Dr. Mydin's Rim Asia (Pacific) Aircraft Accidents of Medical Cause
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Civilian Air-crew Medical Standards

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"Aviation, by itself, is not inherently dangerous. (But to an even greater degree than the sea), it's not forgiving of carelessness, not forgiving of incapacity, not forgiving of neglect."  (Lamplugh, 1932)

Table: Causative Factors in Aircraft Accidents Royal Malaysian AirForce

Accidents are not acceptable. Accidents, causing injuries,  occur in every state (situation) of life. This is pointed out aptly here at the First Malaysian Bengkel (Workshop) on Preventing Accidents, March 1990.

Morbidity/mortality, that accidents caused, concern here the Medical Profession (in a direct manner).

Airplane (aircraft) accidents, and injuries caused, are numerous since here flight start in history.

Such accidents here cause these (injuries) from:

  • (Forces of deceleration)
  • (Restraining equipment)
  • (Shrapnel from disintegrating/exploding aircraft)
  • (Unyielding objects)
  • (Fire)
  • (Birdstrikes)
  • (Escape from aircraft, and during subsequent survival)

The (commonest) types of injuries here seen in (fatal) accidents are multiple traumatic injuries, burns. Injury from non fatal accidents is fracture, burns, internal organ bleeding.

Safety from these flight accidents (Aviation Safety) is ' prevention of accidental injuries, (and hence fatalities), through education, consult, not forgetting research'.

Both safety of flight (Flight safety),  ground safety comprise Aviation Safety.

Data (from research) showed that human-error account here for large part of accidents caused in Malaysia,) highlighting the importance of human factors, not forgetting this (important) need for the manner here that medical sciences here  contribute to safety (Flight Safety). It must be pointed out that these (undesirable, sudden) incapacitation that diseases (medical condition) caused  are not uncommon.  A forgetting nature (forgetfulness), fatigue is not irrelevant either. Type of misjudgement (confined to flight) called Spatial Disorientation, mistakes in aircrew perception (out of interaction between the aircraft, the aircrews' special senses such as vision, balance and proprioception, and the three dimension of the atmosphere) here cause too (accidents).

General principles of accident causation, prevention apply to aviation accidents. A great part of (research) findings on accident causation/prevention is applicable to accidents in aviation.

(Importantly) accident causation in aviation is a result of (human) behaviour - change can prevent these accidents (principles of modification can be used).

Secondly, stress that is imposed on man by flight (environment) (and the mechanics of flight are well understood, defined clearly in physical, physiological, psychological, pathological terms). That which have been, when applied (diligently), must cause a drop in the rate of accidents (and injuries arising from them).

This is the cornerstone manner (human-factors, human-sciences) contribute to safety of avition. There is need to co-operate between doctors (and agencies involved in aviation safety in the region must not be ignored).

Both agency (regulatory/non-regulatory) involve here (in the process of improving  safety in aviation). Regulatory in this form of Dept. of Civil Aviation, Dept. of Air Force could take (direct) corrective action by imposing (relevant regulations.) A non regulatory agency is a tremendous participant in education, consult (and research) (with active encouragement, cooperation and involvement of regulatory agencies).

It is of concern here that (for example) for the duration 1972 - 81, an average of 11 accidents did happen in the Royal Malaysian Air Force (out of which two were fatal accidents - 5 deaths per year). From 1990 - 93, 16 deaths from 11 fatal accidents, which averages about same.

In comparison in 1977, in Malaysia, 6 deaths (medically certified) caused by cholera, 29 caused by typhoid fever, 6 caused by whooping cough, 41 caused by malaria. Moreover, this concern here that aircraft accidents in a manner involve  much trained, (skilled human) resources, at prime of life.

This here, during 1964-65, percent 73 of a total (deaths involving flying officers) in the US Air Force, airplane accident is cause.

 

 

 

 

Stethoscope

Table: Causative Factors in Aircraft Accidents, Civil Aviation Malaysia

Table: Categories of Human Failure, Civil Aviation Malaysia.

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THE (MEDICAL) SCOPE OF AVITION SAFETY

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This scope here of involvement of doctors in aviation accident prevention is not different from the traditional scope, i.e.
 
  • The Flying Safety Programme
  • Standard Action (procedures) in (the event of) Airplane Accidents, and
  • Investigating accidents

The role of doctors in flying safety is of a few aspects, i.e. (Flight Medicine), (Flying Activities), (Involvement in Flying Safety Committees), (Research Development Activity).

Flight Medicine involve this manner doctors here select (applicants for aircrew/air-traffic controller training). (Medical Selection) is (one of the most effective)  flying safety aspect doctors could involve in (although international regulations in aviation confine this responsibility to those doctors with additional qualifications in Aviation Medicine, or those with Flying License and experience).

By performing thorough physical check up (and complete evaluation of applicants for flying training) this doctor can prevent accidents, in future (as well as costly elimination from flying training programmes). He should maintain such need for high physical (and psychological) standards here.

Having passed pre-selection physical check up (and upon acceptance/completion of training) physical standards, in a manner for flying, should be monitored (by means of periodic physical examination). The incidence of accidents caused by (sudden medical) incapacitation is low. But this is for reason, those higher standards in (medical) selection produce a very fit (healthy) group. (The Periodic Physical Examination is aimed at maintaining this).

Air-crew need to be provided prompt (personalised) routine medical attention/ care. Maintaining health/physical fitness of air-crew do heighten flight safety in a manner direct. (Each) disease/injury could be found by terms of this mpact (that such conditions may have on each flier's ability to perform safely and effectively). Higher (professional, medical) standards bring around confidence among air-crew (which pay off by this earlier reporting of disease/injury, early treatment - lower morbidity). Delay in finding (medical) care (and/or a practice of self-treatment by aircrew) result in unacceptable situation (fraught with hazard, particularly in the flying environment). Not a disease (alas) should compromise flight safety.

Early return to flying state should be sought. Yet, it's mperative (that full professional consideration be given to ensure) complete cure (from the disease/injury, and the effects of medications) is found. (The stresses) flight is not forgiving (especially when a person's physiology/ability to respond is compromised).

 

 

The Mid-air Collision

Current Debate on (Periodic) Physical Check Up

Physiological Training

Flying/Flightline Activity

Airplane Accidents: Standard Actions (Procedures)

Research/Development