ALCOHOL CONCENTRATION - MODERATE DOSE

50.0 -
GROUND LEVEL ——
12,000 FEET ——
40.0 F T 20,000 FEET ------
38 30.0 F
mo
E 20.0 +
10.0 -
O

30 60 120 180 240
TIME (min)

Frevre 10. Blood alcohol concentration for the moderate dose expressed as milligrams percent for three cabin
conditions as a function of time, Reported as means plus or minus standard error,


a lower heat production when sedated or relaxed
by the alcohol.

The results of the oxygen saturation findings
were as expected for the altitude effect. Subjects
at 20,000 ft. were on a normal oxygen mixture
and their 0, saturation readings were not sta-
tistically different from those obtained at ground
level. Men at 12,000 ft. without supplemental
oxygen had statistically lower readings than the
other two groups.

In obtaining physiological measures it is often
difficult to eliminate the psychological factors.
Alcohol is reported to cause an elevated blood
pressure,? yet with our subjects those with mod-
erate alcohol doses had lower systolic pressures
and pulse pressures than those without alcohol.
This might be interpreted as indicating that the
moderate alcohol group was less apprehensive
concerning the testing situation than the control
group. All subjects were naive. Although the
blood pressures reported for the various cabin
conditions are within physiological norms, there
is a statistical difference for the 20,000 ft. read-
ings. Decrease in blood pressure in men at 14,900
ft., particularly the systolic, has been suggested.?°

The performance tests used for this study
apparently were neither sensitive nor critical
enough tests to detect differences due to single
effects. Reaction time has been reported to de-
teriorate from 10 to 50% with blood alcohol levels
of 0.1 to 0.2%,° while other authors state that
reaction time results are varied and contradic-
tory."°

Those subjects with normal oxygen (at ground
level and at 20,000 ft.) improved in the motor
coordination task after the first hour, while those
at 12,000 ft. demonstrated little improvement
after the one-hour measurement, indicating that
perhaps hypoxia may have prevented the im-
provement seen at the other altitudes. On the
motor coordination test the high alcohol dosage
group started with the lowest score but showed
the most improvement (an increase of 11 com-

pletions per minute) from the beginning score
to the final score, while the other two groups
gained only five completions per minute from
initial to final reading.

The results of the blood alcohol determinations
present data for which a suitable explanation is
not apparent at this time. The blood levels of
alcohol were highest at 20,000 ft. for those sub-
jects receiving the higher alcohol dosage. There
could possibly be some relationship to an in-
creased body water loss at altitude with normal
oxygen.® At this time, however, this appears
to be an unlikely explanation, since an elevation
in blood alcohol levels at 20,000 ft. was not seen
with the moderate alcohol dosage group. There-
fore, it appears that this phenomenon is depen-
dent upon both dose and cabin condition, A
search for explanations and methods of testing
for mechanisms causing this result is planned
for further study.

V. Summary.

In a study of 54 human subjects using three
aleohol consumption levels and three simulated
aircraft cabin conditions it was found that al-
cohol caused an increase in heart rate and an
increase in skin temperature. Internal body
temperature was lower with alcohol but did in-
crease as blood alcohol levels decreased.

The performance tests used apparently were
not critical enough to detect significant difference
due to single variables although some interac-
tions were evidenced.

Blood alcohol determinations for those receiv-
ing the high level of alcohol yielded significantly
higher levels of blood alcohol for those at 20,000
ft. than at the other two cabin conditions. How-
ever, the readings at 20,000 ft. were not sta-
tistically different from readings obtained at the
other conditions for those receiving the lower
dose of alcohol, A suitable explanation for this
finding is not apparent at this time.



98.0 -

96.0 F

94.0 -

92.0 -

90.0

{

OXYGEN SATURATION

+10.3
96.5
40.2

+0.
97.6 *0.1
91.9
]

4

GROUND 12,000 20,000

LEVEL

FT. FT.

Ficure 4. Oxygen saturation expressed as percentage saturation for three cabin conditions. Reported as means
plus or minus standard error.


