Atpl

040 HUMAN PERFORMANCE &
LIMITATIONS
© G LONGHURST 1999 All Rights Reserved Worldwide

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Produced and Published by the
PROFESSIONAL PILOT STUDY CENTRE
EDITION 1.01.00 1999
This is the first edition of this manual, and incorporates all amendments to previous editions, in whatever
form they were issued, prior to July 1999.
EDITION 1.01.00 COPYRIGHT © 1999 G LONGHURST
The information contained in this publication is for instructional use only. Every effort has been made to ensure
the validity and accuracy of the material contained herein, however no responsibility is accepted for errors or
discrepancies. The texts are subject to frequent changes which are beyond our control.

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TABLE OF CONTENTS
Human Physiology
The Need for Oxygen
The Effects of Flight on Human Physiology
Flying and Health
Information Processing in General
Information Processing in Aviation
Fatigue and Sleep Management
Stress and Stress Management

TABLE OF CONTENTS
Psychology, Personality and Flight Deck
Management
Flight Deck Design, Documentation and
Procedures

040 Human Performance & Limitations
Introduction
The SHEL Concept
Liveware
Liveware-Hardware
Liveware-Software
Liveware-Environment
Liveware-Liveware

Introduction
1. In 1940 Meier Muller calculated that approximately 70% of all aircraft accidents were
attributable to man's performance, that is to say human error. In 1975 the International Air
Transport Association (IATA) proved that in the intervening thirty five years there had been no
reduction in the human error input to accident statistics. A frequently used term is ‘pilot error’ and
whilst in some accidents it has been the proven cause of an accident, questions must be raised about
other factors which led the pilot to make the mistake in the first place, and what other human factors
were involved.
FIGURE 0-1
Human Factors Pie
Chart
Page 1 © G LONGHURST 1999 All Rights Reserved Worldwide

2. Arguably the greatest disaster in aviation history was the double B747 collision in Tenerife in
which 583 people died. This accident resulted entirely from a series of human factors deficiencies.
Significantly, seventeen months earlier, the International Air Transport Association, in its Technical
Conference, concluded that ‘the wider nature of human factors and its application to aviation seem
still to be relatively little appreciated. This neglect may cause inefficiency in operation or discomfort
to the persons concerned; at worst, it may bring about a major disaster’. In 1998 the FAA released
fatal accident statistics for the period 1987 to 1996 which showed that in U.S. carriers 32% of
accidents were caused by loss of control and 12% by “controlled flight into terrain” (parentheses by
author). For the rest of the world carriers the figures were 28% and 26% respectively. In the 1950’s,
when commercial jet transport started, the worldwide accident rate was close to 30 accidents per
million departures. By the end of 1997 the rate was about 1.4 accidents per million departures
(Boeing 1998), and statistically today it remains the safest form of transport compared with others.
Some UK statistics in 1994 illustrate this. A one in a million risk of being seriously injured or killed
requires five hours of air travel time. This compares to thirty minutes by car. The decreased accident
rate can be attributed to improved aircraft technology, air traffic control, operations and
maintenance structures, industry infrastructure, and regulations. However, pilot training is arguably
the most significant route to improve safety. The performance of flight crews, particularly in
emergencies, may be regarded as a product of natural ability and training. Flight deck automation
has been generally well received by pilots and the aviation industry as a whole, and accident rates for
advanced technology aircraft are generally lower than for more conventional aircraft, but there is
now increasing concern about automation; fear that pilots may place too much faith in automation,
and may lose manual flying skills. Glass cockpits with integrated displays and flight management/
autopilot systems are now very reliable and allow accurate and economical operations with
improved safety. However, many experts within the industry are concerned about the changing role
of the human from active pilot to system monitor (Weiner & Curry 1980). Many believe that the
gradual removal of the human from a decision-making role may actually decrease safety. ICAO and
almost everyone else is now of the opinion that the most significant means of reducing human factors

accidents has been the introduction of Crew Resource Management training (CRM). It has recently
been identified in the USA that CRM errors have contributed to a large proportion of accidents and
incidents. It thus may be said that competent CRM leads to competent, and therefore more safe,
operation of aeroplanes. CRM training encompasses far more than the traditional simulator training,
and includes development of attitude, stress and risk management and crew cooperation, all of which
are now recognised as being essential in the development of competency and the improvement in
safety.
3. It should be borne in mind that when dealing with accident statistics the true picture may
never be revealed due to the fact that there are countries which do not release, or have not released,
reliable data to the world at large (China and the former Soviet Union to name but two). The
development of more capable and accident-survivable flight data recorders and cockpit voice
recorders has contributed significantly to the establishing of direct causes of accidents, and more
indirect, or contributory, causes. However, ‘black boxes’ can only record data of a technical nature.
In order to reduce the human error aspects it is only by human factors training at all levels that there
can be any real hope of reducing the global accident rate. The task is that more difficult when the
growth in air transport continues at the present rate. Training in human factors has therefore
become an ICAO requirement and candidates for the European professional pilots licence are
examined in the subject.
The SHEL Concept

4. The SHEL concept, first published in a European Community paper, is an acronym for
Software, Hardware, Environment, Liveware as shown in Figure 0-2. Man, the centre of the model,
is Liveware and is the most flexible part of the system, although man's performance is variable.

FIGURE 0-2
Basic SHEL Model
5. The design of the other parts of the system must take this into account and it is therefore
necessary to examine this central part of the system in detail.
Liveware
6. Liveware varies considerably in physical size and shape and it would be impossible to design
equipment or machines which could be used by every person. A compromise is necessary so that
machinery is able to be used by a calculated percentage of the population. Liveware requires food,
water and oxygen, and performance is affected by variables in the three. Liveware possesses
sophisticated sensors, not all of which are suited to flying. He is also a complete information
processing system, although limited by quantity and rate of processing. Man possesses speech, not
always such an effective communication system as is often supposed. He has evolved to survive in a
very narrow band of environmental conditions, which places limitations on his ability to function.
Since Liveware is at the centre of the model all other parts must of necessity be designed and adapted
to match his capabilities.

Liveware-Hardware
FIGURE 0-3
Liveware-
Hardware
7. This is the man-machine interface as shown at Figure 0-3. Ergonomics is the study of humans
in their working environment and the amount of physical and mental effort required. Seat design,
whether it be for a busy office or for flightdeck crew and passengers, has to take into account the
many varying sizes and weights of the people who will use them. Particularly in aviation careful
design of information displays must match the information processing capability of Liveware. The
development of the "glass cockpit" grew from the theory that if information is not required at a
given time then it is not necessary to display it.

Liveware-Software
FIGURE 0-4
Liveware-Software
8. This interface, shown at Figure 0-4, is concerned with non-physical aspects such as computer
programmes and symbology. ‘User-Friendliness’ is paramount. Symbology must be so designed that
meaning is conveyed with no ambiguity and is easily understood. Two commonly seen examples at
Figure 0-5 illustrate the concept.
FIGURE 0-5
Common Signs

Liveware-Environment
FIGURE 0-6
Liveware-
Environment
9. Of all the interfaces in the model this is the one which was known about in the early days of
aviation, and is shown at Figure 0-6. Liveware has evolved to survive and function on the surface the
earth, not in the hostile environment that is the atmosphere. In the early days of aviation when
speeds and altitudes were fairly low, little additional protection against the environment was
required. As aircraft performance gradually improved the requirement for better protection grew.
Simple oxygen systems using a mask evolved into pressurised and heated aircraft interiors and then
to quiet and fully airconditioned systems. More recently the effects of ultra-violet radiation and
ozone are being recognised, and with long-range flights now being a part of everyday life the
problems of ‘jet-lag’ have arisen.

Liveware-Liveware
FIGURE 0-7
Liveware-Liveware
10. This is the interface between people, as at Figure 0-7. The flight crew and cabin crew must
function as a team and good interaction with passengers may well be vital to the safe conduct of a
flight. The latest phenomenon of ‘air-rage’ amongst (albeit few) passengers is causing concern. The
successful and safe operation of a modern aircraft requires leadership, cooperation and teamwork.
This not only applies to the crew, but to those whose responsibilities lie in design, engineering/
servicing, crew rostering etc.
11. The study of human factors is a study of human performance and behaviour and tries to
predict the reactions of people when faced with given circumstances. Dealing with an emergency on
an aircraft is just one small part.

Human Physiology
The Respiratory System

The Circulatory System
The Anatomy of the Ear
The Anatomy of the Eye

Human Physiology
1 Human Physiology
1. In this chapter those aspects of human physiology which are particularly relevant to flying are
considered.
The Respiratory System

2. Air can be drawn into the body through the nose and mouth. The nose warms, moistens and
filters air which is then taken to the lungs via the trachea (windpipe). The two lungs are the organs
within which the exchange of gases between the atmosphere and the blood takes place. The lungs
occupy almost the entire chest cavity and together with the heart are the only major organs in the
chest.
Chapter 1 Page 1 © G LONGHURST 1999 All Rights Reserved Worldwide

Human Physiology
FIGURE 1-1
Structure of the
Lungs
3. The trachea divides into two bronchi within the chest which supply the left and right lungs,
see Figure 1-1. Each bronchus divides many times, like the branches of a tree, to produce millions of
tiny passages or bronchioles each of which ends with many grape like air sacs called alveoli, see
Figure 1-2.

Human Physiology
FIGURE 1-2
Alveoli

Human Physiology
4. Each alveolus is covered with fine capillaries which carry blood and, because the walls of the
alveolus are very thin and a pressure gradient exists across them, oxygen readily diffuses into the
blood and carbon dioxide is removed from the blood. Oxygen is taken up by the protein
haemoglobin in the red blood cells and transported in the blood throughout the body. Haemoglobin,
found within the red blood cell, is a highly complex and specialised oxygen transport system that
allows far more oxygen to be carried by blood than could be achieved by simple solution. The
haemoglobin also has the property of remaining bound to oxygen molecules until it enters an area of
very low oxygen tension where the oxygen is released to diffuse into the tissues. Carbon dioxide
diffuses into the blood from the tissues of the body, and is carried in solution in the blood as carbonic
acid.
5. Each lung is enclosed in a double membrane called the pleura. The lungs and pleura are
protected by the ribcage. A sheet of muscle called the diaphragm is located beneath the lungs.
Breathing is performed by movement of the ribcage and diaphragm. To inhale, the muscles between
the ribs contract, which pulls the ribcage upwards and outwards - at the same time the diaphragm
contracts downwards - thus the volume of the chest is increased and the lungs expand. This
produces a negative pressure in the lungs which consequently fill with air. To breathe out the ribcage
muscles relax and the diaphragm rises causing the chest volume to reduce and air to be exhaled from
the lungs.
Lung Volumes
Vital Capacity The maximum volume that can be exhaled after full maximum inspiration.
Residual Volume The volume which is left in the lungs after full maximum expiration
(approximately 25% of vital capacity)

Human Physiology
Total Lung Capacity The volume of the lungs when completely inflated. TLC = vital capacity +
residual volume
Tidal Volume The volume of air entering or leaving the lungs in a single breath (normal is 500ml)
The normal respiratory rate is 12 – 20 breaths per minute.
6. The breathing process is illustrated at Figure 1-3.
FIGURE 1-3
Mechanics of
Breathing

Human Physiology
The Circulatory System

7. The heart is a pump made up of four chambers; two atrium, or ‘suction’ chambers and two
ventricles, or ‘discharge’ chambers. Arteries are blood vessels which carry blood away from the
heart. All arteries except the pulmonary artery carry oxygenated blood. Veins carry blood back to
the heart. All veins except the pulmonary vein carry de-oxygenated blood. The oxygen enriched
blood from the alveoli of the lungs is drawn through pulmonary veins to the left atrium of the heart.
Blood is transferred from there to the left ventricle and discharged, through the aorta to the arteries,
which distribute it to all parts of the body. The arteries progressively branch out into capillaries,
through which oxygen is diffused into the tissues.
8. Carbon dioxide is transferred from the tissue to the blood and carried into the veins and
drawn back to the right atrium of the heart. The right ventricle then pumps the blood to the lungs,
where carbon dioxide diffuses into the alveoli and is expelled. Figure 1-4 illustrates the circulatory
system.

Human Physiology
FIGURE 1-4
The Circulation
System

Human Physiology
9. Blood mainly comprises a liquid medium called plasma, red blood cells (corpuscles) of which
the greatest constituent is haemoglobin, and white cells which attack and kill bacteria and form the
major part of the immunisation or protection against disease. A reduction in the quantity of
haemoglobin in the blood is called anaemia, the symtoms of which include tiredness, breathlessness
when physically working, pallor (paleness) and reduced resistance to infection. It may be caused by
several factors, including lack of iron, excessive loss of blood, and reduced red blood cell production.
Blood pressure is defined as the pressure of the blood against the walls of the main arteries and is
measured in millimeters of Mercury (mm Hg). It is normally measured at the brachial artery of the
arm in the sitting position, when the pressure is most similar to that of blood leaving the heart. Two
pressures are measured. The higher is systolic pressure, which occurs when the heart ventricles are
contracting (pumping) and the lower is diastolic pressure when the ventricles are relaxing and
refilling with blood. Normal pressure varies with age.
10. A young adult will have a systolic pressure of about 120 mm Hg and a diastolic pressure of
80 mm Hg, referred to as 120/80 or 120 over 80. Blood pressure will usually increase with age, a
general rule of thumb is that systolic pressure will be 100 plus age in years. Pulse rate is the number
of heartbeats per minute and for the average adult at rest is about 72. Stroke volume is the volume of
blood pumped during each ventricular contraction and is typically 70ml/beat. Cardiac output is pulse
rate multiplied by stroke volume and averages 4.9 – 5.3 litres per minute. Since the average adult
body contains about 5 litres of blood, this means that the total body blood content is pumped
through the heart about every minute. Pulse rate varies. Some factors which will affect it are physical
effort, fright or threat (see chapter 9 Stress), hormones, excitement, and drugs.

Human Physiology
11. In the nineteenth century the French physiologist Bernard noted the consistency of the
chemical composition and physical properties of blood and other body fluids, which he referred to as
the ‘interior environment’. The twentieth century American physiologist Cannon later coined the
term homeostasis to refer to the dynamic constancy of an organism’s internal environment. In
complex organisms such as humans it involves constant monitoring and regulation of numerous
factors, including oxygen and carbon dioxide, hormones, nutrients, and other organic and inorganic
substances. Within limits, the concentrations of these substances remain unchanged in body fluid
despite changes in the external environment.
The Anatomy of the Ear

12. The anatomy of the ear is shown at Figure 1-5. Our ears enable us to hear, but additionally
help us to maintain our balance. The external ear is a passage connecting the ear drum to
atmosphere. Sounds create pressure variations which cause the ear drum to vibrate. This vibration
is transferred to the fluid filled cochlea through a series of small bones in the middle ear. Nerves in
the cochlea transmit the vibrations as electrical impulses to the brain, where they are interpreted as
sounds. The frequency range of human hearing is from 20 Hertz to 15,000 Hertz.
13. The main purpose of the eustachian tube is to allow air pressure to equalise on either side of
the eardrum.

Human Physiology
FIGURE 1-5
The Ear

Human Physiology
FIGURE 1-6
The Inner Ear

Human Physiology
14. In providing for balance, the inner ear functions as a series of accelerometers, detecting linear
and angular acceleration of the head. Figure 1-6 illustrates the angular accelerometers, which take
the form of three semi-circular, mutually perpendicular canals. Not shown in Figure 1-6 is the
otolith organ, which measures linear acceleration. The complete system is known as the vestibular
apparatus and it provides the brain with the information which, when combined with visual
information, enables it to control and maintain spatial orientation.
The Anatomy of the Eye

15. The anatomy of the eye is shown at Figure 1-8. Structurally, the eye is like a camera. The
pupil is the aperture, the size of which is adjusted by the iris, controlling the amount of light entering
the eye. The light then passes through a lens which, in conjunction with the cornea, focuses it on the
retina - the rear wall of the eye which corresponds to the film in the camera. The refractive power
(focus) of the eye is adjusted by the ciliary muscles, which adjust the shape of the lens. The cornea
provides the coarse focusing, being responsible for about 70% of the bending of light rays. The lens
is responsible for focus adjustment (also known as accommodation) of the eye. The formation of
the visual image on the retina is inverted and reversed laterally, as shown at Figure 1-7.

Human Physiology
FIGURE 1-7
Retinal Image
Reversal
16. Visual field is the area in front of the eye in any part of which an object can be seen without
moving the eye. With both eyes open it is known as the binocular field, whilst with one eye open it is
known as the uniocular field, which is restricted inwards by the nose.

Human Physiology
FIGURE 1-8
Anatomy of the
Eye

Human Physiology
17. The retina is a complex layer of nerve cells connected to the optic nerve, which transmits
electrical signals to the brain. These light sensitive cells are made up of two types of receptors, called
rods and cones. The central area of the retina, the fovea, is made up entirely of cones with these
being progressively replaced by rods towards the peripheral area. The cones are colour sensitive and
are used for direct vision in good lighting; the rods are insensitive to colour and are used in poor
lighting. The greatest visual accuracy (acuity or central vision) occurs at the fovea, but rapidly
decreases away from this point, towards the periphery of vision.
18. The eye adapts to changing light levels in two, distinct, processes. First the size of the pupil
(aperture) is increased to admit more light to provide a coarse adjustment. As light levels decrease a
finer adjustment takes place through transference of the sensing task from cones to rods. When light
intensity has fallen to the point where the cones cease to function, colour discrimination is lost and
the central part of the retina (fovea) becomes blind, slightly better vision is achieved by looking off
centre by about ten degrees (10°). Further away from the fovea, peripheral vision is useful only for
detecting relative movement. It is for this reason that another aircraft on a collision course (and
therefore on a constant bearing) may not be noticed whilst it remains in peripheral vision.

Human Physiology
19. The difference between rod and cone cells must also be considered in the design of cockpit
lighting. Light levels need to be high enough to retain central vision, but not bright enough to
destroy night vision. In daytime it is highly advisable for pilots to wear sunglasses of an approved
pattern, to filter out ultra violet light and the blue component of visible light, both of which can
damage the eye. Within the visible spectrum light possesses variations in wavelength. Light which
contains wavelengths in roughly equal proportions is known as white light. Light entering the eye is
resolved into these different wavelengths and perceived as different colours. Defects in the cone
structure on the retina result in colour-blindness, which is a congenital and inherited defect. A
common form is green/red blindness where green and red are perceived as shades of yellow. Colour
blindness is important when colour coding is used for purposes such as warning systems and
displays, although usually it does not cause a serious handicap.
20. Flight in lightning conditions may cause temporary blinding. The recommended procedure in
such conditions is to turn the flight deck lighting fully up and to lower the seats and visors in order
to minimise the blinding effects.

The Need for Oxygen
The Atmosphere
Gas Laws
Oxygen - Effects of Altitude
Decompression
Hypoxia
Time of Useful Consciousness
Hyperventilation

The Need for Oxygen
2 The Need for Oxygen

1. Man cannot live without oxygen. Before considering the effects of oxygen (or the lack of it)
on the way in which we perform at altitude, it is first necessary that we revise some fundamental
facts concerning the Earth's atmosphere.
The Atmosphere
2. Humans, being primarily earthbound creatures, are adapted for the lower region of the
atmosphere (the troposphere) where there is sufficient oxygen to sustain life. The atmosphere is air,
which comprises a number of gases, the principals of which are oxygen (21%) and nitrogen (78%).
The remaining 1% is mainly carbon dioxide, argon and other gases. These values remain constant
up to a height of at least 60 kilometers; the only significant change is with regard to ozone. Water
vapour also exists in the atmosphere, however the proportion of the atmosphere which is water
vapour will vary.
3. Because air is a gas and gases are compressible, air near the surface of the Earth is compressed
to about 14.7 lb/sq in. This compression means that air at the surface is dense and warm. Both air
density and temperature (at least within the troposphere) decrease with altitude, as the diminishing
weight of the air above reduces the amount by which the air is compressed. These relationships are
defined in the ICAO standard atmosphere which assumes:

The Need for Oxygen
Mean sea level pressure 1013 hPa (Hectopascals)

Mean sea level density 1225 grams/cubic metre
Mean sea level temperature +15°C
and a temperature lapse rate of 1.98°C per 1000 ft to -56.5°C at 36,090 ft, thereafter remaining
constant.
Gas Laws
4. The gas laws of particular relevance in aviation medicine are:
(a) Boyle's Law which states that for a fixed mass of gas at constant temperature (T), the
pressure (P) is inversely proportional to the volume (V). Put more simply, if the
amount of gas and the temperature do not change, pressure multiplied by the volume
is constant.
In other words PV = constant,

or
P1 V1 = P2 V2
(b) Charles' Law which states that for a fixed mass of gas at constant pressure, the
volume is directly proportional to the temperature (in degrees absolute).
V
In other words ---- = constant,
T

The Need for Oxygen
or
V V
------1- = ------2-
T1 T2
(c) Jolley’s Law which states that the pressure of a given mass of gas is directly
proportional to its temperature, providing its volume does not change.
In other words --P- = constant,

T
or,
P P
1 = ------
------ 2
T1 T2
(d) The gas laws may be combined into a single general gas law which may be expressed
as
P V P V
1 1 2 2
-------------- = --------------
T1 T2

The Need for Oxygen
(e) Dalton's Law of Partial Pressures which states that in a mixture of gases, the pressure
exerted by one of the gases is the same as it would exert if it alone occupied the same
volume. From this the partial pressure of oxygen in the atmosphere can be derived for
any altitude since the pressure at that altitude can be measured and the proportion of
oxygen in atmospheric air is constant. As will be seen, this is of great significance to
man in his ascent through the atmosphere.
5. In order to live humans must produce energy from the food they eat. To do this, simple food
products in the tissues are oxidised. The sum of the chemical and physical changes that occur in the
body is known as metabolism. It is also often known as internal respiration. It involves the
breakdown of complex organic constituents of the body and the release of energy, and the building of
other substances which form tissue and organ material. Energy chiefly comes from carbohydrates
which are broken down into sugar and stored in the liver for future needs of the body. Metabolism
results in the production of waste products such as urea, uric acid, salts, undigested food remains
(mainly cellulose) and bacteria. This process requires a constant supply of oxygen to every living cell
in the body and the removal of carbon dioxide. External respiration can thus be considered as the
exchange of the respiratory gases, oxygen and carbon dioxide, between the air we breathe and the
tissues of the body. Transport within the body is carried out by the blood and because the body can
only retain a small amount of oxygen there is a constant need to replenish the supply by breathing.
In contrast the body has quite a large store of carbon dioxide mostly carried in the blood in chemical
combination with water as carbonic acid. The body is more sensitive to changes in carbon dioxide
levels than to changes in oxygen levels, however, the levels of both are monitored by the respiratory
centre in the brain, which receives inputs from chemosensitive cells in the aorta and the carotid artery
near the carotid bifurcation.

