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PubMed2005

Utilizing the urinary 5-HTOL/5-HIAA ratio to determine ethanol origin in civil aviation accident victims.

Specimens from fatal aviation accident victims are submitted to the FAA Civil Aerospace Medical Institute for toxicological analysis. During toxicological evaluations, ethanol analysis is performed on all cases. Care must be taken when interpreting a positive ethanol result due to the potential for postmortem ethanol formation. Several indicators of postmortem ethanol formation exist; however, none are completely reliable. The consumption of ethanol has been shown to alter the concentration of two major serotonin metabolites, 5-hydroxytryptophol (5-HTOL) and 5-hydroxyindole-3-acetic acid (5-HIAA). While the 5-HTOL/5-HIAA ratio is normally very low, previous studies using living subjects have demonstrated that the urinary 5-HTOL/5-HIAA ratio is significantly elevated for 11-19 h after acute ethanol ingestion. Recently, our laboratory developed and validated an analytical method for the simultaneous determination of both 5-HTOL and 5-HIAA in forensic urine samples using a simple liquid/liquid extraction and LC/MS/MS and LC/MS/MS/MS. In this previous work a 15 pmol/nmol serotonin metabolite ratio cutoff was established in postmortem urine, below which it could be conclusively determined that no recent antemortem ethanol consumption had occurred. In the current study this newly validated analytical method was applied to five ethanol-positive aviation fatalities where the origin of the ethanol present could not previously be conclusively determined. In four of the five cases examined the detected ethanol was demonstrated to be present due to postmortem microbial formation, and not consumption, even though some indication of ethanol consumption may have been present.

Accidents, Aviation↗
PubMed2001

Fatal aviation accidents in Lower Saxony from 1979 to 1996.

So far no national or regional studies have been published in Germany regarding the number of fatal aviation accidents and results of autopsy findings. Therefore, we evaluated all fatal aviation accidents occurring in Lower Saxony from 1979 to 1996. A total of 96 aviation accidents occurred in this period involving 73 aeroplanes. The crashes resulted in the death of 154 people ranging in age from 19 to 68 years. The greatest number of victims in a single crash of an aircraft was (n=7). Other types of fatal accidents were crashes of aircraft and helicopter while on the ground (n=5), hot-air balloons (n=2), parachutes (n=10), hang glider accidents (n=5) and the striking of a bystander by a model airplane. Autopsies were performed on 68 of the 154 victims (44.2%), including 39 of the 73 pilots (53.4%). Some of the autopsies yielded findings relevant to the cause of the accident: gunshot wounds, the presence of alcohol or drugs in blood and preexisting diseases. Our findings emphasize the need for autopsy on all aviation accident victims, especially pilots, as this is the only reliable method to uncover all factors contributing to an accident.

Accidents, Aviation↗
PubMed2005

Toxicological findings from 1587 civil aviation accident pilot fatalities, 1999-2003.

INTRODUCTION: The prevalence of drug and ethanol use in aviation is monitored by the Federal Aviation Administration (FAA). Under such monitoring, toxicological studies for the 1989-1993 and 1994-1998 periods indicated lower percentages of the presence of controlled substances (illegal drugs) than that of prescription and nonprescription (over-the-counter) drugs in aviation accident pilot fatalities. In continuation, a toxicological assessment was made for an additional period of 5 yr. METHODS: Biosamples from aviation accident pilot fatalities submitted to the FAA Civil Aerospace Medical Institute (CAMI) are analyzed, and those findings are stored in a database. This database was examined for the 1999-2003 period for the presence of controlled substances (Schedules I-V), prescription/nonprescription drugs, and ethanol in the fatalities. RESULTS: Out of 1629 fatal aviation accidents from which CAMI received biosamples, pilots were fatally injured in 1587 accidents. Drugs and/or ethanol were found in 830 (52%) of the 1587 fatalities. Controlled substances from Schedules I-II (SI-II) and Schedules III-V (SIII-V) were detected in 113 and 42 pilots, respectively. Prescription drugs were present in 315 pilots, nonprescription drugs in 259, and ethanol in 101. SI-II substances were detected in 5 of 122 first-class medical certificate-holding airline transport pilots. In addition to the controlled substances, many of the prescription/nonprescription drugs found in the fatalities have the potential for impairing performance. CONCLUSIONS: Findings from this study were consistent with those of two previous toxicological studies and support the FAA's programs aimed at reducing the usage of performance-impairing substances.

