Leukocyte subsets and neutrophil function after short-term spaceflight. (1/199)

Changes in leukocyte subpopulations and function after spaceflight have been observed but the mechanisms underlying these changes are not well defined. This study investigated the effects of short-term spaceflight (8-15 days) on circulating leukocyte subsets, stress hormones, immunoglobulin levels, and neutrophil function. At landing, a 1.5-fold increase in neutrophils was observed compared with preflight values; lymphocytes were slightly decreased, whereas the results were variable for monocytes. No significant changes were observed in plasma levels of immunoglobulins, cortisol, or adrenocorticotropic hormone. In contrast, urinary epinephrine, norepinephrine, and cortisol were significantly elevated at landing. Band neutrophils were observed in 9 of 16 astronauts. Neutrophil chemotactic assays showed a 10-fold decrease in the optimal dose response after landing. Neutrophil adhesion to endothelial cells was increased both before and after spaceflight. At landing, the expression of MAC-1 was significantly decreased while L-selectin was significantly increased. These functional alterations may be of clinical significance on long-duration space missions.  (+info)

Eastward long distance flights, sleep and wake patterns in air crews in connection with a two-day layover. (2/199)

The present study describes the spontaneous sleep/wake pattern in connection with an eastward (Stockholm to Tokyo, +8 h) transmeridian flight and short (51 h) layovers. To describe all sleep episodes and the recovery process across 4 days, and to relate adjustment to individual differences, 49 Scandinavian Airlines System (SAS) air crew were monitored for 9 days with activity monitors and sleep/wake diary before-during-after flight. The outbound flight involved a period of wakefulness extended to 21 h, frequently (87% of air crew) terminated by a long nap in Tokyo which was calm but difficult to wake up from. Then followed two night oriented sleep periods of normal length but of reduced efficiency, containing many and long awakenings. Napping was common during the extended periods of wakefulness, particularly during flights. During the recovery days, ease of rising from sleep in the mornings was difficult throughout, and feelings of not being refreshed returned to baseline levels on the third recovery sleep. Elevated daytime sleepiness (24% of the day) was observed on the first recovery day. No individual differences related to gender, age or position (cabin/pilot) was found in sleep strategy. Poor adjusters, subjects with a perceived lowered capacity on recovery days, showed more premature awakenings abroad and less refreshing sleep during the last 12 months, suggesting a decreased ability to cope with air crew scheduling. Comparisons with a westbound flight showed the eastbound flight layover sleep to be more problematic and containing more napping.  (+info)

Melatonin: aeromedical, toxicopharmacological, and analytical aspects. (3/199)

Melatonin, a pineal hormone present in the blood of humans and other species, has a distinct diurnal variation in its biosynthesis and, therefore, in its concentration. This variation has suggested the possibility of a regulatory function in day/night-dependent physiological processes such as sleep and has led scientists to explore the effects of administered melatonin on the modulation of circadian rhythms. For the self-treatment of sleep disorders and other benefits, melatonin use has been extolled to the extent that 20 million new consumers were added to the U.S. retail market in 1995. Its principal aeromedical application has been in the experimental treatment of jet-lag effects. For aircraft passengers, melatonin administration at destination bedtime appears to improve sleep quality and to decrease the time required to reestablish normal circadian rhythms. For international aircrews that travel through multiple time zones without time to adapt to new environments, taking melatonin before arriving home may further impair already disturbed circadian rhythms. Its use to adjust to shiftwork changes by air traffic controllers, aircraft maintenance workers, and support personnel is even more controversial. Limited studies suggest that giving this hormone to shift workers should be done only under controlled conditions and that taking it at the wrong time may actually impair job performance. Because of its possible interaction with certain medications and the changes in its concentrations observed in some clinical conditions, the practitioner must exercise caution during the medical certification of airmen. The variations in the concentration of melatonin can be effectively determined by radioimmunoassay, high-performance liquid chromatography, and gas chromatography-mass spectroscopy analytical techniques. These techniques are capable of measuring the human daytime (10 pg/mL) and nighttime (30-120 pg/mL) melatonin in plasma/serum. Melatonin measurements in victims of accidental death may allow forensic scientists and accident investigators to use the relationship between its concentration and the time of day when death occurred. The most accurate estimations of the time of death result from analysis of melatonin content of the whole pineal body, whereas less accurate estimates are obtained from serum and urine analyses. Pineal levels of melatonin are unlikely to be altered by exogenous melatonin, but its blood and urine levels would change. High blood levels in a daytime crash victim would suggest exogenous supplementation. The possible interfering effects of postmortem biochemical processes on melatonin concentrations in whole blood and in other tissues are not well understood, and there is a need for the continuing research into melatonin's chronobiological properties to define its proper applications and limitations. The indiscriminate use of melatonin by aviation professionals may pose unacceptable safety risks for air travel.  (+info)

