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At least 253 records · Page 14Linked to original sources
PubMed1999

Cosmic rays and dosimetry at aviation altitudes.

Recent concerns regarding the effects of the cosmic radiation field at aircraft altitudes on aircrew have resulted in a renewed interest in detailed measurements of the neutral and charged particle components in the atmosphere. CR-39 nuclear track detectors have been employed on a number of subsonic and supersonic aircraft to measure charge spectra and LET spectra at aircraft altitudes. These detectors are ideal for long term exposures required for these studies and their passive nature makes them suitable for an environment where interference with flight instrumentation could be a problem. We report here on measurements and analysis of short range tracks which were produced by high LET particles generated mainly by neutron interactions at aviation altitudes. In order to test the overall validity of the technique measurements were also carried out at the CERN-CEC field which simulates the radiation field at aviation altitudes and good agreement was found with dose values obtained using mainly heavy ion calibration.

Aircraft↗
PubMed1999

Elevated creatinine after ingestion of model aviation fuel: interference with the Jaffe reaction by nitromethane.

A 2 years 9 month-old-boy who ingested model aviation fuel was found to have an elevated serum creatinine concentration of 0.53 mmol/L (normal range 0.02-0.05 mmol/L) by the Jaffe (alkaline picrate) reaction. However, when the creatinine concentration was measured using a specific enzymatic assay, it was within the normal range. It was shown that nitromethane, a constituent of aviation fuel, interferes with the Jaffe reaction, leading to a falsely elevated creatinine reading. This phenomenon has been reported only once previously and, despite its potential clinical importance, nitromethane does not appear in published lists of substances that interfere with the Jaffe reaction.

Aircraft↗
PubMed1995

Health physics and aviation: 1990-1994.

For several years, the U.S. Federal Aviation Administration has explicitly recognized flight crew members as workers who are occupationally exposed to radiation. To help these workers assess their radiation risks, the FAA has developed a computer program that will estimate cosmic-ray exposures from individual flights. They have published documents which inform crew members of the statistical risks associated with their radiation exposure, and they have issued an advisory to the commercial air carriers suggesting that they institute an appropriate educational program for their employees. These developments represent a significant change from ten years ago when the Federal Aviation Administration concluded that, in the area of in-flight radiation exposure, any regulatory involvement on their part would be unwarranted because the vast majority of crew members would not exceed the recommended maximum permissible dose limits then applicable to members of the general public.

Aviation↗
PubMed2004

How to turn a team of experts into an expert medical team: guidance from the aviation and military communities.

There is no question that interdisciplinary teams are becoming ubiquitous in healthcare. It is also true that experts do not necessarily combine to make an expert team. However when teams work well they can serve as adaptive systems that allow organisations to mitigate errors within complex domains, thereby increasing safety. The medical community has begun to recognise the importance of teams and as such has begun to implement team training interventions. Over the past 20 years the military and aviation communities have made a large investment in understanding teams and their requisite training requirements. There are many lessons that can be learned from these communities to accelerate the impact of team training within the medical community. Therefore, the purpose of the current paper is to begin to translate some of the lessons learned from the military and aviation communities into practical guidance that can be used by the medical community.

Aviation↗
PubMed2005

Safety lessons from aviation.

Thirty years ago the world of Commercial Aviation provided a challenging environment. In my early flying days, aircraft accidents were not unusual, flying was seen as a risky business and those who took part, either as a provider or passenger, appeared grudgingly willing to accept the hazards involved. A reduction in the level of risk was sought in technological advances, greater knowledge of physics and science, and access to higher levels of skill through simulation, practice and experience. While these measures did have an impact, the expected safety dividend was not realized. The most experienced, technically competent individuals with the best equipment featured far too regularly in the accident statistics. We had to look at the human element, the impact of flaws or characteristics of the human condition. We call this area Human Factors. My paper describes the concept of Human Factors, its establishment as a key safety tool in aviation and the impact of this on my working life.

Aviation↗
PubMed1997

The role of trainee knowledge structures in aviation team environments.

The importance of having well-developed knowledge structures to enhance complex team performance has been recently indicated in the training effectiveness literature. This work tested that proposition within an aviation team training setting. Results suggested that aviation team training improved the knowledge structures of those participants who received the training. Knowledge structure data also provided information related to the training that was not available from more traditional measures of learning. Finally, results obtained from the knowledge structure measures were consistent with performance results, suggesting that knowledge structure measures are a potentially valid predictor of performance.

Aerospace Medicine↗
PubMedDate not supplied

Aviation model cognitive risk factors applied to medical malpractice cases.