Accidents, Aviation↗
PubMed2005

An evaluation of civilian aviation accidents in Turkey from 1955 to 2004.

BACKGROUND: Documentation and analysis of aviation accidents is very important to improve aviation safety and post-accident survival. In this study we aimed to evaluate the civilian aviation accidents between 1955 and 2003 in Turkey to identify the risk factors for fatal and non-fatal injuries. METHODS: Records of Civilian Aviation Office of The Turkish Ministry of Transportation were retrospectively analyzed. RESULTS: A total of 562 aviation accidents occurred within the boundaries of Turkey in the 48-year study period. There was at least one casualty in 237 of these accidents. There were 27 major accidents with more than 5 casualties. There were more major accidents with survivors than without survivors. Major accidents occurred more frequently within the near vicinity of an airport. There are significantly more accidents with survivors in the accidents occurring near the airports. The mean number of accidents with more than 50 casualties is 0.167 (8/48) per year. CONCLUSION: Accidents occurring near the airports have a more chance of having survivors. Emergency disaster preparedness plans should be on hand and drills with no more than 50 injured should be regularly exercised in all airports.

Accidents, Aviation↗
PubMedDate not supplied

[Heliogeophysical factors and aviation accidents].

It was shown by two independent methods that there is a certain correlation between the number of aviation accidents and heliogeophysical factors. The statistical and spectral analyses of time series of heliogeomagnetic factors and the number of aviation accidents in 1989-1995 showed that, of 216 accidents, 58% are related to sudden geomagnetic storms. A similar relation was revealed for aviation catastrophes (64% out of 86 accidents) and emergencies (54% out of 130 accidents) that coincided in time with heliogeomagnetic storms. General periodicities of the series were revealed by the method of spectral analysis, namely, cycles of 30, 42, 46, 64, 74, 83, 99, 115, 143, 169, 339 days, which confirms the causative relation between the number of aviation accidents and heliogeomagnetic factors. It is assumed that some aviation accidents that coincided in time with geomagnetic storms, are due to changes in professional abilities of pilots that were in the zone of storms.

Accidents, Aviation↗
PubMed1983

General aviation accident rates and pilot community population size: an examination of rural-urban differences.

Most investigations of general aviation accidents involving human factors have emphasized biomedical and psychological concerns, with comparatively few contributions from other disciplines. This study derives from a social science orientation and investigates the relationship between general aviation accident rates and the population size of the involved pilots' communities of residence. After excluding agricultural, air taxi, and commercial helicopter operations, an analysis of 48 Colorado communities reporting at least one 1978 accident-involved pilot revealed a correlation of -0.51 between accident rate per 1,000 pilots and community size. The smallest, and generally most rural, communities produced total and fatal accident rates of respectively 2.55 and 5.36 times greater than those for the largest metropolitan areas. A similar trend characterizes U.S. nationwide general aviation accidents and appears as well for automobile mishaps, thus lending additional support to the present findings. Discriminant analysis of individual-level data for 92 of the accidents revealed that the conventional explanations of airport facilities, terrain, pilot qualifications and exposure, and aircraft complexity failed to exert substantial effects on differences among the categories of accidents grouped by community size. Two alternate explanations are offered which speculate that: 1) the rural-urban accident differential may represent a function of variations in "pilot density," and 2) the observed differences may be attributed to attitudinal differences between rural and urban pilots produced by the former group's exposure to a type of "rural subculture."

Accidents, Aviation↗
PubMed2002

The value of experienced medical personnel during the investigation of general aviation accidents.

A multidisciplinary approach to accident investigation is routine in commercial aircraft accidents. A medical team is usually assigned to assist with the investigation. As far as general aviation accidents are concerned, in a majority of cases, these resources are not available to the investigator-in-charge. We describe a general aviation accident to illustrate the scope of medical and human factors information that can be determined by professionals who assist the authorities with the investigation. Following the example, we suggest a method of identifying available expertise. Voluntary contributions from trained specialists need to be utilized to assist general aviation accident investigators and help promote aviation safety.

Accidents, Aviation↗
PubMed2001

Prevalence of drugs and alcohol in fatal civil aviation accidents between 1994 and 1998.

