(17/151) Age, flight experience, and risk of crash involvement in a cohort of professional pilots.
Federal aviation regulations prohibit airline pilots from flying beyond the age of 60 years. However, the relation between pilot age and flight safety has not been rigorously assessed using empirical data. From 1987 to 1997, the authors followed a cohort of 3,306 commuter air carrier and air taxi pilots who were aged 45-54 years in 1987. During the follow-up period, the pilots accumulated a total of 12.9 million flight hours and 66 aviation crashes, yielding a rate of 5.1 crashes per million pilot flight hours. Crash risk remained fairly stable as the pilots aged from their late forties to their late fifties. Flight experience, as measured by total flight time at baseline, showed a significant protective effect against the risk of crash involvement. With adjustment for age, pilots who had 5,000-9,999 hours of total flight time at baseline had a 57% lower risk of a crash than their less experienced counterparts (relative risk = 0.43, 95% confidence interval: 0.21, 0.87). The protective effect of flight experience leveled off after total flight time reached 10,000 hours. The lack of an association between pilot age and crash risk may reflect a strong "healthy worker effect" stemming from the rigorous medical standards and periodic physical examinations required for professional pilots. (+info)
(18/151) Unusual limb injury associated with sport parachuting.
The case is reported of an open injury of the right arm sustained during a parachute jump. The fracture was managed in the usual way with wound debridement, wound irrigation, skeletal stabilisation, and reconstruction of the soft tissues. Good shoulder and elbow function were achieved. The combined effort of an orthopaedic trauma surgeon and plastic surgeon is essential to improve outcomes in such cases. (+info)
(19/151) The spine in sport and veteran military parachutists.
Spinal injuries and symptoms were studied in 109 ex-military parachutists and 112 sport (free fall) parachutists by means of postal questionnaires. 46 ex-military parachutists aged 50 years or over had a radiological examination of the lumbar spine and 58 sport parachutists had a radiological examination of the cervical spine as part of the survey. A history of back pain was significantly (P<0.01) associated with body weight in sport parachutists but not with the number of descents or with the subject's age. In the older ex-military group neither age, weight, nor the number of descents was significantly associated with backache. Of those ex-military parachutists x-rayed, 10 (21.7%) were found to have vertebral body fractures (most frequently at D12), and 8 of these were unaware of these lesions. Vertebral fractures caused no disability and did not permanently curtail parachuting activities in either the sport or ex-military group. Of the ex-military parachutists x-rayed, 84.7% had lumbar disc degeneration of all grades of severity, 17.4% had moderate changes, and 10.8% had severe changes. The frequency of moderate and severe disc degeneration was significantly related to age but not to body weight or to the number of descents. Spondylolysis was found in 2 subjects (4.3%) and spondylolisthesis unassociated with spondylolysis in 4 (8.7%). Spondylolisthesis was always associated with a history of back pain.A low prevalence of radiological cervical intervertebral disc degeneration of all grades of severity of 8.7% was found among the free fall parachutists (mean age 33 years). 2 cases of cervical vertebral body fracture were seen, one related to a parachute landing injury and the other to a parachute opening injury. This study does not implicate parachuting as a cause of intervertebral disc degeneration, either cervical or lumbar, nor as a cause of spondylolysis or spondylolisthesis. Serious long-term disability from pain appears to be uncommon among parachutists despite the frequency of the spinal trauma they sustain. (+info)
(20/151) Applying the lessons of high risk industries to health care.
High risk industries such as commercial aviation and the oil and gas industry have achieved exemplary safety performance. This paper reviews how they have managed to do that. The primary reasons are the positive attitudes towards safety and the operation of effective formal safety management systems. The safety culture provides an important explanation of why such organisations perform well. An evolutionary model of safety culture is provided in which there is a range of cultures from the pathological through the reactive to the calculative. Later, the proactive culture can evolve towards the generative organisation, an alternative description of the high reliability organisation. The current status of health care is reviewed, arguing that it has a much higher level of accidents and has a reactive culture, lagging behind both high risk industries studied in both attitude and systematic management of patient risks. (+info)
(21/151) Estimating capacity requirements for mental health services after a disaster has occurred: a call for new data.
OBJECTIVES: We sought to estimate the extended mental health service capacity requirements of persons affected by the September 11, 2001, terrorist attacks. METHODS: We developed a formula to estimate the extended mental health service capacity requirements following disaster situations and assessed availability of the information required by the formula. RESULTS: Sparse data exist on current services and supports used by people with mental health problems outside of the formal mental health specialty sector. There also are few systematically collected data on mental health sequelae of disasters. CONCLUSIONS: We recommend research-based surveys to understand service usage in non-mental health settings and suggest that federal guidelines be established to promote uniform data collection of a core set of items in studies carried out after disasters. (+info)
(22/151) Occupational health problems in modern work environment.
Analysis of occupational health problems in Lithuania and their relation to factors of modern work environment is presented. The article analyses the health of transport workers, airlines pilots and stewards, video display terminal workers and its relation to work environment. OBJECTIVE: To investigate and evaluate influence of changing occupational environment to workers' health. MATERIAL AND METHODS: Complex evaluation including several enterprises with different work profile and conditions. Evaluation of work environment, assessment of psychophysiological and ophthalmological data of workers as well as morbidity studies were performed. RESULTS: Occupational environment of transport workers is related with high levels of noise, vibration, mercury, carbon monoxide, welding aerosols, and dust. Main diseases for transport workers are upper respiratory tract and lung diseases, accidents, cardiovascular and musculoskeletal disorders. Cases of temporal morbidity for pilots and stewards are upper respiratory tract and lung diseases, accidents, intoxications and nervous system diseases. The main effects of video display terminal on operators' health are vision fatigue and musculoskeletal disorders. Ophthalmologic symptoms and vision fatigue are related to changes in eyes and central nervous system fatigue, as well as syndrome of "dry eyes". CONCLUSIONS: Changeable work environment is affecting employees' health with specific changes, which depend upon work character, experience and worker's age. (+info)
(23/151) Translating teamwork behaviours from aviation to healthcare: development of behavioural markers for neonatal resuscitation.
Improving teamwork in healthcare may help reduce and manage errors. This paper takes a step toward that goal by (1) proposing a set of teamwork behaviours, or behavioural markers, for neonatal resuscitation; (2) presenting a data form for recording observations about these markers; and (3) comparing and contrasting different sets of teamwork behaviours that have been developed for healthcare. Data from focus groups of neonatal providers, surveys, and video recordings of neonatal resuscitations were used to identify some new teamwork behaviours, to translate existing aviation team behaviours to this setting, and to develop a data collection form. This behavioural marker audit form for neonatal resuscitation lists and defines 10 markers that describe specific, observable behaviours seen during the resuscitation of newborn infants. These markers are compared with those developed by other groups. Future research should determine the relations among these behaviours and errors, and test their usefulness in measuring the impact of team training interventions. (+info)
(24/151) The complexity of team training: what we have learned from aviation and its applications to medicine.
Errors in health care that compromise patient safety are tied to latent failures in the structure and function of systems. Teams of people perform most care delivered today, yet training often remains focused on individual responsibilities. Training programmes for all healthcare workers need to increase the educational experience of working in interdisciplinary teams. The complexities of team training require a multifunctional (systems) approach, which crosses organisational divisions to allow communication, accountability, and creation and maintenance of interdisciplinary teams. This report identifies challenges for medical education in performing the research, identifying performance measurements, and modifying educational curricula for the advancement of interdisciplinary teams, based on the complexity of team training identified in commercial aviation. (+info)