62nd International Congress

27 Pages·2014·0.14 MB·English

Rev SanidI CMAiliSt MMe x2. 0Su1p4l.. dAelb Nsotr. a5c, 2ts014: 11-37
ICASM 2014
Scientific Agenda
Abstracts
OP01 pilots and aircrews reveal that fatigue is an important concern
TECHNOLOGY INNOVATIONS-TO BOLDLY GO WHERE throughout todays 24/7 flight operations. Regulatory efforts ai-
NO ONE HAS GONE BEFORE med at limiting flight hours and ensuring at least minimal periods of
INNOVATIONS TECHNOLOGIQUES-ALLER LÀ OÙ AUCUN crew rest have to some extent mitigated fatigue-related difficulties
HOMME N’EST ALLÉ AVANT on the flight deck, but it is clear that a combination of more effec-
tive counter- fatigue strategies has been the key to optimizing
M Antunano aviation safety in recent years. Over the past few decades, our
FAA Civil Aeromedical Research Institute, Oklahoma City, OK, USA scientific understanding of human sleep, fatigue, and circadian
[email protected] rhythms has expanded considerably. As a result effective counter-
measures such as 1) ensuring quality off-duty sleep, 2) optimizing
This presentation will describe emerging developments in ae- crew scheduling, 3) taking advantage of strategic napping, 4) utili-
rospace transportation technologies, as well as the latest zing counter-fatigue medications, 5) employing rest breaks, 6) ta-
breakthroughs in the design and implementation of advanced medi- king advantage of posture effects, 7) treating sleep disorders, and
cal technologies and their practical impact on aerospace medicine, 8) eliminating unproven practices have all helped to safeguard the
human performance and flight safety. alertness, performance, and safety of both civil and military aviation
Technological developments in commercial passenger aircraft personnel. In Part I of our aviation counter-fatigue discussions,
(narrow and wide body), silent aircraft, very light jets, hybrid these strategies will be briefly reviewed.
aircraft, electric aircraft, lighter than air vehicles, personal flying
machines, unmanned aerial vehicles/systems, supersonic and hy- OP03
personic vehicles, suborbital commercial space vehicles, orbital AVIATION FATIGUE COUNTERMEASURES PART II:
commercial space vehicles, commercial space ports and commer- ADVANCES IN FATIGUE MANAGEMENT
cial space stations will be discussed. Technological innovations in CONTRE-MESURES DE LA FATIGUE EN AVIATION PARTIE II:
medicine such as digital medicine, bio-engineering, virtual medical AVANCÉES EN GESTION DE LA FATIGUE
imaging, regenerative medicine, stem cells therapies, cloning, brain
computer interfaces, biomedical devices, genomics and genethera- JL Caldwell
pies, nano- medicine, neuro-technology, medical robotics, enginee- Naval Medical Research Unit-Dayton, Wright-Patterson AFB, OH
red replacement organs, etc., will be discussed. [email protected]
Several life-altering medical breakthroughs on the horizon in-
clude: restoring vision to the blind, organs on demand, brain repair Decades of research and operational experience have validated
and augmentation, elimination of genetic conditions, cures for neu- the traditional approaches currently in use to manage the aircrew
rological conditions, prevention of heart attacks, elimination of fatigue stemming from unpredictable work hours, long duty pe-
cancer deaths, development of smart drugs, and vaccines against riods, circadian disruptions, and disturbed or restricted sleep. Howe-
cancer. ver, our evolving understanding of the nature of fatigue along with
recent advances in technology has created new possibilities for the
OP02 future of fatigue management in aviation. In Part I, the current,
AVIATION FATIGUE COUNTERMEASURES. PART I: scientifically-validated countermeasures were reviewed. Here, in
VALIDATED STRATEGIES FOR FATIGUE MANAGEMENT Part II, immerging ideas and opportunities will be presented. Among
CONTRE-MESURES DE LA FATIGUE EN AVIATION. PAR- the new promising counter-fatigue approaches are: 1) blue light to
TIE I: STRATÉGIES VALIDÉES EN GESTION DE LA FATIGUE optimize alertness in the workplace, 2) alternative therapies for
fatigue such as hypnosis, 3) selection of fatigue-resistant indivi-
JA Caldwell duals for deployment in high-fatigue environments, and 4) strate-
Coastal Performance Consulting, Yellow Springs, OH, USA gies for enhancing slow-wave sleep to bolster the beneficial effects
[email protected] of short sleep periods or power naps. While these countermeasu-
res are still in the investigative stages, many promise hope for
Pilot fatigue is a significant, but often under-reported problem enhanced alertness and performance during otherwise compromi-
in both civilian and military aviation operations. Although estima- sed times when sleepiness negatively impacts the safety and effec-
tes vary, official statistics indicate that fatigue is involved in tiveness of a mission. Once the countermeasures are scientifically
approximately 4-8 percent of aviation mishaps, and surveys of validated, they can be integrated into a safety system so that fati-
REV SANID MILIT MEX. SUPL DEL NO. 5, 2014: 11-37 11
ICASM 2014. Abstracts
gue can be more effectively managed and safety and performance Introduction. Modafinil is in use for maintenance of per-
can be optimized. formance/alertness during extended wakefulness. This presen-
tation submits a synopsis of our studies to examine certain
OP04 issues related to its optimal dosage, effect size, untoward
FATIGUE RESEARCH AT THE FAA CIVIL AEROSPACE- effects, effects on tolerance to +Gz, value in shift work and
MEDICAL INSTITUTE effect on subsequent quality of sleep & its modulation with
RECHERCHES SUR LA FATIGUE À L’INSTITUT CIVIL DE- Zolpidem.
MÉDECINE AÉROSPATIALE DE LA FAA Methodology. Three placebo-controlled double-blind studies
were conducted on healthy male non-smokers. In Study I, 45 par-
EM Forster, D Burian, TE Nesthus ticipants, divided into three groups, were administered two doses
FAA CAMI, Oklahoma City, Oklahoma, USA of placebo/modafinil (100 mg)/modafinil (200 mg) at ~16 & ~25
[email protected] hours of extended wakefulness of 32 hours. In Study II, 20 fighter
pilots were examined during simulated flying (0,19 & 26 hours of
The Federal Aviation Administration (FAA) has been con- extended wakefulness and after 6 hours of subsequent sleep indu-
ducting research on the impact of human fatigue on civil aviation ced with zolpidem). They received two doses of modafinil (200
operations since the 1960s. Fatigue is a complex state characteri- mg)/placebo at 2300 h on D1 and 0600 h on D2 followed by zolpi-
zed by a lack of alertness and reduced mental and physical per- dem (10 mg)/placebo at ~1330 h on D2. Study III examined effica-
formance, often accompanied by drowsiness. Fatigue research cy of modafinil (100 mg) and zolpidem (10 mg) during shift work
performed by scientists at the FAA Civil Aerospace Medical with sleep/rest window misaligned with circadian rhythms in 72
Institute (CAMI) in Oklahoma City is currently focused on two participants. Task performance/sleepiness/fatigue/sleep-quality/
disciplines: human factors and functional genomics. The study of +Gz tolerance were dependent measures.
