Conjoint Associate Professor Pooshan Navathe

© by the Aerospace Medical Association, Alexandria, VA. BACKGROUND: In 2012 the Australian Institute of Health and Welfare produced a report titled 'Dementia in Australia.'2 The report noted that the number of people with dementia in Australia would reach almost 400,000 by 2020. Australia is a jurisdiction which does not impose a mandatory retirement age for pilots. With an aging population it was hypothesized that conditions such as Parkinson's disease (PD) were likely to be seen more commonly by the Civil Aviation Safety Authority (CASA). It was decided that this was an appropriate time to retrospectively study the data held by CASA. METHODS: An interrogation of CASA databases was undertaken. Data was produced comparing percentage of Class 1 certificate holders over 60 yr of age against time. A cohort of pilots and controllers with PD was identified. The history of the cases was reviewed. RESULTS: The study confirms that the pilot population is aging in line with population trends. Over a period from 1992 to 2012, 22 cases of pilots and controllers with PD were identified. DISCUSSION: The study confirmed that PD will be of increased relevance over the next decade. Gaps between policy and practice managing past cases were identified. Updated guidelines have been published aiming to address the deficiencies identified in the study. Historically pilots and controllers have been able to maintain certification for an average of 3.75 yr. This information should be of benefit to clinicians, pilots, and controllers when considering occupation and treatment options.

Attention-deficit/hyperactivity disorder is a problematic diagnosis in the context of aeromedical certification. Certain characteristics of the disorder such as impaired attention potentially affect the safe conduct of flying. Pharmacological treatment with stimulants also has issues surrounding short half-lives and effects on the recognition of fatigue. This article gives a broad overview of the issues involved and provides certification guidelines as adopted in the Australian Civil Aviation Safety Authority which may be helpful if adopted by other certification bodies. © by the Aerospace Medical Association, Alexandria, VA.

¿ Whether pilots with insulin-dependent diabetes should be allowed to fly has long been a controversial issue. ¿ Hypoglycaemia remains a significant threat to flight safety, and a barrier for pilots with insulin-dependent diabetes to overcome. ¿ Some countries allow recreational pilots to fly while treated with insulin under strict conditions. ¿ Recent changes in aeromedical certification in Australia will give pilots with diabetes more freedom to exercise the privileges of their licence, while adopting mechanisms to ensure the safety of air navigation.

Background: Female pilots now fly many types of aircraft including military fighters capable of maneuvers that produce high, sustained acceleration in the +Gz axis. Although women have participated as subjects in various centrifuge studies, little is known about the acceleration tolerance of female pilots. Methods: Between April 1995 and December 1997, 17 female pilot trainees were studied at the Institute of Aerospace Medicine, Bangalore, India. The subjects were 23.2 ± 1.4 yr old and led physically active lives. Their relaxed +Gz tolerance limits (defined as peripheral light loss) were tested using the High G and Disorientation Demonstrator. The protocol included a series of rapid onset runs (RORs) to tolerance followed by a single gradual onset run (GOR) to tolerance. Results: The mean ROR tolerance was 4.2 ± 0.4 G. The mean GOR tolerance was 5.2 ± 0.6 G. Three of the subjects were unable to complete the GOR due to severe nausea. Two women reported breast discomfort at levels of 3.5 G and beyond. No other problems were reported. Conclusions: The acceleration tolerances for the female pilot trainees were comparable to those for male pilots previously studied in our laboratory.

The 1 Aero Medical Training Centre has surveyed aircrew of the Indian Air Force to determine the prevalence of Spatial Disorientation (SD), as related to aircraft stream, age, flying experience, geographical location and other operationally significant variables. The reported prevalence of SD is 75% among fighter aircrew, 64% in transport aircrew, and 55% in helicopter aircrew. Whereas the prevalence of SD does not appear to vary significantly with age and flying experience, it is higher in fully operational pilots and in pilots returning to flight duties after a ground tenure, as compared to ab-initio and type-converting pilots.

Human error is known to be a major contributory factor in aviation accidents, with spatial disorientation (SD) a preeminent cause within this group. This paper presents incidence of SD-related accidents in some major Air Forces of the West, and compares it with Indian Air Force (IAF) data from 1970 to 1990. Incongruence between the Indian and Western (U.S. and British) data is discussed, and possible reasons for this are highlighted. The authors suggest a review of the existing working definition of spatial disorientation with particular reference to its usage by accident investigators.

Spatial disorientation (SD) is a term which continues to have different meanings for different classes of people involved with aviation. The advent of new terms like "situational awareness" (SA), has only added to the plethora of existing definitions, leading to a difference of opinion among researchers worldwide. Lack of agreement regarding the semantics of SD among various aircraft accident investigators leads to different yardsticks in determining whether or not an accident is SD-related. These definitional differences do not allow for inter-Air Force comparisons of SD accident data, and a valuable opportunity to learn from the experience of others is lost. The authors examine the existing definitions, and propose a new practical operational definition of SD, for use in investigation and classification of aircraft accidents.

Studies have been carried out on erythrocyte membrane-bound ATPases of ten female subjects at a moderate altitude (2200 m) and at a high altitude (5100 m). Mg2+-ATPase activity of the subjects was found to be significantly stimulated under conditions at a high altitude in comparison to that at a moderate altitude. The changes in total lipids and cholesterol contents of erythrocyte ghosts and plasma Na+/K+ levels at high altitude in comparison to the moderate altitude indicates an alteration in the membrane permeability under high altitude stress. On acclimatization of the subjects from a high to a moderate altitude, the studied parameters reverted to the values as observed at a moderate altitude. © 1983, Taylor & Francis Group, LLC. All rights reserved.