title: In-flight medical incapacitation and impairment of airline pilots.
abstract: Medical incapacitation in the cockpit is rare, although it is a concern that has been the subject of several investigations over the years. With recent heightened interest in this problem, it seemed worthwhile to review all relevant scientific literature on the topic. Medline, PsychLit, the Aerospace Database, and other online databases were searched for studies of pilot in-flight medical incapacitation and impairment. The search revealed 13 articles during the years from 1968 to 2000. The studies represented several different approaches and were divided into five categories as follows: in-flight medical events, career termination, simulator data, questionnaires, and epidemiological analysis. The articles based on in-flight medical events showed that the leading causes of those episodes were myocardial infarctions, cardiac arrhythmias, and epileptic seizures. Few of the other types of studies used data from actual in-flight medical occurrences, instead relying on indirect measures such as career termination due to permanent medical grounding, loss of licensure insurance, or general epidemiological data to estimate the frequency of in-flight medical events. The reviewed studies provided only limited information on the frequency and categories of in-flight medical events and did not include incapacitation rates, making meaningful comparison between studies difficult. Future research needs to be based on actual in-flight medical events, and should be normalized to a useful denominator, such as flight time, to allow for meaningful comparison between studies.
authors.affiliation: Aeromedical Research Division, FAA CAMI (AAM-630), P.O. Box 25082, Oklahoma City, OK 73125-5066, USA. charles.dejohn@faa.gov
authors.forename: Charles A
authors.initials: CA
authors.lastname: DeJohn
authors.forename: Alex M
authors.initials: AM
authors.lastname: Wolbrink
authors.forename: Julie G
authors.initials: JG
authors.lastname: Larcher
mesh_terms: D000060:Accidents, Aviation; D001359:Aviation; D004194:Disease; D016021:Epidemiologic Studies; D006801:Humans; D011795:Surveys and Questionnaires; D000078329:Workforce