human factors in aviation is aimed to gain a better understanding Results. Modafinil improved sleepiness, fatigue, +Gz toleran-
of how humans can best be integrated with aviation systems and ce and performance, the last with a small effect size. 100 mg of
thus minimize human error while optimizing performance. The modafinil was effective. Quality of induced sleep, with manipula-
study of functional genomics is dedicated to the discovery of tion of extended wakefulness with modafinil, was inferior to that in
biomarkers, environmentally responsive genes and their protein the night prior. Sleep after modafinil was less refreshing and res-
products, in the context of normal and abnormal physiological torative. This effect was not attenuated with zolpidem. Untoward
states. This approach combines information from messenger ri- effects with modafinil were negligible. During shift work, perfor-
bonucleic acid (mRNA) and protein expressions with computa- mance did not change. Zolpidem improved sleep quality and redu-
tional methods to examine networks of responsive genes that ced sleepiness in subsequent awake period. Participants perceived
signal factors that may affect human performance inflight. Fati- less fatigued at the end of the study. This perception was not
gue in aviation can have a significant impact on safety, as it can modulated with modafinil/zolpidem.
result in cognitive degradation, reduced productivity, suboptimal Conclusions. Quality of sleep after modafinil is a concern.
performance, and may ultimately lead to loss of life. The presen- Value of modafinil in shift work is debatable.
tation will review recent FAA biomarker research performed in
collaboration with Washington State University on the topic of OP06
DETECTING FATIGUE: LESSONS LEARNED
sleep deprivation relative to cognitive impairment. In addition, a
DÉTECTION DE LA FATIGUE: LEÇONS APPRISES
review of CAMI fatigue research over the 1965-2014 period will
be discussed with an emphasis on Air Traffic Controllers, Flight
Attendants, Pilots, and Maintenance Technicians. Specific re- JC Miller
search topics that will be addressed include sleep, shiftwork, risk Miller Ergonomics, Buffalo, Wyoming, USA
management, long range operations, model validation, manage- [email protected]
ment tools, and training. This research is in response to various
congressional mandates to better understand how fatigue and sche- Focusing on measurement technologies in the domains of psy-
dule issues are manifested in the aviation environment and to chophysiology and human performance, this presentation docu-
transition fatigue countermeasures from the laboratory to the ments a portion of 40 years of lessons learned about fatigue detec-
operational field. tion in field studies and operational transportation environments.
Topics include quantitative and polysomnographic EEG, eye blinks
OP05 and eye closures, heart rate and heart rate variability (vagal tone),
PHARMACOLOGICAL STRATEGIES FOR THE MANA- sleep and activity logging, human performance measurement (es-
GEMENT OF SLEEP & ALERTNESS IN EXTENDED OPERA- pecially variability), and mental lapses and vigilance performance.
TIONS- RESULTS FROM STUDIES CONDUCTED DURING Examples from the technical literature are provided. Having con-
EXTENDED WAKEFULNESS & SHIFT WORK cluded that EEG, ECG, aircraft control measures and measures of
STRATÉGIES PHARMACOLOGIQUES POUR LA GESTION- attention are impractical in the cockpit, a recommendation is made
DU SOMMEIL ET DE LA VIGILANCE DANS LES OPÉRATIONS DE for a detection philosophy that incorporates parallel measurement
LONGUE DURÉE-RÉSULTATS DES ÉTUDES MENÉES PEN- with inputs from sleep and time zone logging, a fatigue model and
DANT L’ÉVEIL PROLONGÉ ET LE TRAVAIL POSTÉ a PERCLOS device.
KK Tripathi OP07
SMO & Sr Advsr (Av Med), Air Force Station, Bidar, Bidar, THE ESTIMATED RISK OF FATAL CARDIOVASCULAR
Karnataka, India DISEASE IN ASYMPTOMATIC AERONAUTICAL PERSON-
[email protected] NEL (SCORE RISK)-A 3-YEAR FOLLOW-UP STUDY
REV SANID MILIT MEX. SUPL DEL NO. 5, 2014: 11-37 12
ICASM 2014. Abstracts
RISQUE ESTIMÉ DE MALADIE CARDIOVASCULAIRE MOR- Methods. The next three months we are going to investigate
TELLE CHEZ LE PERSONNEL AÉRONAUTIQUE SYMPTOMA- 578 files of class 1 pilots born in the years 1959 to 1963 retros-
TIQUE (SCORE DE RISQUE)-UNE ÉTUDE DE SUIVI DE 3 ANS pectively to collect these risk factors and to see if there is any
relationship between a high risk score (more than 10%) and car-
ML Anghel, RN Hristea diovascular events 10 years later. These medical records are held
National Institute of Aerospace Medicine, Bucharest, Romania in the form of paper files at the Aero Medical Institute, a depar-
[email protected] tment of KLM Health Services in The Netherlands. Variables
that are collected for analysis are gender, age, BMI, blood pressu-
Introduction. Cardiovascular diseases (CVD) will always be a re, total cholesterol, HDL-cholesterol, smoking, family history
major concern for aeronautical disposition and aircrew standards. of cardiovascular disease and cardiovascular risk scores based on
The priority concern of the European Society of Cardiology resul- the Dutch risk chart.
ted in publishing of the risk charts (SCORE risk). Results. During the conference we shall present these data and
Aim. To evaluate the proportion of asymptomatic aeronautical per- give an overview of all cardiovascular events within this group of
sonnel meeting the ESC criteria for preventive measures, namely the risk pilots. Secondly the relation between cardiovascular disabilities
of fatal CV death in 10 years (currently or extrapolated to age 55). and high risk scores (more than 10%) will be presented.
Methods. We studied 200 subjects randomly selected from
aeronautical personnel. Patients with established coronary artery OP09
disease were excluded. Using the SCORE risk charts, subjects were PREVALENCE OF RISK FACTORS FOR CARDIOVASCULAR
classified according to their risk, both currently and projected at DISEASE IN CIVIL AVIATION PERSONNEL WITH CORO-
age 55, initially and after 3 years of follow-up. NARY ARTERY DISEASE DURING THE PERIOD 2010-2012
Results. Subjects were divided in 2 groups: below age 40 and PRÉVALENCE DES FACTEURS DE RISQUE DE MALADIE
over age 40. Smoking status was present in 37.5% and respectively CARDIO-VASCULAIRE CHEZ LE PERSONNEL DE L’AVIATION
62.5%. After 3 years, the percents were: 31.5% and 48.5%. Hy- CIVILE PORTEUR D’UNE MALADIE CORONARIENNE AU
pertension was noticed in first group in 9.5% initially, and 10.5% COURS DE LA PÉRIODE 2010-2012
after 3 years. In subjects over age 40 the percents were 18% and
20.5% in follow-up. Hypercholesterolemia was present in group I: K Soleimani, M Abdizadeh
17.5% initially and 15.5% after 3 years; in group II: 38.5% and Civil Aviation Organization & Mahan Airlines, Tehran, Te-
32%.The percentages of subjects who should be targeted for pre- hran, IRAN
ventive interventions according to ESC guidelines were significant [email protected]
in study group II: 2.2% initially and 1.9% after 3 years for current
risk greater 5%, and 27.2% initially and 23.1% after 3 years for Introduction. Coronary heart disease is the most common cau-
projected risk greater 5% at age 55. se of sudden incapacitation in flight and, as predisposing factors to
Conclusions. The percentage of asymptomatic aeronautical this condition are described as cardiovascular risk, we asked: Is the
personnel whose current risk of fatal CVD in 10 years is low; airman prevalence of cardiovascular risk different from that of the
however, assuming no change over time, almost 25% of subjects general population?
over age 40 would be at high risk by age 55. After a 3-year program Objective. To determine the prevalence of risk factors for car-
of preventive measures, the estimated projected risk of fatal car- diovascular disease in civil aviation personnel treated for coronary
diovascular disease was slightly reduced, necessarily enforcing the artery disease by the National Institute of Aerospace Medicine
program of prophylactic measures in subjects over age 40. (INMAE) Fitness and Health committee during the period from
January 2010 to December 2012.
