Aircrew fatigue

INTRODUCTION: Modafinil is a wakefulness-promoting stimulant that has been approved by the Republic of Singapore Air Force (RSAF) as a fatigue countermeasure medication since 2011. Each RSAF aircrew member must undergo a ground test to exclude operationally relevant adverse drug effects prior to consuming the medication for operational reasons. This study describes the RSAF's modafinil ground testing outcomes over a 7-yr period. METHODS: This is a retrospective case series of 243 RSAF aircrew members who underwent modafinil 100-mg test dosing over the 7-yr period from September 2011 to September 2018...

INTRODUCTION: The prevalence of flight-related neck pain in all Royal Air Force (RAF) aircrew is 66% and 70% in UK fast-jet aircrew. The RAF Aircrew Conditioning Programme (ACP) has been designed to enhance pilot performance through reducing fatigue and strain injuries, particularly to the neck. Content validity of the ACP was assessed to determine the appropriateness for delivery to aircrew. METHODS: Six international medical experts reviewed level two of the ACP, which is delivered to student aircrew who have completed basic instruction in cervical spine stability, core stability and initial technique instruction for strength training...

BACKGROUND: Flight crew fatigue is an important factor in aviation, leading organizations to implement fatigue risk management programs to reduce risk. The U.S. Air Force Air Mobility Command (AMC) has implemented the Aviation Operational Risk Management (AvORM) program to aid mission schedulers and flight crews in mitigating flight risks and identifying appropriate levels of risk. The AvORM program uses a scheduling tool and underpinning biomathematical fatigue model. This study examined self-reported fatigue-related incidents within AMC, which provides some indirect and anecdotal evidence as to the effectiveness of the scheduling tool...

INTRODUCTION: A recent U-2 fatigue study, in which 10 subjects completed 2 simulated long-duration missions breathing either 100% oxygen or air in a hypobaric chamber, offered an opportunity to compare subjects' pulmonary function before and after remaining seated in a confined cockpit for 12 h. METHODS: In one U-2 mission configuration, the subject wore a full pressure suit and breathed aviator's breathing oxygen while chamber pressure was maintained at 4572 m (15,000 ft) above mean sea level...

BACKGROUND: Decompression sickness (DCS) is a potential danger and risk for both divers and aircrew alike. DCS is also a potential side effect of altitude (hypobaric) chamber training as well and can present long after training occurs. Literature review shows that altitude chamber induced DCS has approximately a 0.25% incidence. CASE REPORT: A 32-yr-old, active duty military member developed symptoms of DCS 3 h after his hypobaric chamber training. Unfortunately, he did not seek treatment for DCS until 48 h after the exposure...

BACKGROUND: The prevalence of medical symptoms in aviators has not been described in the medical literature. METHODS: An anonymous questionnaire was handed to all Israeli Air Force aviators who went through the routine yearly examination. Because only two women filled the questionnaire, we excluded them. The questionnaire contained a list of 49 symptoms and the aviators were asked to mark symptoms that were present in the last month before the examination as well as age, estimated weekly flying hours, military service status (reserve or career) and type of aircraft (jet-fighter, helicopter or transport)...

INTRODUCTION: Military helicopters are increasingly agile and capable of producing significant G forces experienced in the longitudinal (z) axis of the body in a head-to-foot direction (+Gz). Dehydration and fatigue can adversely affect a pilot's +Gz tolerance, leading to +Gz-induced symptomatology occurring at lower +Gz levels than expected. The potential for adverse consequences of +Gz exposure to affect flight safety in military helicopter operations needs to be recognized. This case report describes a helicopter pilot who experienced +Gz-induced visual impairment during low-level flight...

INTRODUCTION: Night vision goggles (NVG) are linked to increased neck muscle activation and pain. Counterweights (NVGcw) are hypothesized to mitigate these effects. The purpose of this study was to investigate the muscular response to varying helmet loads and postures. METHODS: Volunteering from a representative squadron were 16 male helicopter aviators (pilots, N = 9; flight engineers, N = 7). Subjects performed head movements to assume nine different postures (three directions: left, center, and right, at three different levels: down, level, and up) with four different head loads (no helmet; helmet only; NVG; and NVGcw) in randomized order...

BACKGROUND: Decompression sickness is an inherent occupational hazard that has the possibility to leave its victims with significant long-lasting effects that can potentially impact an aircrew's flight status. The relative infrequency of this hazard within the military flying community along with the potentially subtle presentation of decompression sickness (DCS) has the potential to result in delayed diagnosis and treatment, leading to residual deficits that can impact a patient's daily life or even lead to death...

In the military or emergency services, operational requirements and/or community expectations often preclude formal prescriptive working time arrangements as a practical means of reducing fatigue-related risk. In these environments, workers sometimes employ adaptive or protective behaviours informally to reduce the risk (i.e. likelihood or consequence) associated with a fatigue-related error. These informal behaviours enable employees to reduce risk while continuing to work while fatigued. In this study, we documented the use of informal protective behaviours in a group of defence aviation personnel including flight crews...