HEART RATE

100 - HIGH DOSE iateiael
T MODERATE DOSE — —
\ - NO ALCOHOL ——

95 ae
Le Orn 7 Tr
gok © a ae
Toon fo)

©
(e)
T

BEATS PER MINUTE
0
ul
T

N
ol
T

re) ! ! N n J
30 60 120 180 240

TIME (min)

Freure 1. Heart rate expressed as a function of time for the three alcohol groups. Reported as means plus or
minus standard error,



Tasie I

At Employee Health Clinic
Execution of Forms
Physical Exam—Dress
Milk—Toast
Orientation for Experiment—At Altitude Chamber.
Explanation of test equipment and brief training
on reaction timer and motor coordination test.
Application of electrode, pneumograph and other equip-
ment.
Consumption of beverage (over 30 minute period, 1/6
per 5 min.)
Start of experimental period—Time zero
Ascent to altitude
30 minute readings—begin at + 20 minutes
Heart rate, respiratory rate, internal temperature
and oxygen saturation—recorded simultaneously.
Followed by:
blood pressure measurement
skin temperature readings
motor coordination task
reaction time task
drawing of blood sample (this occurs at approxi-
mately + 30 minutes)
60 minute readings—begin at + 50 minutes—repeat
above schedule.
120 minute readings—begin at + 110 minutes—repeat
above schedule.
180 minute readings—begin at + 170 minutes—repeat
above schedule.
240 minute veadings—begin at ++ 230 minutes—repeat
above schedule,
Experiment concluded.


° CENTIGRADE

Ficcre 3. Rectal temperature in degrees Centigrade expressed as a function of time for the three alcohol groups.

RECTAL TEMPERATURE

HIGH DOSE ----
MODERATE DOSE — —
NO ALCOHOL —

30 60 120 180 240
TIME (min)

Reported as means plus or minus standard error.



AM 68-18

THE EFFECTS OF ALCOHOL AT THREE SIMULATED
AIRCRAFT CABIN CONDITIONS

E. Arnold Higgins, Ph.D.
Audie W. Davis, Jr., M.D.
John A. Vaughan, B.S.
Gordon E. Funkhouser, B.A.
Elinore M. Galerston, B.S.

Approved by Released by
Bld ile [USdge€ suo
J. Roperrt Dinix, M.D, P. V. Smert, M.D.
Cuter, Crvi ArromEpicaL Fevrran Arr Surcson
Insrrrure

September 1968

Department of Transportation

FEDERAL AVIATION ADMINISTRATION
Office of Aviation Medicine

23825



BLOOD PRESSURE

120 118

| SYSTOLIC

100 F-

80 F

DIASTOLIC +!

mm Hg

60 F

GROUND 12,000 20,000
t LEVEL FT. FT.
@) | 4 rT
Fievre 7. Blood pressure (systolic and diastolic) expressed in millimeters of mercury for three cabin conditions.

Reported as means plus or minus standard error.

MOTOR COORDINATION

30 60 120 180 240
TIME (min)

Ficcre 8. Motor coordination expressed as the number of completions per minute for the three alcohol groups as
a function of time, Reported as means plus or minus standard error,

[o)

i

D> 90 - T =0-
Zz '
=

ir 85

Lu

ao

yy 80fF

5 o HIGH DOSE = ----~

EE 75K H MODERATE DOSE — —
WwW ~ NO ALCOHOL —

| N

ao

=

oO

Oo

10


mm Hg

Fieure

120

100 -

BLOOD PRESSURE

190 © sysroLic
126
120 +
100 F
100
£
& 80+
+l
60 + DIASTOLIC
fe) it i L ! at
30 60 120 180 240

TIME (min.)

‘xauRE 5, Blood pressure (systolic and diastolic) expressed in millimeters of mercury as a function of time. Re-

ported as means plus or minus standard error. \

BLOOD PRESSURE |

l systotic "8

80 F

DIASTOLIC +I
60 F

4 NO MODERATE HIGH
ALCOHOL DOSE DOSE
fe) | | |
6. Blood pressure (systolic and diastolic) expressed in millimeters of mercury for the three alcohol groups.

Reported as means plus or minus standard error.

9



AVERAGE SKIN TEMPERATURE

32.807 + . T
i | | :
° | !
ty 32-60 F
fan) I
<q
& 32.40 -
Oo
5
Ww 32.20 F
oO
WM 32.00 +
WJ
Ww
oc
© 31.80 -
ve) + HIGH DOSE =— -----
9 MODERATE DOSE — —
31.60 F NO ALCOHOL = ——
~s
fe) l L | |
30 60 120 180 240

TIME (min)

Fievre 2. Average skin temperature in degrees Centigrade expressed as a function of time for the three alcohol
groups. Reported as means plus or minus standard error,


cated solution of sodium and ammonium oxalate,
and the whole blood was stored at a temperature
of 0.6 to 3.8°C until it could be analyzed. Al-
cohol levels of the blood were determined by the
method of Syed” using a Technicon Autoanalyzer
apparatus.