OP08 Methods. A cross sectional study was conducted by reviewing
PREVALENCE OF CARDIOVASCULAR DISEASE RISK aeromedical records and psychophysiological tests of airmen who
FACTORS AMONG DUTCH COMMERCIAL PILOTS were treated for coronary heart disease. Sixty-one cases were analy-
PRÉVALENCE DES FACTEURS DE RISQUE CARDIOVAS- zed and the following data were extracted: age, blood pressure,
CULAIRE CHEZ LES PILOTES COMMERCIAUX NÉERLANDAIS smoking, cholesterol, glycemia, background, gender, height, flight
hours, and type of license.
W.L.G. van Zijl Results. The prevalence of risk factors in the airmen was: hy-
KLM Health Services BV, Schiphol-Oost, Noord-Holland, The pertension 34.4%, diabetes 9.8%, hypercholesterolemia 31.2%,
Netherlands smoking 57.3%, obesity 19.6%, and sedentary 68.8%.
[email protected] Conclusions. The prevalence of risk factors differs between
the general population and aviation personnel, especially with re-
Introduction. Cardiovascular disease is a major cause for unfit- gard to smoking, which requires specific cessation programs and
ness for flying duties among civil aircrew. During the annual medi- close monitoring to modify the risk profile and therefore improve
cal examination attention is paid to cardiovascular risk factors to aviation safety.
try to prevent cardiovascular disease. According to both JAR.FCL
3 and EASA rules cholesterol levels have to be measured in class 1 OP10
pilots at the first medical examination after their 40th birthday. In A DOPPLER-BASED NOISE-IMMUNE STETHOSCOPE:
2006 the Dutch SCORE based cardiovascular risk chart has beco- USER EVALUATIONS AND UNIQUE TRAINING REQUIRE-
me available. Since then it has been made possible to determine the MENTS
individual 10 years cardiovascular risk in these class 1 pilots based UN STÉTHOSCOPE À BASE DOPPLER IMMUN AU BRUIT:
on the cholesterol/ HDL-cholesterol ratio, the systolic blood pres- EVALUATIONS DES UTILISATEURS ET PRÉ-REQUIS UNI-
sure and smoking behaviour. QUES DE FORMATION
REV SANID MILIT MEX. SUPL DEL NO. 5, 2014: 11-37 13
ICASM 2014. Abstracts
JA Smyrski, JS Crowley, T Cho ÉMISSION DE CERTIFICATS MÉDICAUX PAR DÉROGA-
US Army Aeromedical Research Laboratory, Fort Rucker, AL, TION PAR LA FAA AMÉRICAINE POUR LES PILOTES TRAITÉS
USA PAR TRANSPLANTATION DE CELLULES SOUCHES
[email protected]
MA Berry
Introduction. Helicopters used to provide aeromedical trans- Federal Aviation Administration, Washington, DC, USA
port are extremely noisy (105 dB), preventing auscultation with [email protected]
traditional acoustic stethoscopes. Acoustic engineers at USAARL
have developed a Noise-Immune Stethoscope that is a hybrid In the United States, pilots must hold a first, second, or third
dual function device with a Doppler-based active mode for use in class medical certificate attesting to meeting medical standards in
high-noise environments. The NIS has been shown to be effective U.S. Title 14 CFR, Part 67. The FAA Federal Air Surgeon has the
in laboratory helicopter evaluations, but less consistent results authority to grant Special Issuance of a medical certificate to a
have been obtained in uncontrolled user evaluations in less noisy pilot not meeting the medical standards, as long as there is no
environments (e.g., shipboard, hospital). One consistent com- danger to public safety. A pilot with a disqualifying medical condi-
ment was that users did not feel comfortable using the NIS in tion receiving a new or innovative treatment regimen or modality
Doppler mode. will likely be denied medical certification. However, with time, and
Methods. The NIS was deployed for field-testing with ground experience with a particular treatment, special issuance medical
ambulance crews and air ambulance crews with enhanced personal certification might be considered.
training with an NIS-experienced USAARL flight surgeon. A trai- Stem cell transplantation as a primary or adjunct treatment is
ning CD illustrating proper NIS technique and sounds was also an example of such a situation. Stem cell transplantation is the
disseminated for self-study. infusion, or injection, of healthy stem cells into the body to replace
Results. Flight medics who received personal training and ins- damaged or diseased stem cells. This may be necessary in certain
truction rated the NIS as useful in the aeromedical evacuation envi- bone marrow disorders, or when high-dose chemotherapy or radia-
ronment, while ground ambulance medics did not find the environ- tion therapy is given in the treatment of blood disorders such as
ment noisy enough to make the Doppler mode worthwhile. leukemia, lymphoma or multiple myeloma.
Discussion. The results of the NIS development program and The FAA Headquarters Medical Appeals Branch has evaluated
these user tests, conducted by a variety of agencies, led to a 2013 a total of 16 cases where stem cell transplant was part of the
Army decision to deploy NIS to aeromedical evacuation units. therapy for a variety of medical conditions. In most cases, the
USAARL is now working to ensure that the necessary, effective, underlying disease or other medical treatment was the cause of the
but currently time-intensive training process is carried forward denial of medical certification and not the use of stem cell trans-
into the NIS fielding plan. Further assessment of NIS performance plantation. Four cases were judged acceptable for special issuance
with cardiopulmonary pathology is recommended. medical certification. The diagnoses were Non-Hodgkins lympho-
ma treated with chemotherapy and autologous stem cell trans-
OP11 plant; homozygous sickle cell disease treated by allogenic stem cell
A NEW THEME FOR AVIATION MEDICINE: CAN WE transplant; right temporal lobe primitive neuroectodermal tumor
ACCEPT THE NEW ORAL ANTICOAGULANTS? treated with resection, radiation, chemotherapy, and autologous
UN NOUVEAU THÈME POUR LA MÉDECINE AÉRONAUTI- stem cell transplant; and multiple myeloma treated with external
QUE: POUVONS NOUS ACCEPTER LES NOUVEAUX ANTI- beam radiation and stem cell transplant. These cases will be discus-
COAGULANTS ORAUX? sed in relation to the risks to aviation safety.
OP13
R Quast, B Haaff, S Roelcke
Aeromedical Center Germany, Filderstadt, Deutschland PECULIARITIES OF THE CARDIOVASCULAR CLINI-
[email protected] CAL EXAM IN SPACE
PARTICULARITÉS DE L´EXAMEN CLINIQUE CARDIOVAS-
Background. New oral anticoagulants (NOACs) are an alter- CULAIRE DANS L´ESPACE
native for vitamin K antagonists (VKAs) to prevent stroke in pa-
tients with non-valvular atrial fibrillation (AF) [Heidbuchel, et al. R Iglesias Leal
Europace, 2013 May,15(5).625-51]. The FAA accepts VKAs in Centro de Desarrollo Aeroespacial del IPN, México, Distrito
special cases, EASA differentiates between class 1 + 2 and LAPL. Federal, Mexico
For class 1 +2 medicals no anticoagulation is allowed. [email protected]
Methods. Analysis of literature in order to clarify the risk of
bleeding under a medication with NOACs. Introduction. During space flight, the cardiovascular system
Results. Meta-anaysis of large NOAC trials shows favourable (CVS) experiences very important changes provoked by the ab-
risk/benefit ratio over warfarin. [Ruff et. al. The Lancet 2013] sence of gravity (0G). These changes substantially modify the
Conclusions. Under certain conditions, the use of NOACs normal cardiovascular clinical parameters as measured on Earth, so
appears possible and safe in pilots. The new group of drugs should that if they are evaluated by terrestrial cardiology criteria, they
be discussed in aviation medicine. indicate severe pathology, but are normal at 0G and follow the
process of adaptation to the space environment.
OP12 Methods. A general review was conducted over the accumula-
UNITED STATES FAA SPECIAL ISSUANCE MEDICAL ted experience gained in space medicine, particularly related to the
CERTIFICATION IN PILOTS TREATED WITH STEM CELL anatomical and functional changes that space environment condi-
TRANSPLANTATION tions impress on the CVS.
REV SANID MILIT MEX. SUPL DEL NO. 5, 2014: 11-37 14
ICASM 2014. Abstracts
Results. The principal cardiovascular modifications in space microgravity, making it a good candidate cardiac imaging and moni-
are the following: migration of liquids from the inferior towards the toring tool for future human spaceflight missions.
superior body regions; facial edema; dilation of face and neck veins;
homogeneous pressures (arterial, venous, capillary) in the entire OP15
organism; elevation of the diaphragm and liver (5 cm); diminution HOW IS THE HEMATOLOGY INVOLVED IN THE ERA
of heart size (20%) and horizontalization of the same; alteration of OF AEROSPACE MEDICINE? SYSTEMIC AND HEMATO-
the thorax (becomes shorter and wider); increase of intrapul- LOGICAL CHANGES IN THE ASTRONAUT
monary blood (average of 800 ml); homogeneous distribution COMMENT L’HÉMATOLOGIE EST-ELLE IMPLIQUÉE
of the circulation, ventilation an pulmonary pressures; dimi- DANS L’ÈRE DE LA MÉDECINE AÉRONAUTIQUE? LES CHAN-
nution of the total blood volume (approximately one liter); GEMENTS SYSTÉMIQUES ET HÉMATOLOGIQUES CHEZ
diminution of pulse amplitude and collapse of the superficial L’ASTRONAUTE
veins in the lower limbs. All of these data are abnormal in a cardio-
logical exam on Earth, but are normal in space and follow an adap- A Schcolnik, N Labastida
tive process. UNAM, Mexico, D.F.
Conclusions. The normal clinical cardiovascular parameters in [email protected]
space, if they are evaluated by terrestrial cardiology criteria, would
result indicative of severe pathology, but are normal in 0G and The human body in microgravity presents many metabolic chan-
obey a process of adaptation to the space environment. ges. This has had low progress in space research because there are
a small number of astronauts and many operational difficulties of
OP14 conducting research. There are possibilities of reproducing the effects
EVALUATION OF A MINIATURIZED TRANSESOPHA- of the exposure to microgravity in murine model in the laboratory
GEAL ECHOCARDIOGRAM FOR CARDIAC MONITORING or continuously put human volunteers in head- down bed rest
IN MICROGRAVITY (HDBR) at -6 ºC to evaluate the immune innate response and the
ÉVALUATION D’UNE ÉCHOGRAPHIE TRANSOESOPHA- state of the bone marrow to study the neocytolysis (selective
GIENNE MINIATURISÉE POUR LA SURVEILLANCE CARDIA- hemolysis of neocytes) in microgravity. Circulating reticulocytes
QUE EN MICROGRAVITÉ become neocytes, and later mature erythrocytes. After 10 days in
space, erythrocytes reduction is approximately 10%; they have a
PH Lee, PA Warren, DT Gerson, SK Beder, DJ Piekutowski, shorter half-life and this affects the amount of hematocrit in res-
AN Vu, LM Lee, RF Karol, MK Essandoh, D Chander, AY ponse to a negative stimulus for eritropoyetin secretion by the
Sheikh, D Gaba kidneys. There is a presence of schistocytes and stomatocytes,
The Ohio State University Wexner Medical Center, Columbus, because the glutathione tends to increase the membrane rigidity,
OH, USA
and the erythrocytes tend to deform. Changes in physicochemical
[email protected]
properties of the plasma membrane of erythrocytes are favored by
vascular pressure changes, microviscosity and permeability, and
Introduction. With the prospect of human missions beyond
they can influence the efficiency of oxygen transfer. Also, lactate
Earth orbit in the near future, there is a growing potential need for
concentrations are increased with dominance of an anaerobic state
continuous cardiovascular monitoring in the case of an incapacita-
and this may contribute to the early discomforts of space travel,
ting medical emergency in space. A relatively new miniaturized
such as headaches, nausea, and malaise. This model shows an alter-
transesophageal echocardiogram (TEE) probe may be an ideal ima-
native path in response to programmed cell death. It is vitally
ging and monitoring medical tool for future spaceflight missions.
important to suppress the formation of cancer cells, as well as
Methods. The ImaCor hemodynamic transesophageal echo
having angiogenic and antiapoptotic power which are essential in
(hTEE) probe was evaluated in microgravity in parabolic flight
using a TEE training mannequin equipped with a static but anato- the process of ischemia and acute inflammation at endothelial, reti-
mically correct heart model. Image acquisition and hTEE insertion nal, cardiac, neuronal, and nephron cellular levels. With readapta-
was carried out by five undergraduate students with no prior medi- tion to Earth there appears a stimulation of erythropoiesis which
cal experience. Images were captured both in microgravity and on is aimed at maintaining the optimal level of red blood cells, neces-
the ground at three positions: deep gastric with long axis views of sary for the increased demand of oxygen in the tissues under the
both ventricles, transgastric with a short axis view of the left ven- conditions of gravitation of the Earth.
tricle, and transaortic. Simulated pericardial effusions were also
imaged. The quality of the images was graded on a three-point scale OP16
in a blinded fashion by a board certified cardiac anesthesiologist. SURGERY IN SPACE, EARTH ANALOG AND SPACE
Results. There was no significant difference in the quality of TRAINER
the images acquired in microgravity compared to those obtained on CHIRURGIE DANS L’ESPACE, APPAREIL DE FORMATION
the ground (p > 0.05). This held true for all three views investiga- SUR TERRE ET DANS L’ESPACE
ted as well as for evaluations of pericardial effusions. Post-flight
debriefing of the flyers revealed that insertion of the hTEE probe C Salicrup, JL Mosso
was not impaired in microgravity compared to placement on the AMMA Aerospace Physician-Pilot, Mexico City, D.F., Mexico
ground. [email protected]
Conclusion. The microgravity environment does not appre-
ciably affect the placement of the hTEE probe nor the quality of Introduction. In order to aim for a long term space missions,
the images obtained. Additionally, the hTEE probe can be effecti- we need to manage those pathologies that may only be managed by
vely placed by novice flyers with no prior medical training. The surgery. Proposals about robotic remote surgery has been posted,
hTEE probe is small, lightweight, easy to use, and effective in because of the delay of data transmission this option is unaccepta-
REV SANID MILIT MEX. SUPL DEL NO. 5, 2014: 11-37 15
ICASM 2014. Abstracts
ble, the robotic systems should only be used with partial automa- Expected Results. The simulator will be used to conduct
tion in order to help the surgeon to perform precise procedures. laparoscopic surgical procedures by students from the Paname-
Space long term missions will offer many challenges that, if huma- rican Universitys Faculty of Medicine, as well as by surgery
nity is capable to overcome, life in earth will be easier using this residents, and practicing surgeons. The efficacy of the system
new space technology, then we may begin the real conquer and will be evaluated by comparing the duration of the surgical pro-
colonization of our solar system. One of many challenges is the cedure between the microgravity simulator and conventional
surgery in space, not only the methods but also the continuing methods.
