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Joint Committee on Aviation Pathology: VIII. Medical investigator preparedness for aircraft accident investigation.

The statutory authority and responsibility of the National Transportation Safety Board in the investigation and determination of the probable cause of aviation accidents is described. The Independent Safety Board Act of 1974 acknowledges the importance of obtaining data regarding trauma sustained in an accident by survivors, as well as those persons injured fatally. Information regarding occupant injuries, coupled with extensive examination of the aircraft wreckage, is necessary in order to identify hazards which inflicted the injuries. The human factors investigator is responsible for reporting the facts, conditions, and circumstances relating to first, the accident causation and, second, the injury causation. These two areas, of necessity, rely quite heavily upon the postmortem examination and laboratory analyses of the cras victims. The Safety Board's investigation must determine if a crewmember suffered from a preexisting disease, whether the crew had ingested drugs contraindicated with their flying duties, as well as a description of all injuries and all toxicological and histological findings for crew and passengers. During Safety Board investigations conducted in densely populated cites, over oceans, and in remote areas, both in the United States and overseas, many situations have developed which have caused musch investigative effort due to less than complete postmortem examinations. These situations, in most instances, could have been averted by advance planning by local authorities.

Accidents, Aviation↗

Joint Committee of Aviation Pathology: X. Previous disease in aircrew killed in flying accidents.

This review article discusses the role of previous disease in military, private, and commercial pilots under the headings of occurrence, accident causation, and accident prevention. The importance of minor disease in military flying is stressed as are psychiatric disorders and alcoholism in general aviation. Disease of the coronary arteries is considered with special reference to commercial operations, where the importance of double crewing is emphasized. While symptomatic disease must always be significant, some of the problems associated with increasingly severe selection on the basis of asymptomatic disease are discussed.

Accidents, Aviation↗

The Dynamic Aviation Data System (DADS).

This paper proposes The Dynamic Aviation Data System (DADS), which integrates a variety of existing information sources regarding flight to serve as a tool to pilots in dealing with the challenges of flight. The system is composed of three main parts: a pilot's history on disk; a system that can read proposed flight plans and make suggestions based upon Geographical Information Systems, weather, aircraft, and case report databases that exist throughout North America; and a small hand-held computer that interfaces with the aircraft's instruments and that can be brought into the cockpit to aid the pilot before and during flight. The system is based upon technology that currently exists and information that is already regularly collected. While many issues regarding implementation and cost efficiency of the system need to be addressed, the system shows promise in its ability to make useful flight safety information available to all pilots in order to save lives.

Aircraft↗

Flight performance effects of thermal stress and two aviator uniforms in a UH-60 helicopter simulator.

The effects on flight performance of the four combinations of an unencumbered mission oriented protective posture (MOPP) aviator battle dress uniform (ABDU) and encumbered MOPP4 over ABDU flight ensemble in cool (70 degrees F or 21.1 degrees C, 50% relative humidity [RH]) and hot (100 degrees F or 37.8 degrees C, 50% RH) UH-60 simulator cockpit conditions were evaluated with a repeated measures, 2 x 2 factorial study using nine crews. The encumbered MOPP4 uniform had the most frequent adverse effect on flight performance followed by heat stress, with less frequent effects from the combination or interaction of these two factors. This study confirmed that heat stress and wearing an encumbered U.S. Army MOPP4 flight uniform significantly reduced endurance and flight performance in a UH-60 simulator.

Adult↗

Flight simulator research at the Royal Air Force Institute of Aviation Medicine.

After tracing the development of flight simulators, the author refers to the simulators used for research at the RAF Institute of Aviation Medicine, describing seven examples of the Institute's research carried out with their aid. These cover a comparison of attitude indicators, pilot response, motion cues and landing performance, student pilots assessments, familiarisation behaviour, evaluating an airborne navigation display, and attitude and opinion surveys.

Journal Article↗

The impact of aviation-based teamwork training on the attitudes of health-care professionals.

