High Altitude Environment: Pilots Don’t Know What They Don’t Know – Part II

In Part I of the High Altitude Environment article, we talked about Aviation Medicine and Long-term Effects of Atmospheric Changes on pilot health.

Long-term Tracking of Pilot Health

When a pilot has a medical issue, they don't usually go to their flight physician. Flight physicians have the power to take away medical certificates; so pilots end up going to another doctor to deal with the issue and once a symptom is confirmed and treatment under way, the pilot will go back to the flight physician and ask permission to continue to fly—or get their license back. Once a pilot retires, or hangs up their wings, and the true health effects of aviation start to appear, flight physicians are not usually informed of the ailment, so it's difficult to track the results of a lifetime of exposure to the elements.

There is research and information about specific environmental situations and the human response. The behavior response to lack of sleep, hypoxia, and fatigue are examples of individual subjects that are taught in most ground schools, but that gives us an immediate symptom and behavior we can observe. What about a long-term comprehensive study and tracking of pilots' health? What are the overall medical ailments that flight crews are more prone to experience? There isn't one, but there needs to be.

Since there is an infinite number of variables, it's impossible to definitively say that "this" causes "that." But, if we begin to track the specific diseases (especially cancers) that pilots develop, it would enable the community to work the problem backwards. If there is a trend, we can see what factors cause it, the common denominators among those affected, and determine how we can reduce the exposure to the cause(s).

I conducted a quick, informal survey to see if anything stood out among the 243 pilots who responded. These respondents had 5000 + hours in the air and most of that time was spent above FL250. Since this wasn't scientific and was just for my own curiosity, it's hard to determine the rate of ailments to pilots versus the general population, but the top three commonalities were bladder cancer, throat cancer (nonsmoking pilots), and prostate cancer.

There was also a general theme of deafness, circulation issues, and back pain from sitting. Since the ratio of women to men in the airline world is 95 to 1, I only had one woman respond to the survey and she had no health issues.

Research on High-Altitude Exposure

The aviation industry needs research on long term high-altitude environment exposure. Unfortunately, it will take someone else's lifetime to tell us, and the damage will have already been done. If we can at least know what negative impact the environment has on the human body, we can develop methods and mechanics to alleviate the strength of the impact.

We are already seeing cleaner cabin air. We've been pulling bleed air off engines for quite a while, but aviation is coming full circle with the idea of using electric/generator architecture to provide cabin pressure. They're doing it to save fuel, but the peripheral result is pilots might get to breathe cleaner air. On the other end of the oxygen spectrum, what about the requirement for pilots to breathe concentrated/supplemental oxygen for extended periods of time above FL350/410? What does that do the respiratory system?

The human brain is at odds with its body. We were built with the desire to fly, but not the body to do it. We found a way to fly, now let's find a way to do it by simulating the surly bonds on earth.