education and practice that the space surgeons should need. Preliminary Conclusions. It is expected that the statistical
Methodology. Once that the Surgery Simulator for Space La- findings will support the the simulator as an adequate device to
paroscopy has been tested on a fixed environment on Earth’s sur- emulate microgravity and thus permit medical students and resi-
face, will give us the basis for material/equipment in order to use dents to experience surgery under microgravity conditions. It will
this container in parabolic flights that will simulate a microgravita- also offer an innovative didactic tool that would complement the
tional environment, the container fluid will be replaced by air in surgical program of the Panamerican University. This effort also
order to let the animal material to gravitate as in space. This simu- offers an opportunity to design new laparoscopic tools for use in
lator will also function as a trainer for surgeons in space, whom space.
should preserve their practical skills in order to be ready to act if
its needed. The parallel design of new laparoscopic tools will be OP18
needed in order to overcome the free movement of the internal ULTRACOMPACT ANESTHESIA SYSTEM FOR SPACE
organs and bleeding during a laparoscopy in a micorgavitational MISSION
environment. SYSTÈME D’ANESTHÉSIE ULTRACOMPACT POUR MIS-
Expected Results. This simulator will be used to perform lapa- SION SPATIALE
roscopic procedures in parabolic flights, overcoming the challenges
that have been previously observed, the efficacy of this method with N Ishikita
be compared with the previous microgravity surgery flights. STONY, Morioka, Iwate, JAPAN
Preliminary Conclusions. It’s expected that the simulator [email protected]
not only will function to develop new tools needed for space lapa-
roscopic surgery, it will function as a trainer in space in order to An anesthesia machine used on a space mission should be com-
provide current training for the space surgeons. pact and practical. Inhaled anesthesia is much safer than intrave-
nous anesthesia, since sevoflurane or isoflurane are non-flamma-
OP17 ble, have low toxicity, and depth of anesthesia is regulated through
SURGERY SIMULATOR FOR SPACE LAPAROSCOPY respiration.
TRAINING A simple inhalation anesthesia attachment was invented which,
SIMULATEUR DE CHIRURGIE POUR LA FORMATION SUR by fitting to a conventional bag valve mask (BVM), allows the
LAPAROSCOPIE DANS L’ESPACE addition of key functions: (1) vaporization of the anesthetic agent;
(2) manual/automatic ventilation; and (3) removal of anesthetic
JL Mosso, C Salicrup gas.
Escuela de Medicina Universidad Panamericana, México City, In tests conducted on Earth, when 5 ml of isoflurane were spra-
DF, México yed from the syringe, the inhalation anesthetic gas concentration
[email protected] within the breathing circuit was instantly elevated, and the exhala-
tion anesthetic gas concentration reached a therapeutic range within
Introduction. Richard M. Satava published the first experi- 15 sec. This state lasted for 2 min and then gradually reverted. It
mental space surgery essay; it describes the limitations of open has been confirmed that the anesthetic gas is fully eliminated from
surgery. He also contradicts his essay, because of the potential the body and recovery from anesthesia occurs over a period of 15
organ gravitation along with blood and other fluid diffusion around min.
the spacecraft. He describes in his work that laparoscopic surgery With a novel APL valve using pneumatic pressure as a power
is an alternative to contain the intra-abdominal organs in their clo- source, non-step regulation of airway pressure and repetition of
sed cavity; however, this approach makes it difficult to visualize automatic inhalation/expiration in rats and in artificial lungs were
and manipulate the organs because of their gravitation. As an alter- achieved. Moreover, 99.9% removal of anesthetic gas in breath
native, we propose the use of assisted surgery technology by com- was achieved using an attached activated charcoal filter.
puterized and robotized systems that will solve the technical as- So far, favorable anesthetic effects have been confirmed in ex-
pects caused by microgravity. periments of sedation, asthma treatment, and subgingival scaling in
Objective. To design and build a simulator for laparoscopic humans, subgingival scaling and tooth extraction in dog, and elec-
surgery that also simulates microgravity in the space surgical envi- troconvulsion with the use of muscle relaxants in rats.
ronment in order to perform surgical procedures of the digestive This anesthesia system is not only easy to operate, safe, ultra-
tract on experimental animal. compact, but also does not require electronic components (Elec-
Methodology. A 40 x 40 x 60 cm acrylic simulator, 12 mm tromagnetic Compatibility).
wide, was designed. This container also includes a water irrigation Therefore, if its performance is successfully validated at the
and aspiration system, and surfaces to accommodate the experi- ISS, it is likely to become a powerful tool for medical treatment
mental model, including an acrylic dome. Previously prepared ab- and surgery in space. It may also have promising future applicatio-
dominal organs would be submerged in the simulator to practice ns in disaster medical care, medical support in developing coun-
dissection and suture procedures with conventional laparoscopic tries, anesthesia/ventilation during air or maritime transportation
surgical instruments under a simulated microgravity environment. of patients, etc.
REV SANID MILIT MEX. SUPL DEL NO. 5, 2014: 11-37 16
ICASM 2014. Abstracts
teristics of A-LOC. Convulsions and involuntary body movements
OP19 were observed in 36 and nystagmus was observed in 43 pilots. 30
EVALUATION OF 3D PRINTED SURGICAL INSTRU- out of 71 pilots who had A-LOC were interviewed about the event;
MENTS BY MARS ANALOG CREW MEMBERS amnesia and dreams were reported by 11 and 02 pilots respective-
EVALUATION DES INSTRUMENTS CHIRURGICAUX IM- ly. The average incapacitation period was noted to be 10.14+3.26s.
PRIMÉS EN 3D PAR LES MEMBRES DE L’EQUIPAGE D’UNE Discussion. On the basis of findings like nystagmus, mainte-
MISSION SUR MARS SIMULÉE nance of postural tone, convulsions, amnesia, dreams during A-
LOC, the neuro-physiology of A-LOC has been hypothesized.
JY Wong, AC Pfahnl Presence of nystagmus, maintenance of posture suggests intact
Center for Innovative Technologies & Public Health, Toronto, Vestibulo-Ocular Reflex and Sensory Motor Tract respectively.
Ontario, Canada Non- recollection of dreams, amnesia suggests breach in memory
[email protected] and/or information processing for higher functions. The mecha-
nism in toto can be explained by regional difference in blood flow
Introduction. The first off-Earth fused deposition modeling and vulnerability of cerebral centers to ischemic hypoxia. Convul-
(FDM) 3D printer is scheduled for launch in 2014. This study sions in A-LOC could be attributed to hyper- excitability of nerve
evaluated the functionality of four FDM 3D printed acrylonitrile fibers due to hypoxia.
