Aviation, space, and environmental medicine最新文献

{"title":"Injury rate in a helicopter underwater escape trainer (HUET) from 2005-2012.","authors":"Christopher J Brooks,&nbsp;Conor V MacDonald,&nbsp;Peter N A Gibbs","doi":"10.3357/ASEM.3624.2014","DOIUrl":"https://doi.org/10.3357/ASEM.3624.2014","url":null,"abstract":"<p><strong>Background: </strong>Helicopter underwater escape training (HUET) carries a potential for injury and this paper identifies the injury rate.</p><p><strong>Method: </strong>A marine survival training school registry of all students trained between 2005-2012 in HUET and the coinciding accident records were examined.</p><p><strong>Results: </strong>There were 8902 students trained in a helicopter underwater escape simulator for a total of 59,245 underwater escapes. There were 40 cases where only first-aid was required and 3 serious injuries (a laceration requiring 5 sutures, 1 dislocated shoulder, and 1 water aspiration requiring hospitalization). There were no deaths and no problems reported with using the Emergency Breathing System (EBS) or Air Pocket. Of the injuries, 11 were due to the student using a poor escape technique. The overall probability of injury was 0.74 per 1000 ascents.</p><p><strong>Conclusions: </strong>In HUET training, there is a very low injury rate with almost no significant severity. Although not scientifically proven, this would suggest that the low incident rate is due to good medical screening and the attention given by instructors to anxious students. Compared to other training such as diving, parachute jumping, and submarine escape training, the rate of injury was considerably lower.</p>","PeriodicalId":8676,"journal":{"name":"Aviation, space, and environmental medicine","volume":"85 8","pages":"857-62"},"PeriodicalIF":0.0,"publicationDate":"2014-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3357/ASEM.3624.2014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32649282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bicuspid aortic valve may affect aortic dimensions in aviators.","authors":"Cengiz Ozturk,&nbsp;Ahmet Ozturk,&nbsp;Tolga Cakmak,&nbsp;Suleyman Metin,&nbsp;Sevket Balta,&nbsp;Mustafa Aparci,&nbsp;Ahmet Sen","doi":"10.3357/ASEM.4031.2014","DOIUrl":"https://doi.org/10.3357/ASEM.4031.2014","url":null,"abstract":"Dear Editor: We read the article “ Cardiac indexes in young subjects with and without bicuspid aortic valve, ” written by Grossman et al., with great interest ( 1 ). They aimed to evaluate the effects of bicuspid aortic valve (BAV) on aortic and cardiac parameters in young healthy subjects with and without aortic regurgitation (AR). According to their study, although cardiac dimensions may be slightly increased in pilot applicants with BAV, the presence of AR of a mild-moderate degree does not infl uence aortic or cardiac indexes. They found a slight increase in systolic blood pressure in applicants with BAV and they also found an increase in aortic root diameter, left atrial diameter, left ventricular end systolic volume, interventricular septal thickness, and posterior wall thickness in those with BAV compared with those without BAV ( 1 ). These results are very important in researching the effects of BAV on cardiac structure in aviators during our daily practice. Thanks go to the authors for their contribution. But there are still few data about this subject. Carter et al. found no relationship between the aviation environment and aortic root diameter change ( 2 ). Although there were few pilots with BAV in their study, they found no signifi cant changes in the intraventricular septum width, left ventricular posterior wall width, or left ventricular performance. They found no incidents of sudden incapacitation or other medical event that jeopardized fl ight safety. We need a larger study concerning the effects of the aviation environment like exposure to G force on BAV and cardiac structure. In a recent study, Chen et al. concluded that high sustained positive acceleration had damaged mitochondrial ultrastructure, respiratory function, and antioxidant capacity at the cellular level in rats ( 3 ). In another study, Aparci et al. concluded that aortic dilation might be an occupational disease due to the nature of some professions (e.g., the military, security, weight lifters, athletes, heavy workers, etc.) and they emphasized earlier detection of aortic root dilatation and limitation of such strenuous activities in these individuals might be important for the prevention of future cases of aortic aneurysm and dissection ( 4 ). In a previous study, Grossman et al. (5) investigated the effect of acceleration forces on cardiac morphologic changes in jet fi ghter pilots. They concluded that exposure to acceleration forces in jet fi ghter pilots compared to low-performance aircraft pilots has not been found to signifi cantly