title: Pilot medical history and medications found in post mortem specimens from aviation accidents.
abstract: BACKGROUND
  Federal Aviation Administration (FAA) regulations require pilots to report all medications and medical conditions for review and consideration as to the overall suitability of the pilot for flight activities.
  
  
  METHODS
  Specimens were collected by local pathologists from aviation accidents and sent to the Bioaeronautical Sciences Research Laboratory for analysis. The results of such tests were entered into the Forensic Case Management System. This database was searched to identify all pilots found positive for medications used to treat cardiovascular, psychological, or neurological conditions over the period January 1, 1993, through December 31, 2003.
  
  
  RESULTS
  Toxicological evaluations were performed on 4143 pilots. Psychotropic drugs were found in 223 pilots. Cardiovascular medications were found in 149 pilots. Neurological medications were found in 15 pilots. Pilots reported psychological conditions in 14 of the 223 pilots found positive for psychotropic drugs. Only 1 of the 14 pilots reporting a psychological condition to the FAA reported the psychotropic medication found after the accident. Cardiovascular disease was reported by 69 of the pilots found with cardiovascular drugs in their system. Cardiovascular medications found in the pilots were reported by 29 of the 69 pilots reporting a cardiovascular condition. Only 1 of the 15 pilots reported having a neurological condition to the FAA; none of the pilots found with neurological medications reported the medication.
  
  
  CONCLUSIONS
  Toxicology successfully identified 93% of the medications reported by the pilots. Pilots involved in fatal accidents taking psychotropic or neurological medications rarely reported the medication or their underlying medical condition to the FAA.
authors.affiliation: Civil Aerospace Medical Institute, Federal Aviation Administration, Oklahoma City, OK 73125-5006, USA. dennis.canfield@faa.gov
authors.forename: Dennis V
authors.initials: DV
authors.lastname: Canfield
authors.forename: Guillermo J
authors.initials: GJ
authors.lastname: Salazar
authors.forename: Russell J
authors.initials: RJ
authors.lastname: Lewis
authors.forename: James E
authors.initials: JE
authors.lastname: Whinnery
mesh_terms: D000060:Accidents, Aviation / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D000337:Aerospace Medicine / Q000331:legislation & jurisprudence*; D002317:Cardiovascular Agents / Q000627:therapeutic use; D002568:Certification / Q000331:legislation & jurisprudence; D004363:Drug Utilization; D005554:Forensic Medicine; D006077:Government Agencies; D006801:Humans; D008487:Medical History Taking; D011619:Psychotropic Drugs / Q000627:therapeutic use; D014481:United States; D014938:Work Capacity Evaluation
chemical_list: D002317:Cardiovascular Agents; D011619:Psychotropic Drugs