material available through AME offices, airports,

pilot magazines, etc. :

1. Piloting aircraft during times of emotional
distress can lead to unwarranted low-level and
other unsafe maneuvers.

2. Piloting aircraft during the period immedi-
ately following alochol consumption is ex-
tremely hazardous (due to the elimination of
fear and to deterioration of psychomotor
performance).

3. Continued flight into deteriorating weather by
a VFR pilot results in the possibility of grave-
yard spirals (“get-there-itis” leads to early
membership in the “chapter eternal”).

SELECTED REFERENCES

Crviz ArRonavtics Boarp: General Aviation acci-
dents—A Statistical Review—Calendar Year 1963,
Safety Analysis Division, Bureau of Safety, CAB,
Washington, D.C., May 1965.

Feperat Aviation AcENcy: FAA Statistical Handbook
of Aviation, Statistical Services Branch, Office of Man-
agement Services, FAA, Washington, D.C., 1964.
Hoanan, James : How Safe is Business Flying, Busi-
ness/Commercial Aviation, Vol. 17, No. 2, August 1965.
Catapara, JosepH, Maj. Gen. USAF Ret.: Project
GAPE of the Flight Safety Foundation, Comments
made to the 11th Annual Flying Physicians Associa-
tion, Miami Beach, Florida, August 1965.

U.S. GOVERNMENT PRINTING OFFICE : 1966 O - 224-072



cise of judgment and the arrival at a decision.
The mind accomplishes these events, relying upon
experience and knowledge. When the body is
suffering from one or more of the above factors,
the mind is adversely affected and its command
capability deteriorates.

Some readers may feel that the above is obvious,
but the accident “probable causes” and contribut-
ing factors listed by the CAB show otherwise.
Physicians have found that the simplest dictum
of health (“all things in moderation”) bears fre-
quent. repetition.

The state of mind can influence the body, which
in the final sequence of flight control effects the
actual manipulation of the aircraft. Acquired
lower-order reflexes have saved more than one
aviator and his craft under sudden adverse cir-
cumstances. The mental “override” of emotional
disturbances (panic, depression, euphoria, self-
destructiveness) can nullify the efficacy of such
reflexes. In fact, such disturbances can create and
allow the establishment of a flight condition from
which the “fastest reflexes in the world” can be of
no avail (for example, a low-level “buzz job” car-
riéd to the point of no recovery).

Emotional disturbances can lead to alcohol con-
sumption just prior to flight (the aleohol may be
used to remove fear). On the other hand, alcohol
itself can produce an emotional disturbance
(euphoria plus an absence of fear) that leads the
pilot to undertake unsafe flight practices (for ex-
ample, to make his first night flight—not infre-
quently accompanied by a nonpilot friend who has
similarly imbibed).

The evidence indicates that man’s nature has
changed little in the past 4,000 years. His litera-
ture and art today resemble in plot and gross prin-
ciple that of centuries ago. The change has been
in man’s institutions.

Enhanced training and attitude inculeation offer
means by which fledgling pilots may be better
fitted to avoid established aerial perils (in the same
fashion that seasoned mariners teach junior per-
sonnel to avoid known navigational hazards of the
sea). This activity of necessity is aimed at, and
depends upon, the instructors.

For pilots in general, the Aviation Medical
Examiner, through his recurrent contacts, can re-
emphasize human-factors concepts. The FAA,
CAB, State Aeronautical Officer, private aero-
nautical associations (NPA, NBAA, AOPA, etc.),
university aviation departments, and other groups

must meet the challenge of disseminating these
safety concepts. The Flight Safety Foundation
(New York City) has undertaken a program
jointly supported by the FAA to provide addi-
tional grass-roots educational material to pilots
(Project GAPE: General Aviation Pilot
Education).

The approach, thus, is to study individual acci-
dents and from the total picture of each accident
define the causes. In the case of the current acci-
dent situation, the individual is the key to its
resolution. The individual must practice self-
discipline relative to (1) the desire to take horse-
play into the skies; (2) the temptation to do
obviously foolish things; and (3) the susceptibility
to ignore Nature’s tangible atmospheric signs of
warning.

Beginning with the first days of civilization,
man has found that certain regulations are neces-
sary. It may be that certain “dissuading” new
regulations may be brought about by a relatively
modest number of overall pilots. This will be
largely determined by the pilots themselves and
the degree of success of the education programs.

Here a suggestion is made for the pilot at the
controls who feels his enthusiasm on the verge of
running over: get instruction in a different type
of aircraft or in a new and challenging maneuver
and practice assiduously.

Perfectly performed lazy-8’s, chandelles, spot
landings, and on-pylon turns are examples of
maneuvers with which most private pilots have
difficulties. The constructive nature of the flights,
plus the developing pride of proficiency, will help
evolve a better pilot.

Additionally, each pilot should try to fly every
week, even if for just a pattern or two, and strive
for new ratings (especially IFR). An annual in-
structor-proficiency ride will detect unconscious
bad habits, The above are proven aids to safety
as shown by the high number of total accidents
(fatal and nonfatal) experienced by (1) the
“rusty” pilot and (2) the “professional student.”

During the evening, especially on trips when the
pilot is grounded due to weather, some time can be
spent refreshing one’s knowledge of such subjects
at meteorology. A constant traveling companion
should be a set of succinct flying-information
booklets.

In conclusion, the following three points should
be stressed in conversation and through brochure


AM 66-8

THE PREDOMINANT CAUSES OF CRASHES AND
RECOMMENDED THERAPY

Stanley R. Mohler, M.D.

Approved by Released by
. °o
James L. Harris P. V. Smcen, M.D.
Curr, Azromepica, Epucation Division Feperat Air Surceon
April 1966

FEDERAL AVIATION AGENCY
Office of Aviation Medicine



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


THE PREDOMINANT CAUSES OF CRASHES AND
RECOMMENDED THERAPY

Close scrutiny of the causes of recent general-
aviation fatal crashes reveals that there is a wide
discrepancy between the accident rate (number
of accidents per takeoff or per flight hour) and the
actual risk of flying. The accident rate is about
20 times greater than the risk of flying because of
the following considerations.

For purposes of this paper, we shall restrict our
comments to fatal general-aviation accidents, al-
though there is often a hairline between a fatal
and a nonfatal accident. If we were to consider
all general-aviation accidents, we would necessarily
give attention to the large numbers of ground
loops and other errors in landings. Increased
pilot proficiency is a clear preventive here.

Depending upon the source of statistics and the
specific nature of the definitions, 5% to 15% of
other than minor general-aviation accidents in-
clude such causes as structural failures not related
to flight loads, invisible weather phenomena, etc.
This small percentage is a credit to the products of
the aviation industry. Of the remaining 85% to
91% of the accidents, the bulk occur largely
through horseplay, foolishness, and lack of respect
for nature.

It is within this large latter category that we
will find an opportunity to reduce the annual acci-
dent toll. A reduction in accidents can be ex-
pected to yield an enhanced growth in general-
aviation activities (for one thing, fewer accidents
produce a lower cost of flying).

With rare exception, each fatal accident is the
end result of a chain of circumstances,each link
setting the stage for the connection with the next
link. 7

The following information bearing upon these
links is based upon that used by the Civil Aero-
medical Research Institute in its portion of the
CAB-FAA National Aircraft Accident Investi-
gations School, operated on a continuous basis at
the Aeronautical Center in Oklahoma City, upon
that contained in the documents listed in the

Selected References, and that gathered by the
author and his associates during on-site accident
investigations.

Three major categories of accident causes, fol-
lowed by an example of official 1964 CAB termi-
nology are given below:

1. Horseplay (Unrestrained Exuberance)—“Un-
warranted Low Level Flying.”

2. Foolishness—“Impaired Efficiency and Judg-
ment of the Pilot, Caused by the Consumption
of Alcoholic Beverages.”

3. Lack of Respect for Nature—‘Noninstrument
Pilot Attempted Continued Visual Flight in
Adverse Weather Conditions.”

Has not every pilot had an urge to tempt fate
and cut a safety corner? All human activities
carry some risk, and it is upon this point that we
focus attention: How can we cut the risk to a
minimum while increasing the freedom and pleas-
ure of flying?

The word “doctor” is derived from Latin and
means “toteach.” Physicians “teach” health, and,
thus, it is incumbent upon the flight surgeon, the
only repetitive point of contact for licensed pilots
with a representative of the FAA, to call to the
attention of pilots that a continued state of good
health is directly related to safe operating prac-
tices from the human-factors standpoint.

Aviation Medical Examiners, through concen-
tration and succinct brochures, can disseminate
“eye-opening” information concerning the avoid-
able circuinstances that precipitate general-avia-
tion accidents.

Each pilot should be aware of the inseparable
nature of mind and body. Physical illness, pro-
nounced fatigue, toxic ingesta and absorbables,
and hypoxia temporarily derange body function
and, hence, affect mental function.

The main determinant in the accomplishment
of a successful flight is the capability of the pilot
to “command” the airplane subsequent. to the exer-