in ZZZZ on the ramp with Maintenance and an engine run followed by a taxi out behind an A380 may have allowed fumes in the aircraft but it seems unlikely. Personal health conditions may have been a factor but they didn't indicate that with the doctors. The only other thing I considered was a passenger carry on with a small bottle of hand sanitizer or maybe nail polish remover because of what the [Relief Pilot] had smelled. This also seems unlikely. The flight attendants had never voiced a need to get on the ground quickly for medical care; nor did Medlink deem it necessary. I believe we followed the safest course of action.




Synopsis: B767 Captain reported several flight attendants reported temporary health issues due to fumes in the passenger cabin which eventually dissipated.