BACKGROUND: Both the Institute of Medicine and the Agency for Healthcare Research and Quality suggest patient safety can be enhanced by implementing aviation Crew Resource Management (CRM) in health care. CRM emphasizes six key areas: managing fatigue, creating and managing teams, recognizing adverse situations (red flags), cross-checking and communication, decision making, and performance feedback. This study evaluates participant reactions and attitudes to CRM training. STUDY DESIGN: From April 22, 2003, to December 11, 2003, clinical teams from the trauma unit, emergency department, operative services, cardiac catheterization laboratory, and administration underwent an 8-hour training course. Participants completed an 11-question End-of-Course Critique (ECC), designed to assess the perceived need for training and usefulness of CRM skill sets. The Human Factors Attitude Survey contains 23 items and is administered on the same day both pre- and posttraining. It measures attitudinal shifts toward the six training modules and CRM. RESULTS: Of the 489 participants undergoing CRM training during the study period, 463 (95%) completed the ECC and 338 (69%) completed the Human Factors Attitude Survey. The demographics of the group included 288 (59%) nurses and technicians, 104 (21%) physicians, and 97 (20%) administrative personnel. Responses to the ECC were very positive for all questions, and 95% of respondents agreed or strongly agreed CRM training would reduce errors in their practice. Responses to the Human Factors Attitude Survey indicated that the training had a positive impact on 20 of the 23 items (p < 0.01). CONCLUSIONS: CRM training improves attitudes toward fatigue management, team building, communication, recognizing adverse events, team decision making, and performance feedback. Participants agreed that CRM training will reduce errors and improve patient safety.

Academic Medical Centers↗

The neurology of aviation, underwater, and space environments.

It can be seen that aspects of different environments can have adverse effects on normal, healthy nervous systems. Aerospace and underwater neurology consultants are often required to evaluate aviators, divers, or astronauts who have neurologic problem to determine whether they should be granted a waiver. In general, these considerations include course of the disorder (static, progressive, or paroxysmal), potential for sudden incapacitation that may compromise safety, predictability of course of the disorder, ability to monitor disease, and potential adverse effects of medications. A background in the toxic effects of an abnormal environment on the nervous system can be used to make better clinical judgements when considering effects of exposing someone with an abnormal nervous system to such environmental stressors.

Aerospace Medicine↗

Ultrasonically assisted turning of aviation materials: simulations and experimental study.

Ultrasonically assisted turning of modern aviation materials is conducted with ultrasonic vibration (frequency f approximately 20 kHz, amplitude a approximately 15 microm) superimposed on the cutting tool movement. An autoresonant control system is used to maintain the stable nonlinear resonant mode of vibration throughout the cutting process. Experimental comparison of roughness and roundness for workpieces machined conventionally and with the superimposed ultrasonic vibration, results of high-speed filming of the turning process and nanoindentation analyses of the microstructure of the machined material are presented. The suggested finite-element model provides numerical comparison between conventional and ultrasonic turning of Inconel 718 in terms of stress/strain state, cutting forces and contact conditions at the workpiece/tool interface.

Journal Article↗

Modern acoustic emission technique and its application in aviation industry.

This paper proposes the concept of modern acoustic emission (MAE) technique and describes its application in aviation industry. Modern AE is characterized by the combination of AE parameter and waveform analysis based on the understanding of AE source mechanism, the property of sound wave propagation and the interaction between sound wave and the medium in which the sound wave is propagating. Another feature of MAE is characterized by the application of so-called fully digital AE apparatus with low noise, high speed of data transmission and accurate AE source locating capability. MAE is merely an imagination without the realization of the advanced fully digital AE instrument. The application of MAE in monitoring the conditions of aircraft structures during a fatigue test was taken as an example for showing the important role played by AE. Roles of AE in the evaluation of (environment-related) corrosion damage of aircraft were also presented.

Journal Article↗

Determination of total and polycyclic aromatic hydrocarbons in aviation jet fuel.

