Ethanol and Drugs Found in Civil Aviation Accident Pilot Fatalities, 1989-2013.
BACKGROUND
Biological specimens from pilots fatally injured in civil aviation accidents are analyzed for ethanol and drugs at the Civil Aerospace Medical Institute (CAMI). Prevalence of these substances in the pilots has been evaluated at 5-yr intervals since 1989. In continuation, a fifth 5-yr study (2009-2013) was conducted.


METHODS
The CAMI toxicology/medical certification and National Transportation Safety Board (NTSB) aviation accident databases were searched.


RESULTS
During 2009-2013, samples from 1169 pilots were analyzed. Aircraft involved in the accidents were primarily operating under general aviation. Most airmen were private pilots and held third-class medical certificates. In relation to the first 5-yr (1989-1993) period, the pilot fatality cases decreased by 37% and the presence of ethanol and/or drugs in the pilots increased by 239% in the fifth 5-yr period. The ethanol usage was unchanged, but increases were 267% and 583% with illicit and prescription drugs, respectively. The use of ethanol and/or drugs by aviators, along with underlying medical conditions, was determined by the NTSB to be cause/factors in 5% of the accidents.


CONCLUSIONS
The observed decrease in the fatality cases does not necessarily suggest the decrease in aviation accidents, as active airmen numbers also declined. The increase in the drug positive cases is primarily attributed to the continuous rise in the use of prescription drugs. Although prevalence of ethanol and drugs has been evaluated in fatally injured aviators, such evaluation has not been performed in active pilots not involved in accidents. This type of comparative study would be crucial in assessing aviation safety.
Arvind K
AK
Chaturvedi
Kristi J
KJ
Craft
Jeffery S
JS
Hickerson
Paul B
PB
Rogers
Dennis V
DV
Canfield
D000060:Accidents, Aviation / Q000706:statistics & numerical data*; D002492:Central Nervous System Depressants / Q000097:blood*; D016208:Databases, Factual; D000431:Ethanol / Q000097:blood*; D053593:Forensic Toxicology; D006801:Humans; D013287:Illicit Drugs / Q000097:blood*; D004364:Pharmaceutical Preparations / Q000097:blood*; D015813:Substance Abuse Detection; D019966:Substance-Related Disorders / Q000097:blood / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
D002492:Central Nervous System Depressants; D013287:Illicit Drugs; D004364:Pharmaceutical Preparations; D000431:Ethanol