BACKGROUND: The use of drugs and alcohol in aviation is closely monitored by the FAA Office of Aviation Medicine's (OAM's) Civil Aeromedical Institute (CAMI) through the toxicological analysis of specimens from pilots who have died in aviation accidents. METHOD: Frozen specimens received from local pathologists were tested and the results entered into a computer database for future analysis. The data were sorted based on the class of drug, controlled dangerous substance schedules II, and I controlled dangerous substance schedules III-V, prescription drugs, over-the-counter drugs, and alcohol. RESULTS: Specimens from 1683 pilots were analyzed between 1994 to 1998. Controlled dangerous substances, CDS, (schedules I and II) were found in 89 of the pilots analyzed. Controlled dangerous substances (schedules III-V) were found in 49 of the pilots tested. Prescription drugs were found in 240 of the pilots analyzed. Over-the-counter drugs were found in 301 of the pilots analyzed. Alcohol at or above the legal limit of 0.04% was found in 124 pilots. No abused drugs were found in Class 1 air transport fatal pilots. CONCLUSION: This research supports the very low incidence rate of drugs found in the FAA random drug-testing program. Over-the-counter medications are the most frequently found drugs in fatal aviation accidents and many of these drugs could impair a pilot's ability to safely fly an aircraft. This data is helpful to the FAA in developing programs to reduce the usage of dangerous drugs and identify potentially incapacitating medical conditions that may cause an accident. Data collected from this research can be used to evaluate the effectiveness of the FAA drug-testing program.

Accidents, Aviation↗
PubMed2001

Blood carbon monoxide and hydrogen cyanide concentrations in the fatalities of fire and non-fire associated civil aviation accidents, 1991-1998.

Blood samples submitted to the Civil Aeromedical Institute (CAMI) from aviation accident fatalities are analyzed for carbon monoxide (CO), as carboxyhemoglobin (COHb), and hydrogen cyanide, as cyanide (CN(-)). These analyses are performed to establish possible exposure of victims to smoke from in-flight/post-crash fires or to CO from faulty exhaust/heating systems. The presence of both gases in blood would suggest that the victim was alive and inhaled smoke. If only COHb is elevated, the accident (or a death) could be the result of CO contamination of the interior. Information pertaining to blood levels of these gases in aviation fatalities, in relation to the associated accidents, is scattered or not available, particularly with regard to toxicity. Therefore, considering that COHb> or =10% and CN(-)> or =0.25 microg/ml are sufficient to produce some degree of toxicological effects, the necessary information was extracted from the CAMI database. Samples from 3857 fatalities of 2837 aviation accidents, occurring during 1991-1998, were received; 1012 accidents, encompassing 1571 (41%) fatalities, were fire associated, whereas 1820 accidents were non-fire related. The remaining five accidents were of unknown fire status. There were fewer fire related fatalities and associated accidents in the (COHb> or =10% and CN(-)> or =0.25 microg/ml) category than that in the (COHb<10% and CN(-)<0.25 microg/ml) category. No in-flight fire was documented in the former category, but in-flight fires were reported in 14 accidents (18 fatalities) in the latter category. No non-fire accident fatality was found wherein levels of both gases were determined to be at or above the stated levels. There were 15 non-fire accidents with 17 fatalities wherein only COHb (10-69%) was elevated. The present study suggests that aviation fire accidents/fatalities were fewer than aviation non-fire accidents/fatalities and confirms that aviation accidents related to in-flight fires and CO-contaminated interiors are rare.

Accidents, Aviation↗
PubMed1980

The value of postmortem examination of passengers in fatal aviation accidents.

Annex 13 to the Convention on International Civil Aviation recommens that the state conducting the inquiry into a fatal aviation accident should encourage internal autopsy by an aviation pathologist of those killed. Many countries recognise the value of such examinations on operating crew, but require the examination of passengers merely as aids to identification and to the investigation of the cause of death. This paper attempts to correct this misconception and to demonstrate the importance of examining passengers as completely as possible. The reasons for doing this can be divided into three broad groups. The first concerns accident reconstruction and involves a careful analysis of the injury patterns sustained by the passengers. The second is concerned with the evaluation of the safety equipment provided for passengers' use. The third deals with the multitude of medico-legal problems, both civil and criminal, that inevitably arise after a fatal accident.

Accidents, Aviation↗