The Need for Oxygen
6. Some parts of the body are more sensitive to oxygen and carbon dioxide levels than others.
Whilst the respiratory centre itself is very sensitive, since it is the control centre, a decrease in O2
levels causes a general retardation of mental processes and also affects vision. The predominant
controlling factor in respiratory rate is the level of carbon dioxide.
Oxygen - Effects of Altitude

7. Air pressure may be measured by reference to the height of a column of mercury (the chemical
symbol for which is Hg) which that pressure is capable of supporting. It may also be measured in
millibars or Hectopascals (hPa). In the free atmosphere the average pressure of air at mean sea level
(MSL). is 760 mm of mercury. Of this the partial pressure of oxygen (21% approximately) is 160
mm Hg. That of nitrogen is 590 mm Hg. Within the lungs the proportion of gases are oxygen
14.5%, nitrogen 80% and carbon dioxide 5.5%. The presence of increased quantities of water
vapour and carbon dioxide reduces the partial pressure of oxygen to 103 mm Hg. This partial
pressure is therefore the value to which the human body is adapted. At lower partial pressures the
transfer of oxygen to the blood reduces and functioning of the body deteriorates.
8. Pressure reduces with altitude. At 8000 ft the pressure reduces to 75% of sea level value, at
17000 ft it is 50%, and at 34000ft it is 25%. As ambient pressure reduces with altitude the partial
pressure of oxygen within the lungs also reduces. Apart from a reduction in night vision at 5000 ft,
no significant effect is experienced until about 8000 feet, when mental processes become slower. At
10,000 feet the partial pressure of oxygen is about half the MSL value (approximately 55 mm Hg)
and represents the limit of tolerance. Above 10,000 feet, without supplementing the oxygen
breathed, the body would experience hypoxia - the symptoms of which are discussed later.

The Need for Oxygen
9. In order to maintain a partial pressure of oxygen approximately equivalent to MSL

conditions, the crew member must either be supplied with oxygen enriched air through a breathing
mask, or alternatively the cabin pressure must be artificially increased to a value equivalent to an
altitude of less than 10,000 feet (usually 5000 to 8000 feet).
10. By using a breathing mask and increasing the proportion of oxygen supplied through the
mask to 100%, a partial pressure of oxygen within the lungs equivalent to MSL can be maintained
up to about 34,000 feet. Above that level, even when breathing 100% oxygen at ambient
atmospheric pressure the partial pressure of oxygen within the lungs decreases until, at 40,000 feet, it
is equivalent to breathing air at 10,000 feet (55 mm Hg). Therefore 40,000 feet represents the ceiling
altitude for breathing at atmospheric pressure. At altitudes above 40,000 feet the lungs must take in
oxygen under pressure (pressure breathing) in order to provide an adequate partial pressure of
oxygen. For normal civil aircraft operations such extremes are not necessary, however at Concorde
operating altitudes pressure breathing apparatus must be available in case of cabin decompression.
11. The main oxygen/altitude facts are summarised at Figure 2-1. Appreciate that the altitudes
given in the left hand column of the table are cabin pressure altitudes. Therefore, when Concorde is
flying at 60,000 feet but with a cabin pressure altitude of 8000 feet, it is not required that the pilots
pressure breathe 100% oxygen through a mask. However this facility must be readily available in
case cabin pressurisation is suddenly lost due to an explosive decompression.

The Need for Oxygen
FIGURE 2-1
Oxygen versus .
Above 40,000 feet Pressure breathing of 100% oxygen is required.

Altitude
At 40,000 feet This is the altitude at which breathing 100% oxygen at ambient
atmospheric pressure will give a partial pressure of oxygen in the lungs
which is equivalent to an air breathing altitude of 10,000 feet
(55 mm Hg).
At 34,000 feet This is the altitude at which breathing 100% oxygen at atmospheric
pressure will give a partial pressure of oxygen in the lungs which is
equivalent to an air breathing altitude of MSL (103 mm Hg).
Supplementary oxygen is required above 10,000 feet.
10,000 feet This is this altitude at which air breathing gives the minimum acceptable
partial pressure of oxygen in the lungs (55 mm Hg).
Decompression
12. In a pressurised aircraft the ‘pressure hull’ contains the flight deck and passenger cabin. A
loss of cabin pressure can result from structural failure (normally an explosive decompression), from
the failure of one or more of the air conditioning packs (or of the engines/engine bleed air valves
supplying them) or from the failure of one or more of the cabin pressure controllers (which govern
the position of the outflow valves which themselves regulate the cabin pressure altitude). In the event
of a decompression of the cabin above 10,000 ft the prevention of of hypoxia in the pilot(s) is of
paramount importance. The first action of the operating flight crew must be the rapid donning of
oxygen masks followed by a check of the mask fit and a check that the equipment is functioning
correctly. This functional check must of course be accomplished using the dolls eyes or other flow

The Need for Oxygen
indicators on the oxygen regulator and the oxygen bottle pressure gauge. Those of us that have been
privileged (?) to undergo hypoxia awareness training in a decompression chamber will be only too
aware that you can drift from a state of total awareness into hypoxia; anoxia and subsequent death
whilst remaining in a state of total unawareness. It should be noted that, in the event of a rapid
decompression, there is a risk of lung damage due to the rapidly expanding gas within the lung
cavities. The correct technique is to breath out during decompression as doing so reduces the risk of
lung damage. The subsequent action must necessarily be to initiate a controlled emergency descent to
an altitude of 10,000 ft (subject to local terrain clearance). In the event of sudden decompression due
to structural damage at high altitude, it may be impossible to lose height rapidly enough to prevent
hypoxia and decompression sickness among cabin occupants. Under such circumstances the
provision of emergency oxygen is necessary.
13. Structural damage to the aircraft hull can result in the cabin pressure falling below ambient
atmospheric pressure due to the venturi effect of the air flowing over the fuselage, emphasising the
necessity for the automatic provision of emergency oxygen to all cabin occupants.
14. The provision of oxygen to flight deck crew is normally accomplished by means of stored
(high pressure) oxygen which is supplied via pressure reducing valves and oxygen regulators, one of
which is illustrated at Figure 2-2.
15. The provision of oxygen to the passengers is normally accomplished by means of ‘chemical
generators’. At a pre-determined cabin pressure altitude (normally 9000 feet) the flight crew are
warned that the cabin pressure altitude is increasing. In the event that no corrective action is taken
by the flight crew the passengers will be presented with oxygen masks at a cabin pressure altitude
(normally 14,000 feet). This is known colloquially as "the rubber jungle". The chemical generators
which supply oxygen to these masks are activated by pulling on the masks. One generator will
typically supply three or four masks (one bank of seats) and will supply oxygen for, typically, 15
minutes.

The Need for Oxygen
FIGURE 2-2
Typical Oxygen
Regulator
Hypoxia
16. If the oxygen available in the blood is inadequate for the requirements of the tissues, this is
known as hypoxia. In flying, hypoxia is due to reduced atmospheric pressure at altitude. Hypoxia
can be recognised by progressive symptoms, but it must be emphasised that the onset of hypoxia can
be insidious, so that the sufferer may not be aware of it.

The Need for Oxygen
17. The first symptoms of hypoxia may appear as personality changes. Typically a person will
become euphoric and lose some inhibitions, as if under the influence of alcohol. Judgement
(including self-criticism and concentration) deteriorates. Decision-making becomes more difficult
and basic senses, especially vision, are dulled; night vision being the first to be affected. The skin
becomes pale and develops a bluish tinge where it covers the lips, earlobes and fingernail beds.
Light-headedness and dizziness (symptoms of hyperventilation) may also be present.
Unconsciousness and death will follow if oxygen deprivation continues. The period available to an
individual to recognise the problem, and be capable of doing something about it, can be very short.
This period is known as the time of useful consciousness and is discussed in greater detail below.
18. Hypoxia can be increased by a number of factors, but the underlying principle is that, if the
body needs more oxygen than normal then the lack of it becomes more acute. For example, in
conditions of cold, during heightened activity or when feverish or ill the body's demand for oxygen is
likely to be greater. Fatigue, drugs/alcohol and smoking are all likely to increase susceptibility to
hypoxia. One of the by-products of smoking is carbon monoxide (CO), and the presence of this in
the body reduces oxygen-carrying capacity. A heavy smoker may have an apparent altitude increase
of 5000 feet as far as oxygen level is concerned.
19. The treatment of hypoxia is obvious; the sufferer must receive oxygen as quickly as possible.
Time of Useful Consciousness

20. The time of useful consciousness is the time available to recognise that hypoxia exists and to
be able to do something about it. When sudden decompression occurs, the oxygen content of the air
in the cabin naturally falls to outside levels. The table at Figure 2-3 illustrates the approximate times
of useful consciousness.

The Need for Oxygen
FIGURE 2-3
Times of Useful Altitude Approximate time of useful consciousness
Conciousness
40,000 ft 10 - 20 seconds
35,000 ft 15 - 30 seconds
30,000 ft 30 seconds - 1 minute
25,000 ft 2 - 3 minutes
22,000 ft 4 - 8 minutes
18,000 ft 30 minutes
Note the marked reduction above about 20,000 feet.
21. The times given at Figure 2-3 apply to a person breathing air at sea level pressure. For a
person who is already subject to mild hypoxia (that is to say a person who is breathing air at a
typical pressurised cabin pressure altitude of 5000 to 8000 feet) the times given may be reduced by
half if a rapid loss of cabin pressurisation occurs.

The Need for Oxygen
Hyperventilation
22. Hyperventilation results from over-breathing. Usually it is brought on by anxiety (possibly
because the patient believes that insufficient oxygen is available), however any form of stress may
induce the condition. The effect of over-breathing is that carbon dioxide is ‘washed out’ of the
blood. The chemistry of the blood changes as a consequence of the deficiency of carbon dioxide and
the acidity of the body falls below its normal level. The reduced acidity causes dizziness, tunnel
vision, tingling in the hands and feet and stiffening of fingers and hands. The patient may ultimately
collapse into unconsciousness, whereupon the rate and depth of breathing returns to normal and the
patient recovers.
23. The treatment of hyperventilation involves trying to reassure and calm the patient in order to
decrease both the rate and depth of breathing. The problem can be in determining whether a patient
is suffering from hypoxia or hyperventilation, because the symptoms of hyperventilation can also be
present in hypoxia. Obviously the correct diagnosis is important, since one can be fatal whilst the
other cannot, and since the treatment of one condition when the other exists will make matters worse
rather than better.

Entrapped Gases and Barotrauma

Diving and Flying
Effects of Acceleration (G)
Motion Sickness
Flickering Light Effects
Night Vision

The Effects of Flight on Human

3
Physiology
1. It is now necessary to consider some additional effects of flying on human physiology.
Entrapped Gases and Barotrauma

2. Barotrauma is the trauma (pain) which can result from excessive differential pressure caused
by barometric (pressure) changes. There are a number of cavities within the body which naturally
contain gas, and this gas will expand as ambient air pressure decreases. This can lead to discomfort
and, in some cases, extreme pain. Areas of particular note are the ears, sinuses, gastrointestinal tract,
teeth and lungs.
Ears. Reference to Figure 3-1 in the chapter entitled Human Physiology shows that the middle ear
is a cavity, closed at one end by the ear drum. The middle ear is connected to the nose and throat by
the eustachian tube, the nasal end of which tends to act as a non-return valve. This valve opens when
ambient atmospheric pressure is decreasing (in the climb), but tends to remain closed when outside
pressure is increasing (in the descent). If air pressure in the middle ear cannot rise at the same rate as
ambient pressure, because of a closed or blocked eustachian tube, the ear drum will be stretched
inwards causing intense pain, this is known as otic barotrauma. Figure 3-1 illustrates the problem.

FIGURE 3-1
The Eustachian
Tube
3. When the eustachian tubes are free of infection the normal movement of the jaws involved in
talking and chewing should be sufficient to maintain pressure equilibrium between the middle ear
and the outer ear (hence the standard practice of offering sweets to the passengers prior to the
descent). One consequence of a cold or influenza is that the eustachian tubes become infected,
increasing the risk of otic barotrauma.
Sinuses. These are air spaces in the facial part of the skull bone, connected to the nasal passages.
As with the eustachian tubes, the sinuses can more easily compensate in conditions of decreasing
ambient pressure (ascent) than increasing ambient pressure (descent). When a person is suffering
from a cold or influenza the tissues at the nasal end of the sinuses become inflamed and swollen,
again exacerbating the problem.

Gastrointestinal Tract. Gas forms and collects in the intestinal tract as a result of the digestive
processes. This is normally vented naturally in ways which even the most coy among us are aware
of. If the body is being subjected to decreasing external pressure these gases expand. Generally, it is
only a problem for other flight deck occupants, but if the entrapped gas is in the small bowel it will
be unable to escape and can be agonizing. The situation can be avoided by not eating highly spiced
foods, beer and baked beans - all of which ferment more than most food or drink.
Teeth. Small pockets of gas can be trapped in the teeth during dental filling work or as a result of
an abscess. In the event of the latter it would be unwise to contemplate flying. Filling problems can
be avoided if the dentist is aware that his patient is aircrew. Pain caused in the teeth in this way may
be described as aerodontalgia or barodontalgia.
Lungs. These vent easily and normally during pressure changes. It is however possible for lung
damage to occur if an individual fails to breathe out during a sudden decompression.
Diving and Flying

4. Scuba diving as a pastime has increased in popularity in recent years, especially among flight
crews who regularly visit ideal diving locations such as the Mediterranean and Caribbean. The use
of air under pressure for breathing increases the quantity of nitrogen in solution in the body. On
ascent from a dive this nitrogen tends to come out of solution and can form in bubbles, causing
decompression sickness (DCS). Decompression sickness comes in various guises, depending on where
the bubbles of nitrogen form. Formation in the joints (the bends) causes pain which is aggravated by
movement of the affected joints. Less commonly, the nitrogen bubbles may form in the skin (the
creeps), the nervous system causing partial paralysis (the staggers), or the lungs (the chokes). The
last named can be fatal.

5. These symptoms, and their avoidance by controlled rates of ascent, are well known to
properly trained divers. What is perhaps less well publicised is the additional potential hazard of
flying after diving. Whilst the increased nitrogen solution may not have been sufficient to cause
decompression sickness after a diving session, the further decompression associated with flight at
altitude may be sufficient to bring on an attack. Certain conditions increase the risk of experiencing
DCS. These include cabin altitudes in excess of 25,000 feet; duration (DCS becomes more likely
with increased exposure); age (as age increases so does the risk) and weight (obesity increases the
risk).
6. In order to reduce the risk of decompression sickness, you should not fly within 12 hours
after diving to a depth of 30 ft or less with the associated use of compressed air. If a dive to a depth
of more than 30 ft has been carried out, this restriction is extended to 24 hours. These guidelines are
minima and longer periods are advisable, especially if a series of dives has been made. Cabin
altitudes as low as 6000 ft can lead to post diving DCS.
Effects of Acceleration (G)

7. The human body is designed to cope with a continuous acceleration in the form of Earth
gravity. Other accelerations occur when the body is subjected to changes in rate, or direction, of
movement. These accelerations are felt as linear or angular momentum -forcing the body sideways
or downwards or rearwards and so on. Since the blood has mass, the changes in momentum can
affect the circulation of the blood in the body.

8. With the body in an upright posture, gravitational force will result in the blood pressure in
the lower extremities being greater than that in the head, known as hydrostatic blood pressure
difference. However, the body is adapted to this situation. If the gravitational force is increased - as
when pulling out of a dive - the blood pressure in the head may fall to a point where the blood supply
to the eyes and the brain ceases. Vision loss and loss of consciousness can result when this force
reaches about 3.5 times the normal gravitational force (3.5 G). Such a condition is known as positive
G (+G). After removal of the excess G, recovery will be delayed by the fact that the blood has
concentrated in the lower limbs from where it does not readily return for recirculation. Pilots of
aircraft required to carry out high G manoeuvres (typically fighters) have to wear clothing which
resists this transference of blood. During manoeuvres in which the momentum is, relative to the
body, upward a condition of negative G (-G) exists. Blood is then forced upward and can cause
much greater discomfort than positive G. Most importantly, this upward movement of blood can
overload the heart, causing it to slow down. Maximum tolerance level is -3G for very short periods,
whereas +7G or +8G can be tolerated with proper training and equipment.
9. Impact acceleration effects depend upon the strength of various parts of the body and the
relative direction of the acceleration. With proper restraining seat harnesses the body can withstand
up to a maximum of +25G in the vertical axis and +45G in the fore and aft axis for this short term
acceleration.
Motion Sickness
10. The vestibular apparatus of the ear, already described, supplies the brain with signals which,
when compared with visual references, enables spatial orientation to be established and maintained.
If the balance and visual references do not concur, this causes disorientation and it is probably this
disorientation which leads to the symptoms of motion sickness. These include nausea and
clamminess.

11. The motion which occurs in the air and at sea is abnormal and will cause motion sickness, to
a greater or lesser extent, in any person who has a normal sense of balance, if the motion is
maintained for long enough. If the motion of the aircraft which the vestibular apparatus is recording
is not matched by visual cues and anticipated movement, the symptoms of motion sickness will be
heightened. This may account for the apparent reduction of susceptibility with experience. The
experienced pilot anticipates the movement which will occur in particular flight conditions and
‘rationalises’ the differences between what his sight and his sense of balance are telling him. Without
this precognition, the novice pilot succumbs more rapidly to the sensory mismatch.
12. Passengers have the advantage of being able to close their eyes, which removes one of the
mismatching factors. It has been found that concentration upon an associated task - visual flying for
example - helps to suppress the symptoms of motion sickness. Apart from a small percentage of
individuals who never become accustomed, susceptibility to motion sickness decreases with
exposure. There are medicines available which reduce the symptoms, but in most cases they produce
side effects which may degrade performance. The advice of an aviation physician should always be
sought by aircrew before using "travel sickness" drugs.
Flickering Light Effects

13. Bright flickering lights can cause epileptic-type fits in susceptible individuals. The best known
examples are the flicker effect from a bright television or driving in sunlight through an avenue of
trees, however the shadows of rotating helicopter rotor blades or slowly windmilling aeroplane
propellers in bright sunshine produce the same effect. A number of helicopter passengers have
recently suffered fits from this cause and pilots should be aware of the symptoms.
14. Problems are mostly caused by ‘flash’ frequencies of between 5 Hz and 20 Hz. A four-bladed
helicopter rotor at 240 rotor rpm, for example, will produce an apparent flash frequency of 16 Hz.

15. Susceptible individuals may already be aware of a feeling of unease or discomfort in a flicker
environment and should consider such precautions as wearing sunglasses. They should not, of
course, operate as helicopter pilots. If symptoms occur for the first time in flight, pilots should don
sunglasses if available and if feasible turn out of the sun to diminish flicker effect and make an
emergency landing. Premonitory symptoms of mental unease or discomfort may last for some
minutes before an actual fit, but this cannot be relied upon.
16. Public transport helicopter operators should consider the provision of warning notices to
passengers. Affected passengers are usually on the sunny side of the helicopter and measures to
reduce flicker intensity and contrast, such as wearing sunglasses or covering an adjacent window
with a newspaper or tightly closing and covering eyes, will usually be effective.
Night Vision
17. The rods take up to 30 minutes to adapt fully to night vision, however other factors may
reduce night vision capability. Hypoxia (even mild hypoxia such as that encountered at about 5000
feet or in a pressurised cabin) reduces night vision, as do smoking, age, alcohol, illness and
stimulants.

Flying and Health
Noise - and Age - Induced Hearing Loss

Visual Defects and their Correction
Pilots and Spectacles
Arterial Disease and Coronary Risk
Diet, Exercise and Obesity
Fits, Faints and the EEG
Psychiatric Disease and Drug Dependence
Alcohol
Tropical Diseases and their Prophylaxis
Disinsection
Rabies
Common Ailments and Fitness to Fly
Medication and Flying

Legal Aspects of Fitness to Fly

Blood Donation and Flying
Toxic Hazards (including Carbon Monoxide and Ozone)
Radiation
Incapacitation in Flight

Flying and Health
4 Flying and Health

1. It is axiomatic that aircrew should perform their flying tasks to the best of their ability. It is
therefore imperative that they understand how to remain fit to fly. At times external pressures might
appear to be important and we probably all know aircrew who have gone flying with a head cold
‘because the aircraft is pressurised so it won't affect me’. Such an attitude is irresponsible as it not
only affects the cold sufferer but also the rest of the crew and the passengers. Each year a number of
aircrew are permanently grounded due to sinuses or ears being damaged by flying with a cold. In
addition to the common cold there are a number of other ailments which should prevent aircrew
from flying. However, before we go on to describe these ailments the following confidential human
factors incident report taken from the December 1988 FEEDBACK makes interesting reading:
Let's Go Flying - It Was Only a Little Heart Attack

‘It was Good Friday. I was rostered for a Malaga flight with a departure of 0730. After completing
my pre-flight preparations I left my First Officer in the aeronautical information service room to ‘tidy
up’ while I went to the bank in the airport concourse. On the way there I suddenly experienced an
intense pain high up in the centre of my chest. My first thought was maybe this was a heart attack.
At that time in the morning I was able to find an empty office where I was able to rest until the pain
subsided. The pain felt like an intense rasping in the air passages like one experiences when
undertaking prolonged violent exercise. I also became aware that I was breathing very deeply.