affect cardiac and aortic indexes ( 5 ). In addition to these studies, we previously investigated longterm Valsalva and anti-G maneuvers and found they have no effects on aortic and cardiac morphologic and systolic functions, but do have effects on right ventricular diastolic function in aviators ( 6 , 7 ). In the present study (1), the authors concluded that similar preparticipation criteria for pilot applicants should be applied","PeriodicalId":8676,"journal":{"name":"Aviation, space, and environmental medicine","volume":"85 8","pages":"867"},"PeriodicalIF":0.0,"publicationDate":"2014-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3357/ASEM.4031.2014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32649285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"You're the flight surgeon: traumatic brain injury.","authors":"Henry Klein","doi":"10.3357/ASEM.3840.2014","DOIUrl":"https://doi.org/10.3357/ASEM.3840.2014","url":null,"abstract":"","PeriodicalId":8676,"journal":{"name":"Aviation, space, and environmental medicine","volume":"85 8","pages":"871-3"},"PeriodicalIF":0.0,"publicationDate":"2014-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3357/ASEM.3840.2014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32649287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carpe diem.","authors":"Philip J Scarpa","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":8676,"journal":{"name":"Aviation, space, and environmental medicine","volume":"85 8","pages":"877"},"PeriodicalIF":0.0,"publicationDate":"2014-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32649290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"British army air corps accidents, 1991-2010: a review of contrasting decades.","authors":"Mark S Adams,&nbsp;Ian P Curry,&nbsp;Steven J Gaydos","doi":"10.3357/ASEM.3977.2014","DOIUrl":"https://doi.org/10.3357/ASEM.3977.2014","url":null,"abstract":"<p><strong>Introduction: </strong>Accident investigation and review are important not only to attribute failure modes, but also mitigate risk, improve safety, and enhance capability. It was hypothesized that an interesting perspective on British Army Air Corps (AAC) rotary-wing (RW) accidents may be garnered by contrasting data from the previous two decades with a general operational (OP) shift from European theaters of conflict to operations in Southwest Asia.</p><p><strong>Methods: </strong>AAC mishaps for the period from January 1991 through December 2010 were reviewed within an air safety management system. Accidents, defined by category 4 or 5 aircraft damage or death or major injury of personnel, were selected. Analysis was conducted jointly by a minimum of two specialists in aviation medicine.</p><p><strong>Results: </strong>There were 37 accidents that occurred in 6 differing airframes at an average rate of 2.5 per 100,000 flying hours. From 1991-2000, 25 accidents (9 OP) occurred with a rate of 2.8 per 100,000 flying hours. From 2001-2010, 12 accidents (5 OP) occurred with a rate of 2.1 per 100,000 flying hours. Aircrew human factors (HF) errors represented 84% of attributable causation for both decades. Spatial disorientation (SD) represented a higher proportion of HF-related accidents for OP flying.</p><p><strong>Discussion: </strong>Despite the perception of a more difficult OP theater for the latter decade, the overall rate and the proportion of OP accidents did not differ appreciably. Rather than theater-specific threats or challenges, it has been the longstanding and prominent player of HF error and specifically SD in OP flying that has remained entrenched in the causal chain.</p>","PeriodicalId":8676,"journal":{"name":"Aviation, space, and environmental medicine","volume":"85 8","pages":"852-6"},"PeriodicalIF":0.0,"publicationDate":"2014-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3357/ASEM.3977.2014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32649370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in the levels of mannan-binding lectin and ficolins during head-down tilted bed rest.","authors":"Jens Kelsen, Thomas D Sandahl, Line Storm, Petra Frings-Meuthen, Jens F Dahlerup, Steffen Thiel","doi":"10.3357/ASEM.3915.2014","DOIUrl":"10.3357/ASEM.3915.2014","url":null,"abstract":"<p><strong>Background: </strong>Spaceflight studies and ground-based analogues of microgravity indicate a weakening of human immunity. Mannan-binding lectin (MBL) and H-, L-, and M-ficolin together constitute the lectin pathway and mediate the clearance of pathogens through complement activation. We hypothesized that simulated microgravity may weaken human innate immune functions and studied the impact of 6° head-down tilted bed rest (HDT) for 21 d on MBL and ficolin levels.