butadiene styrene thermoplastic surgical instruments during a 4
month-long simulated Mars mission. OP21
Methods. Five crew members (2M, 3F, median age: 28 years) USAF GLOC RATES FOLLOWING THE IMPLEMENTATION
with no prior surgical experience completed 16 timed sets of simu- OF FULL-COVERAGE G-SUITS
lated prepping, draping, incising, and suturing tasks to evaluate the TAUX DES PHÉNOMÈNES DU VOILE NOIR DANS LA USAF
relative speed of using four 3D printed instruments compared to SUIVANT L’UTILISATION DES COMBINAISONS ANTI G À
conventional instruments. COUVERTURE COMPLÈTE
Results. The average and standard deviation for time to com-
pletion of the prepping task for the control sponge stick was 10.1 KG Hughes
± 3.0 s and 3D printed instrument was 10.0 ± 2.9 s. The average 711 Human Performance Wing, Wright Patterson AFB, USA
and standard deviation for time to completion of the draping task [email protected]
for the control towel clamp was 4.3 ± 1.2 s and 3D printed instru-
ment was 4.7 ± 1.7 s. The average and standard deviation for time Introduction. G-induced loss of consciousness (GLOC) has
to completion of the incising task for the control scalpel handle been a risk associated with all high-G aircraft resulting in loss of
was 18.6 ± 7.2 s and 3D printed instrument was 16.3 ± 4.9 s. The aircraft and life. G-suits used by the USAF had changed little since
average and standard deviation for time to completion of the sutu- the 1940s until the implementation of Advanced Technology Anti-
ring task for the control toothed forceps was 60.5 ± 21.9 s and 3D G Suits (ATAGS) in the F-22 Raptor in the late 1990s. Full cove-
printed instrument was 59.8 ± 19.9 s. rage G-suits are used by many military services in countries around
Conclusion. For long duration analog mission crew members the world to include the United Kingdom, Norway and Finland.
with no prior surgical experience, there was no substantial diffe- The USAF has used ATAGS in the F-22 for the past two decades,
rence in time to completion of simulated tasks with control vs. and the F- 35 Joint Strike Fighter is equipped with full coverage G-
FDM 3D printed sponge stick, towel clamp, scalpel handle and suits. Epidemologic mishap data convinced the USAF to imple-
toothed forceps. ment full-coverage G-suits in legacy aircraft (F-16 and F-15C)
beginning in March 2011.
OP20
Methods. A brief review of full coverage (FC) G-suit technolo-
PHYSIOLOGICAL INTERPRETATION OF A-LOC INCI-
gy and USAF historical GLOC data will be presented, along with
DENTS
GLOC mishap rate analysis since Mar 2011 to evaluate the effect
INTERPRÉTATION PHYSIOLOGIQUE DES INCIDENTS A-
of full-coverage G- suit technology on USAF GLOC rates.
LOC
Results. The average GLOC rate in the US Air Force F-16 is
1.47/100,000 flying hours (FH) for the 20-year period of 1993-
SK Sushree, KP Rohith, A Gowda, P Sannigrahi 2013, and has been 4.2/100,000 FH and 3.9/100,000 FH in the past
Indian Air Force, Bangalore, Karnataka, India two years since the integration of FC G-suit technology. Approxi-
[email protected] mately 30% of F-16 pilots are flying with FC G-suits, and no
GLOCs have occurred while wearing them.
Introduction. Although the phenomenon of Almost Loss Of Conclusion. GLOC rates in US Air Force F-16 pilots has
Consciousness (A-LOC) is known to the Aviation Fraternity sin- continued to rise since the implementation of FC G-suit use, howe-
ce 1980s, it is not well researched. Very few studies have attempted ver these GLOCs have occurred in the pilots wearing legacy 5-
to elaborate the characteristics of A-LOC; however, the explana- bladder G-suits which indicates the GLOC rate may be higher than
tions are not conclusive. The present study is a retrospective analy- it appears.
sis which has endeavored to address the lacunae in the literature.
Methods. The study was conducted in the Department of Accelera- OP22
tion Physiology and Spatial Orientation, IAM IAF, Bangalore. A re- EFFECT OF TOTAL SLEEP DEPRIVATION ON STRAINING
trospective analysis of the G training data in High Performance Human G LEVEL TOLERANCE AND ITS MITIGATION WITH MO-
Centrifuge for a time span of 4 years (2009 to 2013) was carried out. DAFINIL
Results. In total 8093 videos were analyzed and 71 A-LOC EFFETS DE LA PRIVATION TOTALE DE SOMMEIL SUR LA
incidents were reported. The videos were evaluated for the charac- TOLÉRANCE AUX G ET SES ATTÉNUATIONS AVEC MODAFINIL
REV SANID MILIT MEX. SUPL DEL NO. 5, 2014: 11-37 17
ICASM 2014. Abstracts
H Singh, K Tripathi Indian Air Force, Jamnagar, Gujarat, India
Indian Navy, Port Blair, Andaman & Nicobar, India [email protected]
[email protected]
Introduction. Super maneuverable aircraft are capable of exe-
Introduction. Present study examined effect of 32 hours of cuting maneuvers involving Gy acceleration. This has resulted in a
Total Sleep Deprivation (TSD) on straining G level tolerance and renewed interest in centrifuge studies involving Gy acceleration.
its modulation with Modafinil. However, the restraint systems available in the centrifuge seat are
Methods. Straining G level tolerance of 45 well rested and designed primarily for Gz acceleration and are largely ineffective in
slept, healthy, male humans (20-22 years) was measured in a base- preventing sideways movement of the torso, as well as neck snap
line (non sleep deprived) state and after 32 hours of TSD. During under Gy acceleration. Thus additional restraints are needed for
TSD, the participants were randomised to receive two doses of participants undergoing Gy acceleration.
Placebo (Gp P), Modafinil 100 mg (Gp M1) or Modafinil 200 mg Methods. The present study was conducted on High Perfor-
(Gp M2) at ~16th and ~25th hour. Oral temperature, HR and mance Human Centrifuge. 30 healthy male volunteers participated
MAP were also recorded. Stanford Sleepiness Scale (SSS) was in the study. All subjects underwent a combined acceleration pro-
used to score subjective perception of sleepiness/alertness. Resul- file +Gz/+2Gy using the newly designed restraint system. A res-
ts were analysed using ANOVA/ pairedt test/Friedmans ANOVA. traint was designed specifically for this acceleration profile. Effec-
Results. Modafinil (especially 200 mg) caused significantly tiveness of the restraint was tested both subjectively and objecti-
increase in HR and MAP and prevented a nocturnal circadian dip vely.
in oral temperature. Straining G level tolerance decreased signifi- Results. All subjects were found to be comfortable with the
cantly after TSD in Gp P (5.5 ± 0.2 G in baseline vs. 4.8 ± 0.3 G new restraint and it was found to be very effective in restraining
after TSD; t = 2.51, p = 0.026) and Gp M1 (5.2 ± 0.2 G in baseline subjects while undergoing Gy acceleration.
versus 4.3 ± 0.3 G after TSD; t = 2.98, p = 0.011). In Gp M2, Conclusion. The study brings out a new effective system for
there was no significant change (5.1 ± 0.2 G in baseline vs. 5.0 ± 0.2 restraining subjects during Gy simulation in centrifuge. The opera-
G after TSD; t = 0.56, p = 0.583). Scores on SSS increased signifi- tional significance of installing a restraint system in addition to the
cantly in Gp P (§2 = 28.88 p = 0.000) and M1 (§2 = 10.74 p = five point harness in aircraft capable of executing significant Gy is
0.013) but not in Gp M2 (§2 = 2.29 p = 0.514). also highlighted.
Conclusion. Modafinil (200 mg) effectively mitigated decrea-
OP25
se in level G tolerance due to TSD. It corroborated with scores of
“FIRE EATER’S” LUNG DISEASE FOLLOWING A HELI-
subjective perception of sleepiness/ alertness. Such an effect was
COPTER ACCIDENT: A CASE OF AIRCRAFT FUEL ASPI-
not seen with 100 mg dose.