Flying and Health
A few years earlier, during a line check, my training Captain suffered a heart attack, losing
consciousness for a short while. I tried to compare my feelings with the symptoms he had
experienced but there was no comparison. I did not consider there was any likelihood of my losing
consciousness, my pulse was beating its regulation 72, I had no pain in my left shoulder or arm and
there was no tingling in my fingers. I concluded that what I had experienced was not a heart
problem but a respiratory one.
After about 10 minutes I felt able to continue to the bank, complete my business and return to
acquaint my First Officer with what had happened. By now I was feeling quite normal. The F/O and
I pooled our respective medical knowledge (not a lot) and concluded that as I now felt OK we could
do the flight, he would take the outbound leg and keep an eye on me, and if there was no recurrence
of my problem, I would bring it back.
At that time of the morning in Manchester Airport there was no one available to give medical advice
at short notice. I had 119 passengers already on the aircraft and a tight departure slot, missing which
would have meant a 5 hour delay.
The flight was completed and was completely uneventful. The following day I was rostered for
Palma with the same depart time of 0730. I had a good night's rest and felt perfectly normal while I
was at rest, but exercise brought back some pain and deep breathing. As the company was pressed
for crews that weekend I informed Ops that I would do my Palma flight but would report sick on my
return. It was quite a stressful day, a 3 hour delay at Manchester, considerable re-routing en route
and a 3 hour delay at Palma. This time I had a different F/O and briefed him about my problem, but
at all times when I was not physically active I felt completely normal. However, on return to
Manchester I found I was unable to walk in from the aircraft without the pain returning. The F/O
carried my flight bag for me and eventually escorted me to the car park.

Flying and Health
I rested at home for the remainder of the Easter break and on the Tuesday morning contacted my
aviation medical examiner who arranged for me to go immediately to the Manchester specialist heart
hospital for examination. Despite a thorough examination with 2 ECGs being taken, nothing was
found to be wrong with me. I was asked to return the following day to see the senior cardiologist for
a stress test. Despite telling this doctor I was unable to walk 50 yards I was put on the tread-mill and
collapsed shortly after I started. I was admitted to the CCU where I suffered a massive heart attack 3
hours later - 8 out of 10, I was told subsequently, where 10 is death’.
2. The author goes on to speculate as to what might have happened had he suffered the heart
attack in the air. Suffice to say that happily he (and his passengers and crew) survived to tell the tale.
The warning signs were there for him and a number of others to see, yet he still flew four trips with
F/Os who were aware that he had a major problem and an operations/crewing department which
failed to query the fact that he felt unfit and intended reporting sick on return from Palma, yet was
still going to fly.
Noise - and Age - Induced Hearing Loss

3. The anatomy of the ear has been previously described. Vibrations in the atmosphere are
conducted by the ear drum and ossicles (small bones) to the transducer system called the cochlea.
The cochlea converts the vibrations into electrical impulses to the brain.
4. Damage to the conductive system may arise through perforation of the ear drum or infection
of the middle ear. Often damage of this nature can be successfully treated and does not necessarily
result in hearing loss; if it does, it is known as conductive deafness.

Flying and Health
5. Damage to the transducer system (cochlea) is much more serious and successful treatment is
rare. The system is, of necessity, sensitive to vibration and can be permanently impaired if subjected
to excessively loud noise. The impairment may be only temporary if exposure is for a short period,
but continuous exposure leads to irreversible damage. The length of exposure needed decreases with
increase of noise level.
6. Noise levels are measured in decibels (db). The datum of zero decibels is what would be
experienced in a completely soundproof chamber. 30 decibels equates to distant conversation. 60-
70 decibels equate to street noise and 100-120 decibels to a jet aircraft taking-off nearby. Temporary
deafness will result from exposure to noise levels in excess of 90 decibels, but this will become
permanent if exposure is extended. The deafness suffered is a function of total noise, consequently
120 decibels for 1 minute is as bad as 90 decibels for several hours.
7. Obviously, hearing loss is serious for pilots and positive measures should be taken to prevent
it. If you indulge in hobbies or pursuits during which you will be subjected to high or continuous
noise levels (for example clay pigeon shooting, motor racing or disco dancing), it is important to use
hearing protection. Ear muffs and insert ear plugs are effective in reducing noise induced hearing
loss. Whilst the modern flightdeck is designed to present minimum noise levels, it should be realised
that airport ramps can be noisy places and flightcrew should take all precautions necessary to shield
themselves from such noise.
8. Age reduces the effectiveness of the hearing system, the high frequency range being most
affected (this is also true of noise induced hearing loss). This ‘high tone deafness’ will be exacerbated
in individuals who have also been subjected to high noise levels and is known as presbycusis.

Flying and Health
Visual Defects and their Correction

9. The anatomy of the eye has been previously discussed. The refraction process by which light
is focused on the retina is shared between the cornea and the lens, with about 70% of the refraction
being achieved by the cornea. Defects in either cornea or lens will reduce the clarity of the perceived
image and the shape of the eye ball can cause image distortion.
Long sightedness
10. (Hypermetropia) is caused by the eye ball being too short. The distance from cornea/lens to
retina is less than their focal length and near objects become blurred, as shown at Figure 4-1. The
condition can be corrected with a convex spectacle lens.
FIGURE 4-1
Hypermetropia

Flying and Health
Short sightedness
11. (Myopia) is due to the eye ball being too long. The distance from cornea/lens to retina is
greater than their focal length and distant objects become blurred, as shown at Figure 4-2. This
condition is corrected with the use of a concave spectacle lens. Pilots who need correction for either
condition will normally be allowed to fly so long as their corrected vision allows them to read normal
small print in good lighting at a distance of 30 cm, and to read 6/9 in each eye (usually the second
from bottom line on the standard optician's chart read at a distance of 6 metres).
FIGURE 4-2
Myopia

Flying and Health
12. The focal length of the eye is adjustable to allow it to focus on either near or distant objects, a
process known as accommodation. This process degrades with age as the elasticity of the lens
decreases. In most people this becomes apparent in middle age with inability to read small print, a
condition known as presbyopia. This is usually corrected with a prescription of reading glasses with
weak convex lenses. If a pilot were myopic when young and has also become presbyopic (unable to
focus on close objects) with increasing age this can be corrected with bifocal lenses. Prior to
obtaining them, however, the pilot should seek the advice of an Aviation Medical Examiner.
Likewise, contact lenses may be very suitable for some forms of visual defect but again expert advice
should be obtained.
13. Opacity of the lens, resulting in blurred vision, is known as a cataract. It is often seen in the
elderly, but may be congenital or due to some form of metabolic disease such as diabetes. Cataracts
may also result from prolonged exposure to infra-rad radiation or ionising radiation.
14. Glaucoma is a condition in which the optic nerve is damaged. When the clear liquid in the eye
(aqueous humor), which normally flows in and out of the eye, is prevented from draining properly
the pressure in the eye (intraocular pressure) increases. This rise in pressure can damage the optic
nerve.
15. Astigmatism occurs where the image of an object is distorted because not all the light from it
is focussed on the retina. It is usually caused by abnormal curvature of the lens or cornea. The defect
can be cured by the wearing of cylindrical lenses, which cause exactly the opposite distortion and
thus cancel out that due to the eye.

Flying and Health
16. Empty field myopia is caused by the eye reverting to its resting focus on a point about 2
metres away. (Note: medical opinion appears to vary on the exact distance). When flying at altitude
or above cloud and sometimes at night with nothing definite to focus on this problem will occur,
resulting in poor ability to detect small distant objects (such as other aircraft). Active and frequent
re-focusing on distant objects (clouds, ground, vapour trails, stars or even the wing tip) helps to
alleviate the problem.
Pilots and Spectacles

17. Most pilots over the age of 40 need spectacles to correct their vision for reading. In addition
some will need correction for distant vision and a number will need correction for vision at the
instrument panel range. The importance of wearing spectacles which are suitable for flying was
illustrated by an accident in which the pilot, who was wearing full-lens reading glasses, misjudged the
distance available for an overshoot. The following points should be borne in mind when correcting
visual defects:
Near vision correction. Where the only correction necessary is for reading, pilots should never
use full-lens spectacles whilst flying because the pilot's task requires frequent changes from near to
distant vision and the latter is blurred by reading glasses. Half-moon spectacles or lower segment
lenses with a neutral upper segment must be used in these circumstances.
Near and distant vision correction. Where correction for both near and distant vision is
required, bifocal lenses are essential and pilots are advised to discuss with their Medical Examiner
the shape and size most suitable for each segment. Where triple correction is necessary for near
vision, the instrument panel range and distant vision, then specialist advice is required and should be
sought from the Medical Department.

Flying and Health
Variable focus lenses. Variable focal (progressive power, varilux) lenses are an alternative to
bifocal or multifocal lenses. There is no clear demarcation between upper distance vision and the
near vision correction of the lower portion of the lens. There is a gradual merging of correction
power. Such lenses are laterally contoured resulting in some distortion at the periphery of the lateral
visual fields. This distortion can be overcome by moving the head so that the object comes closer to
the centre of the field of view. Some wearers find adaptation difficult and when fatigued or hypoxic,
their adaptation may break down and cause disorientation. Varifocal lenses are, therefore, not
advised for general use in flying. Exceptions may be made in cases where very low dioptric
(magnification) powers are involved and the pilot is fully adapted to them in everyday use.
Technology in this field is constantly changing and this advice may be modified in future.
Sunglasses. Reflections from cloud tops with clear sky above cause the pilot to be subjected to
very high light levels. The blue and ultra violet light levels are greater at higher altitudes. These
elements can cause cumulative damage to the retina over several years. Good quality sunglasses can
give protection against these problems by filtering out blue and ultra violet components of the
spectrum. Generally green or brown tints are best at filtering the blue end of the spectrum, but other
factors such as the constituents of the lens material itself can influence the filter characteristics.
Colour tints alone are not a reliable guide to filter quality. The lens should also have a luminance
transmittance value of 10% - 15%, which in effect means that the light value passing through to the
eye is reduced by 85% - 90%.
All spectacles restrict peripheral vision and thick frames should be particularly avoided. Good
airmanship requires spectacle wearers to increase their head movements in scanning for collision
avoidance. Photosensitive lenses should not be used when descending through cloud from VMC on
top because of the time taken for the lenses to clear.

Flying and Health
Contact Lenses. Before a Medical Certificate may be endorsed approving the wearing of contact
lenses, the applicant must obtain a report from an ophthalmologist or an approved contact lens
practitioner which includes the following information:
(a) field of vision;
(b) details of:
(i) unaided visual acuity;
(ii) corrected visual acuity for spectacles and contact lenses;
(iii) the prescription for both spectacles and contact lenses;
(iv) confirmation that the contact lenses have been worn constantly and
successfully for over 8 hours a day over a period of at least 1 month.
If these requirements are met and provided the medical report is otherwise satisfactory, the
Certificate may be endorsed to permit the use of contact lenses for flying, provided a pair of ordinary
spectacles is carried at all times while exercising the privileges of a licence.
Bifocal contact lenses for the correction of presbyopia are unsuitable for use in flying. Any near
vision correction must be provided by 'look-over' spectacles. In such cases, therefore, suitable
bifocal spectacles should be carried for emergency use.

Flying and Health
Radial Keratotomy. There is great interest in some countries in the surgical treatment of the
myopic eye by means of controlled multiple radial incisions into the cornea. This procedure is
currently unpredictable in its results. Side-effects are common and the long term effects are
unknown; it is certainly not a permanent cure for myopia. This procedure is not advised for
potential aircrew and great caution is exercised in accepting those who have undergone the
operation. Pilots contemplating radial keratotomy or other corneal surgery are strongly advised to
contact their Medical Branch before the procedure is undertaken.
Arterial Disease and Coronary Risk

18. In the UK nearly half of all deaths are due to some form of cardiovascular problem. The
heart is a muscular pump which distributes blood around the body. Like any other muscle it requires
an adequate supply of oxygenated blood. This blood is conveyed to the heart through the coronary
arteries and these can become partially or totally blocked with increased age. This reduces the
supply of oxygen to the heart muscles, which becomes apparent when its workload is increased due
to physical exertion. The symptoms are usually chest pain, sometimes extending to the neck and
shoulders and arm on the left side. The pain often increases with exertion and decreases with rest,
and it is called angina. It indicates severe restriction of coronary blood flow and it may lead to heart
failure.
19. Sudden blockage of a coronary artery (coronary thrombosis), in an already downgraded

coronary system, can cause cessation of heart function (cardiac arrest) often preceded by severe chest
pain. The interruption of blood supply to part of the heart muscle can cause the death of that part of
the heart and is known as myocardial infarction.

Flying and Health
20. The risk of coronary heart disease is increased by a family history of heart disease, smoking,
high blood pressure, high blood cholesterol, lack of exercise and diabetes. The effects of stress,
obesity, alcohol and diet are still not clear. Clearly a person at risk of heart failure is unsuitable to
hold a pilot's licence and the above risk factors are important since the condition of the coronary
arteries is difficult to detect. An ECG (Electrocardiogram) measures the electrical activity of the
heart muscle and ECG tests give some indication, especially of a past infarcation of which the
individual can be unaware.
21. Apart from family history, the individual may be able to decrease some of the risk factors of
coronary heart disease, for example by stopping smoking and taking regular exercise. Smoking also
increases the risk of lung cancer and reduces the oxygen-carrying capacity of the blood due to high
levels of carbon monoxide being carried by haemoglobin. The capacity for physical work is thus
reduced. Regular blood pressure monitoring is important, since high blood pressure (hypertension)
is the main risk factor in the development of the condition known as a stroke (a sudden attack of
weakness affecting one side of the body which can lead to serious paralysis or death). High blood
pressure can be treated and controlled if caught early enough. Low blood pressure is known as
hypotension. It may occur after excessive fluid loss (for example after vomiting or diarrhoea). Other
causes may be myocardial infarcation, severe infections and allergic reactions, or even an overdose of
drugs used to combat hypertension. It may lead to lightheadedness, impaired consciousness, and
fainting.

Flying and Health
Diet, Exercise and Obesity

22. Diet is simply defined as the mixture of foods that a person eats. A balanced diet is one which
contains adequate quantities of all the nutrients. Nutrients include carbohydrates, fats, proteins,
minerals, and vitamins. Carbohydrates are absorbed rapidly and are used as a fuel by the muscles
and central nervous system, having been first converted into glucose. Fats provide the body with
heat energy, but take longer to be absorbed. Proteins are used for the repair and building of body
tissue. Minerals are used for the general maintenance of health, but produce no energy. An example
is iron, which is essential for the production of haemoglobin. Vitamins are required in small
amounts. In addition water and fibres are required. Fibre cannot be digested or absorbed but is used
to enable correct functioning of the digestive and bowel processes.
23. Low blood sugar level is known as hypoglycaemia. It is caused by insufficient food intake,
especially when the person is very active, or the wrong food intake, or it may be caused by the
excessive consumption of alcohol. Diabetes is a disease connected with the absorption and storage of
sugar in the body and insulin, which is necessary for the process, has to be injected daily.
24. The ideal weight for healthy adults, roughly speaking, is the weight they were at age 21. At
this age growing is completed, eating habits are probably not excessive and most 21 year olds are
physically active. Weight in excess of this target weight is usually fat and primarily due to taking in
more energy than is expended (over-eating). When the excess of body fat reaches a certain (ill-
defined) level the individual is said to be obese.
25. Avoidance of excess weight is best achieved by not over-eating. Exercise is a highly inefficient
way of burning off calories and losing weight. It is extremely effective in reducing the risk of
coronary heart disease, provided it has the effect of doubling the pulse rate for a least 20 minutes, 3
times per week. Squash, tennis, jogging or a brisk walk are good - golf or an afternoon stroll are less
so.

Flying and Health
26. Obesity can lead to a variety of diseases including hypertension, diabetes, and gout, which in
turn can lead to coronary heart disease. Obesity results in a reduced tolerance to G accelerations,
hypoxia, and decompression sickness. Smoking has the same effect. It may also give rise to general
cardiovascular problems (blood circulation). The extra load on the joints can lead to arthritic
problems. Whilst obesity is not defined exactly, the body/mass index (BMI) relates ideal weight to
height. The BMI equals weight (kg) divided by height (metres squared). A normal BMI is regarded
as 21 to 25. A BMI of 25 to 30 is considered to be overweight and a BMI in excess of 30 represents
obesity.
Fits, Faints and the EEG

27. Loss of consciousness is obviously something which is not acceptable in a pilot. A fit is the
term used generally to describe some form of epilepsy. Fainting is a reduction in consciousness due
to the interruption of the blood supply to the brain.
28. Epilepsy refers to a disruption of electrical activity in the brain and is usually described as
major or minor. Minor epileptic fits often last only a few seconds, whereas major epilepsy involves
convulsions and uncontrolled physical movements. In both cases consciousness is lost and
consequently epilepsy is an absolute bar to holding a pilot's licence. Usually the condition is well
known from early life, but epilepsy can be brought on by head injury. The presence of epilepsy may
be detected through EEG (electro-encephalogram) testing of the brain waves (small voltages induced
during normal brain activity).

Flying and Health
29. Fainting (syncope) is a loss of consciousness caused by the reduction of the blood supply to
the brain and can occur in healthy individuals. Typical causes are loss of blood, shock, lack of food
and abnormal posture. Examples of fainting when there is no trauma are standing up suddenly or
standing still for long periods. Isolated incidences of fainting, providing the cause can be identified,
will not normally affect fitness to fly. Repeated fainting, or fainting due to physical or medical
problems, will obviously require treatment.
Psychiatric Disease and Drug Dependence

30. Psychiatric illness may be sub-divided into two basic forms - psychosis and neurosis.
Psychosis (loss of contact with reality) results in permanent denial of any form of flying licence.
Neurosis (anxiety, depression, phobia, obsession) can be treated and controlled, but flying is
prohibited during such treatment. A return to flying status is possible after a satisfactory period of
treatment and recovery.
31. Habituation is the condition of being psychologically dependant on a drug used to confer
contentment and well-being whereby a marked craving for the drug occurs if is withdrawn, although
no physical withdrawal symptoms occur. Examples are nicotine in tobacco, cannabis, and many
"soft" drugs. Dependence on drugs affects an individual's performance, physical and mental health,
and is therefore detrimental to flight safety. Drug dependence can be overcome, but specialist help is
essential to successful treatment and is a prerequisite to regaining a flying licence which was
withdrawn because of drug dependence.

Flying and Health
Alcohol
32. Alcohol increases (slows down) reaction times, impairs discrimination and perception in the
visual and auditory systems (including the balance system) as well as causing disruption to short and
long-term memory. It also reduces the ability to reason and leads to reduced inhibitions and self
control. These are hazards not only for the aircraft crew but for passengers also. A reduced sense of
balance and increased susceptibility to other sensory illusions is extremely dangerous, particularly in
the aviation environment. The first signs are more likely to be noticed by friends and working
colleagues rather than by higher authority or the medical department. There is therefore a personal
onus on such people to use whatever personal influence they may have, which may include
encouraging acceptance by the affected individual of medical intervention and counselling. Such
approaches should be prompt, positive, and frank. Professional treatment is widely available.
33. Alcoholism is difficult to recognise, but it is another form of drug dependence. Most
alcoholics, at least in the early stages of the condition, appear no different to the rest of the
population. Those most susceptible are people exposed to "pressures" to drink, either socially or
because of boredom. The World Health Organisation (WHO) definition of alcoholism is when
repeated excessive use of alcohol damages a person's physical, mental or social life.
34. Damage due to excessive use of alcohol can occur before dependence develops. The
maximum safe intake of alcohol is currently considered to be 21 units per week for men and 14 units
per week for women. One unit is equivalent to half a pint of normal beer or a single measure of wine
or spirits. Damage is physical and affects organs -liver, brain, heart and so on.

Flying and Health
35. Symptoms of the onset of alcoholism (dependence) are an increased intake before the effects
are noticeable, ‘secret drinking’, ‘morning after’ effects including shaking and loss of memory. Over
reaction to criticism of the individual's drinking habits is another classic symptom. The condition
can be treated by total abstinence, but successful treatment requires early help from colleagues, a
positive attitude in the sufferer and professional counselling.
36. Alcohol is a contributing factor in a number of aircraft accidents each year. Research
experiments have demonstrated that 40 milligrams (mg) of alcohol per 100 millilitres (ml) of blood
(half the UK legal driving limit) results in a significant increase in errors committed by both
experienced and inexperienced pilots even in simple aircraft. This quantity of alcohol is equivalent to
one pint of beer or a double measure of spirits.
37. Alcohol is removed from the body at a rate of approximately 15 mg per 100 ml of blood per
hour. (A little less than one ‘unit’ per hour).
38. National Authorities may place differing regulations on flight crew. For example, the UK
CAA recommend that pilots should not fly for at least 8 hours after taking small amounts of alcohol;
proportionately longer if larger amounts are consumed. It should be remembered that alcohol can
have delayed effects on blood sugar levels and the inner ear. In the latter case the effects can be
prolonged (possibly 24 hours) and increase susceptibility to disorientation and motion sickness.
Tropical Diseases and their Prophylaxis

39. The so called tropical diseases are mostly diseases arising from inadequate sanitation and
hygiene and this provides the best indication of how to avoid them. In fact many of them are
prevalent outside the Tropics - cholera and typhoid killed thousands in Siberia at the time of the
Russian revolution.

Flying and Health
40. The World's major killer is malaria, which is transmitted by mosquitoes. It is only eradicated
by destroying the breeding grounds of the insect. In countries where this has not been done the best
protection is physical - covering the body, use of insecticide sprays and sleeping under nets or in air
conditioned rooms. Anti-malarial medicines are only partially effective. The appearance of
symptoms after an infected bite can vary from a few days to a month or longer, depending on the
type of malaria. Symptoms vary and are often severe. Headaches, extreme tiredness, nausea,
intermittent fever, rapid breathing and diarrhoea may all come and go. Any occurrence of similar, or
‘flu-like’ symptoms after travelling through a malarial area should be regarded seriously and medical
advice sought.
41. Yellow Fever is also transmitted by insect and is prevented by vaccination. The vaccination,
effective for 10 years, is a prerequisite for entry to many countries and therefore a standard
requirement for international pilots.
42. The danger of contracting typhoid and polio can be reduced by vaccination, as can hepatitis
A (for short periods). There is also a vaccine against cholera, but its protective qualities have been
proved virtually useless. All these diseases, and many others, are carried in food which has been
unhygienically prepared. The best method of prevention is only to eat from accredited sources.
43. Sexually transmitted diseases are much more prevalent in the third world countries and the
only reliable protection against contracting them is by avoiding all forms of sexual contact.

