Abstract
Abstract. The National Transportation Safety Board (NTSB) database was searched to identify fatal accidents in aviation related to trauma and stressor-related disorders in the United States and the medical requirements of aviation authorities were assessed. Between 2000 and 2015, eight pilots with a diagnosis of posttraumatic stress disorder (PTSD; of which two were aviation-related PTSDs) died in aviation accidents. These results indicate a minimum frequency of history of diagnosed PTSD in aviation fatalities to be 8 out of 4,862 fatal accidents (0.16%) in the United States. The guidance from aviation regulatory authorities is to medically assess pilots with a prior history of PTSD based on individual functional impairment and treatment response. The assessment of individual impairment would be significantly improved by the systematic data collection following aviation- and work-related traumatic events. It is also important for investigators to recognize the traumatization that occurs in aviation accident and incident investigations.
References
(2017). Citalopram is less effective for patients with neurological disorder and/or post-traumatic stress disorder. Personalized Medicine in Psychiatry, 4–6, 32–38. https://doi.org/10.1016/j.pmip.2017.07.003
. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). Washington, DC: Author.
(2014). Evidence-based pharmacological treatment of anxiety disorders, post-traumatic stress disorder and obsessive-compulsive disorder: A revision of the 2005 guidelines from the British Association for Psychopharmacology. Journal of Psychopharmacology, 28(5), 403–439. https://doi.org/10.1177/0269881114525674
(2013). Psychological therapies for chronic post-traumatic stress disorder (PTSD) in adults. The Cochrane Database of Systematic Reviews, 12, CD003388
(2017). Pilot mental health assessment and support. London, UK: Taylor & Francis.
(2014). An analysis of post-traumatic stress symptoms in United States air force drone operators. Journal of Anxiety Disorders, 28(5), 480–487. https://doi.org/10.1016/j.janxdis.2014.05.003
. (2016). Designated aviation medical examiner’s handbook. Australia: CASA. Retrieved from https://www.casa.gov.au/manuals-and-forms/standard-page/designated-aviation-medical-examiners-handbook
. (2016). Acceptable means of compliance (AMC) and guidance material (GM). EASA. Retrieved from https://www.easa.europa.eu/system/files/dfu/AMC%20and%20GM%20on%20the%20medical%20certification%20of%20pilots%20and%20medical%20fitness%20of%20cabin%20crew.pdf XX
. (2016). Guide for aviation medical examiners. FAA. Retrieved from https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/
. (2012). Manual of civil aviation medicine, ICAO. Retrieved from http://www.caa.co.za/Documents/Aviation%20Medicine/Manual%20of%20Civil%20Aviation%20Medicine.pdf
(2013). Psychological and pharmacological treatments for adults with posttraumatic stress disorder (PTSD) (Comparative Effectiveness Reviews, No. 92). Rockville, MD: Agency for Healthcare Research and Quality (US). Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK137702/
(2014). Cumulative traumas and risk thresholds: 12‐month PTSD in the world mental health (WMH) surveys. Depression and Anxiety, 31(2), 130–142. https://doi.org/10.1002/da.22169
(2017). Posttraumatic stress disorder in the world mental health surveys. Psychological Medicine, 47(13), 2260. https://doi.org/10.1017/S0033291717000708
. (2017). Association of DSM-IV posttraumatic stress disorder with traumatic experience type and history in the world health organization world mental health surveys. JAMA Psychiatry, 74(3), 270–281. https://doi.org/10.1001/jamapsychiatry.2016.3783
. (2017). Accident database and synopsis. Retrieved from http://www.ntsb.gov/aviationquery/index.aspx
. (2005). Post-traumatic stress disorder: Management. Retrieved from https://www.nice.org.uk/Guidance/cg26
(2013). Mental health diagnoses and counseling among pilots of remotely piloted aircraft in the United States air force. Medical Surveillance Monthly Report, 20(3), 3.
(2013). Dissociation in posttraumatic stress disorder: Evidence from the world mental health surveys. Biological Psychiatry, 73(4), 302–312. https://doi.org/10.1016/j.biopsych.2012.08.022
. (2017). Position statement. Aviation and aerospace psychology. Pilot mental health and wellbeing. Leicester, UK: BPS. Retrieved from https://www.bps.org.uk/sites/beta.bps.org.uk/files/Policy%20-%20Files/Aviation%20and%20aerospace%20psychology%20-%20pilot%20mental%20health%20and%20wellbeing.pdf
. (2016). Civil aviation medical standards. Retrieved from https://www.tc.gc.ca/eng/civilaviation/opssvs/cam-menu.htm
(2012). Major depression and fitness to fly by different aviation authorities. Aviation, Space, and Environmental Medicine, 83(9), 909.
(2016). Formation of the U.S. Air Force aviator post-traumatic stress disorder study group. Retrieved from http://www.dtic.mil/dtic/tr/fulltext/u2/1022586.pdf
. (2016). ICD-10 online version. Geneva: WHO. Retrieved from http://www.who.int/classifications/icd/icdonlineversions/en/
