Abstract: ABSTRACTThis paper will examine the impacts of obesity in aviation medicine. The World Health Organisation (WHO) has described the problems of obesity and being overweight as one of the greatest public health challenges of the 21st century (1) and this will certainly lead to increasing numbers of obese aviators (or potential aviators) presenting for medical certification. These people may not realise the impact their increased weight could have on their flying career and is often going to be an incidental finding in their examination rather than the specific problem they present with. This leads to the question for the medical examiner, does being overweight/obese matter in aviation and how might it increase a person’s risk of incapacitation in the cockpit' PubDate: Fri, 29 Jan 2021 00:00:00 GMT
Abstract: ABSTRACTVenous thromboembolism (VTE) is the condition in which blood clots form within the venous circulatory system, and consist of DVT (deep vein thrombosis) and PEs (Pulmonary emboli).It is a common condition, with an estimated life-time risk of 8% and an annual incidence of 0.84-1 per 1000 population1, 2 and represents a significant economic burden: within Australia the annual estimated cost in 2018 being $1.72 billion AUD3.The condition is considered aeromedically significant for both aircrew and passengers; diagnosis and treatment may have implications on an aviators medical certificate and the general public are often concerned about developing “economy class syndrome”.This paper reviews the pathophysiology of VTE, the relationship between VTE and its treatment in the aviation environment. It also reviews some of the international aeromedical regulatory guidelines and provides a suggested approach to certification in case of VTE. PubDate: Fri, 29 Jan 2021 00:00:00 GMT
Abstract: ABSTRACTThis paper examines the historic but tragic first human vertical rocket flight which took place in south-western Germany on 1 March 1945. The primary lesson learned from the flight was that, as a result of the combination of psychological and physiological stresses, a human pilot could not be expected to fly a vertically launched rocket manually. An autopilot would be essential for the guidance of the Natter rocket interceptor up to its operational altitude. No further human vertical rocket flights took place until 1961 when Major Yuri Gagarin was launched into orbit. In early April 1945 a fully operational Natter flew successfully into the lower stratosphere under the control of a three-axis autopilot and crewed with a dummy pilot. Both dummy pilot and rear fuselage were recovered successfully under separate parachutes. In less than a year the engineers and scientists in collaboration with aviation physicians and physiologists at research institutions across Germany had laid down the basic principles which still apply to human rocket flight today. PubDate: Fri, 29 Jan 2021 00:00:00 GMT
Abstract: ABSTRACTThe COVID-19 pandemic has presented a unique and challenging environment for aeromedical organisations. We present lessons learnt during the development and implementation of our operational processes and procedures at The Royal Flying Doctor Service (RFDS) Western Operations for the transfer of suspected COVID-19 patients. To date, we have conducted 105 such fixed-wing transfers. The unique geography and health care system of Western Australia mandates that long-range, fixed-wing transfers are often required to centralised tertiary care. These lessons learnt provide a framework for the essential logistical, equipment and human factor considerations for developing an effective system. The translation of predominantly hospital-centric protocols into the aviation environment requires careful forethought, effective leadership and teamwork. Conducting COVID-19 suspected aeromedical retrievals significantly impacts all aeromedical retrieval operations and aeromedical personnel that should be realised by an aeromedical organisation. PubDate: Fri, 29 Jan 2021 00:00:00 GMT
Abstract: ABSTRACTAimTo compare occupational flying hours (a surrogate for occupational exposure to radiation) of commercial pilots subsequently diagnosed with melanoma, with those without melanoma.MethodsNested case-control study of de-identified male commercial pilots in Australia 2011-2016, ascertained through the Civil Aviation Safety Authority (CASA). Cases were pilots diagnosed with melanoma 2011-2016; controls were randomly-selected pilots age-matched 1:2 with invasive cases. Total flying hours and hours flown in the last 6 months in 2011, date of birth and state of residence were also obtained. We estimated the association between total flying hours (in tertile groups), and melanoma by odds ratios adjusted for age and state (ORsadj; 95% confidence intervals (CIs)).ResultsDuring 2011-2016, 51 pilots developed invasive melanoma and 63, in situ (mean ages 47 and 49 years, respectively). Their median cumulative flying hours in 2011 were 6,108 and 6,900 respectively, compared with 7,500 for 102 control pilots (mean age 48.6). Risk of invasive melanoma did not increase per 1000 total hours flown (ORadj=1.00) nor did risk increase in pilots with highest vs lowest total flying hours (ORadj=1.18, 95% CI 0.44-3.15). Total flying hours were inversely associated with invasive melanoma development in pilots aged < 50 (ORadj=0.37, not significant), and not associated with melanoma on exposed sites. Recent flying hours were not associated with melanoma. Results were unchanged with inclusion of in situ cases.ConclusionRisk of melanoma in Australian commercial pilots is unrelated to cumulative or recent occupational exposure to radiation as indicated by total and recent flying hours. PubDate: Thu, 30 Jan 2020 00:00:00 GMT