Flying and Health
44. Parasitic Worms are another health hazard. Tapeworms exist mainly in two forms, the beef
tapeworm and the pork tapeworm. The beef tapeworm grows in the human small intestine. Its eggs
are passed into the faeces and if this finds its way on to grazing land the eggs may be consumed by
cattle, where they will survive after slaughter of the animal. Thorough cooking of the meat will
destroy the eggs, but they will survive undercooking and then hatch in the intestine. The pork
tapeworm has a similar life history, except that after hatching may develop in the tissue beneath the
skin and can be very dangerous if they find their way to the heart or central nervous system.
Symptoms are vague abdominal pains, feeling of general malaise, and bleeding from the rectum.
Other worms are roundworms, which can be contracted from unwashed vegetables, and
hookworms, contracted from the soil via bare feet.
Disinsection
45. In order to prevent the spread of disease-carrying insects from an infected country to one
which is not, aircraft cabins are sprayed with insecticide (disinsection).The procedure is carried out
after boarding, with cabin doors shut and ventilation/airconditioning systems off before takeoff at
the last port of call before the country which requires the treatment to be administered. The aircraft
holds receive similar treatment.
Rabies
46. Rabies is mainly a disease found in certain mammals such as dogs, cats, foxes, squirrels, and
monkeys. The result of infection is usually a fatal viral fever. It may be transmitted either via a bite
from an infected animal or by the saliva of the animal entering the blood via a scratch on the skin.
Avoidance of animals is the best defence but since cure is not guaranteed immediate medical
attention must be saught if an animal is encountered as described. Rabies is found worldwide but
not in the UK, Australia, New Zealand, or Scandinavia.

Flying and Health
Common Ailments and Fitness to Fly

47. If you don't feel well on the ground, your condition is unlikely to improve with the rigours of
flying and consequently your performance as a pilot will be impaired. If you have any doubts about
your fitness to fly both you, and possibly your passengers, will benefit if you don't.
48. Examples of common illnesses whose symptoms are worsened by flight are the common cold
and gastroenteritis. The symptoms of gastroenteritis can be relieved by prescribed drugs, but a pilot
should not resume flying until spontaneous recovery is complete.
49. When any illness is being treated with drugs, either professionally or self prescribed, the user
should regard himself as unfit to fly. Never fly whilst undergoing medication without first obtaining
expert aviation medical approval. All drugs have side effects, most of which affect performance to
some extent.
Medication and Flying

50. Accidents and incidents have occurred as a result of pilots flying whilst medically unfit and
the majority have been associated with minor ailments rather than overwhelming medical
catastrophes. Although the symptoms of colds, sore throats, diarrhoea and other abdominal upsets
may cause relatively little problem whilst on the ground, they may become dangerous when flying by
distracting the sufferer from the various flying tasks. Symptoms may also increase in severity in the
altered environmental conditions in flight. The side effects of medication prescribed or bought over
the counter for the treatment of such ailments may also be highly undesirable. The following are
some of the more widely used medicines which are normally considered incompatible with flying:

Flying and Health
Antibiotics such as the various penicillins and tetracyclines may have short term or delayed side
effects which affect pilot performance. More importantly, their use usually indicates that a fairly
severe infection is present and apart from any effect of the medication taken, the effects of the
infection will almost certainly mean that the pilot is not fit to fly.
Tranquillizers, anti-depressants and sedatives affect the ability to respond to a particular

situation. Anxiety is a normal response to danger which alerts and primes the body for action.
Inability to react due to the use of this group of medicines has been a contributory cause to fatal
aircraft accidents. You must not fly when taking them.
Stimulants such as caffeine, amphetamines (often called pep pills) used to maintain wakefulness
or suppress appetite are often habit forming. Susceptibility to the various drugs varies from one
individual to another, but all of them may cause dangerous over-confidence. Overdosage causes
headaches, dizziness and mental disturbance. The use of pep pills whilst flying cannot be permitted.
If coffee is insufficient, you are not fit to fly. Remember that even excessive coffee-drinking has
harmful effects, including disturbance of the heart's rhythm. Listed below are some common caffeine
sources and doses per unit volume of 150 ml, the average cup size:

Flying and Health
brewed coffee 85 mg
instant coffee 60 mg
decaffeinated coffee 3 mg
brewed tea 50 mg
cola drinks 32-65 mg
cocoa 6-24 mg
Anti-histamines can cause drowsiness. They are widely used in cold cures and in the treatment of
hay fever, asthma and allergic rashes. They may be in tablet form or be a constituent of nose drops
or sprays. In many cases the condition itself may preclude flying, so that if treatment is necessary,
expert advice should be sought so that modern drugs which do not cause drowsiness can be
prescribed.
Drugs for the relief of high blood pressure can cause a change in the mechanisms of blood
circulation and impairment of intellectual performance which could be disastrous when flying. If the
blood pressure is such that drugs are needed the pilot must be temporarily grounded. Any treatment
instituted should be discussed with an expert in Aviation Medicine before returning to flying.
Anaesthetics. Following local and general dental and other anaesthetics a period of time should
elapse before returning to flying. This period will vary depending on individual circumstances but
will usually be at least 24 hours following a local anaesthetic and 48 hours following a general
anaesthetic.
Analgesics. The more potent analgesics may have marked effects on performance. In any case
the pain for which they are being taken indicates a condition which is a bar to flying.

Flying and Health
Oral contraceptive tablets in the standard dose do not usually have adverse effects although
medical advice should be sought prior to changing to a different type. The effects of a new course of
tablets should be established prior to resuming flying.
51. Many preparations are now marketed containing a combination of medicines. It is essential
therefore that, if there is any change in medication or dosage however slight, the effect should be
observed by the pilot on the ground prior to flying. Although the above are the commonest
medicines with adverse effects on pilot performance it must be noted that many other forms of
medication, although not normally affecting pilot performance, may do so in individuals who are
oversensitive to the particular preparation. You are therefore exhorted not to take any medicines
before or during flight unless you are completely familiar with their effects on your own body. If you
are in any doubt ask a doctor experienced in aviation medicine.
52. If you are taking any medicine you should ask yourself the following three questions:
(a) Do I feel fit to fly?
(b) Do I really need to take medication at all?
(c) Have I given this particular medication a personal trial on the ground of at least 24
hours before flight to ensure it will have no adverse effects whatever on my ability to
fly?
53. If you are ill and need treatment do make sure that the doctor you consult knows you are a
member of an aircrew and also knows whether or not you have recently been abroad.

Flying and Health
Legal Aspects of Fitness to Fly

54. Medical fitness. JAR-FCL states that the holder of a medical certificate must be mentally and
physically fit in order to exercise the privileges of the applicable licence. Accordingly, licence holders
or student pilots must not exercise the privileges of their licences, related ratings or authorisations
whenever they are aware of any decrease in their medical fitness that might prevent them from
exercising those privileges safely. In addition, a licence holder or student pilot should without undue
delay seek the advice of the authority or Authorised Medical Examiner (AME) if they:
(a) are admitted to hospital or clinic for more than 12 hours, or,
(b) undergo a surgical operation or invasive procedure, or,
(c) need the regular use of medication, or,
(d) need to use correcting lenses regularly.
55. Illness, injury and pregnancy reporting. The holder of a medical certificate issued in
accordance with JAR-FCL Part 3 is required to inform the authority in writing of :
(a) any significant injury involving incapacity to act as a member of a flight crew, or in the
case of a female, on becoming aware that she is pregnant. Such a report is to be made
immediately.
(b) any illness involving incapacity to function as a member of a flight crew throughout a
period of 21 days or more. Such a report is to be made as soon as the period of 21
days has elapsed.

Flying and Health
In both cases the medical certificate is deemed to be suspended, immediately in the case of injury and
upon confirmation of pregnancy and, after 21 days in the case of illness.
56. Lifting of suspension of a medical certificate. In the case of injury or illness the suspension of
the medical certificate will be lifted subject to the licence holder either, being medically examined
under arrangements made by the Authority and found to be fit or, being exempted by the Authority
from a medical examination.
In the case of pregnancy, the suspension may be lifted by the Authority during the pregnancy for such
period and subject to conditions decided by the authority and on completion of the pregnancy on
being found fit to resume flying.
Alcohol and Drugs

57. JAR-OPS 1.115 states the following:- ‘An operator shall not permit any person to enter (or be
in, and take all reasonable measures to ensure that no person enters or is in, an aeroplane when)
under the influence of alcohol or drugs to the extent that the safety of the aeroplane or its occupants
is likely to be endangered.’
Blood Donation and Flying

58. The UK CAA recognises that pilots may wish to donate blood (or bone marrow). In the case
of blood donation there is a very slight risk of post-transfusion faintness (syncope). Pilots should
therefore refrain from donating blood or plasma if they are required to fly within 24 hours (48 hours
in the case of bone marrow donation).

Flying and Health
Toxic Hazards (including Carbon Monoxide and

Ozone)
59. There are a vast number of substances used in the construction and operation of aircraft
which are either toxic or potentially so. Engine exhaust gases contain carbon monoxide which is a
colourless, odourless, but highly toxic gas and is a potential hazard in piston-engined light aircraft
which sometimes use exhaust system heat exchangers (mufflers). The effects are headaches, nausea,
lethargy, sluggishness of mental processes or mental confusion and unconsciousness. Carbon
monoxide is readily absorbed by the red blood cells, giving the blood a bright red colouration which
is apparent in the cheeks, giving the patient a "healthy" complexion.
60. Fuel, lubricant and hydraulic oil vapours are all irritants and their fumes can be toxic. In
pressurised aircraft the likelihood of these entering the ventilation system is reduced, but oil leaks in
gas turbine compressors can easily lead to polluted air conditioning supplies in passenger carrying
aircraft. Anti-icing fluids and fire extinguishants can be highly toxic and can conceivably enter the
cabin air from the same source. A further potentially serious hazard comes from mercury. Whilst it
is now extremely unlikely that any aircraft equipment will contain mercury, it may well be
transported as cargo. Mercury at normal temperatures is a metallic liquid and even in this state is
absorbed through the skin and alimentary canal. Its vapour, especially at high temperatures, is taken
in through the lungs. Acute poisoning causes severe abdominal pains, vomiting, excreted blood, and
kidney damage.

Flying and Health
61. Most polycarbonates (plastics) give off highly toxic fumes when burning. Since many of the
cabin furnishings and much of the passenger luggage is made from these materials, toxic fire hazards
are considerable in the cabin. Toxic smoke is the main cause of passenger deaths in aircraft ground
accidents. Aircraft cargoes often contain toxic substances such as agricultural chemicals, which are
particularly hazardous in this respect. Ozone, an oxygen varient, although effective in absorbing
ultra-violet light from the sun and thereby protecting the planet, is toxic and can cause lung damage
through emphysema (loss of elasticity of the lung structure). Initial symptoms on exposure are
dryness of the throat and nose, irritation and coughing and general chest discomfort. Some relief
may be gained by breathing through a damp cloth.
62. Below the tropopause ozone levels are not normally high enough to cause problems, however
above 40,000 ft concentrations of ozone increase markedly. Latitude and season also affect the the
concentration of ozone; generally with the highest levels occuring winter and spring and at higher
latitudes. Engine compressors, due to high operating tempratures, break down ozone to an extent
and fortunately air for the cabin air conditioning systems is drawn from the engine compressors.
Additionally, the aircraft's air conditioning/pressurisation systems can employ carbon filters and
catalytic converters to further break down the gas.
Radiation
63. Crews at high altitude are exposed to varying levels of heavy-ion cosmic radiation that
originates from the Sun and outer space. This occupational exposure has been formally
acknowledged by the US FAA since 1990. Ionising radiation originates from the Sun and cosmic
radiation from outer space. Occasionally, cargo may also be a source of radiation. Exposure to
ionising radiation increases with altitude and latitude; in particular there is a significant increase in
neutron radiation above 30,000 ft. Radiation levels change with solar activity. When solar flare
activity is low there tends to be a reduction in radiation from the Sun, but also at these times the

Flying and Health
solar wind activity is low. While the solar wind carries radiation from the Sun to the Earth it also
deflects a large proportion of cosmic radiation from outer space. Therefore during these periods the
Earth experiences an increase in radiation from space. During periods of high solar flare activity,
readings from crew monitoring badges have recently shown greater consistency and somewhat
higher readings in ionising radiation. Radiation can affect reproductive cells and foetuses. Ionising
radiation may cause genetic defects. Crew members may wear radiation monitoring badges. Unlike
those worn by other personnel exposed to radiation (such as X-ray workers) these detectors are
specifically designed to monitor the various types of radiation expected at high altitude, including
gamma, beta, and X-ray as well as neutron radiation. The wearing of such detectors is essential in
order to build a better picture of the problem, as well as monitoring individual health. Aircraft
which are certified to operate above 49,000ft must be equipped with instrumentation to measure and
indicate continously the dose rate of total cosmic radiation being received and the cumulative dose
on each flight (JAR-OPS 1.680).
Incapacitation in Flight
64. Statistics from the ICAO computer in Montreal show that in the 10 years to 1989, seven
aircraft crashes were positively attributed to pilot incapacitation. In addition, five pilots died at the
controls though their aircraft were safely landed by a second pilot. Thankfully sudden incapacitation
of a pilot is extremely uncommon and only rarely the cause of an aircraft accident. Gradual or
insidious incapacitation may be unnoticed by the pilot or other crew and is probably under-reported
as it usually happens at a stable phase of flight and is often short-lived.

Flying and Health
65. The most common cause of sudden pilot incapacitation is acute gastro enteritis. Gastro
enteritis is usually caused by food poisoning, as a result of unhygienic food storage, preparation and
serving. Common symptoms are vomiting and nausea, abdominal pains, diarrhoea, and fever.
Simple methods of reducing risk involve common sense. Eat and drink at accredited establishments
only, avoid seafood (particularly in less developed countries), drink only bottled water, and do not
accept ice in drinks unless its source is proven. Personal hygiene plays its part, and most people are
taught its importance from an early age. Hands in particular should always be thoroughly washed
after visiting the lavatory and again always before eating food of any sort. This also applies to those
people responsible for the preparation and handling of food. Some food is easily contaminated by
bacteria. Bacteria multiply by binary fission, the process by which a fully-grown bacterium divides
into two identical parts. Under the right conditions this process occurs every twenty minutes; one
germ can become over two million in about seven hours. The process occurs within the temperature
range 10°C to 63°C, the most rapid rate occurring at 37°C. Dangerous bacteria are not normally
found in foods with high contents of acid, sugar, salt, or fat, nor in dehydrated food. The two most
common forms of food poisoning are ‘Salmonella infection’ and ‘Staphylococcal infection’. Risk can
be minimised by not leaving prepared food standing in ambient temperatures for too long, keeping
hot foods above 63°C, and cold foods below 10°C. Other measures include good overall sanitation
of utensils used for preparation and storage of food, separation of cooked and raw foods, the
frequent washing of hands with anti-bacterial soap by personnel engaged in food preparation and
handling, no smoking in food areas, and preventing personnel suffering from infections (particularly
intestinal) from entering food preparation and storage areas.
66. The causes of incapacitation fall into three catagories, summarised below:

Flying and Health
Sudden unconsciousness is most likely to be caused by a massive heart attack though even this
is likely to be preceded by chest pain and numbness in the arm. Should a pilot recognise symptoms
which indicate that a heart attack is imminent his immediate action should be to engage the autopilot
and ensure that the aircraft is flying in a safe direction and at a safe height. This at least gives the
other pilot (or ex-wartime pilot beloved of Hollywood movies such as ‘Airplane’) the chance to safely
land the aircraft. Other conditions which could lead to unconsciousness are noxious fumes, hypoxia
and hyperventilation. Again the autopilot should be engaged as a first step.
Debilitating pain or illness can be caused by many things including otic barotrauma, severe
sinus pain, migraine, gastroenteritis, food poisoning, decompression sickness, renal or gall bladder
colic - a severe pain caused by a stone in the kidney or gall bladder - and the after effects of
medication or viral infections. Whilst the onset of symptoms is likely to be slow and should give the
pilot plenty of time to alert the other pilot in a multi-crew aircraft, the immediate action should be to
engage the autopilot, for again loss of consciousness could result.
Blindness is the final category, and could be either temporary or permanent. Whilst it is possible
that a medical affliction could strike a pilot blind it is extremely unlikely. The most probable causes
of temporary blindness are lightning strikes (especially at night) and smoke so dense as to obscure the
instruments and the outside world. Permanent blindness in civil flying is less of a risk although bird
strikes - the most likely cause - are possible, especially during the critical take-off and landing phases.
As with the other forms of incapacitation the immediate action should be to engage the autopilot,
having first ensured that you are climbing clear of obstructions. The important thing is that you are
able to engage the autopilot without having to look at it - the time to practice this being in the
simulator and not on short finals to Heathrow.

Flying and Health
67. The obvious point is that you should not fly unless you are totally fit. Unfortunately
commercial pressures sometimes cause an individual to forget this basic rule. In FEEDBACK No 5 a
pilot describes the following incident:
'I was operating a scheduled service with five passengers. In addition to this being a single pilot flight
the autopilot was u/s. At the relevant time therefore I was hand-flying in smooth air. Without any
warning I experienced very strong sensations of rolling, to the extent that I moved the control wheel
rapidly in alternating directions, involuntarily. Fortunately, as it proved, I recognised these
symptoms as being similar to those associated with a viral labyrinthitis infection which I had
experience some years previously, and I knew that by concentrating very hard on one spot - in this
case the attitude indicator - I could mitigate the effects of the vertigo. I did this and within a few
seconds the vertigo receded. The flight was continued without further incident. The relevant part of
this incident from a human factors point of view is what I did after landing. As might be imagined, I
had been more than a little alarmed, not least by the possibility of a recurrence before I could land, so
I was initially reluctant to operate the return flight. However, as it would be both difficult and
expensive for my company to fly out another pilot to replace me, and as the return was not due to
depart until that evening, I decided that if there was a recurrence in the next few hours I would
contact my company, but if not I would operate the flight. Subsequent tests diagnosed Meuniere's
disease resulting in the loss of my licence. Had I known this at the time I certainly would not have
flown the return sectors but I was influenced by the financial pressures on my employers and also by
the desire not to inconvenience other pilots at an awkward time of the year'.
68. If you are unfit do not fly. Your employer and the bereaved relatives of your passengers will
not thank you for trying not to inconvenience them.
69. With the advent of high quality simulators, incapacitation training has become feasible and
the mandatory training now required has proved so effective that pilots with a known higher-than-
average risk of sudden illness can be allowed to fly in a multi-crew aircraft.

Stimulus/Sensation
Attention
Perception
Decision Making
Memory
Learning
Motor Programmes
Response Execution
Workload

5 Information Processing in General

1. The human being is multi-sensory. The senses (which enable perception) are vision, hearing,
touch, smell, and taste. The Central Nervous System comprises the brain and spinal chord, and is
responsible for the integration of all nervous activities. The Peripheral Nervous System comprises all
parts of the nervous system outside the central nervous system and includes the cranial nerves and
their branches, which link the receptor organs with the brain and spinal cord. The brain acts rather
like the processor ‘chip’ in a computer in that it processes all sensory inputs, is the origin of thought,
and acts as a memory storage site. The brain is divided into three connected parts known as the
hindbrain, midbrain, and forebrain. The largest part of the hindbrain, at the bottom, is known as the
cerebellum. It is responsible for the maintenance of muscle tone, balance, and the synchronisation of
muscle activity under voluntary control by converting muscular contractions into smooth
coordinated movements. Sensory impulses are transmitted throughout the body by bundles of
conducting nerve fibres. Those nerves which transmit impulses from the brain or spinal cord to the
muscles and glands are known as motor nerves and those which transmit inwards from the sense
organs to the brain and spinal cord are known as sensory nerves. The basic functional unit of the
nervous system is the neurone, or nerve cell. A resting cell is electrically charged, or polarised,
because of the different ion concentrations outside and inside the cell. When a nerve impulse is
triggered depolarisation occurs and electrical current flows across the neurone and spreads
throughout the system. The point at which a stimulus begins to evoke a response is known as the
sensory threshold. The ability of cells to respond to a stimulus is known as sensitivity. For example
the cells within the retina of the eye are sensitive to light and react by sending impulses to the brain,
but are only able to do so when there is a minimum level of light. Sensory adaptation occurs when a
sense organ shows a gradually diminishing response to repetitive or continuous stimulation.
Examples are touch receptors in the skin which ‘forget’ the presence of clothing a short while after

they have been donned, and the nose which will no longer sense the presence of an odour if it
becomes continuously present. The autonomous (vegetitive) nervous system is that part of the
nervous system which is responsible for the control of body functions which are not consciously
directed, such as heartbeat, sweating, and intestinal movement. These biological control systems are
neuro-hormonal in that they react to hormones which are produced within specialised nerve cells and
secreted from the nerve endings into the circulation. In a normal environment they are highly
regulated.
2. An automatic response to a stimulus is known as a reflex action. It may be conditioned, such

as the production of saliva when food is seen or smelt, or non-conditioned such as ‘the knee jerk’ or
the withdrawal of a hand when accidentally placed on a hot object.
3. The task of controlling an aircraft in flight is one in which sensory perception (sight, balance,
hearing, touch) produces co-ordinated physical responses. In between the sensory perception and the
physical responses is a decision making process which produces (hopefully) the correct responses. In
this chapter we consider how the senses work and how their inputs are processed by the brain. We
will also consider the potential weaknesses of human information processing procedures. In this
chapter human information processing procedures are discussed in general terms, however, where
examples of how the various procedures function in specific situations, flight deck scenarios are used
wherever possible.
4. In order to visualise and quantify how information is processed it is necessary to construct a

‘model’ in which events follow sequential stages. The model which follows is based upon a system of
stages first proposed by Broadbent in 1971. He considers the decision making process in three
distinct stages:
(a) Information is first received and coded.

(b) Then the information is translated and stored.
(c) Finally an appropriate response is selected and executed.
5. An advantage of this approach is that errors of decision making can be analyzed to determine
at which stage failure occurred:
(a) A failure of perception at the 1st stage - perhaps indicating that the person is being
overloaded with information.
(b) A failure of memory at the 2nd stage.
(c) A failure to select and execute the appropriate response despite having successfully
interpreted the information.
6. It should not be thought that human information processing is neatly compartmented into
these, or other, stages. Various parts of the brain cannot be identified as carrying out the specific
functions of the model stages. The model is simply a convenient way to represent the process and it
is illustrated at Figure 5-1. The various stages in the model are discussed more fully in the following
text. First, with reference to Figure 5-1, let us take a simple example. Suppose you start to fall
forward. The vestibular apparatus senses the topple and sends a signal to the brain which perceives
this as forward topple. Visual sense perception says that there is a wall in front of you and the brain
decides from memory stored information that an appropriate response would be to stick out an arm.
This action is executed and fed back internally to the sensory store as a muscular action. External
feedback from sense of touch in the fingers tells the brain that the wall has been contacted and finally
the vestibular apparatus informs the brain that the topple has ceased. What we have just described is
known as a closed loop control system.