The aviation jet fuel widely used in turbine engine aircraft is manufactured from straight-run kerosene. The combustion quality of jet fuel is largely related to the hydrocarbon composition of the fuel itself; paraffins have better burning properties than aromatic compounds, especially naphthalenes and light polycyclic aromatic hydrocarbons (PAHs), which are characterised as soot and smoke producers. For this reason the burning quality of fuel is generally measured as smoke fermation. This evaluation is carried out with UV spectrophotometric determination of total naphthalene hydrocarbons and a chromatographic analysis to determine the total aromatic compounds. These methods can be considered insufficient to evaluate the human health impact of these compounds due to their inability to measure trace (ppm) amounts of each aromatic hyrcarbon and each PAH in accordance with limitations imposed because of their toxicological properties. In this paper two analytical methods are presented. Both are based on a gas chromatographic technique with a mass detector operating in be selected ion monitoring mode. The first method was able to determine more than 60 aromatic hydrocarbons in a fuel sample in a 35-min chromatographic run, while the second was able to carry out the analysis of more than 30 PAHs in a 40-min chromatographic run. The linearity and sensitivity of the methods in measuring these analytes at trace levels are described.

Fuel Oils↗

Determination of phenolic antioxidants in aviation jet fuel.

The world-wide aviation jet fuel used for civil and military aircraft is of a kerosene type. To avoid peroxide production after the refinery process a specific antioxidant additive should be added on fuel. The antioxidants generally used are based on hindered phenols in a range of concentration 10-20 microg/ml. In the present work a specific method to measure the concentration of phenolic antioxidants is shown. The method is based on a liquid chromatographic technique with electrochemical detection. The technique, because of its selectivity, does not require sample pre-treatments. The analysis of a 5-10 ml fuel sample can be performed in less than 10 min with a sensitivity of 0.1 microg/ml and a RSD=2.5%. A comparison with another highly selective gas chromatographic technique with mass spectrometric detection with selected ion monitoring (GC-MS-SIM) is reported. The sensitivity of GC-MS-SIM method was 2 microg/ml with a RSD=3.1%.

Antioxidants↗

Locomotor problems of supersonic aviation and astronautics.

Modern high-speed aviation and space flight are fraught with many problems and require a high standard of health and fitness. Those responsible for the health of pilots must appreciate the importance of early diagnosis even before symptoms appear. This is particularly true in terms of preventing spinal injuries where even a single Schmorl's node may make a pilot unfit for high-speed flying. Spinal fractures are frequent during emergency ejection and landing. Helicopter crews are particularly prone to spinal disc degeneration due to vibration. By effective lowering of vibration by changes in the seats, a reduction in such lesions is possible. The osteoporosis and muscle atrophy occurring among astronauts subjected to prolonged weightlessness can be prevented by regular physical exercises.

Aerospace Medicine↗

Barotitis in children after aviation; prevalence and treatment with Otovent.

Barotitis is an acute or chronic inflammation caused by environmental pressure changes. The most common cause is the pressure change during descent in civil aviation. To prevent barotitis the middle ear pressure has to be equalised several times during descent. This can be achieved by performing the Valsalva manoeuvre, but for children, many of whom have a dysfunction of the Eustachian tube, this is difficult to perform and they are therefore at high risk of developing barotitis during flight. The traditional treatment modalities of barotitis are inflation by a Politzer balloon, myringotomy or prophylactic grommet insertion. An alternative treatment or prophylactic measure is autoinflation using the Otovent treatment set. This prophylaxis/treatment can be performed by the child with assistance from its parents as soon as possible or rather before the descent has started. The prevalence of barotitis amongst transit passengers was found to be highest in young children, 25 per cent, compared with adults, five per cent. Only 21 per cent of the youngest children with negative middle ear pressure after flight managed a successful Valsalva's manoeuvre, whereas 82 per cent could increase the middle ear pressure inflating the Otovent set. In conclusion we recommend autoinflation using the Otovent set by children and adults with problems clearing the ears during flight.

Acoustic Impedance Tests↗

Portable, but suitable: devices in prehospital care might be hazardous to patient or to aviation safety.