OBJECTIVE: Aviation accidents have been reduced substantially by training pilots to avoid high-risk behaviors caused by cognitive errors. To determine whether similar cognitive cause factors or errors are involved in medical malpractice cases, and to evaluate the reliability of identifying such factors, physicians reviewed state and federal malpractice cases in a legal database. METHOD: Reviewing physicians evaluated 30 cases meeting inclusion criteria from state and federal malpractice cases for the year 2004 in the 8th US Circuit Court of Appeals region, using criteria for cognitive factors derived from aviation. The cases were categorized into three classes based on the degree of agreement between the reviewers. The results as to prevalence of the factors and reliability of identifying the factors were then analyzed statistically. RESULTS: Fifty-nine percent of the cases met criteria for strong and good correlation with the factors. Cognitive factors involving IMSAFE (illness, medications, stress, alcohol, physiogical (f), and emotional) and medical team management/leadership can be reliably identified. Other factors, such as hazardous attitudes and loss of situational awareness, were identified with minimal reliability. CONCLUSION: The aeronautical cognitive causative approach can be translated into a medical approach to reliably identify cognitive causes of errors in a significant proportion of medical malpractice cases from a legal database.

Accidents, Aviation↗
PubMed1999

[Aviation physiology].

Aviation physiology should be known at least in parts by the physicians advising air travellers. Due to reducing atmospheric pressure at altitude gas volume in body cavities expands (Boyle's law). This might not be a problem during ascend since air can disappear easily through natural ways. However, air must return to body cavities during descend and a person with a cold may suffer from painful barotitis. Hypoxia is mostly due to a reduced pO2 in high altitude (Daltons's Law). This may be prevented by an aircraft cabin or supplemented oxygen. Decompression sickness is very rare in aviation but divers should comply to a dive free interval before flying.

Aerospace Medicine↗
PubMed2000

Blood pressure and sympathetic activity in normotensive aviators during short-haul fixed-wings flights.

BACKGROUND: In order to evaluate the impact of in-flight stress on BP and sympathetic activity during a short fixed-wing flight, we have studied 18 healthy and normotensive commercial captain aviators, aged 37.5 +/- 4.9 yr. METHODS: The protocol consisted of a 120-min flight period, divided into segments of pre-flight, take off, mid-cruise, approach and landing, and a 120-min control period. In both flight and control periods, all subjects underwent BP monitoring, heart rate recording and urine collection for catecholamines. RESULTS: Systolic and diastolic BP (SBP/DBP) were higher during the flight, as a whole, when compared with the control period (134 +/- 11 vs. 121 +/- 8 mmHg, p < 0.05 and 84 +/- 8 vs. 76 +/- 9 mmHg, p < 0.05, respectively). During the flight period, SBP increased in the pre-flight, take-off, approach and landing segments, whereas DBP increased in the take-off, mid-cruise, approach and landing segments. Heart rate did not change in any flight segment. Urinary catecholamines increased during the flight period in comparison to control period 0.20 (0.10 1.8) mg x mg-1 creatinine vs. 0.10 (0.10-1.0) mg x mg-1 creatinine; p < 0.05). CONCLUSION: We conclude that inflight stress increases BP of the normotensive aviators by sympathetic activation during short-haul flights.

Adaptation, Physiological↗
PubMed2001

The special operations aviation flight medic.

Medical support in the Army Special Operations Forces is a comprehensive continuum of care that begins at the point of injury and extends through definitive management. Each special operations unit has unique medical needs and, as a result, has developed specially trained medical personnel to fulfill those needs. The 160th Special Operations Aviation Regiment has developed the special operations aviation flight medic to fill this role. The training of these medics involves a systematic, graduated approach with specific milestones to ensure a standardized level of training.

Aerospace Medicine↗
PubMed2000

Prevalence of chlorpheniramine in aviation accident pilot fatalities, 1991-1996.