FIGURE 5-1
Sites of
Information
Processing

Stimulus/Sensation
7. Sensation, or the sensory process, is the result of physical stimuli activating the sensory
receivers (eyes, ears, etc). The information they receive is transmitted to the short term sensory store.
This stage in the perception process appears to fulfil the task of holding information until the
conscious mind has the capacity to perceive it. To this end the ‘echoic’ sensory store is able to hold
sounds in a sort of sub-conscious memory for 2 to 8 seconds, whilst the ‘iconic’ sensory store holds
images for only ½ to 1 second. After this time, if not ‘perceived’, the information is lost.
Attention
8. Overriding perception, decision and response is our ‘attentional capacity’. In effect this is our
scope for conscious thinking. Unfortunately, the mind has a limited rate for processing information
and its capacity for holding information simultaneously is also limited. Thus, the attention any
particular stimulus receives depends on its relative importance and whether any ‘attentional capacity’
is available to perceive it.
9. In the aviation context this is the danger of being pre-occupied with one problem, to such an
extent that other problems go unnoticed, possibly with serious consequences.

10. Vigilance is a monitoring process to detect infrequently occurring and low intensity events.
Much research has been carried out on the subject but it is arguable that the most notable factor in
the human capability to exercise vigilance is motivation, or the will to do the job. Many factors are
involved in motivation, such as financial reward, personal reward, job-satisfaction, and social
standing to name but a few. It may be argued that a computer or machine, since it is not motivated,
is better at vigilance than the human. It does not suffer from gradual overload breakdown (but it
does from sudden breakdown), is fast, does not become tired, can monitor complex situations, and
can compute rapidly. However, it is incapable of reasoning, cannot correct errors, and does not
possess intelligence. Hypovigilance is the term used to describe low vigilance levels in man. It may
arise through boredom, particularly if the task is routine, tiredness (or both), lack of job satisfaction,
stress, and lack of motivation.
11. It will be seen from Figure 5-1 that attention has to be divided between perception of sensory
information, exchange of information to and from the short term memory, concentrating on decision
making and response selection, and executing the selected response. The extent to which attention
can be divided in these ways is governed by:
Selectivity. A sampling process by which the host of inputs arriving at the sensory store is
prioritised. When demands on attention become too competitive the process can become over-
selective and discard important information. For example, in the L1011 crash in the Florida
Everglades a relatively minor malfunction led to the pilots failing to monitor the aircraft's height.
Focusing. In order to complete a task the natural tendency is to focus attention entirely on the
task in hand. Anything which distracts attention from that task is likely to be detrimental to its
successful completion - the more complex the task, the more damaging the distraction.

Division. Attention can be divided between stimuli or tasks provided that the combined
demands do not exceed the capacity of the central decision making process, or overload the memory
stores. Fortunately, even when our attention is concentrated upon one task, relevant high priority
messages are able to intrude. This is known as the ‘cocktail party effect’ where, despite being
surrounded by a babble of noise and being engaged in conversation, your attention can be diverted if,
for example, your name is called. Because of this facility a call from ATC, using the aircraft callsign,
may intrude even when cockpit activity is intense.
Arousal and Stress. Stress usually increases the rate of arousal (alertness) of an individual and
tends to concentrate the attention on the cause of the stress. This can reduce the amount of attention
paid to other sensory information, so that important information is discarded.
Perception
12. Perception is the name we give to the process of recognising and understanding a stimulus.
The perception process is considered to involve the creation of mental models of what we think is
true. The two inputs to this model are the stimulus itself and previous experience that can be related
to the stimulus. Once this model has been produced it is not easily changed and subsequently we
tend to select information that supports our model, possibly rejecting valid, but contradictory,
information in the process. This effect, known as ‘confirmation bias’, has contributed to numerous
aircraft incidents and accidents. Situational awareness is the perception of our position (literally
perhaps) in our own environment. The more accurate and comprehensive our information, the
better is our mental model and the greater is our situational awareness.

Decision Making
13. The decision maker is the conscious, thinking part of the brain and is closely linked with the
working memory and response execution. This part of the brain is where the perceived picture is
either acted upon, put into memory or discarded as unimportant. Once again attentional capacity is
all-important and the occupation of decision-making channels by stress or other distractions means
that the decision-making process is likely to be degraded or slowed.
14. Decision making requires our full attention and consequently only one such conscious
operation can be carried out successfully at any one time.
Memory
15. From Figure 5-1 it will seen that the memory system is considered in two parts; the working
or short term memory and the long term memory. A third, subconscious part of memory is that
devoted to the operation of automatic actions, such as those that form the basis of a skill. This is
sometimes called the motor memory.
16. As its name suggests, the short term or working memory only retains information for a
limited period, for example the time between looking up a radio frequency and selecting it. The
capacity of the short term memory is also limited, typically to five to nine unrelated items of
information. This number can be increased to some extent by association of related items. This
process is sometimes referred to as ‘chunking’. For example, the three letter identification of a radio
navaid may be memorised in association with the appropriate frequency.

17. Information is only retained in the working memory for a matter of 10 to 20 seconds, after
which it is replaced by new information from the sensory store. However, if information in the
working memory is repeated (or ‘rehearsed’, to use a popular term) it will be retained for a
considerably longer period.
18. The long term memory retains two types of information, known as semantic memory and
episodic memory. Semantic memory is the store of information relating to ability and understanding,
for example how to fly an aircraft or spell a particular word. Episodic memory is the memory of
events which have been experienced. Unfortunately our memory of events tends to become coloured
by what we think should have occurred in that situation. In cases of amnesia it is likely that it is the
episodic (rather than the semantic) element of memory which is lost.
Learning
19. Learning is known as an internal process and learning is controlled by training; it is
accomplished by the student and not, as is often supposed, by the instructor. Learning is achieved by
memory technique, mental training, and skill development.
20. Memory technique uses the long-term memory. For example, if a telephone number is looked
up in the directory, it is forgotten within seconds. This is the use of short-term memory. However, if
a persons own telephone number is asked, it will be given correctly with no references. This is the
use of long-term memory. In order to remember a new telephone number, it must be repeated
consciously many times to improve retention. This is known as rehearsal. Mental training involves
the use of another person who is a teacher or instructor and is achieved through the use of lessons,
lectures, discussions, and tutorials. The latter makes use of one instructor and one student (one on
one). Skill development comprises practice to hone a learned motor skill. All learning is enhanced if
the student is motivated to learn in the first place, and motivation is essential when difficult parts of
the learning process are encountered.

Motor Programmes
21. Many of the tasks an individual is called upon to perform are repetitive and their
performance has become automatic with practice and requires no conscious thought. Minor attitude
corrections in otherwise straight and level flight are an example. These routine actions require
minimal attention and are known as motor programmes. Such actions do not rely upon a feedback
process from previous actions and are therefore an example of an open loop control system. A
motor programme and a conscious action can be exercised simultaneously. For example, the pilot
can fly the aircraft (motor programme) whilst talking to ATC (conscious action).
22. Whilst the acquisition of automatic responses (motor programmes) has the advantage of not
diverting attention from more demanding tasks, the disadvantage is that they are prone to error
which is likely to be undetected because of the absence of feedback. Conscious monitoring (periodic
checking of actions) is therefore essential when operating a motor programme.
23. Unlike conscious operations (such as decision making), several motor responses can be
conducted simultaneously.
Response Execution
24. At the decision stage an appropriate response to received information is selected. At the
response execution stage the decision is translated into action and appropriate motor responses are
initiated. Just how appropriate these responses are will be influenced by the pressure the individual
is under at the decision making stage. If the situation is urgent the response may be selected and
made before all available information has been processed. Furthermore, the more aroused the
individual the faster the response, but the less accurate it is likely to be. Responses tend to be slower,
but more accurate, with age.

Workload
25. The level of performance any individual is capable of is limited by his ability to process the
available information. Up to a point, performance is improved if the individual's workload is
increased. When workload is light the individual may be bored and easily distracted, missing
important pieces of information relative to the task. At higher workloads, interest is stimulated and
attention held, improving performance. When workload becomes excessive however, the attention
processes are overloaded by too much information and the response executions needed are more
than the time which is available permits. This is called, respectively, qualitative and quantitative
overload.
26. Figure 5-2 illustrates the relationship between workload and performance. In aviation this
relationship is of vital importance in ensuring that the pilot's workload is sufficient to maintain
interest and attention, whilst leaving spare capacity to cope with an emergency situation. Stress
occupies some of our attentional capacity and under high workload, whilst the scan of information
may increase, the scope of the information considered is likely to narrow. Consequently, important
information can be lost.

FIGURE 5-2
Workload and
Performance
27. Figure 5-3 illustrates the workload associated with the various stages of a typical flight
profile.

FIGURE 5-3
Typical Flight
Profile Workload

Illusions
Visual Illusions
Vestibular illusions
Somatogravic Illusion
Visual Clues in Landing
Visual Search and Mid Air Collisions
Behavioural Patterns
Skill Based Behaviour
Rule Based Behaviour
Knowledge Based Behaviour

6 Information Processing in Aviation

1. The previous chapter discussed human information processing in terms of perception,
decision and response. Let us now consider the problems of perception and information processing
in aviation.
Illusions
2. Figure 6-1 shows two examples of visual illusions. The mental models we form are of a
triangular and three pronged structure respectively - in fact, on examination it is seen that neither is
possible as a real world object. When a mental model differs from the real world, this is known as an
illusion.
FIGURE 6-1
Examples of
Illusions: The
Penrose Triangle
The Schuster
Illusion

Visual Illusions
3. In aviation, visual illusions are usually associated with experience or expectation. For
example, a pilot who is used to flying over a well developed forest and using tree height as a guide to
altitude may fly dangerously low over an area of newly planted saplings. Other visual illusions are
not uncommon. For example a stationary light against a dark background can appear to wander
(autokinesis) and a rotating object on a vertical axis can appear to reverse direction of rotation (ATC
surveillance radar antennae are a good example of the latter illusion).
Vestibular illusions
4. Remember that the vestibular apparatus contained within the inner ear consists of three
mutually perpendicular semi-circular canals, which act as angular accelerometers, and the otolith
organ, which acts as a linear accelerometer (see Figure 1-6 in the chapter entitled Human Physiology.
5. It is the semi-circular canals which give rise to vestibular illusions, however the otolith organ
contributes to somatogravic illusions, which are discussed shortly.
6. In flight, angular accelerations involve rolling, pitching and yawing manoeuvres, and it is
rolling manoeuvres (real or perceived) which are most likely to give rise to vestibular illusions. The
otolith organ senses accelerations in straight and level flight.
7. The semi-circular canals contain fluid. As angular accelerations occur this vestibular fluid
flows around the semi-circular canal or canals which are affected by this acceleration. As the
vestibular fluid flows, nerve tissue (Cupula) projecting into the canal is bent away from its ‘at rest’
position and signals the brain that an angular acceleration is occurring.

8. Vestibular illusions can occur in one of two ways, one involving very low angular
accelerations and the other far more likely to occur with high angular accelerations, in both cases in
the rolling plane. These are known as somatogyral illusions. Such illusions are not really illusions as
such, since they originate from the balance system and not the visual.
9. If an aeroplane rolls very gently away from wings level this may go unnoticed by the pilot, as
the very small angular acceleration involved is below the threshold of detection of the relevant semi-
circular canals. When either the attitude indicator (artificial horizon) or an external visual reference
(the real horizon) alerts the pilot to the error the correcting roll back to wings level may well be made
at a rate which is sufficient to be sensed by the vestibular system. A conflict now exists in that the
visual indications are that the aircraft is wings level, however the input to the brain from the
vestibular system insists that the aircraft has now rolled away from that which was previously
perceived as being wings level. This is a condition which is frequently known as ‘the leans’ and this
very compelling feeling of leaning may persist for some time.
10. Ideally, at the precise moment that an angular acceleration ceases, the vestibular system
should register the cessation. Unfortunately the vestibular fluid suffers from inertia, indeed the
greater the angular acceleration the greater the inertia. Lets take a situation that we all hope will
never happen for real, that is to say recovering from an inadvertent spin. Having recognised the spin
and broken the stall it is important to level the wings. The aircraft will therefore be rolled wings level
at a high rate of roll. As the wings level attitude is approached it is necessary to stop the roll, and this
will again involve a high rate of angular acceleration. Because of the inertia of the vestibular fluid
the vestibular apparatus is still signalling a roll (beyond the desired wings level attitude) even though
the roll has ceased. The temptation therefore is to roll back into the spin in the original direction.
The effect is illustrated at Figure 6-2.

FIGURE 6-2
Semi-Circular
Canal
Somatogravic Illusion
11. Somatogravic illusions are those involving a false perception of attitude relative to the
gravitational vertical. The somatosensory system consists of pressure and position nerve receptors
distributed throughout the body which detect body weight and therefore provide a stimulus to the
brain based upon the direction in which gravity is acting, thus producing a vertical reference. This
reference can also be fooled by inertia and acceleration.

12. On accelerating (say on a go-around) the body detects inertial force in the opposite direction.
The somatosensory system detects the resultant of body weight and ‘inertial weight’, which is
displaced backwards. Since this resultant is our basic vertical reference the only sensory conclusion is
that the body must have pitched up, as illustrated at Figure 6-3. If the pilot reacts by pitching down
the inertia increases and displaces the resultant weight even further, so the illusion increases.
Students of the basic instruments syllabus will be aware that the air-driven artificial horizon, when
subjected to acceleration, also indicates a pitch up, providing false ‘confirmation’ of the illusion.
FIGURE 6-3
The Somatogravic
Illusion

13. Both vestibular and somatogravic illusions result in spatial disorientation. The only solution
to all forms of spatial disorientation is for pilots to trust the most reliable form of information
available to them. This will almost invariably be the flight instruments rather than their own
sensations and this basic fact forms the basis of all instrument flying instruction. Appreciate that,
despite their sophistication, even modern state of the art flight simulators cannot adequately
reproduce the forces which fool the body's vestibular and somatosensory systems. Consequently,
although experienced instrument rated pilots may react appropriately to the false inputs experienced
during normal flight manoeuvres, they may react inappropriately when exposed to unusual flight
situations.
Visual Clues in Landing

14. The landing phase of flight demands exact visual interpretation of the available cues used to
judge height and rate of descent. In the following text the landing procedure has been sub-divided
into three, sequential, phases:
Initial Judgement of Correct Glide Slope. Initial judgement of a correct glide slope may be
made using such aids as visual approach slope indicators (VASIs), precision approach path indicators
(PAPIs), by positioning the aircraft at predetermined heights above known ground features
(especially when circuit flying), or by some other method. When judging whether or not the aircraft
is on the correct glide slope the pilot is presented with an image which approximates to that shown in
Figure 6-4.

FIGURE 6-4
The Visual
Glideslope
Judgement
15. In order to fly a three degree approach the visual angle (the angle between the horizon and the
impact point chosen on the runway) should be three degrees (assuming a flat earth), see Figure 6-5.
FIGURE 6-5
Glideslope Visual
Geometry

NOTE: Binocular (or stereoscopic) vision is not essential for the judgement of depth or distance
and only plays a part up to a distance of approximately 12 metres. Several ‘cues’ aid depth
perception, and these include relative size and clarity of objects in view, relative movement, texture
and perspective. The scattering of light caused by particulates in the lower atmosphere results in the
fading of the colour intensity of distant objects. A range of hills or mountains which are distant will
appear faded in colour and indistinct when compared with closer terrain. The reduction in colour
intensity enables us to assess the distance even though the height of the hills is unknown. Distance
perception is therefore not derived by stereoscopic vision alone. Humans learn by experience of the
world about them, and therefore binocular vision is not essential, even for flying.
It is often true that a pilot making a visual judgement is prevented from seeing the horizon by poor
visibility or because it is night. Position may be estimated in such circumstances in a number of
ways. The extended sides of the runway intersect at the horizon and the texture gradient in the
surrounding terrain indicates horizon location though these cues are only accurate when the terrain
and runway are level. A sloping runway or terrain may produce incorrect estimates of horizon
location by the pilot with resulting incorrect approach judgements being made. Terrain which slopes
down to the touchdown end of the runway can give a false impression of being too low. Conversely,
when the ground is rising up to the touchdown end the approach feels too high. The brightness of
lighting directly influences the estimation of range. Lights which are dimmed or faint because of
intervening mist or smoke appear further away.
Visual Glide Slope Maintenance. In order to visually remain on the glide slope the pilot must
aim for the impact point whilst maintaining the correct approach angle. The pilot knows that he is
correctly approaching the impact point because this is the point on the ground from which visual
texture flows on the retina, see Figure 6-6.

FIGURE 6-6
Assessment of
Impact Point
Final Approach Phase. Immediately prior to touchdown the pilot may well be required to
make height adjustments to avoid undershooting the visual impact point. At Figure 6-7 it can be
seen that the aircraft will undershoot the impact point by a considerable distance if the approach is
continued without any flare. To make the necessary height adjustments the pilot may use a number
of visual cues. These cues include the apparent speed with which ground texture is passing the
aircraft and the apparent size of the ground texture and known objects (as altitude reduces the
apparent speed increases as does the apparent size of the texture and known objects). These cues are
largely removed if the approach is over water, snow, featureless terrain or is carried out at night. In
such circumstances the pilot may have to rely on the apparent size (or width) of the runway.
16. Various studies into the effects of rain on the windshield have been conducted and no
definitive conclusions have been reached. The shape of the windshield, the aircraft aerodynamics and
speed, the effects of various rain repellant coatings and wipers will give rise to inconsistent effects.
However, an approach in precipitation will result in reduced forward visibility and therefore the
range from touchdown will tend to be overestimated.

17. If the runway is narrower than anticipated the pilot may interpret the reduced width to be
due to increased range and so touch down before expected - the well known ‘co-pilot's landing’. An
important function of good approach lighting is to provide the pilot with adequate cues in the
undershoot to enable proximity to the ground to be judged at night.
18. A particularly hazardous situation can occur at night when approaching an aerodrome over
dark terrain or the sea. This problem is sometimes called the black hole effect. In this situation, the
darkness of the intervening area between aircraft and approach/runway lights causes them to appear
brighter than they should. This illusion creates a false impression of nearness, which results in a
perception of being too high for the range. The pilot may react by descending (into the black hole)
by too much or too soon.
FIGURE 6-7
Visual Impact
Point versus
Actual
19. Further illusions can occur as a result of up or down sloping runways. A runway that slopes
upwards from the approach end tends to give a false impression of height on the approach. If
appropriate corrections are made a lower-than-normal approach and a risk of undershoot follows, as
illustrated at Figure 6-8. A downward sloping runway from the approach end produces an
impression of being too low and adjustments to height would result in landing long.

20. A further illusion can occur when taxiing due to eye height above the ground. A pilot, for
example, who is used to a small aeroplane and is converting to a large one, will initially tend to taxi
too fast. This is because subconciously he is assessing the relative speed of movement of the taxiway
beneath him.
FIGURE 6-8
Effect of Sloping
Runway

Visual Search and Mid Air Collisions

21. Cruise flight in transport aircraft involves relatively few manoeuvres and long periods of
flight on constant heading and altitude. In visual cruise flight a common illusion affects the
evaluation of relative altitude. A distant range of mountains which appears higher than the aircraft
is revealed as being lower at closer range. The same is true of approaching aircraft. This can lead the
pilots of both aircraft into initiating unnecessary avoiding action which might, of itself, cause a
collision.
22. Any two aircraft on a collision course will maintain the same relative bearing (see Figure 6-9),
whereas aircraft not on a collision course have changing relative bearings. In the latter case the
relative movement is likely to attract the eye, but the former may be missed for several reasons.

FIGURE 6-9
Collision Course
Geometry
23. Firstly, if the closing aircraft is hidden by some structural obstruction, for example a
windscreen pillar, it may never be seen.

FIGURE 6-10
Growth of Object
on a Collision
Course

24. Secondly, the retinal size of the approaching aircraft increases with closing distance, but not
in direct proportion to time-to-impact. This is illustrated at Figure 6-10, where a closing (relative)
speed of 800 kt is assumed. Given that the target relative position is constant, the likelihood of
acquiring it in time to take avoiding action is limited.
25. Empty field myopia can result in a pilot being unable to detect an approaching aircraft until it
has reached a greater retinal size, by which time the reaction time available may be very short.
26. Finally, the retina has a blind spot where the optic nerve exits. Figure 6-11 illustrates the
presence of this blind spot. Hold the page at arms length, close your left eye and fix your right eye on
the vertical line to the left of the diagram. Draw the page slowly towards you. The asterisk will
disappear and then reappear.
FIGURE 6-11
Blind Spot
Demonstration

27. Visual acuity (resolution of fine detail) is at its best in the fovea, and falls off markedly away
from this central retinal area. Consequently, in order to detect small objects the eye must be
continually moved to avoid blind spot loss. The eyes move in a series of jerks known as saccades,
with short rests between each movement. Each saccade and rest cycle lasts for about 0.3 seconds.
The eye "sees" during its stationary periods and the brain integrates these to produce a smooth
perception. Any object which is passed over during eye movement remains unseen. Visual search is
therefore enhanced by making eye movements as small and as frequent as possible. The best
technique for visual searching of the sky is to slowly scan small areas vertically and horizontally, each
area overlapping by about ten degrees. By night, where empty field myopia is more likely, this should
be accompanied by frequent focussing on any available visible distant objects or in their absence by
looking at the wingtips using logo lights or wing icing-detection lights.
Behavioural Patterns
28. Anyone engaged in a skilled task will behave in the performance of that task in accordance
with three basic concepts:
Skill based behaviours are those procedures which have been acquired with practice and may be
executed without conscious thought. The lathe operator manipulating the machine controls and the
pilot operating the flying controls are examples of this.
Rule based behaviours are those which have been learned in connection with certain
circumstances - responding to a fire warning with the appropriate drill, for example.
Knowledge based behaviours are non-procedural responses, which require the use of
knowledge and experience - deciding when to initiate a missed approach or where to aim a shotgun
to allow for wind and target movement.

