Health and Flying 6

Ability to hold a flying licence

At the time of writing both EASA and the UK CAA are in the process of revising their policy with regards to diabetes.

It would seem that pilots suffering from diabetes will be allowed to follow their flying profession as long as they are stringently monitored and each case is looked upon on an individual basis. This monitoring will demand a demonstrated stability of the condition, and regular blood sample self-testing during flight/duty. This is to ensure that an individual does not begin a flight or shift with too high or too low a sugar level, and that a safe level is maintained.

Diseases Spread by Animals and Insects

Rabies (Hydrophobia)

Rabies is a viral infection which affects the neural tissues. It is transmitted by the saliva of infected dogs and other animals. Madness, foaming at the mouth and death often follow if urgent treatment is not forthcoming. The early symptoms include fever, headache, restlessness and painful spasms of the larynx when attempting to drink. The incubation period in humans can vary between ten days and a year. Immunisation consists of 5 inter-muscular injections of the vaccine.

Aircrew must always pay strict regard to the law concerning the carriage of animals in aircraft and to the dangers associated with physical contact.

Insects, Worms and Parasites

Some insects are carriers of disease. The use of insecticides should be used in aircraft prior to take-off from an area where this possibility might occur. On landing from such areas, airport authorities normally insist that further use is made of insecticides. A number of health authorities insist on the production of the discharged aerosols on arrival as proof of use. Fumigation of aircraft on a regular basis is also mandatory.

Travellers in developing counties should be warned of the dangers of the parasitic diseases transmitted from one host species to another. For example certain parasites are passed from snails to human or other mammal hosts. Avoid wading through muddy or damp areas in bare feet as small cuts or breaks in the skin can allow the entrance of the parasites. Avoid swimming in rivers or lakes since they are a host to many forms of parasites.

Some of the more important carriers are listed below:

•Lice, fleas and mites

These can cause typhus, plague, scabies and ascending paralysis and infection.

•Worms

Worms can live in the human body and gain nourishment from their host. They include ringworm, roundworm, tapeworm, flukes and hookworm. These can usually be successfully treated by drugs under qualified medical supervision.

Conscientious personal hygiene is the best preventative against both insects and parasites.

Sexually Transmitted Diseases

All travellers should be aware of the higher incidence of sexually transmitted diseases in developing countries. AIDS has, in recent years, received most publicity but there are countless

other sexually transmitted diseases. Some of them are now proving extremely difficult to treat, as over the years they have mutated into specific drug-resistant strains. Some varieties of syphilis for example, once thought easily cured by penicillin, now require a cocktail of drugs over a long period of time.

The means of catching these diseases is self-evident, and likewise the means of avoiding them.

Personal Hygiene

A high standard of hygiene is essential if the body is to remain healthy and free from infection. Some of the elementary precautions are listed:

•Careful and daily cleansing of the body including scalp, gums and teeth.

•Washing and drying hands after the use of the toilet.

•Ensure that eating utensils are scrupulously clean.

•Minor cuts and abrasions are promptly treated and covered.

•Regular exercise.

•Balanced diet.

Stroboscopic Effect

In helicopter operations it has been found that a limited number of people are affected by the stroboscopic effect of sunlight reaching the observer through the rotor blades. Problems are normally caused by ‘flash frequencies’ between 5 and 20 Hz. This can lead to feelings of nausea, giddiness and, in extreme cases, cause an epileptic-type fit.

Should either a member of the crew or passengers display symptoms, the preventative actions are:

•Turn the aircraft out of sun.

•Move the person affected to a seat in the shade, if possible.

•Make the individual close his/her eyes, or cover the window.

•The wearing of sun glasses may help reduce the effects.

Radiation

Introduction

We are all exposed to radiation which can, it is believed, increase the risk of cancers and may affect fertility. This is an area of a great deal of current research. It is worth noting that international air law stipulates that records must be kept of all flights above 49 000 ft and the levels of radiation exposure incurred by both aircraft and crew.

Types of Radiation

We are all exposed to two types of radiation:

•Galactic Radiation.

•Solar Radiation.