</p><p><strong>Methods: </strong>Within a 6-mo period, seven men underwent two periods of HDT. Blood samples were analyzed for MBL, H-, L-, and M-ficolin, mannose-binding lectin-associated protein of 44 kDa (MAp44), and collectin liver 1 (CL-L1) by time-resolved immunofluorometric assays (TRIFMA).</p><p><strong>Results: </strong>We observed well-defined individual preintervention levels of MBL and ficolins. Remarkably similar intraindividual changes occurred for MBL and MBL levels decreased (mean 282 ng · ml⁻¹) in the recovery phase. Conversely, CL-L1, a protein with MBL-like properties, increased (mean 102 ng · ml⁻¹) during the recovery phase. M-ficolin increased (mean 79 ng · ml⁻¹) within the first 2 d of HDT, followed by a decrease (mean 112 ng · ml⁻¹) during the recovery phase. L-ficolin increased (mean 304 ng · ml⁻¹) during HDT, while H-ficolin was essentially unaffected. MAp44, a down-regulator of the lectin pathway, decreased initially (mean 78 ng · ml⁻¹) in the recovery phase followed by an increase (mean 131 ng · ml⁻¹).</p><p><strong>Discussion: </strong>Alterations in MBL and ficolin levels were modest and with our current knowledge do not lead to overt immunodeficiency. Pronounced changes occurred when the subjects resumed the upright position. In selected individuals, these changes appear to be a conserved response to HDT.</p>","PeriodicalId":8676,"journal":{"name":"Aviation, space, and environmental medicine","volume":"85 8","pages":"805-11"},"PeriodicalIF":0.0,"publicationDate":"2014-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3357/ASEM.3915.2014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32649445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flight attendant radiation dose from solar particle events.","authors":"Jeri L Anderson,&nbsp;Christopher J Mertens,&nbsp;Barbara Grajewski,&nbsp;Lian Luo,&nbsp;Chih-Yu Tseng,&nbsp;Rick T Cassinelli","doi":"10.3357/ASEM.3989.2014","DOIUrl":"https://doi.org/10.3357/ASEM.3989.2014","url":null,"abstract":"<p><strong>Introduction: </strong>Research has suggested that work as a flight attendant may be related to increased risk for reproductive health effects. Air cabin exposures that may influence reproductive health include radiation dose from galactic cosmic radiation and solar particle events. This paper describes the assessment of radiation dose accrued during solar particle events as part of a reproductive health study of flight attendants.</p><p><strong>Methods: </strong>Solar storm data were obtained from the National Oceanic and Atmospheric Administration Space Weather Prediction Center list of solar proton events affecting the Earth environment to ascertain storms relevant to the two study periods (1992-1996 and 1999-2001). Radiation dose from exposure to solar energetic particles was estimated using the NAIRAS model in conjunction with galactic cosmic radiation dose calculated using the CARI-6P computer program.</p><p><strong>Results: </strong>Seven solar particle events were determined to have potential for significant radiation exposure, two in the first study period and five in the second study period, and over-lapped with 24,807 flight segments. Absorbed (and effective) flight segment doses averaged 6.5 μGy (18 μSv) and 3.1 μGy (8.3 μSv) for the first and second study periods, respectively. Maximum doses were as high as 440 μGy (1.2 mSv) and 20 flight segments had doses greater than 190 μGy (0.5 mSv).</p><p><strong>Discussion: </strong>During solar particle events, a pregnant flight attendant could potentially exceed the equivalent dose limit to the conceptus of 0.5 mSv in a month recommended by the National Council on Radiation Protection and Measurements.</p>","PeriodicalId":8676,"journal":{"name":"Aviation, space, and environmental medicine","volume":"85 8","pages":"828-32"},"PeriodicalIF":0.0,"publicationDate":"2014-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3357/ASEM.3989.2014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32649366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pilot fatigue: relationships with departure and arrival times, flight duration, and direction.","authors":"Philippa H Gander,&nbsp;Hannah M Mulrine,&nbsp;Margo J van den Berg,&nbsp;A Alexander T Smith,&nbsp;T Leigh Signal,&nbsp;Lora J Wu,&nbsp;Gregory Belenky","doi":"10.3357/ASEM.3963.2014","DOIUrl":"https://doi.org/10.3357/ASEM.3963.2014","url":null,"abstract":"<p><strong>Introduction: </strong>Flight timing is expected to influence pilot fatigue because it determines the part of the circadian body clock cycle that is traversed during a flight. However the effects of flight timing are not well-characterized because field studies typically focus on specific flights with a limited range of departure times and have small sample sizes. The present project combined data from four studies, including 13 long-range and ultra-long range out-and-back trips across a range of departure and arrival times (237 pilots in 4-person crews, 730 flight segments, 1-3 d layovers).