Skill Based Behaviour

29. There are three phases in learning a motor skill such as flying; the cognitive phase, the
associative phase, and the automatic (autonomous) phase. The cognitive phase involves talking
about, and discussing, the task. It includes the level of skill which is to be achieved and the errors
which may be expected and made. The associative stage is the practical stage where the correct
techniques are learned and practised. At this stage errors are progressively reduced. The automatic
phase involves the perfection of performance (skill honing). Here the skill is speeded up and
accuracy improved.
30. There are various ways of achieving the skills necessary for the required level of skilled based
behaviour. Each skill may be practised individually, eventually integrating all the individual skills
into a smooth whole. Alternatively, the full range of skills may be practised to achieve the same final
outcome. Usually, skill acquisition is a combination of the two. Once acquired, a skill is usually
stored as "non-declarative knowledge", which means that a person possessing a skill finds it difficult
to pass on to another person. Furthermore once acquired, the user often finds it difficult to either
quantify or modify this skill and attempts to do either may detract from his execution of the skill.
Golfers stuck on a medium handicap may find it hard to progress because of this. Often it is
necessary to go back to basics and relearn a skill in order to improve it.
31. Skill based behaviour is largely automatic ("second-nature") and can be exercised at the same
time as other activities requiring conscious control - walking and talking, flying and eating a
sandwich, and so on. This remains true so long as the demands are within the capacity of the
decision making process. If the flying demands increase, the sandwich disappears down the throttle
quadrant!

32. In an ideal situation, each skill is checked as it is used. Hence, although lowering the flaps
may be automatic, a conscious check is made to ensure that the correct action has been taken. This
is often not done when other demands are high and is a common source of erroneous control
operation on the flight deck. Skill based behaviour is most prone to error when the user is
preoccupied with other tasks.
33. Another common error in connection with skill-based behaviour occurs when a particular
operation is associated with a given environmental situation. When this environmental situation
exists, an individual may be convinced that he has exercised the associated skill, when in fact he has
not. This condition is known as ‘environmental capture’. Typical examples are:
(a) Believing you have been given take-off clearance because you are at the holding point.
(b) Believing you have checked ‘three greens’ because you are on finals.
Rule Based Behaviour

34. It is rule based behavioural training which has made aviation as safe as it is. By its very
nature, the formulation of rule based behaviour training has involved a great deal of forethought and
care. All rule based behaviour requires conscious thought, since it involves decision making using
information stored in the long term and short term memory.
35. This rule based, or procedural training is particularly well suited for use in simulators, since it
applies largely to the emergency procedures which cannot be safely practised in the air. The main
area of failure in rule based behaviour is its reliance upon stored information, which must be recalled
from the long term memory and then "ticked off" in the short term memory. Hence, involved
procedures too complex to be fully memorised must be documented. Flight reference cards and
checklists are examples of this.

Knowledge Based Behaviour

36. Often referred to as reasoning power, knowledge based behaviour is the process of arriving at
a decision based upon all the available data - environment, experience and learning. The ability of
the pilot to think and evaluate is essential in a potentially hazardous situation.
37. Knowledge based behaviour is required in all decision making and problem solving
situations, since they involve evaluation of information and reaching a conclusion. The greatest
inherent danger in knowledge based behaviour is that there may be a number of possible conclusions
which can be reached with a given set of data, but only one of them is correct.
38. A simple example of evaluation and conclusion follows. A group of people are told that there
is a rule which connects any three letters and an example is given as A, C and E. Each member of the
group is asked to find another set of letters and is then told whether or not they satisfy the rule. One
might choose n + 2 letters as the rule and come up with B, D and F - to be told that it doesn't satisfy
the rule. Another might choose n + 2 letters, n + 4 letters and be told that doesn't satisfy the rule
either. Both will probably be equally "cheesed off" when told that the rule is that the 3 letters must
spell a word.
39. It is important that you appreciate that any evaluation using ambiguous data can result in the
wrong conclusion being reached. Additionally, when the data upon which an evaluation is based is
ambiguous, it reinforces the tendency of the individual to manipulate the data to suit a favoured
theory. Clearly this has serious implications in aviation where knowledge based interpretation of
data may make all the difference between resolving and exacerbating an emergency situation.

40. Errors may be broadly categorised as isolated error or a chain of errors. An isolated error
exists on its own and is almost impossible to predict. For example, a captain who routinely delivers
a good performance fails to lower flaps before takeoff for no reason. The error is detected by the
first officer who points it out. The flaps are then lowered and the flight proceeds normally.
However, if the omission is not noticed by the first officer then he has made the second error. This is
a chain of (albeit only two) errors and the aircraft crashes during takeoff. This has actually
happened on numerous occasions. In 1987 at Detroit an MD80 crashed after an attempted takeoff
with no slats or flaps ( the aircraft is not certificated for "clean" takeoffs). Other incidents within the
same airline resulted in an FAA inspection of the operation, which revealed poor check standards,
lack of flightdeck leadership, disregard of standard operating procedures including checklists done
from memory etc. In another case a chain of errors could have resulted in a serious accident. In a
DC10 bound for Miami from Europe the crew set up the autothrottles and autopilot incorrectly. The
aircraft slowed down and the pre-stall buffet was interpreted as engine vibration. Attention to the
engine indications led them to believe that no.3 engine had a problem. The stick-shaker then
operated and this was interpreted as a rough-running engine, which was shut down. The crew finally
realised the true situation when the aircraft stalled. The AIB report into the Kegworth 737 accident
suggests that misinterpretation of the (albeit poorly presented) information led to the wrong engine
being shut down.
41. Situational awareness is the process of maintaining a mental model which compares with the
real world situation. In order to maintain an accurate comparison, in other words to maintain
situational awareness, the following procedures should be adopted:
(a) Make use of all the available data before coming to a conclusion.
(b) Consider as many alternative conclusions as you can think of - then decide which best
matches the data.

(c) Don't jump to conclusions - use careful consideration.
(d) Stop and take stock from time to time, to see whether your original conclusion still
holds good.
(e) Test both your actions and any new data against your conclusion - start again from
scratch if necessary - don't make the facts fit the conclusion, make the conclusion fit
the facts.
(f) See things how they are, not how you'd like them to be. Hope for the best, anticipate
the worst.

Fatigue
Biological Rhythms
Disturbance of Biological Rhythms
Travelling Across Time Zones
Abnormal Sleep Patterns
Sleep Patterns
Sleep Cycles
Sleep Requirements
Sleeping Problems
Sleep Management
Sleeping Drugs

7 Fatigue and Sleep Management

1. It is essential for all aircrew and operations personnel to have an understanding of the human
need for sleep and of the problems which might disrupt normal sleep patterns. As a result of the
confidential incident reporting systems adopted in a number of countries, sleep and fatigue related
problems have received much publicity in recent years. Nearly every copy of FEEDBACK contains
reports of aircraft flying along with everyone asleep on the flight deck. The following report is
typical:
Crew report early afternoon to find the aircraft unserviceable, ‘be fixed in one hour’, and so on, you
are at last off before Gatwick's jet ban, my leg, I flew SID and as aircraft accelerated through 250 kt/
10,000 ft I selected autopilot ON - to do this you have to select yaw damper on, its the first
movement of the autopilot selection. Yaw damper malfunctioned and put on full rudder - not good.
Yaw damper deselected - talk to company. Company asked can we carry on without autopilot, it will
be fixed on return tomorrow. The flight to North Africa, refuel and climb out for next stop overall
uneventful. A couple of hours later I'm flying - Captain asleep - all fuel checks done - INS updated -
nice and warm - starlit night - dark Sahara below - nice dark flight deck. I fall asleep, arms on
armrest, 100 plus tonnes at .8 Mach aircraft in my hands. The Captain awoke first, punched me in
the shoulder, and scared the hell out of me. We all awoke very sheepish, I made some soup and we
all compared notes. However, as we had all had disturbed nights/mornings before this trip, half an
hour later I went to sleep again, I awoke with a start to find Captain and Eng. both asleep. I got my
own back by punching the Captain's shoulder and a very shaken crew carried on to our destination.

Fatigue
2. Fatigue may be defined as a source of difficulty which tends to generate confusion and retard
progress. Broadly, it is considered in two forms which are mental fatigue and physical fatigue. It
may be caused by insufficient rest, displaced biological rhythms (commonly called ‘jet lag’), excessive
physical activity, or in the absence of any of these by excessive cognitive work such as preparation for
an examination. Furthermore, environmental factors such as low humidity and noise can both be
fatiguing. For pilots, the first two are distinct hazards, especially in long-haul operations. Overall
loss of sleep is known as sleep deprivation, whilst disruption of the normal sleeping pattern is known
as sleep disturbance. Symptoms of fatigue are extensive and vary within individuals. Of note are
impaired memory of recent events, overall reduction in the ability to perform more complex tasks,
reduced reaction times and decision-making times, and increased error in any computations.
Monitoring and vigilance is also affected. In addition irritability, anxiety, lassitude and depression
may occur. In addition there may be changes of mood, behaviour and appearance. Of particular
interest is that the execution of complex tasks suffer more than that of simple tasks, but more
interesting tasks suffer less than more boring ones. Also worthy of note is that motivation is affected
by even mild fatigue. Furthermore, a fatigued person is unlikely to be aware of his or her
performance deterioration.
3. Aircrew and passengers are frequently subjected to fatiguing procedures during pre-flight
preparations, with long delays and frustrating formalities. The primary causes of fatigue suffered by
air travellers, however, have to do with the normal sleeping and waking patterns and rhythms which
govern most of the body's biological systems.

Biological Rhythms
4. From birth we are accustomed to universal rhythms. The Earth takes 365 days to orbit the
sun, the moon's cycle is 28 days and the tidal cycle is 12 ½ hours. Most significant of all is the
Earth's rotational cycle of 24 hours and most human rhythms have a periodicity of approximately 24
hours. Such rhythms are called circadian rhythms, from the latin circa-dies (approx-day).
5. In fact the cycle is not naturally tied exactly to the Earth's rotational time. Experiments in
which all time cues have been removed (what is called temporal isolation) have shown that the free
running cycle for humans is closer to 25 hours. In real life however, our body cycle is constrained to
a 24 hour cycle by external factors such as light and darkness, social activities and meal times. These
constraining factors are known as zeitgebers (time givers). Sleep is cyclic and has an important effect
upon other body rhythms. The female menstrual cycle of 28 days is another well known example of
a rhythmic cycle.
6. A well researched example of a circadian rhythm is the body temperature cycle as illustrated
at Figure 7-1. The body temperature rises steadily during daytime, to reach a peak during early
evening and then falls during the night to its lowest value at around 0500 hours. Thus it will be seen
that sleep is normally coincident with falling body temperature and waking with rising temp-erature.
The temperature rhythm is not easily altered and is therefore often used as a reference rhythm for
comparison with other cycles, such as the sleeping/waking cycle already mentioned.

FIGURE 7-1
Body Circadian
Temperature and
Rhythm

7. The sleeping/waking cycle can be adjusted to anything from a 20 hour cycle to one of 28
hours, although normally it follows a 24 hour rhythm of one third sleep and two thirds awake.
Figure 7-2 illustrates the credit/deficit concept, in which every sleeping hour earns 2 points, whilst
each waking hour costs 1 point. Thus, 8 hours of sleep earns 16 points and these will be completely
spent after 16 hours of wakefulness. If this ideal pattern is disrupted by unusual or irregular periods
of wakefulness and rest the sleep deficit may accumulate with time. If the ‘normal’ pattern in Figure
7-2 is replaced with a new regular pattern, such as a change to night-shift working, a revised
rhythmic cycle may eventually become established, as shown in Figure 7-3. Wakefulness also follows
a circadian rhythm which affects the ability to sleep. Even a person who has been deprived of sleep
may find it difficult to fall asleep in the morning, whilst the well rested individual has no difficulty in
dropping off in the afternoon.

FIGURE 7-2
The Effect of
Normal Sleep/
Wake Cycles on
the Credit/Deficit
Model

FIGURE 7-3
The Effects of
Shiftwork on the
Credit / Deficit
Model

Disturbance of Biological Rhythms

8. The introduction of electricity, permitting routine shift-work, and air travel with its rapid
time zone crossings, were the major factors resulting in serious disturbance of human biological
rhythms. Obviously, both of these factors affect long-haul aircrew, with duties starting outside of
normal working hours, followed by time zone changes during flight. This disturbance of biological
rhythms has become the standard pattern of life for the long range flight crew member. This pattern
is often called ‘circadian disrhythmia’ or ‘transmeridian desynchronism’. One effect of these high
sounding terms is what is generally referred to as ‘jet lag’. Let's consider the two basic interruptions
to biological rhythms; time zone crossing and abnormal sleep patterns.
Travelling Across Time Zones

9. The time zone shifts associated with long-haul flight can lead to progressive deprivation of
sleep, with its obvious flight safety hazards, since eventually the human body will sleep when sleep
becomes a necessity.
10. In addition to this, travel across time zones means that long-haul flight crew members are
constantly having to resynchronise their body's circadian rhythms to the new time zones. Bodily
functions such as the alimentary and urinary systems have their own circadian rhythm and when
these are out of phase with local day/night, sleep will be disturbed. Continual desynchronisation,
due to repeated time zone crossings, can lead to stomach and bowel disorders.

11. Given sufficient time, the body will resynchronise itself to the new local time zone, as it
becomes accustomed to new eating and social patterns (zeitgebers). The resynchronisation occurs at
the rate of about 1 to 1½ hours per day, which often does not help long-haul flight crews when they
are transitting time zones at too rapid a rate for their body resynchronisation to catch up. Indeed,
some only manage to resynchronise during periods of leave. The problem may be illustrated by
considering the example of a west bound flight followed by an east bound return flight.
12. Most UK/USA flights depart during the morning. Suppose departure time from the UK is
1000 hours for an 8 hour flight to Dulles (Washington DC). Arrival will be at 1300 hours Eastern
Standard Time (1800 UK time). The body temperature rhythm can ‘free run’ to about 25 hours and
this, combined with local zeitgebers (daylight, visits to the Air and Space museum, and so on) will
help the crew to extend their day and then get a good night's sleep during local darkness. However,
because their body's circadian rhythms have not resynchronised, the second night's sleep will be
poor, because night is occurring during what is still a period of ‘sleep credit’ (see Figure 7-2).
13. The return flight to the UK is likely to take place overnight, in order to arrive in the UK at
about 0800 UK time. This will involve a departure from Dulles at about 1900 Eastern Standard
Time, so the crew will have had little chance to rest properly prior to the flight and then of course
they're awake all night on the trip back to the UK. On arrival, having lost a night's sleep the crew
may initially be able to sleep well, however their circadian rhythms are now completely
desynchronised with UK time. Because the biological rhythms have to speed up to resynchronise, as
against their natural tendency to slow down, the resynchronisation process will be an extended one.

Abnormal Sleep Patterns

14. Sleep deprivation is a fact of life for commercial aircrews. Because of early departures and
late arrivals it will inevitably be necessary to be awake when you'd really rather be asleep and
sleeping when you don't want to. The problem with the latter is that the need to sleep in order to
accrue ‘sleep credits’ is at odds with your circadian rhythms, making sleep impossible. Thus, if you
are trying to store up sleep credits, because you are rostered for night duty, the fact that you rested
well the previous night may prevent you from doing so. Therefore, when you start your night duty
you will be in deficit, and you will end the duty suffering from sleep deprivation.
15. Even when your biological rhythm has adjusted to a new sleep pattern, such as regular night
shift work, real world zeitgebers may cause sleep deprivation because you are out of phase with your
environment. Traffic, noisy neighbours and so on may disturb your daytime sleeping pattern.
16. Because some people perform better early in the waking cycle and others later (often called
morning people and evening people), individuals can adjust their sleeping times accordingly. For
example, reducing the previous night's sleep in order to be able to sleep in the late afternoon before
going on duty, or staying in bed longer on the morning of the day prior to night shift.
Sleep Patterns
17. There are two types of sleep, known as orthodox (non REM) and paradoxical (REM) sleep.
REM is an acronym for Rapid Eye Movement and is a characteristic of paradoxical sleep - the
paradox being that of an almost waking brain associated with largely paralytic muscles.

18. Sleep is further subdivided into 5 stages, the first 4 of which occur during orthodox sleep.
The fifth stage is REM sleep. An individual's progress through the five stages of sleep can be
determined by electronically monitoring brain activity (EEG), eye movement (EOG), muscle tension
(EMG) and heart rate (ECG). The electro-encephalogram (EEG) shows what is called Beta activity
when a person is alert and Alpha activity when the person is relaxed, but awake. Brain wave
frequency ranges are generally considered to be above 12 Hz in the Beta range (awake and active)
and 8 to 12 Hz in the Alpha (awake and relaxed) range.
19. Stage 1 sleep is the transitional phase between waking and sleeping, during which alpha
activity is decreasing and the EEG measures low voltage, and mixed frequencies. Slow rolling eye
movement also occurs. This stage lasts from 1 to 10 minutes. Stage 2 lasts about 10 minutes, with
theta (4 to 8 Hz) and delta (2 to 4 Hz) activity. Stages 3 and 4 are sometimes called Slow Wave Sleep
and consist almost entirely of delta activity. The final, fifth stage consists of REM sleep, during
which the EEG measurements are similar to those in stage 1, but of low amplitude. Eye movement is
rapid (hence the name) and muscles are relaxed. It is only from the REM stage that dreams are
recalled.
Sleep Cycles
20. Transference from one stage of sleep to another occurs about 30 times during a normal
night's sleep, and the REM stage recurs approximately once every 90 minutes and increases in length
as the period of sleep progresses. A typical night's sleep is likely to consist of 4 or 5 cycles. Figure 7-
4 shows a typical profile for a night's sleep. Note that to gain a full series of cycles, (that is to say a
normal length of sleep for the person concerned) it is not the length of time awake which is
important, but the timing of the sleep within the circadian pattern.

FIGURE 7-4
Sleep Profile
Sleep Requirements
21. It is perhaps surprising that very little is known about the functions of the two types of sleep.
Neither can be said to be deeper, or more restorative, than the other, but it has been demonstrated
that deprivation of one type will be made up for in subsequent sleeping periods.

22. It is thought that REM sleep and slow wave (orthodox or non REM) sleep have different
restorative functions and it is possible that, in general terms, REM sleep may be associated with
mental restoration and slow wave sleep with physical restoration. It must be said that there is little
evidence to support these suppositions.
23. The amount of sleep required is fairly well documented and for most adults is between 8 and
9 hours, with regular shift workers generally requiring slightly less. Age is also a factor, affecting
both the quantity of sleep needed and when it is taken. For example, although older people need less
sleep, they're also less flexible about when they sleep. In practice there are no hard and fast rules
about the quantity of sleep. If sleep patterns are regular, the body will tend to take the sleep it needs.
As a rule it tends to be REM sleep which is deficient after a disturbed night's rest. Consequently, the
following night's sleep is likely to contain a higher-than-normal proportion of REM sleep.
Sleeping Problems
24. The first problem most people associate with sleeping is that of insomnia. There are in fact
two kinds of insomnia; clinical and situational:
Clinical insomnia results in a person having difficulty in sleeping in normal circumstances (an
inability to sleep when the body requires sleep).
Situational insomnia results in a person having difficulty in sleeping because his or her biological
(circadian) rhythms are disturbed, due to travel or shift work, for example.
25. Other disorders connected with sleep are:
Sleep walking (somnambulism) and sleep talking (somniloquism) neither of which is normally a
problem (unless you sleep walk in Moscow in mid winter).

Narcolepsy, which is a disorder which would preclude flying as a career, since sufferers fall asleep
even when involved in a situation demanding their full attention.
Apnoea, which involves a temporary cessation of breathing during sleep, which may cause the
sufferer to awake frequently, resulting in sleep deprivation.
Sleep Management
26. The disturbance to biological rhythms, and consequent sleep loss, caused by shift work and
time zone crossing can be reduced to a minimum by careful management. This requires Operations,
Rostering and Crewing personnel to ensure that crew rosters take account of duty and rest periods,
but it also requires that aircrew adopt a responsible attitude towards taking proper sleep during their
rest periods.
27. Let us return to our crew flying from the UK to Dulles International and assume that they are
going to arrive at 2200 UK time (1700 Eastern Standard Time), and return overnight the following
night departing at 1900 EST. On arrival they're going to be ready for bed, but if they do sleep now
for 8 hours they will be awake around 0300 Eastern Standard Time and ready for sleep again about
the time they're due to get airborne. Alternatives are to split the sleep into two periods, one shortly
after arrival and the other before departure, or to postpone sleep. No option is entirely satisfactory,
but on balance keeping with the original circadian sleep times appears to offer the best chance of
gaining a full series of sleep cycles. Supplementing with a ‘rest’ before flight may help. Perhaps it
wasn't a very well thought out roster in the first place!
28. Napping can be an asset to an individual whose normal sleep pattern is disturbed. The nap is
not, as one might suppose, a miniature version of normal sleep and it seems to benefit habitual nap
takers more than those who only do so occasionally. The latter often perform worse after taking a
nap.

Sleeping Drugs
29. The use of drugs to counter the effect of sleep loss takes two forms, either to delay the onset
of sleepiness or to obtain sleep. The commonest ‘drug’ used to delay sleep is caffeine, found in coffee
and (to a lesser extent) tea.
30. Sleep inducing drugs are sometimes prescribed for use by aircrew and these are from the
group known as benzodiazepines. Examples of these are Valium, Dalmane, Mogadon, Librium and
Normison, all of which are trade names. With any drug, two characteristics are important to its use;
its half-life and its effect upon performance. Half-life is the time taken for the drug level in the blood
stream to fall to half its peak value. The effect upon performance is much more difficult to quantify,
but is obviously of vital importance in the case of pilots.
31. For this reason, most sleep aiding drugs are considered to be unsuitable for pilots, but so is
reporting for duty without having had sufficient sleep. Normison is currently the benzodiazepine
most frequently prescribed for aircrew. Of course, it is essential that the doctor prescribing the drug
is aware that it is to be used in aviation and that it is to be used in controlling situational rather than
clinical insomnia.
32. Alcohol undoubtedly has some soporific effects and it is a central nervous system depressant,
albeit a non selective one. It must be considered as a drug and, when it does induce sleep, the sleep
pattern is not normal since REM sleep is suppressed. Antihistamines and cold cures may also cause
drowsiness as a side effect, but using them to induce sleep is highly inadvisable and amounts, literally,
to drug abuse.