RATION
MALADIE PULMONAIRE DU ‘CRACHEUR DE FEU’ À LA
OP23
SUITE D’UN ACCIDENT D’HÉLICOPTÈRE: UN CAS
AN ANALYSIS OF TCD TO INTERPRET CHANGES IN
D’ASPIRATION DE KÉROSÈNE
CEREBRAL CIRCULATION UNDER +GZ
UNE ANALYSE DU DOPPLER TRANSCRÂNIEN POUR IN-
TERPRÉTER LES CHANGEMENTS AU NIVEAU DE LA CIRCU- FS Pettyjohn, J Smyrski, MR Ambrose, ML Sternberg
University of South Alabama, Mobile, Alabama, USA
LATION CÉRÉBRALE SOUS +GZ
[email protected]
A Agarwal, S Dinakar
IAF, Pune, Maharashtra, India Introduction. The accidental aspiration of petroleum products
[email protected] is usually in minimal quantities. Inadvertent aspiration of large
quantities of jet fuel is uncommon. This report reviews significant
Introduction. Few recordings of Transcranial Doppler (TCD) petroleum product aspiration following a helicopter crash into salt
under Gz have been reported in literature. This study is perhaps water. Clinical presentation, radiographic imaging findings, and re-
the first description of the characteristics of TCD under Gz. These commended treatment will be discussed.
characteristics have been used to offer probable descriptions of Case Report. Bell 206 L-4 helicopter was used to resupply a
vascular events in cerebral circulation under Gz. deep ocean petroleum drilling platform. During takeoff, aircraft
Methods. 20 participants were subjected to a GOR run. TCD, cleared the edge of the platform, began a slow yaw right. 63-year-
ECG, respiratory rate and non-invasive BP were measured. old male pilot reported loss of tail rotor effectiveness (LTE), de-
Results. Interpretation of TCD wave indicates an increase in ployed emergency flotation device, initiated autorotation. Heli-
vascular resistance under Gz, which gradually increases with Gz copter impacted the water nose low, right drift, rolled, inverted,
till it results in peripheral light loss (PLL). Blood Flow Velocity and sank. Pilot exited through the broken windscreen. Pilot and 22
did not decrease, and in some cases, increased close to PLL. These year old female co-pilot were evacuated to trauma center. Passen-
seemingly bizarre results have been interpreted and explained in ger was uninjured. At trauma center, pilot indicated he swallowed
the paper. little jet fuel and salt water with nausea, vomiting, low back pain,
denied respiratory symptoms. Co-pilot reported severe back pain
OP24 but no ingestion sea water/jet fuel or respiratory symptoms. Pilot
RESTRAINT USE: SIMULATING GY received CT scan evaluation chest and lungs. During CT scan,
UTILISATION DE DISPOSITIF DE RETENUE : SIMULA- became increasingly hypoxic, oxygen saturation of 81%. Oxygen 4
TION GY LPM provided saturation of 94%. X rays indicated rapidly pro-
gressing infiltrates bilaterally lung bases. Series of x-rays and CT
P GOEL scans indicated increasing lung infiltrates progressing to cystic for-
REV SANID MILIT MEX. SUPL DEL NO. 5, 2014: 11-37 18
ICASM 2014. Abstracts
mation. Pilot treated symptomatically progressing to clear lungs
without residual. OP27
Discussion. Petroleum product aspiration has long been PROGRAM UPDATE: NAVAL MEDICAL RESEARCH
known as a consequence of fire eaters. Ingestion/aspiration of UNIT - DAYTON
various types of petroleum products produces a “lipoid pneu- MISE À JOUR DU PROGRAMME: UNITÉ NAVALE DE RE-
monitis” with initial consolidation and subsequent cystic forma- CHERCHE MÉDICALE - DAYTON
tion. The controversial use of antibiotics and steroids will be
discussed. JL Caldwell
Conclusion. This case represents an unusual case of aspira- NAMRU-D, WPAFB, OH, USA
tion of jet fuel and salt water producing a case of “fire eaters” [email protected]
disease in a 63-year-old helicopter pilot.
The Naval Medical Research Unit Dayton (NAMRU-D), loca-
OP26 ted on Wright-Patterson Air Force Base, Ohio, is composed of two
CURRENT TRENDS IN AEROSPACE MEDICINE AND research areas. The Aeromedical Directorate conducts aerospace-
HUMAN FACTORS RESEARCH AT THE FAA CIVIL relevant basic and applied research in the biomedical and behavio-
AEROSPACE MEDICAL INSTITUTE ral sciences. Key areas of investigation include: spatial disorienta-
LES TENDANCES ACTUELLES EN MÉDECINE AÉROSPA- tion (SD), situational awareness, motion sickness, unusual accele-
TIALE ET RECHERCHE SUR LES FACTEURS HUMAINS À ration environments, altitude, sustained operations and fatigue,
L’INSTITUT CIVIL DE MÉDECINE AÉROSPATIALE DE LA FAA personnel selection, and visual sciences. Research efforts focus on
the transition of products from our basic and applied research base
M Antunano to Navy Medicine, Naval Aviation, and other governmental and
FAA Civil Aeromedical Research Institute, Oklahoma City, civilian customers. Recent and anticipated transitions include: va-
OK, USA lidated aviation selection tests, novel training media to reduce SD
[email protected] mishaps, and new medications for motion sickness. Our labora-
tory boasts a unique set of man-rated acceleration devices used by
NAMRU-D researchers and visiting scientists to maintain a tech-
CAMI scientists employ sophisticated equipment and facili-
nology base critical to Naval Aviation and other aerospace custo-
ties to focus on the bioaeronautical aspects of safety and security,
mers. The Environmental Health Effects Directorate conducts ba-
including forensic toxicology, toxicogenomics, biochemistry, acci-
sic and applied research to assess the toxicity of chemicals and
dent research, passenger and crew protection, survival research,
materials used in military operations that may affect our military
environmental physiology, and vision research. There are three
and civilian populations. NAMRU-D has the capability to study
main objectives in the Aerospace Medical Research Program: 1)
toxic effects of materials using in vitro and in vivo systems; then
investigation of the injury and death patterns in civilian flight acci-
data are used to assess risk using in silico (modeling) approaches.
dents along with meticulous analysis to determine causes(s) and
Our in vitro approaches provide data on the cytotoxicity, mutage-
prevention strategies; 2) development of recommendations for
nicity, genotoxicity, and the mechanism of toxic action of these
protective equipment and procedures; and 3)evaluation of optio-
materials. We use animal systems to examine the toxicities of ma-
ns, on behalf of FAA regulatory and medical certification staff
terials via various routes of exposure. Our inhalation capabilities
charged with the proposal of safety and health regulations addres-
are extensive, allowing for exposures to gases and vapors, aerosols,
sing all aircraft cabin occupants.
particulates, and nanoparticles, using both whole-body and nose-
This research program identifies human tolerances, uneven-
only inhalation chambers. We have the ability to assess the toxici-
tful flights, and during civilian inflight incidents and accidents.
ties of chemicals and materials via various routes of exposure at the
The research results enable the FAA to utilize new and evaluate
molecular, cellular, organ, and whole body levels. The results from
existing bioaeronautical guidelines, standards, and models for
these efforts have led to state-of-the-science health protective ex-
aircraft cabin equipment, procedures, and environments. CAMI
posure standards for military and civilian populations.