The purpose of this study was verify the design of a novel Helmet System Support Device (HSSD) that can be used by military aircrew to help intervene on and reduce the high prevalence of neck trouble. Twelve healthy participants repeated simulated helicopter aircrew tasks on 3 separate days. On each day they wore a different helmet configuration, where measures of performance, perceived demand/preference and muscular demand were recorded. The results showed that vigilance tasks were performed over 10% faster with the HSSD configuration compared to wearing the normal helmet configuration...

INTRODUCTION: Bio-mathematical models are increasingly used for predicting fatigue in airline operations, and have been proposed as a possible component of fatigue risk management systems (FRMS). There is a need to continue to evaluate fatigue models against data collected from crews conducting commercial flight operations. METHODS: A comparison was made between several in-flight studies of pilot fatigue, conducted over a 10-yr period on a variety of operations, and the predictions of a widely used bio-mathematical model, the System for Aircrew Fatigue Evaluation (SAFE)...

Blaginin A.A., Grebenyuk A.N., Lizogub LN. - The main ways of improvement of medical support of the Air Forces in modern conditions. Aircrew conducting active hostilities suffers from the whole spectrum of factors and conditions of the combat situation. The main task for the medical service of the Air Force is to carry out preventive and curative action for aviation specialists who are responsible for the combat capability of aircraft formations. The medical service of the Air Force must have forces and facilities for planning, organization and implementation of the treatment of lightly wounded and sick aviation professionals with short periods of recovery, medical rehabilitation of aircrew qfter suffering injuries, diseases, sanatorium therapy of aircrew with partial failure of health, outpatient and inpatient medical examination aircrew - flight commissions, preventive rest of aviation specialists with symptoms of chronic fatigue...

INTRODUCTION: Fatigue is a complex entity with contributing factors that may include insufficient sleep, circadian dysrhythmia, high workload, extended duty periods, clinical sleep pathology, psychosocial aspects, environmental factors, and many others. It can contribute to significant performance deficits and crucial safety lapses. Despite maximal implementation of accepted techniques and best practices for mitigation strategies, the deployed military rotary-wing (RW) environment must still contend with substantial fatigue-related issues among aircrew...

INTRODUCTION: To address the high prevalence of neck dysfunction in helicopter aircrew, a 12-wk training program was designed to examine the effects on neck muscular strength and endurance. METHODS: Subjects were recruited from Canadian Forces (CF) helicopter aircrew and randomized into either a neck coordination training program (CTP; N = 10), an endurance training program (ETP; N = 11), or a nontreatment control (CON; N = 8). Baseline assessments determined maximal voluntary contraction (MVC) strength and endurance capacity using a submaximal contraction to fatigue at 70% of their MVC for extension, flexion, and left (Ltflx) and right (Rtflx) lateral flexion...

INTRODUCTION: In this study we describe our experience of voluntary fatigue reporting among pilots and cabin crew. METHOD: This was a prospective study to determine the crude incidence rate and primary cause of fatigue report form submission among cabin crew and pilots within one airline. All crew duties had already undergone scrutiny at the 'roster build' stage to ensure compliance with fatigue control measures. Reports were investigated by the airline's medical officer to determine the primary cause of fatigue and then allocated to one of five categories...

INTRODUCTION: While many studies have investigated neck strain in helicopter aircrew, no one study has used a comprehensive approach involving multivariate analysis of questionnaire data in combination with physiological results related to the musculature of the cervical spine. METHODS: There were 40 aircrew members who provided questionnaire results detailing lifetime prevalence of neck pain, flight history, physical fitness results, and physiological variables...

INTRODUCTION: Successful military aviation operations depend on maintaining continuous day-night operations. Stimulants are easy to use and popular for sustaining performance because their utility is not dependent upon environmental or scheduling modifications. Dextroamphetamine is authorized for use by the aircrews of all U.S. military services, but its potential for abuse and subsequent addiction is of aeromedical concern. Finding an alternative stimulant, such as modafinil, that displays a low affinity for dopamine uptake binding sites would prove extremely beneficial...

Individuals exposed to extreme heat may experience reduced physiological and cognitive performance, even during very light work. This can have disastrous effects on the operational capability of aircrew, but such impairment could be prevented by auxiliary cooling devices. This hypothesis was tested under very hot-dry conditions, in which eight males performed 2 h of low-intensity exercise (~30 W) in three trials, whilst wearing biological and chemical protective clothing: temperate (control: 20°C, 30% relative humidity) and two hot-dry trials (48°C, 20% relative humidity), one without (experimental) and one with liquid cooling (water at 15°C)...

This paper describes research that aims to provide the overall scientific basis for implementation of a Fatigue Risk Management System (FRMS) for French regional airlines. The current research has evaluated the use of different tools and indicators that would be relevant candidates for integration into the FRMS. For the Fatigue Risk Management component, results show that biomathematical models of fatigue are useful tools to help an airline to prevent fatigue related to roster design and for the management of aircrew planning...