</p><p><strong>Methods: </strong>All studies had tripartite support and underwent independent ethical review. Sleep was monitored (actigraphy) from 3 d prior to ≥ 3 d post-trip. Preflight and at top of descent (TOD), pilots rated their sleepiness (Karolinska Sleepiness Scale) and fatigue (Samn-Perelli scale), and completed a psychomotor vigilance task (PVT) test. Mixed model ANOVA identified independent associations between fatigue measures and operational factors (domicile times of departure and arrival, flight duration and direction, landing versus relief crew).</p><p><strong>Results: </strong>Preflight subjective fatigue and sleepiness were lowest for flights departing 14:00-17:59. Total in-flight sleep was longest on flights departing 18:00-01:59. At TOD, fatigue and sleepiness were higher and PVT response speeds were slower on flights arriving 06:00-09:59 than on flights arriving later. PVT response speed at TOD was also faster on longer flights.</p><p><strong>Discussion: </strong>The findings indicate the influence of flight timing (interacting with the circadian body clock cycle), as well as flight duration, on in-flight sleep and fatigue measures at TOD.</p>","PeriodicalId":8676,"journal":{"name":"Aviation, space, and environmental medicine","volume":"85 8","pages":"833-40"},"PeriodicalIF":0.0,"publicationDate":"2014-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3357/ASEM.3963.2014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32649367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Periorbital emphysema after dive barotrauma without radiological evidence of paranasal sinus injury.","authors":"David J L Pennell,&nbsp;Panagiotis Asimakopoulos,&nbsp;Bhaskar Ram,&nbsp;Derek Y Veitch","doi":"10.3357/ASEM.3990.2014","DOIUrl":"https://doi.org/10.3357/ASEM.3990.2014","url":null,"abstract":"<p><strong>Background: </strong>Scuba diving has increased in popularity since its invention in 1943, with over 21 million PADI registered members worldwide. Injuries to the paranasal sinuses caused by barotrauma are the second most common after injury to the middle ear.</p><p><strong>Case report: </strong>In this paper we present a case of unilateral periorbital surgical emphysema in a 23-yr-old male commercial scuba diver with minimal symptoms following an uneventful 13-ft (4-m) dive. The only symptoms experienced were pain and pressure over the right maxillary sinus and retrorbitally. Imaging with computed tomography showed no fracture of his paranasal sinuses.</p><p><strong>Discussion: </strong>The authors recommend that a high index of suspicion for paranasal sinus barotrauma should be maintained in all patients reporting minor symptoms after diving (even to shallow depths) to facilitate rapid clinical diagnosis and prompt medical management.</p>","PeriodicalId":8676,"journal":{"name":"Aviation, space, and environmental medicine","volume":"85 8","pages":"863-6"},"PeriodicalIF":0.0,"publicationDate":"2014-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3357/ASEM.3990.2014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32649283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aircraft-Assisted Pilot Suicides: Lessons to be Learned.","authors":"Alpo Vuorio,&nbsp;Tanja Laukkala,&nbsp;Pooshan Navathe,&nbsp;Bruce Budowle,&nbsp;Anne Eyre,&nbsp;Antti Sajantila","doi":"10.3357/ASEM.4000.2014","DOIUrl":"https://doi.org/10.3357/ASEM.4000.2014","url":null,"abstract":"<p><p>Aircraft assisted suicides were studied in the United States, United Kingdom, Germany, and Finland during 1956-2012 by means of literature search and accident case analysis. According to our study the frequency varied slightly between the studies. Overall, the new estimate of aircraft assisted suicides in the United States in a 20-yr period (1993-2012) is 0.33% (95% CI 0.21-0.49) (24/7244). In the detailed accident case analysis, it was found that in five out of the eight cases from the United States, someone knew of prior suicidal ideation before the aircraft assisted fatality. The caveats of standard medico-legal autopsy and accident investigation methods in investigation of suspected aircraft assisted suicides are discussed. It is suggested that a psychological autopsy should be performed in all such cases. Also the social context and possibilities of the prevention of aviation-related suicides were analyzed. In addition, some recent aircraft assisted suicides carried out using commercial aircraft during scheduled services and causing many casualties are discussed.</p>","PeriodicalId":8676,"journal":{"name":"Aviation, space, and environmental medicine","volume":"85 8","pages":"841-6"},"PeriodicalIF":0.0,"publicationDate":"2014-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3357/ASEM.4000.2014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32649368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}