Pilot age and performance : An annotated bibliography ( 1990-1999 )

This article is focused on a discussion of the frequency of incapacitation in flight and medical-cause accidents. A safety target of 10 million or more hours in multi-crew aircraft for each fatal accident has been established. The risk of pilot incapacitation contributing to these accidents should be less than 1 accident per 100 million hours. Research indicates that nearly 33% of pilots have experienced a level of physical discomfort that required another crew member to assume their duties. Safety is threatened in only about 3% of the situations. According to the author, the critical time period is the first three minutes or last three minutes of flight. Most of these incidents have been attributed to gastrointestinal symptoms. Flight simulator training has been used to promote pilot recognition of incapacitation and to assist crew members in developing appropriate response strategies. In the past 20 years the author identified only three incidents where medically-related causal factors were cited; a 1972 Trident aircraft that stalled on climb out at London when the captain was incapacitated due to severe coronary artery disease; a DC8 freighter that crashed in Anchorage in 1977 when the captain had a high blood alcohol level; and a DC8 that was flown into the waters of Tokyo bay in 1982 by a captain who had a known psychiatric history. Information is provided regarding the initial and recurring medical examination required of commercial pilots in European countries. The author concludes that current medical certification