Abstract: ABSTRACTAimThe purpose of this research was to employ radiobiological as well as physics principles to investigate materials for an intravehicular spacesuit and a “storm shelter” that might minimize radiation exposure to astronauts during a mission to Mars.MethodsNASA’s OLTARIS space radiation modelling tool was used to investigate thirty-two potential shielding materials. Radiation exposure was estimated during a return transit to Mars of 360 days duration. We assessed each shielding material by its ability to decrease effective radiation dose received by a computerized phantom during the constant galactic cosmic radiation (GCR) and a single solar particle event (SPE). For the “storm shelter” a large liquid fuel tank was modelled adjacent to the phantom during a SPE.ResultsAt standard conditions, graphene appeared to be a promising shielding material when comparing other materials including polyethylene and lithium. The shielding efficacy became comparable to polyethylene but inferior to lithium when materials were normalised to 10g/cm2, 20g/cm2 and 30g/cm2. The graphene around the phantom reduced effective dose from GCR compared with an unshielded transit by 34% (162mSv/yr vs 213.3mSv/yr). A “storm shelter” using a liquid fuel tank was positioned to create a barrier adjacent to the astronauts. The liquid barrier reduced effective dose by 98.8% (44mSv vs 3614mSv). Other mitigation strategies were deduced and divided into launch, transit and habitation considerations.ConclusionA graphene based intravehicular suit could decrease astronaut exposure to harmful radiation during transit to Mars. A storm shelter using fuel as a barrier also decreased radiation dose during a solar particle event. PubDate: Thu, 30 Jan 2020 00:00:00 GMT
Abstract: ABSTRACTA number of studies indicate that pilots have approximately double the risk of developing melanoma compared to the general population. It is not clear which aetiological factors underpin this increase in risk. Possibilities include leisure time sun exposure, cosmic radiation, circadian rhythm disruption and UV exposures in the cockpit. This brief review presents some of the key research on exposures of interest, with a focus on UV radiation. It highlights the need for further research assessing UVA levels within the cockpit of flying aircraft, given the possibility that glass windscreens may not be particularly effective at blocking UVA. PubDate: Thu, 30 Jan 2020 00:00:00 GMT
Abstract: ABSTRACTAimNASA and private spacefaring companies plan to send exploration missions to mars within the next two decades. The environment of space, duration of the mission, distance from earth, and limited available resources present significant challenges for the provision of health care. It has been estimated that at least one medical emergency is likely to occur during such a mission, which may necessitate surgical treatment, and therefore anaesthesia. The provision of safe anaesthesia faces challenges arising from physiological adaptations to space, difficulty achieving and maintaining personnel expertise, possible pharmacological changes in anaesthetic agents used, limited consumable shelf-life and provision of intravenous fluids and blood products. In this review article we discuss these challenges in the context of a hypothetical case. PubDate: Thu, 30 Jan 2020 00:00:00 GMT
Abstract: ABSTRACTAimDefibrillation is a critical aspect of advanced life support, but the inherent risks in the procedure are increased when used during an aeromedical retrieval. The dangers of defibrillation in flight can be divided in to fire, electrical, avionic interference and physical carriage and packaging. A limited body of evidence exists concerning defibrillation in flight, in part, due to under-reporting. Changes in incident reporting, increased team based simulation training and awareness of the dangers of defibrillation should allow aeromedical teams to defibrillate patients safely and expediently. PubDate: Thu, 30 Jan 2020 00:00:00 GMT
Abstract: ABSTRACTAimPilot training has always been a relatively expensive undertaking. So attempts to control these costs by predicting the likelihood of success or failure is a constant that is almost as old as aviation itself. Incorporation of Psychometric testing was made to pilot selection in the years between the first and second world wars. Despite the many changes that have occurred in this area, psychometric testing continues to feature in modern systems of pilot aptitude testing. This paper reviews some of the history of psychometric testing in pilot selection. PubDate: Thu, 30 Jan 2020 00:00:00 GMT
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