Sympathetic outflow to muscle in humans during short periods of microgravity produced by parabolic flight. (4/199)

We have investigated the changes in muscle sympathetic nerve activity (MSNA) from the tibial nerve during brief periods of microgravity (microG) for approximately 20 s produced by parabolic flight. MSNA was recorded microneurographically from 13 quietly seated human subjects with their knee joints extended in a jet aircraft simultaneously with the electrocardiogram, the blood pressure wave (measured with a Finapres), the respiration curve, and the thoracic fluid volume (measured by impedance plethysmography). During quiet and seated parabolic flight, MSNA was activated in hypergravity and was suppressed in microG phasically. At the entry to hypergravity at 2 G just before microG, the thoracic fluid volume was reduced by 3.2 +/- 3%, and the arterial blood pressure was lowered transiently and then gradually elevated from 89.5 +/- 1.7 to 100.2 +/- 1.7 mmHg, which caused the enhancement of MSNA by 91.4 +/- 14.2%. At the entry to microG, the thoracic fluid volume was increased by 3.4%, which lowered the mean blood pressure to 77.9 +/- 2.3 mmHg and suppressed the MSNA by 17.2%. However, this suppression lasted only approximately 10 s, followed by an enhancement of MSNA that continued for several seconds. We conclude that MSNA is suppressed and then enhanced during microG produced by parabolic flight. These changes in MSNA are in response not only to intrathoracic fluid volume changes but also to arterial blood pressure changes, both of which are caused by body fluid shifts induced by parabolic flight, and these changes are quite phasic and transient.  (+info)

Medical advice for commercial air travelers. (5/199)

Family physicians are often asked to advise patients who are preparing to travel. The Air Carrier Access Act of 1986 has enabled more passengers with medical disabilities to choose air travel. All domestic U.S. airlines are required to carry basic (but often limited) medical equipment, although several physiologic stresses associated with flight may predispose travelers with underlying medical conditions to require emergency care. Recommendations for passengers with respiratory, cardiac or postsurgical conditions must be individualized and should be based on objective testing measures. Specific advice for patients with diabetes, postsurgical or otolaryngologic conditions may make air travel less hazardous for these persons. Air travel should be delayed after scuba diving to minimize the chance of developing decompression sickness. Although no quick cure for jet lag exists, several simple suggestions may make travel across time zones more comfortable.  (+info)

Chronic jet lag produces cognitive deficits. (6/199)

Traveling across time zones causes disruption to the normal circadian rhythms and social schedules because of travelers' shift in time. As the endogenous circadian timing system adapts slowly to new time cues, the phase relationship between biological rhythms and external time cues are out of synchronization for a period of time. This disturbance of circadian rhythms has been shown to impair physical and psychological health (Winget et al., 1984). To test the effects of repeated jet lag on mental abilities, airline cabin crew were compared with ground crew. Salivary cortisol was used as a physiological marker for circadian disruption. The cabin crew group, who had a history of repeated jet lag, had significantly higher salivary cortisol levels in an average working day. In addition, this elevated level of cortisol was only seen in the same subjects when the cabin crew were on transmeridian flights but not domestic flights. Cabin crew also exhibited cognitive deficits, possibly in working memory, that became apparent after several years of chronic disruption of circadian rhythms.  (+info)

