 Aircraft cabin air quality can be compromised due to the presence of thermally degraded engine oil and hydraulic fluid fumes. These fumes are known to contain a variety of toxic chemicals, including organophosphates, ultrafine particles, volatile organic compounds, and thermally degraded products. Exposure to these fumes can lead to a range of adverse health outcomes, such as acute and chronic neurological, respiratory, cardiac, and other symptoms. The cumulative effect of repeated low-level exposure to these fumes can be particularly harmful. A comprehensive approach to assessment and treatment of individuals exposed to these fumes is needed. This paper provides a consensus protocol for the recognition, investigation, and management of individuals with suspected or confirmed exposure to toxic fumes in aircraft cabins. This article was authored by Jonathan Burden, Lidia Teys-Budnick, Saver Bauer, and others.