Galactic Radiation

Galactic radiation originates from outside the solar system and produces a steady and reasonably predicable low intensity flux of high energy particles. The earth’s magnetic field deflects most

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Health and Flying 6

of these particles and, additionally, stratospheric absorption gives considerable protection in equatorial regions but this effect declines to zero as the polar regions are approached. Thus the effects of galactic radiation are worst at the poles. The effects of galactic radiation also increase with altitude.

Concorde was exposed to a galactic radiation dose of about twice that to which subsonic aircraft are exposed.

The International Committee on Radiation Protection recommends that the maximum annual permissible dose for the general public is 5 millisieverts (0.5 rem). If Concorde were still in service, this would equate to about 60 return trips across the Atlantic per year.

Solar Radiation

Solar Radiation is of a lower energy than galactic radiation and emanates from the sun via solar flares. This radiation is of a lower energy than galactic radiation but can be intense and unpredictable. Adequate shielding on aircraft would impose uneconomic weight penalties so Concorde had detectors to record exposure, which were mounted on the forward passenger cabin.

Reducing the Effects of Radiation

Designers and manufacturers are paying much more attention to the effects of radiation as the tendency for flights to operate at higher altitudes increases. Little can be done by passengers to avoid the effects other than keeping high altitude travel to a minimum. Responsible operators will monitor crew exposure and will enforce appropriate rostering.

Effects of Radiation

Excess exposure to radiation will affect the central nervous system and damage organs. It can also cause cancer - especially of the skin.

Common Ailments and Fitness to Fly

Minor ailments, such as a slight cold, or mild food poisoning, can cause a deterioration of flying performance. The decision whether or not to fly requires careful consideration by a pilot. If there is any doubt whatsoever with regard to personal fitness, a pilot should not fly.

Drugs and Self-medication

Apart from the primary purpose for which drugs are intended, it is generally true to say that most of them have some unwanted side effects. Individuals will also vary in the way that the primary drug affects them. In some cases, due to a personal idiosyncrasy, a drug may have an adverse effect and the taker may rapidly become very ill.

For these reasons it is absolutely essential that aircrew only take medication which has been specifically prescribed by a medical aviation specialist who is aware of their profession.

Self-medication is particularly dangerous. It not only carries the risk of suffering side effects but also the hazards associated with the underlying illness.

The possible dangers of side effects may not be obvious, particularly when a mixture of drugs is contained in an apparently innocuous compound on sale to the general public in the local chemist.

The precautionary advice contained on the packaging will not take into consideration the unique problems of reduced performance associated with flying.

Below are some examples of groups of drugs and some of their ingredients. The list is by no means complete but suffices to underline the hazards involved.

•Cold, Hay Fever and Influenza Cures: Many of these contain antihistamines, often in a slow release form, which cause drowsiness and dizziness. The drowsiness can be particularly

hazardous because it may not be recognized by the individual and may recur after a period of alertness.

•Anti-spasmodic: drugs are often included in these compounds and they can cause visual disturbances. Quinine can also be present; this can adversely effect hearing and cause dizziness.

•Allergy Treatments: Most of these contain anti-histamines - see above.

•Nasal Decongestants: Whether in drop or inhaler form, these contain stimulants.

•Antacids: Not only do these contain atropine, causing visual problems, but also sodium bicarbonate which liberates carbon dioxide. At altitude the carbon dioxide may cause acute stomach pain due to barotrauma.

•Diarrhoea Controllers: Contain opiates which cause both nausea and depression.

•Weight Controllers: Most of these contain stimulants such as benzedrine or dexedrine which not only cause wakefulness but also nervousness and impaired judgement.

•Stimulants and Tranquillisers can cause:

•Sleepiness.

•Nausea.

•Depression.

•Visual disturbances.

•Mental disturbances.

•Intolerance to alcohol.

•Impaired mental and physical activity.

•Impaired judgement.

•Dizziness.

•Aspirin: Excessive intake can cause gastric bleeding.

Particularly dangerous is the mixing of drugs/medicines. If two are taken at the same time it may render both more potent or cause side effects not experienced with each individual medicine.

Anaesthetics and Analgesics

Following local and general dental and other anaesthetics, a period of time should elapse before air crew return to flying. The period will vary considerably from individual to individual, but a pilot should not fly for at least 12 hours after a local anaesthetic and 48 hours following a general anaesthetic.

Flying and Health 6