BACKGROUND: Chlorpheniramine is known to cause drowsiness, and this side effect has a potential to impair performance and could be a factor in accidents. METHODS: Therefore, to establish the prevalence of this drug in pilot fatalities of aviation accidents, a postmortem toxicology database--maintained at the Civil Aeromedical Institute--was examined for the presence of chlorpheniramine in the fatalities, occurred during 1991-1996. RESULTS: There were 47 (2.2%) accidents involving chlorpheniramine. Of these, 16 had only chlorpheniramine at 109 ng.ml-1 (n = 4) in blood and 1412 ng.g-1 (n = 12) in liver. Other drugs were also present in the remaining 31 cases, wherein chlorpheniramine concentrations were 93 ng.ml-1 (n = 18) in blood and 747 ng.g-1 (n = 12) in liver. Ninety-five percent of all quantitated blood values were at or above the therapeutic level (10 ng.ml-1), giving a 100 ng.ml-1 (n = 21) mean blood value. The drug's mean liver concentration from all cases was 1080 ng.g-1 (n = 24). The average blood value was approximately 10 times higher than the therapeutic value. CONCLUSIONS: The presence of other drugs did not appear to significantly alter the blood chlorpheniramine level, but no such correlation could be established with the hepatic value. The approximate 10-fold increase in the liver concentration was consistent with the general trend of drug distribution in the hepatic compartment. However, the contribution of postmortem redistribution of the drug to alter its concentration cannot be entirely ruled out. This study suggests that chlorpheniramine was present in some aviation fatalities at levels higher than therapeutic levels.

Accidents, Aviation↗
PubMed2002

Human factors in aviation crashes involving older pilots.

BACKGROUND: Pilot errors are recognized as a contributing factor in as many as 80% of aviation crashes. Experimental studies using flight simulators indicate that due to decreased working memory capacity, older pilots are outperformed by their younger counterparts in communication tasks and flight summary scores. OBJECTIVE: This study examines age-related differences in crash circumstances and pilot errors in a sample of pilots who flew commuter aircraft or air taxis and who were involved in airplane or helicopter crashes. METHODS: A historical cohort of 3306 pilots who in 1987 flew commuter aircraft or air taxis and were 45-54 yr of age was constructed using the Federal Aviation Administration's airmen information system. Crash records of the study subjects for the years 1983-1997 were obtained from the National Transportation Safety Board (NTSB) by matching name and date of birth. NTSB's investigation reports were reviewed to identify pilot errors and other contributing factors. Comparisons of crash circumstances and human factors were made between pilots aged 40-49 yr and pilots aged 50-63 yr. RESULTS: A total of 165 crash records were studied, with 52% of these crashes involving pilots aged 50-63 yr. Crash circumstances, such as time and location of crash, type and phase of flight, and weather conditions, were similar between the two age groups. Pilot error was a contributing factor in 73% of the crashes involving younger pilots and in 69% of the crashes involving older pilots (p = 0.50). Age-related differences in the pattern of pilot errors were statistically insignificant. Overall, 23% of pilot errors were attributable to inattentiveness, 20% to flawed decisions, 18% to mishandled aircraft kinetics, and 18% to mishandled wind/runway conditions. CONCLUSIONS: Neither crash circumstances nor the prevalence and patterns of pilot errors appear to change significantly as age increases from the 40s to the 50s and early 60s.

Accidents, Aviation↗
PubMed1992

Spatial disorientation in naval aviation mishaps: a review of class A incidents from 1980 through 1989.

Spatial Disorientation (SD) has long been a major aeromedical factor contributing to naval aviation mishaps. In the past, it has been viewed as a generalized phenomenon, described by its vertigo-related symptoms. More recently, however, three distinct types of SD have been identified, each based on whether the aviator recognizes and responds to its onset. In the current retrospective study, Flight Surgeon and Mishap Investigation Report narratives from 33 Class A mishaps occurring from 1980 through 1989 were reviewed. SD was determined to have been a causal factor in all cases. The mishaps were examined to categorize SD into the three descriptive types and to describe the relationship (if any) between SD and various mission-related factors. Aircraft type, phase of flight, time of day, pilot experience, and flight topography were all considered. The results indicate that Types I and II SD could be identified as causal factors in all 33 Class A mishaps. Further, most Type I SD was experienced primarily by helicopter pilots at night while most Type II SD incidents affected jet pilots during day missions.

Accidents, Aviation↗
PubMed2005

Laparoscopic inguinal hernioplasty in aviators.

Repair of inguinal hernias may be performed using either open surgery or laparoscopic techniques. Following surgery, a 6-wk waiting period is generally recommended before a pilot returns to active duty, including flight in high-performance aircraft. A shorter waiting period would be operationally useful and may be possible following either a trans-abdominal preperitoneal (TAPP) laparoscopic technique or a totally extra-peritoneal (TEP) approach. In this manuscript we present the cases of four aviators who underwent inguinal hernia repair via the TEP approach and were returned to the cockpit 21 d later with no evident complications. Although this sample is small, it emphasizes the potential benefit of the TEP approach in aviators.

Adult↗
PubMed2005

Traumatic iridodialysis in a student naval aviator applicant.

