Aeromedical decision making--it may be time for a paradigm change.

Recent events in the U-2 and F-22 fleets have challenged aeromedical experts, highlighting the need for better in-flight aircrew physiologic and cognitive monitoring capability. Existing aerospace medicine risk assessment tools, while necessary, are no longer sufficient to affect positive safety changes given the evolving nature of the aerospace environment. Cognition and its sub-elements are now primary measures for the "Fit to Fly" decision.

Irritable bowel syndrome: aeromedical considerations.

Irritable bowel syndrome (IBS) is a gastrointestinal disorder diagnosed in accordance with the Rome III criteria. The pathophysiology of this illness is not well defined and there are no known structural abnormalities, biomedical markers, nor inflammatory causes to explain the symptoms. There are a number of serious illnesses, such as colon cancer, ulcerative colitis, and celiac disease that mimic IBS.

Essential thrombocythemia: aeromedical considerations.

Essential thrombocythemia is a chronic myeloproliferative disease with possible thrombotic and hemorrhagic complications due to an abnormal increase in platelets. It is diagnosed by platelet count and the presence of increased numbers of megakaryocytes in the bone marrow. Most patients remain asymptomatic, although thrombotic events can occur in most systems of the body.

Celiac disease: aeromedical considerations.

Celiac disease (CD) is an illness that affects up to 2% of the population. It primarily causes gastrointestinal symptoms, but it can also cause malabsorption, resulting in anemia and loss of bone mass. There is also an association with other illness such as Type 1 diabetes, autoimmune diseases, and neurological illness.

Aircraft disinsection.

Aircraft disinsection has been an international practice since the 1920s, the purpose of which is to protect public health, the environment, agriculture, and livestock by the eradication of disease vectors. Although most nations of the world have discontinued this practice, about 20 continue with this requirement. Aircraft disinsection is sanctioned by international law with the World Health Organization (WHO) publishing general procedural guidelines in the International Health Regulations (IHR).

Resources for inflight medical care.

With the anticipated growth of air travel, inflight illness and injury are expected to increase as well. This is because more elderly people and people with preexisting disease are taking to the air. Although inflight medical events and deaths are uncommon, physician passengers are occasionally called upon to render care.

Medical guidelines for space passengers--II.

It now appears likely that commercial entities will carry paying passengers on suborbital spaceflights in this decade. The stresses of spaceflight, the effects of microgravity, and the limited capability for medical care onboard make it advisable to develop a system of medical clearance for such space tourists. The Aerospace Medical Association, therefore, organized a Space Passenger Task Force whose first report on medical guidelines was published in 2001.

Peanut allergy in-flight.

An unknown but probably significant number of airline passengers are allergic to peanuts. Reactions can be mild, moderate, or severe (life threatening). Because peanuts are sometimes dispensed by flight attendants on commercial flights, there is public concern that passengers are at risk of an in-flight allergic reaction.

Cabin air quality: an overview.

In recent years, there have been increasing complaints from cockpit crew, cabin crew, and passengers that the cabin air quality of commercial aircraft is deficient. A myriad of complaints including headache, fatigue, fever, and respiratory difficulties among many others have been registered, particularly by flight attendants on long-haul routes. There is also much concern today regarding the transmission of contagious disease inflight, particularly tuberculosis.