III. Results.

The data were treated by an analysis of vari-
ance technique for repeated measures, with a
multiple-range test employed where appropriate."
The variables were: level of alcohol consumed,
cabin condition, and time.

Analyses for Respiratory Rate showed no sig-
nificant effects for any of the variables.

Heart Rate. A significant effect was exhibited
for alcohol dosage level: the higher the level of
alcohol, the higher the heart rate (Fig. 1). The
analyses also showed a significant effect for time,
with a maximum rate occurring at the one-hour
measurement, and declining steadily thereafter.

For Skin Temperature there was a significant
alcohol dosage effect with higher temperatures
for those with alcohol (Fig. 2). There was also
a time effect with the highest reading occurring
at three hours.

With Rectal Temperature a significant effect
was seen for time, with the highest reading
coming at the end of the experiment. There was
also a significant alcohol-time interaction (Fig.
3).

The Oxygen Saturation measures demonstrated
no alcohol effect, but the altitude effect was seen.
Readings for subjects at 20,000 ft. were not
statistically different from readings obtained at
ground level, however, both these groups had
significantly higher readings than those subjects
at 12,000 ft. (Fig. 4).

Blood Pressure analyses yielded significance
for time effect, primarily due to a decreasing
systolic pressure through time (Fig. 5). An
alcohol-dose effect was also seen with the highest
pulse pressure exhibited by those without alcohol
and the lowest. exhibited by those with the mod-
erate alcohol dosage (Fig. 6). In addition, there
was a cabin condition effect with men at 20,000
ft. on oxygen exhibiting the lowest blood pres-
sure (Fig. 7).

Reaction Time gave no significant effects ex-
cept for time. Scores improved with time, indi-
cating a possible training effect.

For Motor Coordination there were no effects
due to cabin condition or alcohol level, but im-
provement in score was seen with time. Some
interactions were present. There was an alcohol-
time interaction : the highest alcohol-dosage group
started lowest and showed the most. increase in
score, while the moderate alcohol group was
higher than the group without alcohol (Fig. 8).
There was also a cabin condition-time interaction,
with the 12,000 ft. group leveling off at one hour
and the two groups with normal oxygen con-
tinuing to improve after that time (Fig. 9).

Blood Alcohol Concentration determinations
demonstrated, of course, a difference due to al-
cohol dosage level. There was also a cabin con-
dition effect, with those at 20,000 ft. on oxygen
having the highest blood levels. A time effect
was also seen, with the peak levels being reached
at one hour. Those subjects receiving the mod-
erate dose of alcohol revealed no significant
differences in blood alcohol levels at any time
period, due to cabin condition (Fig. 10). How-
ever, those receiving the high dosage of alcohol
demonstrated a significantly higher blood level
of alcohol at 20,000 ft. than at the other two
cabin conditions (Fig. 11).

IV. Discussion.

The increased heart rates with increasing blood
alcohol concentrations correspond to findings of
other investigators.? The heart rate and blood
alcohol concentration curves correlate well with
the highest rates occurring at the same time as
the highest blood alcohol concentrations,

The higher skin temperatures observed in sub-
jects with the higher blood alcohol concentrations
are consistent with the expected peripheral
vasodilatory effect reported for alcohol.

The no-alcohol subjects had the highest rectal
temperature but showed little change through
time. Those with the moderate alcohol dose
started with a lower rectal temperature, but
reached almost the same level as those without
alcohol by the end of the test period, when their
blood alcohol levels were negligible. Those re-
ceiving the higher alcohol dosage started with a
lower rectal temperature, and it remained lower
throughout the experiment. These responses
might be assumed to be the results of two factors:
(1) a greater rate of heat loss due to the higher
skin temperatures of those with alcohol, and (2)



ALCOHOL CONCENTRATION — HIGH DOSE

120.0 - T
Tr Os
H a _
110.0 F oO” aN
100.0 F
Or
32 30
io)
€ 80.0 fF
70.0 F
GROUND LEVEL SNS
60.0 F 12,000 FEET —— ;
20,000 FEET ----- -
%
fe) 1 1 1 1 _I
30 60 120 180 240

TIME (min)

Figure 11. Blood alcohol concentration for the high dose expressed as milligrams percent for three cabin condi-

tions as a function of time. Reported as means plus or minus standard error.