Airway management during spaceflight: A comparison of four airway devices in simulated microgravity. (7/199)

BACKGROUND: The authors compared airway management in normogravity and simulated microgravity with and without restraints for laryngoscope-guided tracheal intubation, the cuffed oropharyngeal airway, the standard laryngeal mask airway, and the intubating laryngeal mask airway. METHODS: Four trained anesthesiologist-divers participated in the study. Simulated microgravity during spaceflight was obtained using a submerged, full-scale model of the International Space Station Life Support Module and neutrally buoyant equipment and personnel. Customized, full-torso manikins were used for performing airway management. Each anesthesiologist-diver attempted airway management on 10 occasions with each device in three experimental conditions: (1) with the manikin at the poolside (poolside); (2) with the submerged manikin floating free (free-floating); and (3) with the submerged manikin fixed to the floor using a restraint (restrained). Airway management failure was defined as failed insertion after three attempts or inadequate device placement after insertion. RESULTS: For the laryngoscope-guided tracheal intubation, airway management failure occurred more frequently in the free-floating (85%) condition than the restrained (8%) and poolside (0%) conditions (both, P < 0.001). Airway management failure was similar among conditions for the cuffed oropharyngeal airway (poolside, 10%; free-floating, 15%; restrained, 15%), laryngeal mask airway (poolside, 0%; free-floating, 3%; restrained, 0%), and intubating laryngeal mask airway (poolside, 5%; free-floating, 5%; restrained, 10%). Airway management failure for the laryngoscope-guided tracheal intubation was usually caused by failed insertion (> 90%), and for the cuffed oropharyngeal airway, laryngeal mask airway, and intubating laryngeal mask airway, it was always a result of inadequate placement. CONCLUSION: The emphasis placed on the use of restraints for conventional tracheal intubation in microgravity is appropriate. Extratracheal airway devices may be useful when restraints cannot be applied or intubation is difficult.  (+info)

Incidence of cancer among commercial airline pilots. (8/199)

OBJECTIVES: To describe the cancer pattern in a cohort of commercial pilots by follow up through the Icelandic Cancer Registry. METHODS: This is a retrospective cohort study of 458 pilots with emphasis on subcohort working for an airline operating on international routes. A computerised file of the cohort was record linked to the Cancer Registry by making use of personal identification numbers. Expected numbers of cancer cases were calculated on the basis of number of person-years and incidences of cancer at specific sites for men provided by the Cancer Registry. Numbers of separate analyses were made according to different exposure variables. RESULTS: The standardised incidence ratio (SIR) for all cancers was 0.97 (95% confidence interval (95% CI) 0.62 to 1.46) in the total cohort and 1.16 (95% CI 0.70 to 1.81) among those operating on international routes. The SIR for malignant melanoma of the skin was 10.20, 95% CI 3.29 to 23.81 in the total cohort and 15.63, 95% CI 5.04 to 36.46 in the restricted cohort. Analyses according to number of block-hours and radiation dose showed that malignant melanomas were found in the subgroups with highest exposure estimates, the SIRs were 13.04 and 28.57 respectively. The SIR was 25.00 for malignant melanoma among those who had been flying over five time zones. CONCLUSIONS: The study shows a high occurrence of malignant melanoma among pilots. It is open to discussion what role exposure of cosmic radiation, numbers of block-hours flown, or lifestyle factors--such as possible excessive sunbathing--play in the aetiology of cancer among pilots. This calls for further and more powerful studies. The excess of malignant melanoma among those flying over five time zones suggests that the importance of disturbance of the circadian rhythm should be taken into consideration in future studies.  (+info)