title: Civilian aviation fatalities involving pilot ethanol and a previous record of substance abuse.
abstract: BACKGROUND
  Pilots are subject to the same temptations as the general population, but due to the demands of flying, the use of ethanol or other impairing substances are more likely to have severe consequences. The Federal Aviation Administration (FAA) requires pilots to report all adverse legal actions involving their use of ethanol and/or other drugs. The purpose of this study was to evaluate fatal civil aviation accidents between the years 2000 and 2007 in which ethanol was present in the pilot and the pilot had a record of previous drug and/or alcohol offenses.
  
  
  METHODS
  Case histories and accident information for the period under study were obtained from the National Transportation Safety Board (NTSB). Toxicological information was obtained from the Civil Aerospace Medical Institute's Forensic Toxicology Research Laboratory.
  
  
  RESULTS
  During the examined period 215 of the 2391 pilot specimens received for toxicological analysis had documented alcohol or drug related offenses. Of the 215 pilot specimens received, 23 showed evidence of ethanol consumption prior to the fatal incident and 16 of those had ethanol concentrations above the FAA's legal limit of 40 mg x dl(-1).
  
  
  CONCLUSIONS
  These results confirm earlier reports that pilots with previous alcohol and/or drug offenses are more likely than others to engage in repeated substance abuse in association with flying with resultant fatal accidents. These findings support the NTSB's recommendation that the FAA implement more thorough verification of alcohol and drug offenses as a means of identifying pilots at increased risk of causing accidents.
authors.affiliation: Civil Aerospace Medical Institute, Federal Aviation Administration, Bioaeronautical Sciences and Accident Research Laboratory, Oklahoma City, OK 73169-6901, USA. sabra.botch@faa.gov
authors.forename: Sabra R
authors.initials: SR
authors.lastname: Botch
authors.forename: Robert D
authors.initials: RD
authors.lastname: Johnson
mesh_terms: D000060:Accidents, Aviation / Q000401:mortality / Q000706:statistics & numerical data*; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology*; D006801:Humans; D011363:Professional Impairment / Q000706:statistics & numerical data*; D012008:Recurrence; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology