we

30.

31.

35.

37.

38.

39.

Al.

Tampietro, P. F. and Goldman, Ralph F.:
“Prediction of Energy Cost of Treadmill
Work”; CARI Report 62-5, April, 1962, pp
1-4.

Larkens, William T.: The Ford Story;
Robert R. Longo Co., Wichita, Kansas,
1957, pp 1-178.

Lowenstein, Otto: Experimentelle Hys-
terielehre (Experimental Hysteria, sub-
titled “A Study of the Experimenta] Foun-
dations of Psychogenic Trauma”); Verlag
von Friedrich Cohen in Bonn, 1923, pp
1-412,

McFarland, Ross A.: “Health and Safety
in Transportation”; Public Health Report,
August, 1958, pp 663-630.

McFarland, Ross A.: “Human Problems
in Jet Air Transportation”; Society of Auto-
motive Engineers Transactions, Vol 64,
1956, pp 437-452,

Mohler, Stanley R.: “Aging and Pilot Per-
formance”; Geriatrics, February, 1961, pp
82-88.

Mohler, Stanley R.: “The General Biology
of Senescence”; Postgraduate Medicine,
December, 1961, pp 527-536,

O'Connor, William F.: “Community Re-
actions to Airports: A Psychosociological
Approach”; Aerospace Medigine, March,
1962, p 366, '

Office of Carrier Aécounts and Statistics:
Handbook of Airline Statistics; Civil Aero-
nautics Board, Washington, D. Cc, Decem-
ber, 1961. ,

Office of Plans: Aviation Forecasts; Fed-
eral Aviation Agency, Washington, D. C.,
1961.

Ovington, Earle L.: “The Psychic Factérs
in Aviation”; Journal of the American Med-
ical A€sociation, August 1, 1914, pp 419-
420,

Palmer, Henry’R.: This Was Air Travel;
Superior Publishing Company, Seattle,
1960, pp 1-190.

42.

47.

49,

51.

52.

-+17-

Pearson, Richard G.: “The Cause of Death
and Injury in Modern Lightplane Crashes”;
Aerospace Medicine, March, 1962, p 348.

Post, Mae: (Personal Communication by
Mrs. Wiley Post to the author, Snyder,
Texas, September 14, 1962).

Post, Wiley and Gatty, Harold: Around the
World in Eight Days; John Hamilton,
Limited, London, 1931 pp 1-222.

Ray, Jim: The Story of Air Transport;
John C, Winston Company, Philadelphia,
1947, pp 1-104.

Smith, Dean C.: By the Seat of My Pants,
Little, Brown and Company, Boston, 1961,
pp 1-245.

Smith, Paul W.: “Toxic Hazards in Aerial
Application”; CARI Report 62-8, April
1962, pp 1-8.

Snyder, Richard G.: “Human Survival of
Extreme Vertical Deceleration in Free-
Fall”; Aerospace Medicine, March, 1962,
p 369.

Swearingen, J. J., Hashbrook, A. H., Sny-
der, R, G., and McFadden, E. B.: “Kine-
matic Behavior of the Human Body Dur-
ing Deceleration”; CARI Report 62-13,
June, 1962, pp 1-8.

Swearingen, John J. and Mohler, Stanley
R.: “Sonotropic Effects of Commercial] Air
Transport Sound on Birds”; CARI Report
62-4, March, 1962, pp 1-5.

Swearingen, J. J., Wheelwright, C. D., and
Garney, J. D.: “An analysis of Sitting
Areas and Pressures of Man”; CARI Re-
port 62-1, January, 1962, pp 1-10.

Thompson, Horace: Proceedings of the
Second National Clinic for Domestic Avia-
ation Planning; Harlow Publishing Corpo-
ration, Oklahoma City, November 15-18,
1944, pp 1-396.

Thompson, Horace: Proceedings of the
National Aviation Clinic; Times-Journal
Publishing Company, Oklahoma City,
November 19-21, 1945, pp 1-239,


present is for the total number of active air-
men; many licensed airmen have let their medi-
cal certificates expire without later renewal —
others have current medical certificates but are
not active airmen — still other persons have
current Class II medical certificates but are
not pilots: for example, tower air traffic
controllers).

The thread of aviation medicine and aero-
medical research comes to us along a winding
trail. Bert’s classical studies in the 19th cen-
tury in relation to balloonists ascending to high
altitudes, set the stage for scientific aeromedi-
cal activities.” Bert explained why some early
balloonists returned to earth dead.

Dr. John Kelly, a Medical Reserve Corps
lieutenant, was the first “flight surgeon” in the
U.S. when in 1911 he was assigned to College
Park, Maryland. The U. S. Army had at that
time only one airplane.

Dr, Louis Bauer became Director of the Cen-
tral Medical Research Laboratory at Hazel-
hurst Field, Mineola, Long Island, in 1919, and
conducted research on high altitude physiol-
ogy. This facility moved to Mitchel Field in
late 1919, and in the early 1930's, a final move
was made to Randolph Field, Texas, where the
famous School of Aviation Medicine developed.

In the period leading up to World War H,
the Navy developed a school of ayiation medi.
cine at Pensacola, and, an aeromedical labora-
tory was established at (Wright-Patterson Air
Force Base in Dayton. ;

Dr. Bauer resigned his commission in 1926
and became the first medical director in the
new Aeronattics Branch of the Bureau of Air
Commerce, U. S. Department of Commerce.
The designated aviation medical examiner sys-
tem was established and the original physical
standards for civil airmen were defined. An
attempt was made in 1930 to relate the: acci-
dent rates with the types of physical deficidn-
cies.’ Definite correlations were found.

The Civil Aeronautics Administration medi-
cal laboratory was established on Aug, 2, 1946,
in Oklahoma City at the Aeronautical Center
at Will Rogers Field.“ Later, Dr. Stovall, Chief
of the Medical Division, CAA, transferred the
laboratory to Ohio State University, where the

establishment of an Institute of Civil Aviation
Medicine was planned. Mr. John Swearingen
was the laboratory director. In 1958, the Civil
Aeromedical Research Laboratory was trans-
ferred back to Oklahoma City.

In 1959 and 1960, Dr. James Goddard, the
FAA's first Civil Air Surgeon, and Dr, John E.
Smith, Chief of the Research Requirements Di-
vision under the Civil Air Surgeon, began to
lay the basis for the present Civil Aeromedical
Research Institute. Dr. H. D. Estes became
the first Director of the Institute in 1960.

The evolution of civil air transportation has
been a steadily progressing phenomenon, al-
though many set-backs have occurred and are
occurring. For a discussion of the economic
problems currently facing the airlines, see Mr.
Harding’s recent article."

The world’s first scheduled airline was
launched in 1909. Count Zeppelin and Dr.
Eckener created the Deutsche Luftschiffahrts-
Aktien-Gesellschaft, which operated dirigibles
between Friedrichshafen, Frankfurt, Hamburg,
Leipzig, Potsdam and Dresden. For five years
this airline carried more than thirty-seven thou-.
sand passengers without injury. Low speeds,
low cruising altitudes, and good maintenance
helped to produce this good safety record.

The first scheduled airline to use heavier-
than-air equipment operated a Benoist flying
boat between St. Petersburg and Tampa, Flor-
ida. It made two round trips a day and carried
one passenger at a time. This operation began
on January 1, 1914. The twenty-two mile one

‘ way flight took twenty minutes.

The Air Commerce Act of 1926 provided for
air mail egntracts to private operators and
marked the start of air transport in the U. S.°
The first year of private contractor airline op-
eration saw five thousand seven hundred and
eighty-two passengers carried, This number
makes an ‘interesting contrast with the more
than fifty million domestic passengers carried
by scheduled U. S. airlines in 1960, and the
estimated figure of seventy-five million for
1967."

In the twenties, many of the commercial air-
liners, for example the Ford Tri-Motors, had
no safety belts for the passengers. The wicker

-l-


the preservation of health of general popula-
tion groups ranging in age from infancy to old
age. This is in sharp contrast to the aims of
military aerospace medicine research pro-
grams,”

In 1961, well over 50,000,000 passengers,
many with chronic diseases (for example, cor-
onary artery disease, emphysema, asthma, cere-
brovascular insufficiency, and extreme obesity),
many with the general infirmities of old age,
were transported by the scheduled airlines.
Many pregnant women, infants and children
were carried as passengers. In civil aviation
emergency situations (explosive decompression,
passenger impact protection in crash landings,
rapid aircraft evacuation requirements), tradi-
tional safety procedures are often inadequate.”

Nonduplication of Effort

The Air Force and Navy aerospace and avia-
tion medicine research programs, and the space
medicine research program of the National
Aeronautics and Space Administration, focus
their major attention upon the requirements of
the young adult male who is a pilot or crew

‘ member of a high performance weapons sys-

tem on wings, or of an orbital craft. Today,
these military aerospace medicine research pro-
grams have almost no bearing upon the aviation
medicine research requirements of civil
aviation.”

The research of the Veterans Administrati
deals with a special population of chronically
ill veterans, and the findings have little direct
bearing on human factors problems {n aviation.
Similarly, the research: of the Public Health
Service has only an occdisional and’ isolated in-
stance of a specific contribution to air safety. /
Drugs in Civil Aviation

The general aviation pilots, of whom there
are several hundred thousand with current
FAA thedical certificates, need knowledge of
what drugs they may ‘ake and still safely fly.
Preventive drugs, which are taken for long peri-
ods following the early diagnosis of a chonic
disease; are becoming more numerous. Gen-
eral aviation pilots have no upper age limit,

and as the number of older general aviation
pilots increases, the number of pilots with
chronic disease will increase.

In all cases undergoing treatment, should
the pilot be grounded because he is undergoing
good preventive medicine treatment for a con-
dition which in its early untreated stage would
not justify grounding the pilot? Many physi-
cians think not (including the author), On
the other hand, some of these preventive drugs
have side effects in many persons which would
make these persons unsafe pilots while taking
the drugs. By and large, the military aviation
programs remove pilots from flying status while
they are taking medication. In civil aviation,
through pilot and airman performance studies
by aeromedical specialists, information may be
developed which will enable us to identify the
drugs which are not detrimental to pilot per-
formance. Many pilots may, thus, be kept in
the air at a safety level equivalent to their level
of safety when not receiving medication.

Civil Air Carrier Pilot Aging

At ninety miles per hour, the corrugated
aluminum Ford Tri-motor airliner would drone
over its destination airfield, enter the pattern,
and glide in at seventy-five miles.per hour, to
a gentle full stall landing having a roll of three
hundred feet or less." So long as the pilot was
in reasonably good health for aviation activities,
his age made little difference in his ability to
land these low-performance aircraft.

Today, the jet airliners have to be greased on
at about one hundred and forty miles per hour,
or so, and leave little margin for reflex error.
Pilot aging, a process, having a wide variation
in rate within the pilot population (as in all
populations); ultimately has a detrimental ef-
fect on the ability of pilots to handle these de-
manding airliners." As yet, no one has devel-
oped van index which can be used to assess the
functional age of a given pilot and relate this
index to his performance capability. The mili-
tary aerospace medical research programs are
doing little which bears upon this question. A
major civil aeromedical research program
(FAA’s Georgetown Clinical Research Institute)

~2-

se


se

Trites, David K.:
fic Management:
tion of Effectiveness of Air Traffic Control-
lers”; CARI Report 61-1, December, pp
11.

“Problems in Air Traf-
I. Longitudinal Predic-

. Trites, David K. and Cobb, Bart B.: “Prob-

lems in Air Traffic Management: III.
Implications of Age for Training and Job
Performance of Air Traffic Controllers”;
CARI Report 62-3, February, 1962, pp
1-10.

U. S. Civil Service Commission: “An-
nouncement 281-B, Career Opportunities
in the Federal Aviation Agency for Air
Traffic Control Specialist”, May 22, 1962,
pp 1-6.

U, S. House of Representatives: Hearing
before the Subcommittee of the Committee
on Appropriations (Fiscal Year 1963), U.S.
House of Representatives, 87th Congress,
Spring, 1962, pp 1-1209.

U. S. Senate: Hearings before the Sub-
committee of the Cémmittee on Appropria-
tions (Fiscal Year 1963), U. S. Senate, 87th
Congress, Summer, 1962, pp 1-1434,

59.

61,

~18-

Viteles, Morris $.: An Historical Introduc-
tion to Aviation Psychology, Report No, 4,
Division of Research, Civil Aeronautics
Administartion, October, 1942, pp 1-71.

Viteles, Morris S.: The Aircraft Pilot, Five
Years of Research (Summary of Out-
comes); Division of Research, Civil Aero-
nautics Administration, June 15, 1945, pp
1-46.

Harding, William B.: “Mergers Might
Save the Airlines”; The Atlantic, Septem-
ber, 1962, pp 46-50.

Swearingen, John J., McFadden, E, B.,
Gamer, J. D., and Blethrow, J. G.: “Hu-
man Voluntary Tolerance to Vertical Im-
pact”; Aerospace Medicine, December,
1960, pp 989-998,

Mingos, Howard: The Aircraft Year Book
for 1932, 33, 34, 35, 36; Aeronautical Cham-
ber of Commerce of America, Inc., New
York, New York.

Oklahoma Aviation News: Volume 1,
Number 1, September 1, 1946, Oklahoma
City, Oklahoma, pp 1-6.


phases of flight. Thus, for example, a jet pas-
senger is just as committed to undergo the risks
of take-off and landing on a short flight as he
is on a long flight. An accident rate based
upon a fatalities per mile calculation, would
indicate, however that the passengers in the
long jet flight, assuming a 100% fata] accident
occurred at the termination, were traveling at
less risk than the passengers in a short jet flight
experiencing a 100% fatal accident at the ter-
mination.

The same is true with calculations which de-
termine the aircraft accident rate by dividing
the number of accidents by aircraft flight hours.
Let us remember that the “accident rate” is one
thing, and the “risks of flying” another. By-
and-large, the present FAA and CAB methods
of accident rate computation indicate rates
which are somewhat below the actual risks as-
sociated with flying, as noted above.

So far this year, there is no spectacular in-
dication that these regrettable rates are declin-
ing, When one considers the rapid introduction
of new types ‘and categories of civil aircraft,
only the concerted interaction of the aircraft
industry, the airlines, the FAA and the CAB,
could have led to keeping the rates from in-
creasing. However, a large dent can be made
in the present rate through the application of
the fruits of civil aeromedical research.

I would also like to point out here that quite
often when an aircraft accident o¢curs, the vic-
tims represent some of the Nation’s top execu-
tive, scientific, and cultyral talent. Air safety
is, thus, doubly important to our country. For
example, just a few days ago, on October 6,
Mr. Tom Slick, well known Texas philanthropist
died in a light plane accident ip’ Montana
(CARI researchers are assisting in we investiga-
tion), and on October 7, U.’S. Representative
Clem Miller died in a light plane accident in
California.

The title of this paper incorporates three ele-
ments in federal civi] aeromedical research.
Our responsibilities are clear: (1) to insure
that no loss of life or limb in civil aviation ac-
tivities occurs for reasons which could have
been prevented had adequate and timely hu-
man factors knowledge been available, and (2)

to keep abreast of evolving aviation equipment,
and, through anticipation of the requisite future
human factors information, conduct appropriate
studies,

The aims are consistent with, and part of,
the mission of the Federal Aviation Agency:
(1) to enhance the air safety record, and (2) to
foster the growth of civil aviation.

Selected accomplishments are enumerated
in this paper and its bibliography. Much re-
mains to be done, and we shall continue to
strive to achieve that level of aeromedical re-
search which insures an optimum air safety
record with respect to the human factor ele-
ments,

Planned air safety, consistent with economic
realities, then, is the key to aviation’s continued
growth and successes in the years and decades
to come.

REFERENCES

1. Aldrich, J. W., Robbins, C. S., and Dyk-
stra, W. W.: “Bird Hazard to Aircraft”;
Wildlife Leaflet 429, U. S. Department of
the Interior, January, 1961, pp 1-10.

2. Anderson, H. Graeme: “Aeroplane Acci-
dents”; The Scientific American Supple-
ment, 87, 1919, pp 30-31.

3. Balke, Bruno: “Human Tolerances”; CARI
Report 62-6, April, 1962, pp 1-15.

4. Benford, Robert J.: Doctors in the Sky;
Charles C. Thomas, Springfield, 1955, pp
1-326.

5. Civil Aeronautics Board (Bureau of Safety):
Accidetits in Aerial Application Activities,
CAB, Washington, D. C, Calendar Year
1959, pp 1-23,

6. Civil Aeronautics Board: Summary Reports
of (Accidents, U. S. Genera] Aviation;
Docket Cases 2-001 to 2-0100, containing
January-March, 1962, incidents.

7. Cobb, Bart B.: “Problems in Air Traffic
Management: II. Prediction of Success
in Air Tarffic Controller School”; CARI
Report 62-2, February, 1962, pp 1-15,

-15—


in this retrospective fashion, new and uneval-
uated equipment and flying techniques have
replaced the older examples.

D. Civil Aviation: Passenger and Crew
Emergency Procedures, Oxygen Equip-
ment and Safety Measures.

This category of CARI research is focused on
providing the aircraft manufacturers and the
airlines with information on factors vital to the
preservation of life during civil aircraft emer-
gencies,

A study of emergency evacuation patterns in
large civil aircraft is underway.”

An accident may be considered to be an un-
planned experiment (albeit unfortunate), and
CARI, from its vantage-point as a component
of the FAA, and a not infrequent assistant to the
CAB, is obtaining heretofore lacking informa-
tion on the stumbling blocks to rapid escape in
air carrier accidents,

Narrow aisles, rare escape doors, inade-
quately briefed passengers, elderly women,
children, the general confusion which may ac-
company a crash landing: these are factors
which interact to impede a rapid egress from a
burning aircraft, Certain corrective measures
are possible and are being incorporated in
future aircraft. Much more remains to be
studied with respect to this topic, and CARI is
providing attention to these additional matters.

Better protection of the passengeié and crew
in today’s civil jet aircraft which fly at altitudes
up to 40,000 feet, in the event of an explosive
decompression, is being studied at CARI.’

These studies also anticipate the require-
ments of the ntxt evolutionary step in the large
civil aircraft, which will see the Supersonic
Transport rising to altitudes of ,009/t0 60,000
feet. The dive-ram principle af recompression
will likely be employed, and a large increase of
cabin heat resulting from the compressed, ait
will occur. Survival tolerances of civil air caré
rier populations( including all age groups, preg-
nant women®and persons with chronic cardio-
vascular conditions) to these explosive decom-
pressions, and to cabin heats of 170 degrees
Fahrenheit for five minutes, are being deter-
mined,

CARI is working with the aircraft industry’
on an explosive decompression study, particu-
larly with Lockheed, to whom CARI has given
a contract for the conduct of special high alti-
tude chamber studies, of a type heretofore not
conducted by military or other groups.”

It is possible that if middle-aged and elderly
persons with certain chronic diseases (for ex-
ample, cerebrovascular insufficiency, coronary
artery disease, pulmonary emphysema, obesity,
anemia) are found not to tolerate these po-
tential decompressions and recompressions,
flight on this next generation of aircraft will be
proscribed for them by their physicians.

A CARI investigation of an accident involv-
ing a twin-engine Convair revealed how im-
properly installed rearward facing seats caused
vertebral fractures in certain occupants.

Another CARI study revealed that a possible
attraction by a popular civil aircraft type for
starlings may be due to the similarity of the
taxiing sound of the aircraft and cricket chirps.
+ % More recent studies indicate that the
suspect sound may come from the propeller tips
during taxiing operations, and may possibly be

eliminated through cockpit manipulation of the

propeller pitch controls.

E. Civil Aviation Personnel: Drug Effects
on Performance and Safety of Aircrew
and Ground Support Personnel.

Aircraft accidents have occurred which quite
likely would not have occurred had the pilots
not been taking certain drugs. Included in
this category of studies is the acute alteration
of behavior which immediately follows alcohol
ingestion, and the subtle residual effects of al-
cohol ingestiba-which persist twenty-four hours
after ingestion,

Air traffic controllers, non-pilot aircrew mem-
bers, and maintenance men may take various
drugs (aspirin, antihistamines, antimotion-
sickness drgs, “wake-up” and “diet” médicines,
barbiturates, nasal decongestants, and other
drugs). No good information exists concern-
ing the role of these drugs in producing per-
formance decrements in these various categories
of aviation personnel.

-T7-


been long standing mysteries in aviation.* Also,
studies of the best methods of training student
pilots are being conducted.” These studies are
helping us to diminish the possibilities of pilot
error, of air traffic controller error, and of errors
by maintenance men,

Physiologists are involved in these studies,
and relatively recently, the neurophysiologists
have cast light on a cause of aircraft accidents
in a certain percentage of pilots who have a
susceptibility to becoming temporarily uncon-
scious during periods when they are observing
flickering light. The condition is flicker ver-
tigo. It may be precipitated by sunlight flick-
ering through helicopter rotors, or through air-
plane propeller blades, particularly in light
single-engined aircraft.

Judgement may be affected by alcohol,
drugs, fatigue, hypoxia, carbon monoxide, per-
sonality and character deficiencies, and other
factors, such as poor pilot instruction and ill-
ness. Poor judgement often leads the general
aviation pilot to fly into weather conditions
with which he cannot cope. Poor judgement
leads a pilot to decide to dive on a friend's

: house. Poor judgement leads a week-end pilot

to fly an unfamiliar airplane, or to fly his family
and himself into oblivion through careless flight
planning and operation of the aircraft.

Judgement, thus, is a quality which in a given
individual, moves up and down, in accordance
with mood, spirit, mental and physical condj-
tions, and stress factors (for example, a pressitig
business appointment), Human factors studies
by civil aeromedical research scigntists are
yielding new information in this highly impor-
tant area, v ;

' ,
The human engineers and psyshologists are

helping, to work on diminishing pilot, erroy/
through decreasing the chances of cockpit mis-
takes. The opportunity for errors in pilot ma-
nipulation of the various switches and other
flight,pengine and equipment controls (flap
control, landing gear gcontrol, propeller pitch
control, fuel cut-off control, etc.) has been en-
hanced through the scrambling of location of
these elements within successive models of a
given aircraft by the same manufacturer, as

well as by different manufacturers in their con-
struction of similar types of aircraft. FAA’s
“Project Little Guy” is working on this matter,
plus the matter of attempting to devise a stand-
ardized instrument design and instrument panel
overall lay-out, which would aid in diminishing
errors on the part of the pilot.

The possibility that stall warning and gear-
up warning lights and horns may not reach the
attention of pilots at times because of over-
loaded visual and auditory sensory channels,
has led one CARI researcher to investigate
other biological sensory systems as potential
avenues for warning signals.”

CATEGORIES OF RESEARCH
Organizational Pattern of Research Programs

The Aeromedical Research Division of the
Aviation Medical Service (the Aviation Medi-
cal Service is under the direction of the Civil
Air Surgeon who reports to the Administrator
of the Federal Aviation Agency) works closely
with the other three major medical Divisions
(the Aeromedica] Standards Division, which
writes the aeromedical standards for civil air-
men and conducts the medical portion of FAA’s
accident investigations, and the Aeromedical
Certification Division, which provides current

medical certificates to more than one million,

civil airmen and conducts special refresher
seminars for the designated aviation medical
examiners, and the Clinical Services Division,
which examines FAA personnel and conducts
an employee health program). Questions are
referred td the research program and, following

_ appropriate study, answers ‘are retumed.

The Aeromedical; Research Division also
maintains close liaison with the hardware and
systems reséarch and development program
conducted at the FAA’s National Aviation
Facilities Experimental Center in Atlantic City.
' The Aeromedical Research Division consists
of the Civil Aeromedical Research Institute,
located at the Aeronautical Center in Oklahoma
City, and the Georgetown Clinical Research
Institute, located :at the Georgetown Medical
Center in Washington, D. C. Of the following

~4-

se


‘a

is working upon the possibility of devising an
index which, for a given pilot, may enable him
to fly air carrier aircraft beyond his chronologi-
cal age of sixty (the upper cut-off time at
present), if his functional age is lower."

Crash Impact Survival

Flight in light and heavy airplanes, helicop-
ters, short take-off-and-landing aircraft, gyrop-
ters, gyro-dynes, and other yet-to-be-developed
aerial machines, will always entail some risks to
those within, for all of these are human crea-
tions and are operated by humans. So long as
the human is imperfect, he will be a potentially
weak link in the operation and maintenance of
his aircraft.”

In the long run, it will pay (in terms of de-
creased mortality and morbidity and a de-
creased fear of flying in the general popula-
tion) the aviation industry to incorporate
features in all new aircraft which will protect
the occupants from impact injury. This facet
of aeromedical research requires the interdis-
ciplinary team approach wherein biologists,
engineers, accident investigators, engineering
test pilots, physical anthropologists and flight
surgeons cooperate in joint studies.

The military aeromedical escape studies
focus attention on the ejection seat and para-
chute method of avoiding injury through re-
moving the occupants from an. ircraft prior
to impact. These studies have ilittle applica-
tion to civil aviation Where, for example, the
air carrier pilot, as commander of his craft,
cannot leave it in flight so long as the pas-
sengers are aboard, Providing civil passengers
with ejection seats or parachutes seerhs to be an
impractical and unlikely escape précedure for
adoption in civil air carrier opergtions.

Improvement in light plane interiors to dim-
inish or prevent injury to occupants in potenti-
ally survivable accidents is within immedjate
reach.”

¥
Human Errors

When we talk about civil airmen, what size is
the group we discuss, and what are the medical
certification facts in terms of numbers?

During the January 1 to June 30, 1961,
period, almost 112,000 persons went to FAA
designated Aviation Medical Examiners for
Class I, II, or III medical certification." About
15,000 (13%) of these persons had medical con-
ditions and physical deficiencies which potenti-
ally could be hazardous to the safe discharge
of ‘their respective aviation activities, About
500 applications had to be denied (115 appeals
were reviewed by the Medical Review Board
of the Aviation Medical Service, and 72 were
denied again, 16 were certified, and 27. were
deferred for additional information). The over-
all history has been that less than two per cent
of the applicants are ultimately denied each
year.

The persons certified as noted above, are the
principals most involved in the discussion which
follows.

When a civil aircraft crashes, a constellation
of factors usually have interacted to set the
stage for the precipitating factor, or “probable
cause”, the legal determination of which, is the
responsibility of the Civil Aeronautics Board.

For a flying aircraft, either the aircraft, the
occupants, or an outside factor, constitute the
three areas within which the “probable cause”
rests. The Comet disasters were attributed to
metal fatigue, and, thus, the aircraft was at
immediate fault. In the National Airlines bomb
accident over North Carolina, neither the air-
plane nor an outside factor were determined as
immediately involved thus, the solution lay
within the sphere of occupant behavior. In bad
weather, during a period of decreased visibility,
a Capital Viscount was struck over Maryland
by a violent thunderstorm; hence, an outside
factor was;implicated. In addition, the pos-
sibility, as reported by the Civil Aeronautics
Board, that certain late weather information
bearing on this storm was not relayed to the
pilot, falls within the outside factors area.

It is estimated that human errors and other
human factors are associated intimately with
eighty-eight per cent of civil air carrier acci-
dents.”

Psychological studies of decreased perform-
ance ‘in fledgling pilots, fatigued pilots, and ill
pilots, are shedding new light on what have

-~3-


8. Cohen, S. Ralph (Editor): Proceedings of
the First National Clinic of Domestic Avia-
tion Planning; Harlow Publishing Corpora-
tion, Oklahoma City, November 11-13,
1943, pp 1-277.

9. Cooper, Harold J.: “The Relation Between
Physical Deficiencies and Decreased Per-
formance”; The Journal of Aviation Medi-
cine, March, 1930, pp 4-24.

10. Darling, Lois and Darling, Louis: Bird;

Houghton Mifflin Company, Boston, 1962,
pp 1-261.

11. Davis, Kenneth S.: The Hero, Charles A.

Lindbergh and The American Dream;
Doubleday and Company, Garden City,
New York, 1959, pp 1-527,

12. Dille, J. Robert: “The Effects of Simu-

lated Altitude on Penetrating Eye In-
juries”; CARI Report 62-12, May, 1962, pp
16.

13. Daugherty, Jack W., Lacey, Dane Eugene,

and Korty, Patricia: “Problems in Aerial
Application: I. Some Biochemical Ef-
fects of Lindane and Dieldrin on Verte-
brates”; CARI Report 62-10, May 1962, pp
16,

" 14, Du Bois, Eugene F.: “The Anatomy and

Physiology of the Airplane Cockpit”; Aero-
nautical Engineering Review, April, 1945,
pp 1-3, ‘ i

15. Earhart, Amelia: Last Flight; Harcourt,

Bract and Company, New York, 1937, pp
1-226. :

16. Federal Aviation Agency: “Aerial Applicg-
7

tion”, Fly By, October 1962, p 3.

17, Federal Aviation Agency contdct 3039:

1

es

ie

“Vestibular Investigations in Mammals”,
University of Oklahoma Research Institute,
91962.

8. Federal Aviatten Agency Contract FA-
3082: “Effects of Slow and Rapid De-
compression on Humans at 45,000 Feet”;
Lockheed Aircraft Company — California
Division, 1962.

21.

27.

29,

-16—

. Henmon, V. A. C.

. Federal Aviation Agency: Third Annual

Report, FAA, Washington, D.C, 1961, pp
161.

. Grahame-White, Claude: Aviation; Collins’

Clear-Type Press, London, 1912, pp 1-262.

Halaby, Najeeb E.: “FAA Develops
Unique Studies to Determine True Age”;
The Air Line Pilot, February, 1962, pp 4-7.

. _Hasbrook, A. Howard: “Crash Survival by

Design”; Arizona Engineer and Scientist,
March, 1958, pp 1-3.

Hasbrook, A. Howard: “Evacuation Pat-
tern Analysis of a Survivable Commercial
Aircraft Crash”; CARI Report 62-9, May,
1962, pp 1-10.

Hasbrook, A. Howard: “Crash Survival
Study—DC 6 Accident at Elizabeth, N, J.,
on February 11, 1952”; Crash Injury Re-
search Release Number 15, Cornell Univer-
sity Medical College, October, 1953, pp
1-65.

Hasbrook, A. Howard and Earley, John C.;
“Failure of Rearward Facing Seat-Backs
and Resulting Injuries in a Survivable
Transport Accident”; CARI Report 62-7,
April, 1962 pp 1-11.

. Hawkes, Glenn R.: “Tactile Communica-

tion”; CARI Report 62-11, May, 1962, pp
1-7. .

Henderson, Yandell and Seibert, E. G.:
“Medical Studies in Aviation”; Journal of
the American Medical Association, October
26, 1918, pp 1382-1400.

“Air Service Tests of
Aptitude for Flying”; The Journal of Ap-
plied psychology, June, 1919, pp 103-109.

Hitchcock, Mary Alice, and Hitchcock,
Fred A. (Translators): Barometric Pres-
sure, Researches in Experimental Physio-
logy, by Paul Bert, 1877; College Book
Company, Columbus, Ohio, 1943, pp
1-1055.


It has been observed that in certain demand-
ing locations, controllers as a group are some-
what more prone to develop stress-related
medical conditions (for example, peptic ulcer,
hypertension, anxiety psychoneuroses ), so stud-
ies are underway which are attempting to
enable us to better pin-point the stress factors
which lead to these conditions, and to identify
those individuals who are most prone to develop
these conditions. The above mentioned longi-
tudinal sample should prove to be of immense
value here.

For many years to come, man will be a func-
tioning and integral component in the air traf-
fic system, Human error will, therefore, be an
ever present potential threat to air safety. CARI
psychologists have investigated several air traf-
fic controller error incidents, and have made
recommendations for certain changes in exist-
ing air traffic procedures which will help de-
crease the chances of recurrence of these errors.
Of additional interest here is the matter of shift
work in the air traffic around-the-clock activity,
with reference to the work-rest-sleep cycle of

individual. Also, the period which immediately

follows a change to another shift time is being
studied,

The working environment of the controllers,
some being in glass control towers with large-
heavy-fast and small-light-slow aircraft con-
verging from all directions, and others being,
in small, often dimly lit, smoky and congested
en route centers, is being scrutinized from the
individual and group work proficienty stand-
point. A study on the ecology of these groups,
and the factors which may precipitate inter-
personal strife, so detrimental to the efficiency
of the required team effort, is underway.

Excessive fatigue, an allegedly possible con-/

comitant of piloting large civil jet aircraft, is
receiving some attention at CARI.“ The sub-
ject is difficult to define, difficult to measure,
and is ycomplicated by possible pilot-airline
contract implications, Some have felt that the
increased demands of th¥ése aircraft for a higher
level of pilot alertness have produced mental
fatigue which toward the end of a flight can
cayse a’ performance decrement which is de-
trimental to the pilots’ safe handling of the air-
t. .

Others suggest that since a given flight is
now more quickly accomplished with jets, the
jet pilots must make more individual flights
now to reach the maximum allowable monthly
number of flying hours (eight-five), There is,
thus, less time off now, and the extra free-way
traveling to the far-out jet airports associated
with the additional flights compounds the
fatiguing factors, Cutting time-zones more
quickly when flying from West to East, or vice
versa, is also conducive to producing fatigue,

CARI researchers have been in frequent com-
munication with the medical directors of the
major airlines, and with various pilots through
the Air Line Pilot’s’ Association, and are giving
attention to the jet pilot fatigue question.

Other studies in the broad adea of proficiency
include determinations for pilots, ground sup-
port and other essential personnel, of safe levels
of function in the following areas:

1, Visual acuity

2. Color vision

3. Hearing acuity

4, Vestibular function.

Accidents have occurred through excessive de-
ficiencies in these areas so vital to aviation. It
is recognized that some kinds of aircraft and
some types of flying are not as demanding in
these neurophysiologic and psychologic areas as
is the case in other instances. Therefore, CARI
is working closely with the Aeromedical Stand-
ards Division in an attempt to match the medi-
cal standards for airmen with the type of flying
and the nature of the equipment. Through re-
search, the standards can be revised up or down
in timely relation to fufufe equipment through
extrapolation, . In the absence of proper in-
formation developed through research, stand-
ards must be established in accordance with
the‘ best judgement of: medical and aviation
authorities, and changed only after a retrospec-
tive assessment of thé accident and flight ex-
perience with the equipment in question.
Too often, based upon a series of tragedies,
this latter approach shows what the standards
should have been to insure safety for certain
pilots in certain categories flying certain equip-
ment, and by the time new standards are made

-6—


Doc
FAA

62/20
te.

~s

AD RIEIBE

Ab 295 135

CIVIL AEROMEDICAL RESEARCH:
: RESPONSIBILITIES, AIMS,
AND
ACCOMPLISHMENTS

cae

FEDERAL AVIATION AGENCY
, AVIATION MEDICAL SERVICE
AEROMEDICAL RESEARCH DIVISION
, CIVIL AEROMEDICAL RESEARCH INSTITUTE,
OKEAHOMA CITY, OKLAHOMA wo
reprooucen BY oo
NATIONAL TECHNICAL
~ INFORMATION SERVICE

US. DEPARTMENT OF COMMERCE
| SPRINGFIELD, ¥A, “22161

OCTOBER, 1962 -~


These studies are made by going to the scene
of selected accidents and determining the
causes of specific fractures, lacerations, and in-
ternal impact injuries.

Modifications of hazardous structural fea-
tures which can be changed without altering
the function of the structure, are recommended.
Investigators at CARI subject themselves to
prescribed degrees of impact and test the at-
tenuating effects of certain substances for ex-
ample, Stafoam. One investigator, (Mr. Swear-
ingen) has absorbed as much as one hundred
g’s of deceleration force through eight milli-
seconds in a vertical drop test using this latter
substance as an impact cushion." The implica-
tions with respect to the construction of seats
in future aircraft are obvious.

Other studies on impact are conducted using
articulated dummies and high speed cinema-
photography (8,000 frames per second). In
addition, certain long bones and flat bones are
tested against current and proposed aircraft
seat structures with hydraulic presses and elas-
tic propulsion devices, in an attempt to deter-
mine the degret. to which elements of the seat
structure do, or do not, attenuate impact forces
as may be sustained by occupants of a deceler-
ating aircraft.

CARI is conducting the first large-scale
study of human survivors of long free-falls
from heights up to several hundred feet.” The
circumstances of each fall, the characteristics of
the impact surface, the position af the victim
at impact, the injuries sustained, And the con-
valescent course! are being documented in sev-
eral thousand instances. #

Already, certain highly significant findings
are coming td light, which include new infor-
mation bearing upon specific fail poists during
deceleration in the human anatomical struc-
ture, and potential survivability of humans to
extreme impacts,

The fail point information is of key value in
designing aircraft seats so as to position the
occupants in the attitude most likely to lead to
crash survi¥al. One key fail point beginning to
emerge from this study is the site of attach-
ment between the inferior vena cava and the
heart. With respect to survivable impact lev-
els, the CARI study has found cases of survival

of fall victims who sustained as high as two
thousand g’s for a fraction of a second.

Occupant restraint systems which protect the
crew and passengers from flailing injuries dur-
ing crashes are under investigation.” A par-
ticular need exists for proper infant protective
equipment (in many cases at present the mo-
ther must hold her infant during the take-off
and landing of an airliner) and proper shoulder
harnesses for people of all heights and weights.
Shoulder hamesses which can be accommo-
dated to the differing breast structures of dif-
ferent women passengers are required.

A CARI study of the seat pressures exerted
by the ischial tuberosities of a sitting person
revealed some interesting findings." The body
weight is supported by about eight per cent of
the body area when one is sitting on a stool.
When seats are constructed so that four or
five straps support a cushion, the actual body
weight is focused during impact upon only one
or two straps. The results of this study have
an important bearing upon future seat designs.

H. Civil Aviation Generated Biological
Stresses in the General Population

When an airport is planned for a community,
not infrequently certain psychosocial dynamics
characterizing group human behavior begin to
operate which may force the location of the
airport in one of the less ideal sites from the
standpoint of the safe operation of the
aircraft.”,

Since a large airport is more often than not
a relatively permanent facility, its proper lo-
cation is key to air safety. Human behavior
studies of ‘this type have proven their value in
implementing such public health programs as
community immunizations in relation to spe-
cific diseases. Other examples are seen in the
anti-air pollution programs. CARI is investi-
gating the reasons underlying the behavior of
the varidus elements in the community when
the planned optimum location of an airport is
jeopardized, From these studies may come
specific guidelines which will enable those per-
sons responsible for planning and establishing

-9-


CARI is studying these matters, which do
present complex methodological problems. The
information, as it is developed, is disseminated
to the airlines, the pilots and aircrew members,
the controllers, and other persons who are
concerned.

F. Aerial Applicators: Effects of Toxic Chem-
icals upon Health and Safety.

More than one million hours per year of fly-
ing are conducted in the field of aerial appli-
cation." The accident incidence is the highest
of any segment of general aviation, and pos-
sibly one-half of the fatal accidents are due to
pilot decrements in performance due to chronic
toxicosis.

Organophosphate insecticides are in common
use today, and evidence indicates that the high
incidence of pilot fatalities in crop-spraying
with these substances is the result of chronic
absorption by the pilots of small amounts of
organophosphates.” At a certain constitutional
level of absorption, the pilot's nervous system
is poisoned to the point where his reactions
and decisions in flight are not compatible with
aerial applicator maneuvers. Blood tests are
heine refined at CARI which give an index
during the aerial application season of how
much poison a given pilot has absorbed. Also,
protective equipment is being developed which
aids the pilot, his swampers and his flag man
to avoid contamination. +

The biochemical effects of the chlorinated
hydrocarbons used in aerial application (for
example, lindane and dieldrin) are bging stud-
ied at CARI, and recently, CARI investigators
have found that certain members of this class
of compounds have a highly specifj¢ and hith-
erto unsuspected interference effect upon the. /
molecular dynamics involving the high-energy ’
phosphate bond.” It is predicted that this dis-
covery will lead to an entirely new biochemical
research, tool of great potential utility for
medical and life sciences investigations. An
antidote to acute and chronic poison cases due
to these compounds may be devised as a result
of this fyrther clarification of their biochemical
meshanism of toxicity.

. —8

es

CARI keeps in close touch with the Depart-
ment of Agriculture on these studies. The
DOA investigators, however, are primarily con-
cerned with the acute and cumulative effects
of aerial applicator substances on the public
which at times may consume food containing
traces of these chemicals, The pilot’s flying
proficiency in relation to his absorption of these
substances is the FAA's responsibility,

A brief reference to the CAB report on aerial
application accidents in 1959 is pertinent here.’
Of 314 total accidents, 57 were fatal and 57 fa-
talities resulted. One hundred and nine air-
craft were destroyed, and 35 persons were
seriously injured. The accident rate per hun-
dred thousand flight hours was 6.47 for fatal
accidents, and 35.69 for all accidents. The
fatal rate was 78 per cent above that for all
general aviation (although the total accident
rate was 3 per cent lower in aerial application
than for all general aviation).

The report mentions that at least 10 acci-
dents were experienced by pilots affected by
the chemicals being used in aerial application.
Among these, parathion is prominent, Three
fatal accidents were distinctly due to the toxic
effects of the chemicals on the pilots. In ma
other accidents, the possibility that pilot pef-
formance was impaired due to the gradual ac-
cumulation of the chemicals in the pilots dur-
ing the active season is good.

Injury Prevention in Light and Heavy
Aircraft Accidents.

Consistently missing in the structural and in-
terior fittings design of civil aircraft is the
matter of “delethalization”.* Perhaps the great-
jest strides have been made with respect to pro-

/ viding delethalized and-erashworthy airframe
and interior designs in certain of the newer
agricultural aircraft."

The aircraft manufacturers and the airlines
are ‘becoming increasingly interested in incor-
porating anti-crash injury features in their
equipment. CARI is'working with a number
of these groups and is supplying them immedi-
ately with information as it becomes available
through studies by CARI’s Protection and Sur-
vival Branch.


categories of projects, “A” through “H” are con-
ducted at CARI, and “I” and “J” are conducted
at Georgetown.

A. Atr Traffic Controllers and Air Crew
members: Physiological Stress, Fatigue,
and Aging Factors Relating to Profici-
ency.

B. Air Traffic Controllers and Air Crew
Members: Psychological Stress, Fatigue
and Aging Factors Relating to Profici-
ency.

C. Air Traffic Controllers: Proficiency,
Selection Factors, and Optimum Char-
acteristics of Air Traffic Working En-
vironment.

The CARI projects falling within the above
three categories are conducted by scientists in
each of CARI’s six Branches (Biodynamics,
Environmental Physiology, Neurophysiology,
Pharmacology-Biochemistry, Protection and
Survival, and Psychology).

The findings of one of the projects in psy-
chology were recently incorporated in the Civil
Service Announcement No, 281 B, issued May
22, 1962.“ CARI investigators gave certain
psychological tests to air traffic controller stu-
dents and correlated the performance of each
student with his performance while undergoing
air traffic controller training at the Aeronauti-
cal Center. Five test, areas emerged as highly
predictive of ‘school’ performance: (1) ab-
stract reasoning ability; (2) ability with num-
bers; (3) ability to conceptualize space in three
dimensions; , (4) ability to make “non-verbal”
analogies; and (5) ability to solve a bpecial test
of air traffic contro! problems.’

By setting the minimum cht-off scores on the
above tests to an appropriate level, candidates
for air traffic controller training, gan be
screened prior to their entrance in training, and,
with as high as eighty to ninety per cent ac-
curacy, tlitse individuals with little aptitude for
a career in air traffic control can be eliminated.
Previously, these persons were eliminated at
the end of their air traffic schooling, or later,
during their first year of work as controllers.

Through elimination of unfit candidates prior
to training, this study, which cost about forty
thousand dollars, is conservatively estimated to
save the taxpayers more than two million dol-
lars over a ten year period. A contribution to
airsafety results also in that with a high degree
of confidence, persons poorly fit for air traffic
work who, none the less, might scrape by in air
traffic school, are not trained. One interesting
aspect here has been the discovery that persons
who undertake air traffic control training who
are over the age of 35, have a very high rate
of failure.”

Another study in the above area is the longi-
tudinal medical, physiological and psychologi-
cal evaluation of more than one thousand air
traffic controllers, from the day of entrance on
duty for training, to a point a few years later
in their career when their work efficiency and
disease pattern can be assessed. One of the
treadmill test techniques is described in CARI
Report 62-5.”

From the more than one thousand air traffic
students now studied in detail at CARI, certain
patterns are already beginning to appear. Wide
variation in physical habitus and conditioning
are noted, One hypothesis being tested is that
the individual does a better job as a controller
if he is in a better state of physical condition
from the athletic standpoint.

Many people are of the personal opinion that
better physical conditioning leads to better
working ability in all endeavors, This has never
been tested and, may, in fact, be exactly op-
posite to the facts with respect to sedentary
work. The, controller who rates poorly on 2
physical condition scale with respect to his
physical work capacity, may, in fact be highly
conditioned physically to spending long periods
in physical inactivity, and, thus, be at his best
from hig job requirement standpoint, The ven-
erable Wiley Post was of this latter opinion,
and spent weeks of physical inactivity prior to
his solo round the world flight in 1933. He
sat for hours in his parked airplane, and in his
hotel’ room, doing essentially nothing from the
physical work standpoint.

—5-


CIVIL AEROMEDICAL RESEARCH:
RESPONSIBILITIES, AIMS, AND ACCOMPLISHMENTS*

STANLEY R. MOHLER, M.D.

INTRODUCTION

A man, a machine, the atmosphere, and an
airport: these are the basic functional compo-
nents of civil aeronautics.

An additional component, consisting of the
men and electronic equipment comprising the
air traffic system, is now’ as integral a part of
civil aeronautics activities as are the pilots and
their aircraft.”

Two intertwining threads wind inseparably
through the above picture: (1) the mainte-
nance programs related to the health and func-
tional adequacy of airmen and equipment, and
(2) the economics of the dynamic, ever chang-
ing, often hard-pressed, aviatio# industry.

The basic mission ‘of a civil aviation flight is
to return unharmed the occupants of the air-
craft to terra firma, At times the pilot may be,
the sole occupant, at other times, the crew will
be the only occupants, and in still,other cases,
the occupants will consist of the créw and more
than a hundred passengers.,

Any mission which results in death or injury
to an occupant is not a successful mission.
Successful missions must constantly be accom-
plished if civil aviation is to continue to grow
and progress. This paper will indicate the role
of aeroffedical research in helping to prevent
unsuccessful missions,

Involved in the safety of a mission are the
matters of providing assurance that one aircraft
in flight will not jeopardize another, and that
the operation of an aircraft will not need-
lessly endanger the lives or property of the
population-at-large.

A DEFINITION OF AEROMEDICAL
RESEARCH

Aeromedical research is the scientific study
of the interrelation in aeronautics of the human
elements and the hardware, All disciplines and
skills are involved, including physicians, phy-
siologists, psychologists, physical anthropolo-
gists, engineers, and flight test pilots.

Aeromedical research provides the Aviation
Industry and the public with answers to ques-
tions having a vital bearing upon accident and
crash injury prevention. The information de-
rived through aeromedical research when ap-
plied to Aeronautical activities leads to an en-
chancement of the air safety record."

Civil Ait Carrier Passengers ’

i
Civil aeromedical research is responsible for
providing human factors information relating to

“This paper was given in connection with the dedication program of the Civil Aeromedical
Rese: Institute building, October 19-21, 1962, at the Aeronautical Center, Will Rogers

Field, Oklahoma City, Oklahoma.

-1-


seats were provided with hand grips for pass-
enger stability in rough air. Overhead baggage

were used for suitcases, a hazardous
transfer to aviation of practices used with rea-
sonable safety by the railroads.

A final historical note seems pertinent, In
1929, Transcontinental Air Transport provided
travelers with the possibility of crossing the U.S.
in forty-eight hours, The itinerary consisted
of going from New York City at night to Co-
lumbus, Ohio, via the Pennsylvania Railroad.
From Columbus, a Ford Tri-Motor was taken
to Waynoka, Oklahoma, where a Santa Fe
sleeper was taken to Los Angeles. The pas-
sengers were subjected to noise, vibration, air
pressure changes, temperature extremes, and
other stresses.

It is interesting to note that the first human
factors fatality in the U. S, in a heavier-than-
air aircraft apparently was Professor John
Montgomery. Professor Montgomery suffered
from periodic attacks of vertigo and loss of
consciousness. During'a glider flight in 1911
in California, he lost conttol and crashed, Prior

. to dying from his injuries, he told of the oc-
currence of one of these attacks during the
flight leading to his disorientation. Along this
line, through a contract with the University of
Oklahoma, CARI investigators are studying
the matter of vertigo, disorientation, and inner
ear malfunction.” ’

Through the years, aviation notables have
recognized the importance of hunfan factors
research."* for example, Lindberglf conducted
altitude physiology studies in the 1930's, and
Amelia Earhart pressed’for additional investi-
gations of the effects on the spilot of his /
aircraft. ' F

Even as far back as World War I, the castor
oil used in rotary engines would at times cause
incapacitation of the pilots through exhaust
fume ¢phalation, The importance of aviation
medicine became cleam-

The Oklahoma City Chamber of Commerce
held three annual civil aviation, clinics in 1943,
1944 and 1945." Industry and Governmental
officials active in civil aviation participated,

and held brain-storming sessions which at-
tempted to forecast what problems should be
tackled in the post-war era to help foster civil
aviation safety and growth.

These persons did not overlook the human
factors elements, so vital to air safety and de-
velopment. For example, the following re-
search needs are contained in the 1944 book,
as outlined by Mr. M. K. Fahnestock:

I. Biological Sciences

A. Involving Both Aircraft and Person-

nel

1. Pilot and crew fatigue, perform-
ance, maintenance and length of
service.

2, Optimum operating schedules for
equipment and personnel,

3. Design of aircraft to reduce in-
juries in crashes, Available in-
formation indicates that struc-
tural redesigning of planes may
reduce fatalities and serious in-
juries in crashes from medium
heights.

B. Involving Operating Personnel and
Passengers.

1. Pilot and crew training, including
mental and physical examina-
tions, and minimum requirements
for commercial flying.

2. Mental and physical examinations
+ and minimum requirements for
personal flyers.

3. Human ,teactions accompanying
fear and emergencies.

4. ° Physical fitness and influence on
training: and performance.

‘,  §. Public -héalth and disease carry- ’
ing insects.
8. Food and food service for pilots,
crew and all types of passengers.
7. Effects of factors of flight on
impaired physiologically deficient
people.

-l2-

Be


In civil aviation tragedies, there are many
additional examples of injury and death which
resulted from the lack of application of existing
aeromedical knowledge or the lack of existence
of timely aeromedical knowledge. Examples
may be found in the CARI Reports and CAB
reports. Our aeromedical research program
is dedicated to the production of the informa-
tion which is vital to the human factors aspects
in civil aviation. In the absence of this infor-
mation, civil aviation will continue to be peri-
odically shocked through the occurrence of
“difficult to explain” accidents and injuries,

Our tallies show that in the first six months
of calendar year 1962, the following accident
experience occurred:

Air Carrier Fatal Accidents - 4
Air Carrier Fatalities — 248
General Aviation Fatal Accidents — 178
General Aviation Fatalities ~ 361

For general information, the following fig-
ures are instructive: .

The Civil Aeronautics Board reports indicate
the major roles played by the human factors
aspect in these accidents. Until these human
factors aspects are properly defined, and
brought to the attention of aviation personnel
and pilots through education and training, the
accidents will continue at the present, unac-
ceptably high (in my opinion) rate (if you
don’t believe its high, ask some of your neigh-
bors why they feel uncomfortable in airplanes,
or why some of them won't fly at all).

There were last April, a little more than
114,000 general aviation aircraft registered in
the U.S. Also, there were about 2,200 air car-
rier aircraft. In 1961, 437 fatal general aviation
accidents occurred (with 794 deaths), which
means that, roughly, one of each 260 general
aviation aircraft was involved in a fatal acci-
dent. Preliminary estimates indicate that about
one of each 20 general aviation aircraft was
involved in an accident of greater or lesser im-
portance in 1961.

What is the trend over the past three years
in aviation fatalities? There are many appro-
aches to attempting to determine this. Some
recommend taking the number of fatalities per
mile flown. I would like to point out that many
accidents occur during the take-off and landing

Air Carrier Fatal Air Carrier
Actidents Fatalities
Calendar Year,1960 | | 7 499
Calendar Year 1961 12 \ 312
: _ General Aviation Fatal General Aviation
# ; Accidents Fatalities
Calendar Year 1960 ' 48 835
Calendar Year 1961 ’ 437 794
Scheduled, Supplemental ‘
and Commercial Air Carrier Federal Aviation
e Passenger Fatality Rate/100 Fatail Accident Rate/
+ million Passenger-miles 100,000 hours
Calendar Year 1960 1.30 3.5
Calendar Year 1961 0.66 i 84
b
~M4-

a


po

TABLE OF CONTENTS

Introduction .............cceecceeeeseeeeeee

A Definition of Aeromedical Research...................... 1
Nonduplication of Effort.................. 2
Drugs in Civil Aviation... eects 2
Civil Air Carrier Pilot Aging. 2
Crash Impact Survival. 3

3

Categories of Research....... 4

"Organizational Pattern of Research Programs. nr:
A,B, and C: Air Traffic Controller and Air Crew Member

Research. 5
D: Passenger and Crew Emergency and Safety Measures 7
E: Specific Drug Effects........... 7
F: Aerial Applicators seven 8
G: Injury Prevention in Accidents sme 8
H: CiviJ Aviation Produced Stresses on the Population... seven OD

IandJ: Physiologic Age Relating and Prognostic Diseases

vy

,
Brief Historical Resume’.
Closing Statemen

References...

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CIVIL AEROMEDICAL RESEARCH:
RESPONSIBILITIES, AIMS, AND ACCOMPLISHMENTS

STANLEY R. MOHLER, M.D.

Chief, Aeromedical Research Division
Director, Civil Aeromedical Research Institute

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FEDERAL AVIATION AGENCY
AVIATION MEDICAL SERVICE
AEROMEDICAL RESEARCH DIVISION
CIVIL AEROMEDICAL RESEARCH INSTITUTE
OKLAHOMA CITY, OKLAHOMA
OCTOBER, 1962

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an airport, to develop a profile of the com-
munity in question, and, through direct and ef-
fective communication with specific segments,
enlist the requisite community support for re-
sponsible airport location.

This study also has a direct bearing in pro-
viding assistance to those aspects of general
aviation which are hard pressed due to the
widespread closing of the smaller airports. A
return to the scene of a certain number of con-
venient, small airports, is vital to a growing,
and safe, general aviation activity.

Another study under this category is focused
upon the factors which cause overhead air-
eraft noises to be highly irritating to some per-
sons in the community but not to others. Many
people quickly learn to accept these noises as
they did railroad whistles so common in past
decades.

Another study related to the effects of avia-
tion activities on the public gives information
concerning how high persons with penetrating
eye injuries may be safely flown during air
evacuation.” :

1. Physiologic Age Rating for Pilot Certifi-
cation Eligibility.

J. Prognostic Studies of Diseased States
Influencing Flying Safety.

These interdisciplinary studies are focusing

on several hundred civilian pilots, A correla-.»

tion is being made between the physiological,
biochemical, psychological and clinical char-
acteristics of each pilot and his flight perform-
ance as he ages.” . :

It is anticipated that an;index of functional
age will be developed which at a later date
may enable a revision of the current standards
to potentially allow airline pilots who ‘are
chronologically over sixty to continue to fly if
they are functionally less than sixty in age.
Also, the implications for flying safety of cer-
tain chr@nic diseases are being investigated.”

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BRIEF HISTORICAL RESUME’

“Mr. Grahame-white in his 1912 book, Avia-
tion, call§ our attention to the fact that the
Aero Club of France could document only one

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fatal accident for every 92,000 miles flown in
France during the year 1912." The supposed
“perils of aerial navigation” were thus
“dispelled”.

In 1921, the U. S. Post Office Air Mail Serv-
ice had one fatal accident for each 104,000
miles flown.“ No passengers were carried, and
the flying was quite rugged due to weather
hazards and equipment failures.

In 1938, the domestic U. S. scheduled air
carriers handled 1,366,000 passengers over
more than 560 million passenger-miles.” Five
fatal accidents occurred and 35 persons died
(crew and passengers). The passenger fa-
tality rate per 100 million passenger-miles was
445.

In 1960, the comparable figures are 52,-
392,000 passengers for almost 32 billion
passenger-miles, Nine fatal accidents oc-
curred and 329 persons died (crew and pass-
engers — not counting the 34 passenger and
crew fatalities in the January 6, 1960, Bolivia,
North Carolina bomb accident). The passen-
ger fatality rate per 100 million passenger-
miles was 0.93.

It is clear that for a given individual, a given
flight today is much safer than was the case
in earlier years. In fact, the degree of safety
is steadily improving. However, in spite of
this, the total picture over the years in civil
aviation is one of an increasing absolute num-
ber of deaths. Obviously, this latter fact is
due to the continuous growth of aviation ac-
tivities, and, the increasing passenger load per
plane in air carrier activities,

} For example, there were only 9,072 civil air-
planes in the U, S. on Jatfuary 1, 1936 (7,371
7 U. S. Bureau .of Air Commerce licensed air-
craft, 1,701 unlicensed aircraft).* This com-
pares with 117,560 on April 30, 1962.

Also, there were 14,805 Bureau of Air Com-
merce licensed pilots;in 1936 (included 736
scheduled air transport rated pilots and 5,961
licensed private pilots; of the total, only 410
were women pilots). This compares with a
figure of several hundred thousand today (no
one is quite certain what the exact figure at

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II, Social Sciences
A. Economics

1. Influence of air transportation on
goods and markets, including
consumer demand.

2. Economic problems of airline and
airport management.

B. Sociology

1. The effects on people and the
social process of bringing all sec-
tions of the world into intimate
contact with one another.

2. Possible effect of small planes
and helicopters on individual and
community arrangements,

The literal translation of these recommenda-
tions into a material program is now seen in the
Civil Aeromedical Research Institute.

Interestingly, a large portion of the concep-
tual foundation upon which the Civil Aero-
medical Reseatch Institute now rests can be
directly traced to Oklahoma’s air genius, Wiley
Post. “Secretly, I had been forming the Wiley
Post Institute for Aeronautical Research”, is a
statement by Post in his 1931 book, Around the
World in Eight Days.“ He had the idea in
1913, when he was 14 years old. The Civil
Aeromedical Research Institute presently con-
ducts studies which Post undoubtedly would
have applauded: High altitude ‘physiological
effects (Post was among‘ the foremost in this
field with his pressures suit), fatigue (Post
studied his own fatigue pattern, especially fol-
lowing the logs of sleep); depth perception (Post
conducted studies of monocular visign for ob-
vious personal reasons), and biological rythms
(Post studied the effects on the” sleep-wake
cycle and digestive system of cutting time
zones).

Some historical aeromedical papers of note
include an early dissertation by Henderson, et.
al., on thetmedical aspects of flight,” an early
analysis by Anderson of “Aeroplane Acci-
dents”,’ and early batteries of psychological
tests for flying aptitude by HenmonTM and by
Lowenstein." An excellent historical review of

the psychological aspects of aeromedicine is
given by Viteles." About the earliest report by
a pilot on certain aeromedical considerations is
that of 1914 by Mr. Ovington in the Journal of
the American Medical Association.”

The evolution of aviation medicine and re-
search programs contains many exciting steps
by brilliant scientists, Among these are: Dr.
McFarland’s program at Harvard, Dr, Love-
lace’s program in Albuquerque, Dr, Ashe’s
program at Ohio State, Dr. Tillisch’s program
at the Mayo Clinic, the programs of the various
airlines and aviation industries and the Gug-
genheim and Flight Safety Foundations, There
are others, and all have a common aim: en-
hanced air safety.

CONCLUSION

Were there no aircraft accidents due to hu-
man factors, there would be small need for aero-
medical research. Aeromedical researchers,
thus, frequently ask themselves the question:
“What is the current air safety picture?” At
CARI we have instituted within the Program
Advisory Office a means by which a running
up-to-the-minute tally may be kept with re-
spect to all U. S. aircraft accidents. While
some persons and groups appear complacent in
the face of the present record, we are not.

I am not complacent when I go to the scene
of a fatal light airplane accident, as I did re-
cently near my home field, and learn that the
two dead occupants probably would have
lived through the impact if appropriate rela-
tively inexpensive restraint harnesses, such as
developed and recommended by CARI re-
searchers, had been used. I am not compla-
cent when.I come across the fact during a ré-
cent on-the-Séene study of a light-twin accident,
fatal to the ‘four occupants, that the pilot had
been daily taking large amounts of dexedrine,
barbiturates, thyroid extract, and other drugs.
This latter, accident is particularly noteworthy
since a gross failure of judgement on the part
of the highly experienced pilot was involved in
the steps which led to the accident. The com-
bined dosages being taken by the pilot could
easily have had a detrimental effect on his
abilities,

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