Iridodialysis is a relatively uncommon but important sequela of blunt trauma to the eye. It classically presents as a form of polycoria or extra pupil observed during a comprehensive eye examination. This defect results from compression of the anterior-posterior aspect of the globe itself, which stretches the anterior ring segments and leads to the separation of the iris root from the ciliary body. Degraded visual acuity and visual confusion from glare as well as several late-stage pathologic sequelae may result from the injury. Establishing the diagnosis in aviators is important since any visual disturbance may incapacitate the pilot, resulting in a mishap or interference with completion of the mission. We present a case of a student naval aviator applicant who presented to the Naval Aerospace Medical Institute on two separate occasions for medical evaluation of duties involving flying after suffering blunt trauma/iridodialysis to his right eye.

Adult↗
PubMed2005

Utilizing the urinary 5-HTOL/5-HIAA ratio to determine ethanol origin in civil aviation accident victims.

Specimens from fatal aviation accident victims are submitted to the FAA Civil Aerospace Medical Institute for toxicological analysis. During toxicological evaluations, ethanol analysis is performed on all cases. Care must be taken when interpreting a positive ethanol result due to the potential for postmortem ethanol formation. Several indicators of postmortem ethanol formation exist; however, none are completely reliable. The consumption of ethanol has been shown to alter the concentration of two major serotonin metabolites, 5-hydroxytryptophol (5-HTOL) and 5-hydroxyindole-3-acetic acid (5-HIAA). While the 5-HTOL/5-HIAA ratio is normally very low, previous studies using living subjects have demonstrated that the urinary 5-HTOL/5-HIAA ratio is significantly elevated for 11-19 h after acute ethanol ingestion. Recently, our laboratory developed and validated an analytical method for the simultaneous determination of both 5-HTOL and 5-HIAA in forensic urine samples using a simple liquid/liquid extraction and LC/MS/MS and LC/MS/MS/MS. In this previous work a 15 pmol/nmol serotonin metabolite ratio cutoff was established in postmortem urine, below which it could be conclusively determined that no recent antemortem ethanol consumption had occurred. In the current study this newly validated analytical method was applied to five ethanol-positive aviation fatalities where the origin of the ethanol present could not previously be conclusively determined. In four of the five cases examined the detected ethanol was demonstrated to be present due to postmortem microbial formation, and not consumption, even though some indication of ethanol consumption may have been present.

Accidents, Aviation↗
PubMed2006

PET scan as an aid for the return of a head-injured aviator to flying duty.

Head injury is not a rare event in aviators, and poses a difficult dilemma for the flight surgeon regarding return to flying duty due to the fear of post-traumatic epilepsy. Positron emission tomography (PET) is a functional neuroimaging modality that provides additional localizing data in epileptic patients in the interictal phase. We describe a case of penetrating head trauma with no loss of consciousness in a military jet fighter pilot in which the magnetic resonance imaging revealed a minimal brain contusion. PET scan was used as an additional tool for predicting the epileptogenic potential of this finding, thus aiding the decision regarding the return of the aviator to flying duty.

Adult↗
PubMed2006

Pilot medical history and medications found in post mortem specimens from aviation accidents.

INTRODUCTION: Federal Aviation Administration (FAA) regulations require pilots to report all medications and medical conditions for review and consideration as to the overall suitability of the pilot for flight activities. METHODS: Specimens were collected by local pathologists from aviation accidents and sent to the Bioaeronautical Sciences Research Laboratory for analysis. The results of such tests were entered into the Forensic Case Management System. This database was searched to identify all pilots found positive for medications used to treat cardiovascular, psychological, or neurological conditions over the period January 1, 1993, through December 31, 2003. RESULTS: Toxicological evaluations were performed on 4143 pilots. Psychotropic drugs were found in 223 pilots. Cardiovascular medications were found in 149 pilots. Neurological medications were found in 15 pilots. Pilots reported psychological conditions in 14 of the 223 pilots found positive for psychotropic drugs. Only 1 of the 14 pilots reporting a psychological condition to the FAA reported the psychotropic medication found after the accident. Cardiovascular disease was reported by 69 of the pilots found with cardiovascular drugs in their system. Cardiovascular medications found in the pilots were reported by 29 of the 69 pilots reporting a cardiovascular condition. Only 1 of the 15 pilots reported having a neurological condition to the FAA; none of the pilots found with neurological medications reported the medication. CONCLUSIONS: Toxicology successfully identified 93% of the medications reported by the pilots. Pilots involved in fatal accidents taking psychotropic or neurological medications rarely reported the medication or their underlying medical condition to the FAA.

Accidents, Aviation↗