INTRODUCTION: Devices used for support of patients requiring air rescue or conveyance are subjected to severe environments that may affect their ability to function when needed or may affect other systems within the transporting vehicle. METHODS: The ability of four portable ventilators, a suction device, and plastic and rubber tracheal tubes to withstand changes in temperature, vibration, sudden deceleration, and electromagnetic fields was studied in the laboratory setting. In addition, the effects of the operation of these devices on the flight instrumentation was investigated. RESULTS: All of the ventilators tested delivered stable minute volumes at temperatures above zero, but in sub-zero temperatures problems were encountered with the driving gas. Vibrations produced alterations in the performance of two of the ventilators, and resonant frequencies were detected that are identical to those produced by the rotors of the helicopter used. Suctioning became difficult at temperatures below -5 degrees C as the mucus froze in the collecting tubing. The motor produced electromagnetic fields that interfered with the aircraft instrumentation, and resonant frequencies had a deleterious effect on the circuit boards. Plastic tubes were adversely affected by cold, and these chilled tubes were excessively sensitive to vibration and shocks. CONCLUSIONS: The devices used in various aircraft influence certain vital maneuver systems of the craft. Studies on portable ventilators, a suction device, and tracheal tubes showed that, under specific conditions, the equipment was safe to patients and was not hazardous to the aviation safety. However, under certain conditions commonly encountered during air rescue operations, the equipment became dysfunctional or presented safety hazards to the aircraft, and, hence, the crew. The Swedish Air Force has adopted three different criteria constellations: 1) operative; 2) storing; and 3) transport environment.

Air Ambulances↗

Gender influences on performance, mood and recovery sleep in fatigued aviators.

Female aviators now are able to serve in combat roles, but few studies have addressed potential differences between the ability of males and females to withstand combat stressors. This study examined responses of men and women to one operational stressor, sleep deprivation. Pilots were tested on flight performance and mood during 40-h periods of sustained wakefulness. Baseline and recovery sleep also were examined. Gender produced no operationally-significant effects of flight performance or recovery sleep. Although mood tests showed that women felt less tense and more energetic than men, there were no interactions between sleep deprivation and gender on either flight performance or psychological mood.

Adult↗

Fuel spill identification using solid-phase extraction and solid-phase microextraction. 1. Aviation turbine fuels.

The water-soluble fraction of aviation jet fuels is examined using solid-phase extraction and solid-phase microextraction. Gas chromatographic profiles of solid-phase extracts and solid-phase microextracts of the water-soluble fraction of kerosene- and nonkerosene-based jet fuels reveal that each jet fuel possesses a unique profile. Pattern recognition analysis reveals fingerprint patterns within the data characteristic of fuel type. By using a novel genetic algorithm (GA) that emulates human pattern recognition through machine learning, it is possible to identify features characteristic of the chromatographic profile of each fuel class. The pattern recognition GA identifies a set of features that optimize the separation of the fuel classes in a plot of the two largest principal components of the data. Because principal components maximize variance, the bulk of the information encoded by the selected features is primarily about the differences between the fuel classes.

Journal Article↗

Comparative Genomics Reveals Convergent Evolution Between Avivorous Bats (Ia io and Nyctalus aviator).

Investigating the genetic basis of dietary specialization can provide insights into the evolution of niche breadth. In this study, we employed comparative genomics to investigate the adaptive mechanisms enabling two bat species (Nyctalus aviator and Ia io) to shift from insectivory to seasonal bird consumption (avivorous bats). Our findings revealed adaptation related to immune response and lipid metabolism in avivorous bat species. Avivorous bats exhibit strong positive selection and convergent evolution in immune-related genes, which are under heightened selective pressure compared to those of non-avivorous bats. These species also display significantly fewer endogenous retroviral elements. These findings emphasized the significance of immune-driven adaptive evolution in avivory. Additionally, our results showed that the dietary evolution of avivorous bats is accompanied by convergent evolution associated with the lipid metabolism. Notably, CEPT1, the upstream gene required for the activation of the PPAR pathway, underwent positive selection and convergence, which may have affected lipid metabolism. These adaptations may enable avivorous bat species to face the challenge of immune response and nutrition during dietary niche expansion. These findings not only provide comprehensive insights into the adaptive evolution driving the unique diet of avivorous bats but also offered novel perspectives on the molecular mechanisms underlying ecological niche evolution in a dietary context.

Animals↗

Aircraft noise annoyance at three joint air carrier and general aviation airports.

The results of social surveys conducted near three airports that support both general aviation and scheduled air carrier operations are presented and discussed. Inferences supported by these data include: The nature of noise exposure and community reaction at smaller airports may differ from that at larger airports; survey techniques are capable of identifying changes in annoyance associated with numerically small changes in noise exposure; changes in the prevalence of annoyance are causally produced by changes in noise exposure; and changes in annoyance associated with changes in exposure vary with time.

Adult↗