18



THE EFFECTS OF ALCOHOL AT THREE SIMULATED
AIRCRAFT CABIN CONDITIONS

I, Introduction.

The effects of the consumption of alcohol are
the subject of great interest to the scientific com-
munity. Social drinking is practiced by some
65% of the adult population of the United States
today.* Alcohol is known to impair vision, pro-
duce certain types of muscular incoordination,
produce euphoria, and remove inhibitions.” It
has been blamed for many auto accidents**?"?
and has been associated with crime."?*> Problem
drinking is the subject of much psychological,’***
physiological* and legislative research. There
is today much existing and pending legislation
aimed at controlling the “excessive” use of al-
cohol, particularly in connection with automobile
driving.

Blood alcohol levels, per se, are reported to be
inadequate indices of an individual's ability to
perform normally.** It appears to be important
whether the blood alcohol levels are obtained on
the increasing or decreasing portion of the curve
after drinking has-ceased. At a given concen-
tration, individuals whose blood alcohol is de-
creasing perform better than those whose blood
levels are still increasing.

It has been reported that alcohol effects on the
body are similar to those of hypoxia." It has
also been suggested that oxygen therapy is useful
in the treatment of both the acute alcoholic state
and chronic alcoholism.’**° The possibility exists
that oxygen lack and alcohol may have additive
or even synergistic effects. These experiments
were designed to study the combined effects of
different alcohol levels under three different cabin
conditions.

II. Methods.

Fifty-four male, paid volunteers (21 to 29
years old) were used as test subjects. Eighteen
subjects each were exposed four hours singly or
in pairs in an altitude chamber to one of three
altitudes: ground level (1287 ft.), 12,000 ft., or

20,000 ft. The men at 20,000 ft. were supplied
with a normal oxygen mixture through a demand-
type regulator system. One-third of each group
received 600 cc each of bourbon-flavored cola,
one-third received 2.50 ce of 100 proof bourbon
per kilogram of body weight in cola to total
600 cc and the remaining third received 1.25 ce
of 100 proof bourbon per kilogram of body
weight brought to 600 ce with cola.

The same time sequence was followed for each
experiment and is shown in Table I. Heart rate
was measured by three electrocardiogram elec-
trodes, respiratory rate by a mercury-in-rubber
strain gage, and internal body temperature by
a calibrated thermistor probe inserted ten centi-
meters into the rectum. All three parameters
were recorded simultaneously on a six-channel
Grass recorder.

Skin temperatures were obtained with a cali-
brated Stoll-Hardy radiometer (Model HL4),
with average skin temperature calculated from
& seven-point system developed by Hardy and
DuBois.2 Blood oxygen saturation was deter-
mined with a Waters (Model XE-350) ear
oximeter, and blood pressure by auscultation,
using a pressure cuff and mercury sphygmomano-
meter.

Reaction time, determined as the manual re-
sponse to an auditory stimulus, is reported as
the time required to turn off a buzzer by pressing
a key. Five time trials were conducted at each
of the time periods during an exposure, and the
average of the three best scores reported. A
motor coordination test* consisted of making a
three-line configuration in a square as rapidly
as possible. Two 10-second practice trials were
followed by a single 60-second test trial. Scores
were the total number of squares containing the
configurations.

A yenous blood sample of three to five ce was
drawn from each subject at each time period.
Coagulation was prevented by 0.2 cc of a dessi-



ACKNOWLEDGMENTS

The authors wish to thank Dr. H. L. Gibbons for medical coverage and
also wish to express appreciation to the Physiological Operations Section for
operating the altitude chamber for this study.

Qualified requestors may obtain Aviation Medical Reports from Defense Documentation
Center. The general public may purchase from Clearinghouse for Federal Scientific and
‘Technical Information, U.S. Dept. of Commerce, Springfield, Va. 22151.


COMPLETIONS PER MINUTE

95

90

85

80

MOTOR COORDINATION

GROUND LEVEL
12,000 FEET —_——_—
20,000 FEET = ------

1 I 1

30

60 120 180
TIME (min)

Ficure 9. Motor coordination expressed as the number of completions per minute for three cabin conditions as
a function of time. Reported as means plus or minus standard error,

i



e

~

10.

1.

12,

13.

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