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A Medical Review of Fatal High-G U.S. Aerobatic Accidents.
Aerosp Med Hum Perform. 2019 Nov 01; 90(11):959-965.AM

Abstract

INTRODUCTION:

Exposure to high G force is a known safety hazard in military aviation as well as civilian aerobatic flight. Tolerance to high G forces has been well studied in military pilots, but there is little research directed at civilian pilots who may have medications or medical conditions not permitted in military pilots.

METHODS:

In this case-control study, we identified 89 fatal high-G aerobatic accidents and 4000 fatal control accidents from 1995 through 2018 from the NTSB accident database and the FAA autopsy database. We retrieved medications and medical conditions from the FAA's pilot medical databases. Logistic regression models were used to explore the associations of drugs, medical conditions, height, and medical waivers with high-G accidents.

RESULTS:

Seven drugs (alprazolam, clonidine, ethanol, meclizine, phentermine, triamterene, and zolpidem) reached statistical significance in our models, but had such small case counts that we consider these findings to be uncertain, except for ethanol, which was found in seven cases. Of these, only triamterene was known to the FAA. Statistically significant medical predictors included only alcohol abuse (seven cases) and liver disease (only two cases).

DISCUSSION:

Our analysis found that the drug ethanol and the condition alcohol abuse are significantly associated with high-G accidents. Seven other factors were statistically significant, but should only be considered as hypothesis generating due to very low case counts. Our study does not suggest that restricting pilots with otherwise permissible medications or medical conditions from aerobatics is warranted.Mills WD, Greenhaw RM, Wang JMP. A medical review of fatal high-G U.S. aerobatic accidents. Aerosp Med Hum Perform. 2019; 90(11):959-965.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31666158

Citation

Mills, William D., et al. "A Medical Review of Fatal High-G U.S. Aerobatic Accidents." Aerospace Medicine and Human Performance, vol. 90, no. 11, 2019, pp. 959-965.
Mills WD, Greenhaw RM, Wang JMP. A Medical Review of Fatal High-G U.S. Aerobatic Accidents. Aerosp Med Hum Perform. 2019;90(11):959-965.
Mills, W. D., Greenhaw, R. M., & Wang, J. M. P. (2019). A Medical Review of Fatal High-G U.S. Aerobatic Accidents. Aerospace Medicine and Human Performance, 90(11), 959-965. https://doi.org/10.3357/AMHP.5445.2019
Mills WD, Greenhaw RM, Wang JMP. A Medical Review of Fatal High-G U.S. Aerobatic Accidents. Aerosp Med Hum Perform. 2019 Nov 1;90(11):959-965. PubMed PMID: 31666158.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Medical Review of Fatal High-G U.S. Aerobatic Accidents. AU - Mills,William D, AU - Greenhaw,Richard M, AU - Wang,Jennie M P, PY - 2019/11/1/entrez PY - 2019/11/2/pubmed PY - 2020/3/24/medline SP - 959 EP - 965 JF - Aerospace medicine and human performance JO - Aerosp Med Hum Perform VL - 90 IS - 11 N2 - INTRODUCTION: Exposure to high G force is a known safety hazard in military aviation as well as civilian aerobatic flight. Tolerance to high G forces has been well studied in military pilots, but there is little research directed at civilian pilots who may have medications or medical conditions not permitted in military pilots.METHODS: In this case-control study, we identified 89 fatal high-G aerobatic accidents and 4000 fatal control accidents from 1995 through 2018 from the NTSB accident database and the FAA autopsy database. We retrieved medications and medical conditions from the FAA's pilot medical databases. Logistic regression models were used to explore the associations of drugs, medical conditions, height, and medical waivers with high-G accidents.RESULTS: Seven drugs (alprazolam, clonidine, ethanol, meclizine, phentermine, triamterene, and zolpidem) reached statistical significance in our models, but had such small case counts that we consider these findings to be uncertain, except for ethanol, which was found in seven cases. Of these, only triamterene was known to the FAA. Statistically significant medical predictors included only alcohol abuse (seven cases) and liver disease (only two cases).DISCUSSION: Our analysis found that the drug ethanol and the condition alcohol abuse are significantly associated with high-G accidents. Seven other factors were statistically significant, but should only be considered as hypothesis generating due to very low case counts. Our study does not suggest that restricting pilots with otherwise permissible medications or medical conditions from aerobatics is warranted.Mills WD, Greenhaw RM, Wang JMP. A medical review of fatal high-G U.S. aerobatic accidents. Aerosp Med Hum Perform. 2019; 90(11):959-965. SN - 2375-6322 UR - https://www.unboundmedicine.com/medline/citation/31666158/A_Medical_Review_of_Fatal_High-G_U.S._Aerobatic_Accidents L2 - https://www.ingentaconnect.com/openurl?genre=article&issn=2375-6314&volume=90&issue=11&spage=959&aulast=Mills DB - PRIME DP - Unbound Medicine ER -