scientists also study the skills, abilities, behavior, and perfor-
mance of personnel involved in aerospace operations. Resear- OP28
chers look for ways to optimize human performance, efficiency UPDATE FROM THE US ARMY AEROMEDICAL RE-
and safety, through the introduction of new work station/cock- SEARCH LABORATORY: TRENDS IN ROTARY-WING
pit displays and controls, and the effective selection and trai- AVIATION MEDICINE RESEARCH PROBLEMS AND SO-
ning of personnel operating in highly complex technological en- LUTIONS
vironments. MISE À JOUR DE LA PART DU LABORATOIRE DE RECHER-
CAMI’s Aerospace Human Factors Research Division leads an CHE AÉROMÉDICALE DE L’ARMÉE AMÉRICAINE: TENDAN-
integrated program of field and laboratory performance research in CES CONCERNANT LES PROBLÈMES ET SOLUTIONS DE LA
organizational and human factors aspects of aviation work envi- RECHERCHE AÉROMÉDICALE SUR LES HÉLICOPTÈRES
ronments. Research includes human performance under various
conditions of impairment, human error analysis and remediations,
JS Crowley
training analysis and career enhancement, impact of advanced au- U.S. Army Aeromedical Research Laboratory, Fort Rucker,
tomation systems on personnel requirements and performance, AL, USA
human factors evaluations of performance changes associated with [email protected]
advanced multifunction displays and controls in general aviation
and air traffic control, and the psychophysiological aspects of The US Army Aeromedical Research Laboratory, located at
workload on job proficiency and safety in aviation-related human- Fort Rucker, Alabama, the home of Army Aviation, has a 52-year
machine systems. history of applied aeromedical research in support of the unique
REV SANID MILIT MEX. SUPL DEL NO. 5, 2014: 11-37 19
ICASM 2014. Abstracts
physiological and psychological needs of the military rotary-wing C Salicrup
aviator. Over the years, research for the aviator has also been of AMMA Aerospace Physician-Pilot, Mexico City, D.F., Mexico
direct benefit to other customers in the mounted and dismounted [email protected]
Army.
USAARLs 2015 research program is based on five competen- Following the history of aerospace medicine in Mexico has
cies: 1) Aircrew Health and Performance which deals with a wide been a history of research into aerospace medicine problems and
range of aviation medicine problems that include spatial disorienta- solutions. From helicopters to commercial and fixed-wing proble-
tion, fatigue, waiver and retention policies, and health promotion; ms, to the challenges of manned spaceflight, Mexican scientists
2) Sensory Performance, Injury & Protection includes active re- have sought to provide solutions enabling the safe conduct of the
search programs into the protection and enhancement of hearing full spectrum of aerospace operations. This presentation will up-
(e.g., 3D auditory displays, criteria for hearing protection), and the date the Academy on recent developments and future directions
protection and enhancement of vision (e.g., enabling safe flight for Mexican aerospace medicine research.
through brownout conditions, and assessment of options for pres-
byopic HMD-users); 3) Crew Survival in Military Helicopters OP31
and Combat Vehicles assesses the performance of crash survival IMPROVING NIGHT VISION GOGGLE PERFORMAN-
equipmentaircraft-mounted and aircrew-mounted; 4) Blunt, Blast, CE WITH HUMAN SYSTEMS INTEGRATION OF MATE-
and Accelerative Injury & Protection developing new ways to RIAL, PERCEPTUAL, COGNITIVE AND TRAINING FAC-
protect aircrew and mounted Soldiers from operational injury ha- TORS
zards. Current programs investigate spinal injury in rotary-wing AMÉLIORATION DE LA PERFORMANCE DES LUNETTES
aircraft, standards for head- supported mass, and ways to measure DE VISION NOCTURNE AVEC LES SYSTEMES HUMAINS D’
head impact to help predict TBI; and 5) Enroute Care Environment INTÉGRATION DES FACTEURS MATÉRIELS, PERCEPTIFS,
- the effects of the transport environment on pathophysiology and COGNITIFS ET FORMATIFS
patient outcome (e.g., neck injury, pain, vibration).
As always, USAARL is uniquely focused on the problems of the SC Hadley
rotary-wing aviator, is well connected around the US and internatio- USAF, WPAFB, OH, USA
nally, and is always interested in new opportunities for collabora- [email protected]
tion or synergy within the aviation medicine research community.
Night Vision devices were first utilized (and failed) in US mili-
OP29 tary flight in 1969. The implications of night fighting in the 1973
A NEW FACILITY FOR THE AVIATION MEDICINE COM- Arab-Israeli War drove the existing technology straight to flying
MUNITY: PROGRAMMES AND RESEARCH AT THE SPA- with NVGs in the US military with Army Combat Development
NISH AIR FORCE INSTITUTE OF AVIATION MEDICINE Command, Night Vision Labs, and Honey Badger Projects. Nume-
NE NOUVELLE INSTALLATION POUR LA COMMUNAUTÉ rous fatal mishaps occurred because the flying demands far excee-
DE LA MÉDECINE AÉRONAUTIQUE: PROGRAMMES ET RE- ded the night vision technology, training, aircraft cockpit and exte-
CHERCHE À L’INSTITUT DE MÉDECINE AÉRONAUTIQUE rior design and lighting. Many attempts were made but the human
DE L’ARMÉE DE L’AIR ESPAGNOLE system was not integrated fully into the equation.
The technologies of Night Vision Devices have now progressed
F Rios-Tejada to be part of almost every US military aircraft Tactics, Techniques
CIMA, Madrid, Spain, Spain
and Procedures (TTP), deployment and mission profile. They have
[email protected]
become an essential component of military aviation providing su-
perior visual capability over unaided night vision. There are seve-
The Spanish Air Force Institute of Aviation Medicine has a ral inherent limitations associated with human factors and systems
dual component, supporting Military Aviation and the Civil limitations. Manufacturers such as ITT have greatly improved the
Aviation Authority (AESA/EASA). The Department of Aerospa- image intensifier technology, while individual services have greatly
ce Medicine constitutes the frame which supports the Clinical improved cognitive and visual performance through surgery, air-
Area and the Research and Training Labs. crew selection and training.
Research objectives are the aeromedical care of our aviators A review of some of the best human system Integration in
plus the technical support in accomplishing their tasks safely and Night vision Systems from the three US military services (Army,
efficiently. Main trends are related to human resources and budge- Navy and Air Force) will be presented. The review covers techno-
tary support. In order to cope gaps and limitations, a go ahead logy and device characteristics (image quality and field of view),
strategic plan has been established, to assure we will reach the physical configuration (ocular configuration, NVG weight, and
objectives at short and medium range. forward center of gravity), and contextual and environmental fac-
Current and future lines of research are related to clinical aviation tors (mission and task aspects, lighting, weather, and terrain). The
medicine, exposure to hostile flight environments and support to flig- key human factors in NVG use of visual and cognitive performance
ht operations in new scenarios and operations theatre. Research lines (visual acuity and contrast sensitivity, stereopsis and depth per-
and teaching/instruction objectives needs collaboration with national ception, distance and size estimation, spatial orientation, and si-
and international institutions, academy, agencies and industry. tuation awareness), and physical and physiological aspects (neck
strain and injuries, and headaches) will be discussed.
OP30
AEROSPACE MEDICINE RESEARCH IN MEXICO OP32
RECHERCHE EN MÉDECINE AÉROSPATIALE AU MEXI- COLOR VISION NORMAL SUBJECTS PERFORM BET-
QUE TER THAN ALL MILD, MODERATE AND SEVERE COLOR
REV SANID MILIT MEX. SUPL DEL NO. 5, 2014: 11-37 20