33. The best form of personal sleep management is known as sleep hygiene. If you have to try to
sleep during periods of circadian wakefulness, avoid strenuous mental and physical exercise and
caffeine just before going to bed, and ensure that the bed and bedroom are comfortable and that you
are mentally and physically relaxed.

The Environmental Model of Stress

The Physiological Model of Stress
The Transactional Model of Stress
Stress in the Work Place
The Stresses of Living
Arousal Concepts
Coping with Stress
Stress Management
Stress Management Programmes
Stress Effects on Performance

8 Stress and Stress Management

1. Psychological stress is generally defined as a reaction, or response, to adverse environmental
conditions called stressors (Cox, 1978). The aviation environment is rich in potential stressors and
since stress-induced errors may have disastrous consequences, this topic is of particular interest to
aviation psychologists. In any individual stress might arise due to external sources, for example
environmental conditions, or internal factors such as fear of failure. The effect can be short-term
(acute), perhaps due to a sudden realisation that your aircraft is approaching a mid-air collision, or
long-term (chronic) possibly when you are consistently required to work under tension. The effects
on an individual suffering from stress could manifest themselves in a number of ways ranging from
their thoughts, feelings and physiology to their behaviour and mental health. Basically, stress is a
situation which places strain upon the individual in responding to the stressful situation (stressor).
2. Stress comes from a wide variety of sources and the way in which we respond to individual or
multiple stressors, together with the effect on the individual of having to respond, is an extremely
complex subject.
3. Stress sources may be summarised into three main models and this helps in quantifying the
effects of stress upon human performance. These models of stress are as follows:
(a) Environmental models caused by a stimulus.
(b) Physiological models due to a response to a threatening situation.
(c) Transaction models due to the interaction between an individual and the environment.

The Environmental Model of Stress

4. Noise, vibration, temperature and humidity extremes can be stressful since they place a strain
upon an individual's physical and mental well-being. In simple engineering terms, the longer the
stress is endured the greater the strain. With humans the response is not quite as straightforward as
that, since we can develop tolerance to environmental stresses. The degree of tolerance varies
between individuals.
Heat. For most people, a temperature of about 20°C is comfortable and 40°C is about the upper
tolerance level. Excessive heat (and cold) can be stressful and degrade performance.
Noise. As previously stated, high noise levels can lead to hearing loss. Like excessive heat,
excessive noise places a physical strain on the body and the individual's attention tends to become
focused, rather than general.
Vibration. There is little known about the stressful effects of vibration, although the
physiological effects are well researched and can be significantly painful. Hence, there will be
secondary stress from pain.
Humidity. Humidity is the mass (quantity) of water vapour in unit mass of dry air. Relative
humidity (RH) is the percentage degree of saturation 0%RH being dry air and 100%RH saturated
air. The relative humidity of the atmosphere varies considerably and is mainly governed by the
source region of the airmass. Altitude has a significant effect however, in that air generally becomes
drier as altitude is increased. At typical cruising levels, cabin air will have a very low relative
humidity since air at tropopause levels contains very little water vapour. A comfortable level level of
relative humidity is 40-60%. At lower values viruses and bacteria survive longer and a humidity level
of less than 30% is hygienically undesirable. At low humidity levels the upper respiratory tract,

particularly the nose and throat, dries out. Since these tracts act as a filter system, the breathing of
dry air dries the mucous membrane and irritation and dicomfort arise. In addition the eye mucous
membranes may dry out causing further discomfort. The installation of humidifier systems is not
viable due to the weight and payload penalty, for example, to raise the relative humidity of a half full
B747 from 8%to 15% requires about 20 kg of water per hour. The cabin humidity level is affected
by the number of passengers on board, since exhaled air contains water vapour. It should be noted
that alcohol and coffee should be avoided, since they act as diuretics and reduce the water contant of
the body.
The Physiological Model of Stress

5. The strain placed upon the body's natural physiological balance in responding to alarming or
threatening situations is summarised as physiological stress. The response, or adaptation, to a
physiological stressor (threat) occurs in three distinct phases and is known as the General Adaptation
Syndrome, as summarised at Figure 8-1. A sudden threat or alarm, such as an engine fire warning or
finding a snake in your flight bag, produces an initial shock (the alarm reaction) after which the
sympathetic nervous system enables the body to adapt itself mentally and physically to cope with the
problem (the resistance phase). During the alarm reaction phase adrenalin is released, the effect of
which is an increased heart rate and an increased supply of blood to the muscles. Additionally, sugar
is released from the liver, the digestion processes are suppressed and in extreme situations there is the
possibility of bowel evacuation. This is known as the ‘Fight or Flight’ response, which will place a
strain on the body's resources. If the threat continues the cycle can repeat itself, leading to
exhaustion and even death.

FIGURE 8-1
Stress - General
Adaption
Syndrome

The Transactional Model of Stress

6. We are continuously required to respond to demands placed upon us. Each demand is a
stressor, and coping with it is a strain. This is often referred to as ‘the pressure of modern living’.
How much strain each demand, or stress, places upon an individual depends upon the individual's
assessment of the demand and his ability to cope with it. Both assessments are based upon past
experience, information received, personal judgement and the level of support which is available.
The demand may be external (‘you must pass this exam if you want a licence’) or internal (‘I must
pass this exam because I've never failed anything’). Hence, the degree of transactional stress
experienced will depend greatly on the individual's character, because this will influence perception
and interpretation of the demands and the ability to cope with them.
Stress in the Work Place

7. A person's ability to cope with the demands of his job will determine the extent to which he
finds the job stressful. The factors which cause work stress can be broadly summarised as follows:
(a) Job Factors. Working conditions, the workload (too much, too difficult, too little),
shift work, suitability for the job and job satisfaction.
(b) Working Role. An ill-defined or ambiguous role, or confliction between two or more
different roles.
(c) Working Relationships with colleagues.
(d) Career Development. Opportunities for advancement.
(e) Working Climate. Involvement in the organisational structure.

(f) Home and Work Relationship. Interaction of one with the other.
The Stresses of Living

8. Attempts have been made to quantify the stresses of various events that occur in the lives of
individuals, such as marriage, divorce, ill health, debts, bereavements and so on. Each event will
demand a degree of adaptation with associated physical or mental stress.
9. Domestic stress may be due to problems originating at home, which then spill across into the
work environment, or vice versa. Almost invariably, excessive stress from one environment will spill
across into the other.
10. The most stressful experience has been shown to be the loss of a spouse or partner, closely
followed by the death of a close relative.
11. In the very first issue of FEEDBACK the following incident was reported:
For at least two or three years prior to the incident there had been a steady deterioration in the state
of my marriage, to the extent that I would get up in the morning unnecessarily early to get out of the
house before my wife and child woke up. On this particular morning this did not occur and I was
subjected to a non-violent, but angry argument which left me emotionally boiling, a state I remained
in during my drive to the airport, through flight planning and up to the incident itself. There was a
vehicle in the undershoot of which I'd been warned. Radar vectors were given to me to feed in
between two other faster aircraft and I was requested to carry out a short landing and try to clear by
an early taxiway. Just before touchdown there was a solid bump as I clipped the vehicle. A few days
later landing on the same runway with the same van in the same place it could not have appeared
more clear to me, but on the day in question it completely failed to register. What was even more
alarming to me was that never before in my flying career had I made such a misjudgment.

I realised afterwards that the total loss of concentration was caused by the fact that my mind was
entirely filled with continuing emotional conflict from the argument with my wife. Later we
separated and as soon as the separation took place I could almost feel the mental tension and build
up draining away from me and I felt marvellous about my flying again. It was only when the cause
of the conflict was removed that I realised what a strain I had been under, and how it made me
entirely oblivious to what was going on. If anyone had suggested I needed help, I should have said it
was completely unnecessary.
Arousal Concepts
12. Arousal can be thought of as the degree of wakefulness, ranging from deep slumber to
frenetic excitement. At the lower levels of arousal the central nervous system is only partially
functional, transmission of sensory information is slow and performance is therefore slow. Alertness
and interest occur at moderate levels of arousal, whilst extremely high levels of arousal produce the
‘headless chicken syndrome’. At this level indecision and disorganisation take over and errors in
performance occur.
13. The optimum level of arousal in terms of performance is the moderate region, as shown in the
curve at Figure 8-2, however the optimum level will vary according to the complexity of the task.
The more complex the task, the lower the optimum level of arousal. The performance of simple,
often repeated tasks, is unlikely to be affected by a high arousal state, but hand and eye co-ordination
will be impaired. Both under and over arousal states result in stress. The level of stress in each case
will vary from individual to individual. The optimum level for one person might represent an
overload situation for another and boredom for a third.
14. Some people deliberately seek high arousal conditions since these equate to excitement. Such
people may be prone to risk taking and this is clearly an undesirable state for a pilot. Consequently
there are those who thrive on stimulation or high arousal, while others seek to reduce it.

15. Under-arousal can also be stressful since the individual is trying to work when he is, quite
literally, only half awake. An example of this situation in the airline industry is the state of under-
arousal of aircrew during the cruise phase of a long-haul flight.
FIGURE 8-2
The Relationship
between Arousal
and Performance

Coping with Stress

16. The human psychological defence mechanisms against stress may be activated unconsciously
or deliberately, either by taking physical action to remove or reduce the stress or psychological action
to rationalise the problem. Another form of coping is to tackle the symptoms with the use of drugs
or other procedures such as exercise or meditation.
17. The strategy used by an individual in coping with stress varies according to both the
individual and the severity and duration of the stressful situation. The processes by which we adjust
to, or avoid, stress are known as coping strategies and they fall under three main headings:
Action coping. This refers to positive action taken by the individual to either reduce the
intensity of the stress involved or to remove himself from the stressful situation. Examples of action
coping are moving house to a more acceptable environment, changing jobs or going sick rather than
fly with a training captain.
Cognitive coping. When action coping is inappropriate or impossible, reduction of the

psychological and physiological effects of stress may be undertaken. This can range from simply
talking to someone about the problem to counselling and rationalization techniques. The result is
that, although the level of stressful demand has not changed, the problems are seen as being of
reduced importance.
Symptom-directed coping. This may be negative (for example the use of drugs, alcohol or
tobacco) or positive (physical and mental relaxation, for example). Meditation techniques also also
fit into this category.

Stress Management
18. This can either be preventative, by attempting to remove the stressors from the environment,
or curative by attempting to reduce the effect of unavoidable stressors. The curative approach has
attracted the greatest attention and effort. Reducing or removing identified stressors (noise, heat,
etc.) is the typical direct approach, whilst less direct strategies may be evolved for use during specific
stress situations.
19. The essential ingredient for personal stress management is an understanding of that particular
stress, largely through recognition of the symptoms. Whether this is achieved through self analysis or
through professional help, the individual must be willing to:
(a) Recognise that there is a stress related problem.
(b) Accept that it exists.
(c) Do something about it.
20. Whilst these may seem obvious, people whose work demands the exercise of authority are
often the most reluctant to admit that they are experiencing stress related problems, since to do so
might be interpreted as a sign of weakness. The pilot is often a prime example. Pilots are under
constant pressure to meet a variety of deadlines and standards, but their public image (perceived or
real) mitigates against admissions of fallibility.

Stress Management Programmes

21. Physical exercise and the promotion of physical fitness promotes psychological well being and
reduces health related problems. If employer and employees contribute to health and fitness
programmes, both appear to benefit. Various forms of physical and mental relaxation training have
also been found to be beneficial. Muscle relaxation and meditative training have been shown to
produce positive results.
22. Another stress management programme employs self monitoring to control physiological
reactions to stress. This is known as the ‘biofeedback technique’ and appears to reduce such
symptoms as anxiety, migraine and stomach acidity.
23. Cognitive stress management is a technique aimed at changing the way in which an
individual's thought processes (cognition) work, on the assumption that approaching stress from a
different viewpoint will alter one's reaction to that stress.

Stress Effects on Performance

24. Human perception is normally a selective process. Consequently, when presented with a
range of informational stimuli we select those which are pertinent and discard the remainder.
However, the brain can only process one piece of information at a time and others are placed in a
queue in the short term memory. Too many pieces of information at one time overloads the process
and creates stress. The physiological response to this stress may facilitate the reception of
information stimuli, but in so doing the individual's attention has been diverted from the immediate
task in hand to addressing particular items. To put it another way, attention is the focusing of the
thought processes on a particular piece of information (stimulus). Stress induced stimuli will take
precedence over all others. Thus, performance of the task in hand is degraded. Stress motivates the
attention process, but affects overall performance by concentrating attention and reducing
discrimination.
25. The diagram at Figure 8-3 shows some of the effects of stress upon an individual's
performance, behaviour and health.

FIGURE 8-3
Effects of Stress

Psychology, Personality and Flight Deck

Management
Assessing Personality
Extraverts and Introverts
Pilot Personality
Management Styles
The Management Team
Conformity, Compliance and Risk Shift
Group Decision Techniques
Team Interaction
Flight Deck Resource Management

Psychology, Personality and Flight Deck Management
Psychology, Personality and Flight

9
Deck Management
1. The author is not a Psychologist and this is not a psychological treatise. However, having
studied human factors as they apply to individuals, it is now time to examine the ways in which
pilots interact with other crew members. How we react to others is coloured by our perception and
assessment of their intelligence and personality relative to our own. We'll start by taking a look at
these two qualities and how they are assessed.
Intelligence. A great deal of study has been made into defining and quantifying intelligence and
most people are familiar with the concept of Intelligence Quotient (IQ) tests. Whilst these, or
something like them, form part of early selection tests, the qualifications required to become a
commercial pilot are not a direct measure of intelligence, although intelligence is necessary to obtain
these qualifications. Hence, there is no common intelligence level for pilots, or for other crew
members for that matter.
Personality. This is a term which encompasses the stable characteristics of an individual's

behaviour. These characteristics determine how well the individual gets on with other people.

Assessing Personality
2. Whenever we meet someone, we consciously or unconsciously assess their personality and
mentally file them under one or more headings. Some of these headings, and the English language is
said to contain over 17,000 of them, are subjective to say the least. Clearly it is desirable to assess
personality in a more reliable and definitive way, since it is such an important aspect of a pilot's
attributes.
3. Subjective judgements made during interviews, and analyses of association tests (for example
what does this ink blot remind you of?), are both too unreliable for pilot personality assessment. A
more reliable technique known as ‘factor analysis’ compares an individual's responses to set
questions with the responses from a survey of thousands. From the survey a pattern, or standard is
set against which the individual can be assessed. This process enables personality traits to be
identified.
Extraverts and Introverts

4. We often tend to think of people as being either extroverted (bold, forceful, sociable) or
introverted (shy, retiring, unsociable). There is however, a further dimension which must be
considered, the extremes of which are relaxed and anxious. This is illustrated at Figure 9-1. From
this it can be seen that two extraverts, one a naturally relaxed character and the other a ‘born
worrier’ have two very different personalities

FIGURE 9-1
Personalities
Pilot Personality
5. The popular image distinguishes the pilot from most of the population. Various studies have
suggested that this image has some foundation in fact. Of course, different types of flight operations
call for a difference of emphasis on particular personality traits. CHIRP reports regularly confirm
that pilot personality is an important element in overall flight safety. In the case of the commercial
pilot, personality is of added importance because it affects the way in which the flight deck crew
interact with each other. Pilots typically fit into the STABLE / EXTRAVERT category.

Motivation
6. Motivation is a complex internal organisation which drives a person towards a specific goal.
The most fundamental drives are physiological in nature which originate from physiological needs.
These include food and water, sleep, sex, or even pain. Other motivations are those with a social or
psychological orientation. Some people may wish to be highly successful (or even the very best) in a
particular activity field. Others may wish to attain power and exercise that power and their will over
others. Although both general types of motivation are clearly different, it is not always easy to
differentiate in a given situation. For example, someone who wants to eat but is overweight must
reduce food intake. Our natural but powerful sex drive is regulated by cultural and social factors.
7. A much-quoted theory (Maslow 1943) is that there may exist an order of priority, or
hierarchy, in seeking the satisfaction of human needs.

FIGURE 9-2
8. The lower motives in the hierarchy are aroused first and must be satisfied first. Once
achieved, the needs at the next level take priority, and so on. The hierarchy rises from the basic
physiological needs to those related to ego, and at the top of the levels is self-fulfilment.

9. Recently much attention has been paid to what has become job satisfaction, and there are
many factors which influence a persons attitude to the job, such as the pay, the nature of the job,
management policies, the working environment, and the attitudes of colleagues to name a few. In the
last century it was considered that money was the most important, but it is now known that once pay
rises above subsistence level relative income is more important than absolute income: “ My salary is
fine but why should he get more than me for doing the same job?” In aviation the maintenance of
motivation can affect safety, and it is now recognised that this presents a particular challenge. One
example is slow promotion in periods of relative stagnation within an airline. Every pilot aspires to
command, but all recognise that many years will be spent in a subordinate role. Having done so, the
eventual promotion to command will raise a pilots’ self-esteem and motivation.
10. The rewards system has been, and is used, to inspire motivation, with varying degrees of
success. People place different values on rewards, for example some prefer money, others promotion,
recognition or status. It must also be perceived that a reward is attainable. If a person of high
performance perceives the chances of gaining a reward to be the same as that of a low-performer,
then there is an immediate motivation problem. A pilot may just scrape through check rides, do only
what is required to be done, and take little or no interest in the company or the job. In some airlines
he is just as likely to be promoted as the highly competent professional.
11. It is by gaining more knowledge of what motivates people in life that the aviation industry
will move closer to more consistent human performance.

Behaviour
12. On the flight deck, behavioural characteristics which are likely to affect interaction (the way
in which the two or more members of the flight deck crew get along together) tend to be limited to
speech and ‘body language’. The way in which we express ourselves verbally, coupled with eye and
body movements has a considerable effect on interpersonal relationships. These behavioural
characteristics of communication may be habitual (unconscious) or deliberate (conscious). In either
case, they affect how others view us and can be either disruptive or beneficial in the working
environment.
13. Speech implies communication, and communication is an interactive process - one speaker
alternating with another. The ease with which this change-over is achieved affects relationships. The
speaker who won't give way is ‘overbearing’, the speaker who is easily interrupted is ‘indecisive’.
14. Facial expression and body movement when speaking (or listening) conveys added meaning
and can be irritating, encouraging or even endearing. A speaker leaning towards the listener implies
confidence, whilst a listener leaning towards the speaker implies interest. In each case (speaker or
listener) the opposite action implies the opposite emotion.
15. Staring is usually associated with aggression; avoidance of eye contact with guilt, and so on.
The significance of these behavioural patterns is that they establish the relationship between flight
crew members, and these are important to the smooth functioning of the crew as a whole. Of
particular importance is how they affect the exercise and acceptance of the Captain's authority.

Management Styles
16. An airline Captain is the manager of a team. Each team member has a vital role but, in times
of crisis, the Captain must be the undisputed leader. How he exercises his management task will, to
a large extent, affect his leadership ability. The style of management adopted is a function of the
manager's personality and what follows is one example of the link between personality and
management style. It is called the Tri-Dimensional Grid Theory and was developed in the 60's by
W.J. Reddin.
17. The theory describes eight management styles, the names of which convey a feeling of
‘personality’. These styles are made up from three characteristics against which all managers can be
measured. The characteristics are:
(a) Goal directed. Wanting to get the job done.
(b) Person directed. Interest in people.
(c) Effectiveness. The ability to achieve high output.
18. Some pilots have all three, to a greater or lesser degree, some have none and one wonders
who chose them. Most of us, however, fall somewhere in the middle of the grid. The eight, rather
emotive, style titles used by Reddin are:
1.) Deserter. Has none of these characteristics, lets everybody else make the decisions.
2.) Bureaucrat Effectiveness orientated only. Neither person directed nor goal directed.
3.) Missionary. Person directed only. Mr. Nice Guy. Likes to be liked, too democratic.

4.) Developer. Effectiveness orientated and person directed. Can motivate people and
believes in delegation. Does not establish authority.
5.) Autocrat. Goal directed only. Feared and disliked by subordinates. Wastes the
skills of other crew members. The authoritarian type of leader expects
his decision to be followed without question because of his position.
6.) Benevolent Believes in his own ability, but can inspire sub-ordinates. Will
Autocrat automatically ‘take-over’ during indecision or crisis.
7.) Compromiser. Person and goal directed, but not very effective. Responds to the most
recent pressure, whatever the source. Easily persuaded.
8.) Executive. The fully effective pilot. Possesses all three characteristics. Achieves
both high morale and productiveness from his crew. The born leader.
19. The concept of the Tri-Dimensional Grid is shown in Figure 9-3.

FIGURE 9-3
Reddins Tri-
Dimensional Grid
Theory
20. The effectiveness of the Captain (or, for that matter, First Officer) will influence how the crew
accept authority, and therefore their effectiveness as a team. Equally, the Captain's management style
will influence his interaction with the crew. For example, the compromiser will be easily swayed by a
confident (though not necessarily competent) First Officer, whereas the autocrat may be detested to
the extent that everyone loathes working with him. The authoritarian person who is autocratic and
assertive as a leader may be compliant when placed in a subordinate position.

21. Another (in many ways similar) model of leadership styles was that proposed by Blake and
Mouton (1964). It is based on the concept that leaders vary from 1 to 9 in their orientation to people
(relationships) and their concern for achieving the task.
Authority-Obedience Maximum concern is for getting the job done with minimum concern for
the people involved. Dictates to subordinates.
‘Country Club’ management Shows minimum concern for getting the job done but maximum
concern for people. Prefers to foster good feelings which gets primary attention.
Impoverished Management Shows minimum concern for the task and for the team and
contributes minimum effort to remain in the organisation.
‘Organisation Man’ Management Goes along in order to get along, which results in
conformity to the status quo.
Team Management Integrates concern for the job and for people, is goal centred, and seeks
results through the participation, involvement and commitment of all those able to contribute.
22. Of interest, research carried out by Blake and Mouton revealed that prior to a seminar
involving business managers, 69% believed they were 9-9, but after the seminar only 16% believed
they were 9-9.

The Management Team

23. In practice, a flight deck crew forms a management team, with the Captain as team leader.
This can lead to problems of status within the team and to difficulties of role definition if the leader's
management style is a poor one. An autocratic Captain will readily criticise the actions of his
juniors, but won't accept any questioning of his own actions. There are numerous examples of
accidents and incidents which might have been avoided if the First Officer hadn't been afraid to
question an error by a Captain of known irascibility.
24. By the same token a reluctance to take control and, perhaps, destroy a junior's confidence,
has been the cause of more than a few accidents. This situation is worsened when both pilots are of
equal status.
25. There is an optimum ‘trans-cockpit authority gradient’ which allows an effective interface
between pilots on the flight deck (Edwards 1975), and is illustrated at Figure 9-4.
FIGURE 9-4
Trans-Cockpit
Authority
Gradient

26. With two equally qualified captains occupying the seats the gradient may be too flat. With a
dominating chief pilot and a junior and unassertive first officer it may be too steep. In both cases a
reduced performance is liable to occur, and errors may go undetected and uncorrected. In the UK a
study of 249 airline pilots confirmed the importance of the gradient concept and its effect on flight
deck communication.
Conformity, Compliance and Risk Shift

27. A well co-ordinated (almost by definition, well led) team can improve decision making and
problem solving, or at least ensure that the chances of reaching an ideal solution are better. However,
it must be emphasised that the quality of a team decision depends upon the quality of all the team
members, since powers of persuasion exert strong influences. For example, opinions tend to be
weighted according to the perceived status of the person offering them. The decision of a person we
perceive as competent or better than ourselves is less likely to be challenged than a similar decision
made by someone of a lower perceived status. The former case carries the inherent dangers of failure
to challenge a bad decision. If the best solution to a non-flying problem is put forward by the Chief
Steward, it is still likely to be less readily accepted than if it had come from the Captain.
28. There is also a tendency to conform if all except one in a group come up with the same
solution, the odd-man-out can be persuaded to agree or conform with the rest, even though he was
the only one right. This is particularly true of small groups.
29. A team decision will often tend towards bolder action than that which would be reached by
an individual. This is known as risk shifting (Baron 1974), or risky shift. For example, a team might
decide to "have a go" in marginal landing conditions when an individual would have opted to divert.
30. Since commercial flight crews rarely operate regularly as a team, the need for standardised
decision making processes is important.

31. Given that the quality of a group decision is only as good as that which would have been
reached by the best group member, the group decision is therefore likely to be better than the average
group member's decision. However, the dangers of bad decisions due to status, conformity, or risk
shifting appear to diminish with the size of the group. Hence team decisions may be more easily
facilitated in a two-man crew than with a crew of three.
Group Decision Techniques

32. To avoid the pitfalls of group decision, and to optimise problem solving by flight deck teams
a number of guidelines have been developed, and these are summarised below:
Team Leader. Solicit ideas and suggestions before disclosing your own. This helps
prevent fear of conflict with the leader. When you make a decision,
explain your reasons so that nobody feels they have been ignored.
Team (including Leader). Use factual, not emotive, speech (‘you must be a prat if you can't see
that’). Don't be afraid to air uncertainties. When the decision has
been reached, accept it and do your part to implement it.
Team Interaction
33. Up to this point we have considered the flight crew as a team, and how they interact with
each other. However, there are various other teams or groups with whom the flight deck team will
interact, for example the cabin crew, the passengers, the maintenance team, air traffic control and so
on. There is a natural tendency to ally oneself with the immediate team, especially in adversity, and
by definition this makes other teams ‘the enemy’.

34. It is important for a pilot to avoid alienating any other group since each is an integral part of
the overall pattern of aviation and an enemy, once made, is not easily placated.
Flight Deck Resource Management

35. This rather grand title describes the process of managing and using all the people, equipment
and information available on the flight deck. In principle it is no different to resource management
in any other work environment.
36. Accident investigations have made a powerful case for improving the management of human
resources on the flight deck, and various training programmes have been developed to achieve this.
Line Orientated Flight Training (LOFT), for example, is designed to recognise the kind of situation in
which human errors occur. It then teaches how they can be avoided, or the consequences limited.
Working as a team under training, a crew is faced with problem solving exercises which are
subsequently analyzed (including self analysis) during debrief. Individuals are required to ‘role play’
and the aim is to correct errors, or error prone situations in a training environment, where such
errors are not penalised.
37. Such training also serves to highlight inefficient or ineffective use of material resources, and to
properly allocate duties and responsibilities among the crew.

Flight Deck Design, Documentation and

Procedures
Flight Deck Ergonomics

Anthropometry and Biomechanics
Work Space Constraints
Posture and Comfort
Eye Datum
Displays
Display Scale Design
Analogue scale
Digital scale
Illumination and Colour
Warning Information

Control Layout and Design

Checklists
Aircraft Manuals
Automation and Glass Cockpits
Automation and the Longhaul Pilot
Automation Studies
Handling Skills/Recency
Workload
Inexperience

Flight Deck Design, Documentation and Procedures
Flight Deck Design, Documentation

10
and Procedures
1. In this final chapter we consider how much of what we have considered thus far has
influenced the design of, and operation within, the modern flight deck.
Flight Deck Ergonomics

2. The term ergonomics was created in 1949 by the late Professor Morrell. It is the study of
humans in their working environment and the amount of physical and mental effort required.
Human factors is an alternative term for ergonomics. In the case of flight deck design, ergonomics
describes the process of facilitating the interface between the pilot and the controls and
instrumentation.
3. Any pilot can recognise a poorly designed cockpit layout from the fact that it is difficult,
possibly even confusing, to work in. Ergonomics is the collection of data which allows the designer
to produce a layout which is tailored to match the physical characteristics of the people who will use
it.

Anthropometry and Biomechanics

4. The physical dimensions, or anthropometry, of a person determines the ease with which any
piece of equipment can be used, from the span and strength of the hand holding a pair of pliers to the
height and diameter of the steering wheel on a tractor. In both cases, not only the size of the person
is important but also the movement of different parts of the body and the forces they can apply. This
is known as biomechanics. Anthropometry and biomechanics are the studies of human dimensions.
5. Static anthropometry studies and defines such things as joint to joint distances, for example
the distance from wrist to elbow, or contour distances, for example the distance from finger tip to
shoulder. Dynamic anthropometry studies and defines such things as reach and limb clearance
envelopes.
6. Since pilots come in all shapes and sizes it would be impossible to design a flight deck which
was perfect for everyone, and some form of compromise is necessary. For example, leg length/trunk
length ratios vary considerably between the various races and between men and women. However a
pilot, regardless of race and sex, will have to be able to exert sufficient force on the rudder pedal with
the seat adjusted for optimum eye level and one engine out.
7. It is clearly impractical to design a flight deck which will accommodate every individual.
Consequently the distribution of statistics of height, reach, and so on is calculated and flight decks
are designed to accommodate a sensible percentage of the population, known as a percentile.
Suppose, for example, that it is decided that seat height adjustment will be made to suit 90% of all
male heights, excluding the top and bottom 5%. This called designing for the fifth to ninety-fifth
percentile, and it is the design principle used by most civil aircraft manufactures.

Work Space Constraints

8. The perfect flight deck layout simply does not exist, and probably never will. The ideals of
ergonomics have to give way, to a greater or lesser extent, to the practicalities of aerodynamics,
economics and technical reality. The cockpit has to be in the forward part of the aircraft, which is
essentially narrower than full fuselage width, and where window area will be limited by aerodynamic
and structural constraints. For the pilots to sit side by side, these constraints inevitably lead to
crowding of controls and instrumentation in all but the widest bodied aircraft.
9. The size and disposition of the flight deck crew is determined during the design of the aircraft.
By analysing the duties of each crew member the best locations for controls and instrumentation is
decided and crew training programmes produced. Since all flight crew will be seated, controls must
fall within the normal reach of the operator. Figure 10-1 shows the typical reach envelopes of a
seated individual in an upright stance but constrained by a full five point harness.

FIGURE 10-1
Reach Envelopes
of a Seated Human
10. In addition to reach, there must be adequate comfortable clearance for limbs, so that knees
and elbows do not come into contact with equipment within the reach volume. Once again, the
volume of space within the envelope will be based upon a reasonable percentile of pilots. The
concept of percentile distribution is illustrated at Figure 10-2.

FIGURE 10-2
Normal
Distribution of
Heights (British
Males 19-65 Years)

Posture and Comfort

11. Since it is necessary for the pilot to be seated, often for extended periods of time, in a cramped
space it is most important that the seat should be comfortable. Comfort in the seating position
requires a correct seated posture which, when sitting upright, is one in which the spinal shape is the
same as when standing.
12. Most modern pilot seats are adjustable so that they provide lumbar support to maintain the
correct spinal shape. In addition, of course, seats are adjustable to meet operating parameters such
as rudder travel and eye height. To optimise the posture adjustments it is important that they are
made after the operating criteria have been satisfied.
13. The late Dr J.G. Fitzgerald conducted extensive studies into optimum seated posture and its
relevance to comfort. He found that, if the curvature of the spine is correct when seated, the discs
which separate the vertebrae will be evenly loaded and there will be no discomfort. With the
shoulders and buttocks in contact with the seat back, the lumbar support should be adjusted to just
fill the gap made by the lower spinal curvature. Correct curvature, and a seat with adjustable lumbar
support, are shown at Figure 10-3.

FIGURE 10-3
Lumbar Support

Eye Datum
14. During design the aircraft manufacturer is required to take account of the ‘pilot's eye’ view of
both the outside world and the flight deck instrumentation. To do this he will have assumed a design
eye position, or eye datum, and will have constructed the window position and sited the instrument
panels accordingly. Various national and international bodies have produced specifications and
recommendations concerning the design eye position for aircraft. The importance of the design eye
position is illustrated in Figure 10-4. By sitting just 1" too low, 40 metres of ground vision is lost on
the final approach.
FIGURE 10-4
Effect of NOT
Sitting at the
Design Eye Point

Displays
15. A display is the presentation of information and may be visual, aural or tactile. Most flight
deck displays are visual, but audible warnings (GPWS, stall, fire) and tactile warnings (stick shaker)
are also used. The position of the visual displays will be determined by the design eye position.
Interpretation and prioritisation of displays will be affected by factors such as size, legibility,
illumination, colour and design.
16. Visual displays must, by definition, be visible to be effective. They must be large enough and
well lit, and they must be easily read (legible). Size will be dictated by panel space available and
invariably leads to prioritisation. Essential flight instruments will be in a prominent position with
less essential instruments situated elsewhere in the cockpit. Legibility will depend upon size and
layout of letters and numerals. 4 millimetres is the accepted minimum for character height and a
mixture of upper and lower case has been found preferable to all upper case letters.
Display Scale Design

17. Traditionally the analogue (moving pointer) scale was used, but in many instances this has
been superseded by the digital (numerical) display.

Analogue scale
18. Familiar from childhood as the ‘clock face’ display, the circular or semi-circular analogue
scale is still preferred for many aircraft applications. It has the advantage that the position of the
pointer can be instantly interpreted and the associated scale used only when exact readings are
required. This is of particular value with engine instruments (for example the ‘7 o'clock’ position
indicates cruise EGT and with each engine's EGT pointer in the same position all engines are
matched in terms of thrust and within limits). The circular analogue scale with moving pointer is
also ideal for indicating rate of change which is important, for example in respect of the altimeter
when the aircraft is approaching a cleared level or altitude, or with the rpm gauges when power is
being set close to the maximum permitted value.
19. Essential features of a display are ease of reading and accuracy of interpretation. It has been
shown experimentally that it takes about three times longer to read a ‘Three Pointer’ altimeter than it
does to read a digital one. Furthermore, approximately 20% of the readings taken from the three-
pointer altimeter are likely to be misinterpreted, as against none in the case of the digital altimeter.
20. Instead of a circular, or semi-circular scale, analogue displays may be linear. These use a
pointer moving against a fixed horizontal or vertical scale, or a moving scale against a fixed pointer.
These displays are useful for comparing information (for example engine oil pressures and
temperatures of all four engines) since the scales can be positioned in parallel to each other and
occupy limited space. Figure 10-5 illustrates some scale design concepts.

FIGURE 10-5
Scale Designs

Digital scale
21. With purely digital displays the information is presented in numerical forms. They are
particularly useful where exact numerical values are important (for altimeter subscale setting, DME
range). They are also usefully combined with analogue displays, the pressure altimeter being a prime
example. Instead of the potentially confusing three-pointer sensitive altimeter display, a digital
readout of height in thousands of feet, supplemented by an analogue pointer showing height in
hundreds of feet reaps the benefit of both types of scale.
22. An example of this type of altimeter is illustrated at Figure 10-6.
FIGURE 10-6
Counter-Pointer
Altimeter

23. The scale markings will have to cover the full range of values to be covered, and this can
present problems where that range is large. Again, the altimeter is an example of an instrument
which must display a great range of readings (0 - 60,000 ft for example), but must do so legibly. The
three-pointer and analogue/digital display represents two approaches to overcoming this problem.
Alternatively a logarithmic scale may be appropriate, as in the case of the radio altimeter display.
24. The number of graduation marks on a scale should be reduced to the minimum necessary for
ease of interpretation. Unless exact numerical readout is essential, numbers can be representative
rather than exact. For example, if the range of acceptable lubricating oil tank contents is 9.6 to 14.3
litres, this might just as well be represented on a scale of 1 to 5 - a procedure adopted with many
modern ‘glass cockpit’ displays.
Illumination and Colour

25. The illumination of displays to make them visible in a dimly lit cockpit must be such that they
are visible (where appropriate) to both of the pilots. Additionally, light sources must be positioned
so as to cause neither shadow or glare. Illumination may be from floodlighting or internal, or a
combination of both. In either case the brilliance must be adjustable to cover the range of
requirements from poor daylight to night time. CRT (glass cockpit) displays may well require
automatic brightness control to compensate for sudden changes in cockpit light levels, such as occur
during an aircraft turn in day time.
26. Colour coding can be useful as an "attention getter", but should be limited to as few different
colours as possible to avoid confusion. Red, yellow and green are the preferred "warning" colours.
A summary of recommended use of colour in displays is given in the table at Figure 10-7

FIGURE 10-7
Warning Colours Colour Meaning Required Response
Flashing Red Emergency Immediate operator response
Red Alert Corrective response required
Yellow Advise Caution, check again
Green Proceed Condition satisfactory
White Non-critical functions Information only
Blue Advisory Use not recommended
Warning Information
27. Hawkins (1987) suggests that the objectives of a warning system are threefold:
(a) To alert the pilot to the existence of a problem by a flashing light
(b) To describe the problem by means of an illuminated caption.
(c) To direct the pilot's response (for example an illuminated fire ‘T’ handle guides the
pilot to the appropriate response mechanism).
28. Warnings are usually presented as visual and/or aural information and may be accompanied
by tactile information (stick shakers/pushers).

Visual warnings. Usually in the form of flashing or continuous lights, coloured in accordance
with the table at Figure 10-8, accompanied in many cases by text captions. Coloured flags partially
obscuring a display (for example on an analogue display for the radio altimeter and the ILS
presentation) are also used to warn of system failure.
Warning lights are often placed close to the limits of peripheral vision for the simple reason that the
main instrument panel is too cluttered to accept them. In many cases a master warning light in a
prominent position directs the pilot's attention to a warning panel, or cluster.
Audible warnings. These have the advantage of being omnidirectional attention getters and are
normally used in conjunction with visual warnings (engine fire, GPWS). The sound made should be
quite distinct from any other which might be heard in the cockpit and should indicate urgency.
Sounds graduated to urgency may be used.
Voice (spoken) warnings have become popular in relatively recent years (GPWS). The voice warning
must be completely unambiguous and must be quite different from any normal flight deck dialogue.
All audio warning systems suffer from a serious disadvantage in that two or more operating at the
same time proves extremely, if not totally, confusing.
29. Misinterpretation of warnings, especially captions, has led to a number of accidents. People
tend to see what they expect to see, especially in a crisis situation. If you'd been having problems
with number 3 engine EGT and an engine fire warning illuminates, there is an immediate tendency to
assume it's number 3 again. Alternatively, there is the danger of ignoring warnings through over
familiarity. Just because the GPWS usually goes off on the approach to runway 26, or the stall
warning often sounds when you select full flap, doesn't mean that it isn't for real on this occasion.

Control Layout and Design

30. Controls should be placed so that they are easy to reach and use, and in positions which are
appropriate to their use. Furthermore, the direction of movement of a control must be compatible
with its effect.
Standardization. The ‘sense’ of control movement should be compatible with the required effect.
To roll to the left the control wheel is turned to the left, left foot forward for a turn to the left, control
column back to climb. Trim wheels should move in the direction the aircraft is required to move -
forward for nose down and so on. Throttle levers are moved forward for increased thrust, propeller
levers forward for increased rpm and undercarriage levers down to lower the gear. Above all, it is of
prime importance that this sense of control movement should be standardized in all aircraft,
regardless of type.
Simultaneous operation. Some controls need to be operated simultaneously. Where this is the
case it is clearly more convenient for the pilot if these controls are adjacent to each other.
Shape. The shape of a control lever or switch may be made distinctive, to reduce the possibility of
inadvertent operation. In some cases the handle shape represents the function of the lever and some
examples of this are shown at Figure 10-8.

FIGURE 10-8
Control Handle
Shape and
Function

31. There is a certain instinctive way in which most people will operate a given control, for
example clockwise to close, up to increase. These instinctive patterns are studied and applied, since
in a crisis most people will revert to stereotype. On the flight deck, however, with control switches
being located in a 180° arc from floor to ceiling, the ‘sweep on’ concept is being adopted. This is
illustrated at Figure 10-9.
FIGURE 10-9
"Sweep-On"
Switching Concept

Sequence. If a number of switches or controls must be operated sequentially, then ideally they
should be laid out in that sequence on the control panel.
Frequency. The more frequently a particular control is used, the more convenient it should be to
the user.
Importance. Important, but irregularly used controls like flap levers and landing gear selector,
should be positioned within easy reach of either pilot, typically on a central console.
Related controls. Controls with related functions (throttle lever, propeller control and mixture
control) should be grouped together and may be arranged sequentially, if this is appropriate.
Checklists
32. Checklists represent a convenient guide to preset sequences of essential actions. On public
transport aircraft it is required that two types of checklist are carried.
33. The ‘Normal Procedures’ checklist deals with procedures which are appropriate to the
various stages of preparation for flight (before start, engine starting, before taxi, taxiing and before
take-off), the flight itself (after take-off, top of climb, top of descent and before landing), and post
flight (after landing and shut-down), for example.
34. The ‘Emergency Procedures’ checklist deals with the procedures required to deal with aircraft
malfunctions in a logical sequence.
35. In order that either type of checklist be effective, there are certain guidelines which the
checklist manufacturer should adhere to:

Legibility is obviously essential, to achieve this a clear type face, normally black on white, is used
with upper/lower case lettering. The checklist should be resistant to wear from repetitive use, either
by encapsulation in clear plastic or by printing the list on stiff, white plastic.
36. Potentially confusing abbreviations should be avoided and actions should be visibly linked to
the check item, for example:
Fuel tank selection............................... ALL

rather than
Fuel tank selection ALL
37. Some form of action compliance check is desirable, such as a space for ‘ticking off’ items with
an erasable marker. Modern cockpit displays sometimes incorporate electronic checklists with
electronic ‘tagging’ as items are completed. All checklists should be produced in conjunction with
potential users to ensure that the design parameters are both understood and workable.
38. Checklists must, by their nature, be hand held whilst the checks and responses are carried out,
hence they need to be compact and to remain open at any selected page. Flip cards lend themselves
best and about 10 cm in width is a convenient size for holding in one hand. A proper stowage for the
list is necessary, where they are readily accessible but which will keep them out of the way when not
in use. Distinctive colour coding should be used for emergency checklists and every page of these
should be clearly marked to show that it belongs to an emergency checklist.
39. Having constrained the checklist designer to produce checklists which are as close as possible
to the optimum, it is important that the flight crew subsequently use them properly. Above all,
checklists should be actioned carefully, since most errors result from trying to read and action the
checks too rapidly, or without giving full attention to the task.

Aircraft Manuals
40. The object of a manual is to provide information in a clear, understandable form. The old
adage that a picture is worth a thousand words is especially true when the subject is one in which the
user is not an expert. Nobody would contemplate navigating an unknown route using a written
description instead of a chart; the same logic applies to finding the oil sump dipstick or the centre of
gravity.
41. Manuals should be indexed for easy location of subject, by thumb ‘cutouts’ or flags and they
should remain open at a chosen page. This is facilitated by spiral or ring binding. Data tables should
be kept as straightforward as possible, with large quantities of data broken down into easy to follow
sections. System diagrams need to be colour coded for ease of understanding, electrical system
diagrams are notoriously bad in this respect.
42. Manuals should be designed to be easily read and understood in conditions of poor lighting
and pressing need. Too often they are not.
Automation and Glass Cockpits

43. The revolutionary advances in electronic computers and their interface with mechanical
systems in the last two decades has made fully automatic flight a practical, almost commonplace
event. From simply holding the aircraft in straight and level flight, automation routinely takes care
of fuel economy, selection of optimum navigational aids, track following and even landing. The
computer controlled flight system is unaffected by the stressors and distractors to which a human
pilot is prone and will consequently maintain a far more accurate flight profile. However, that flight
profile must be pre-programmed, and often re-programmed. Consequently, the need for the human
pilot will continue, even with so called "full" automation, for many years to come.

44. In addition to automatic control, the computer based flight data system can be programmed
to automatically select and present the most appropriate information to the pilot for a given
condition or emergency. When coupled to a cathode ray tube display (normally the centralised
aircraft systems monitoring screen), the computer can generate analogue and digital displays of any
and all relevant systems information.
45. The term glass cockpit is derived from the cathode ray tube (CRT) display, which takes the
form of a flat, rectangular glass panel upon which the display is electronically generated. So far the
conventional split of three main informational areas has been maintained by the aircraft
manufacturers:
Primary flight displays. Altitude, airspeed, attitude, heading.
Navigational displays. Route map display, in use navigation aids.
Engine instrumentation. Normal engine performance parameters such as EPR, EGT, N1 and N2
speeds, and fuel flow.
46. The CRT panels are situated in front of the pilots, replacing most of the primary mechanical/
analogue instruments of the traditional flight deck (a traditional gyro-mechanical standby artificial
horizon and a combined mechanical airspeed/altitude instrument are normally retained for use
following a total failure of both primary flight displays). Each pilot has his own primary flight
display and navigational display, with the engine display and perhaps the aircraft systems monitoring
screen placed centrally for shared use. A typical layout is shown at Figure 10-10.

FIGURE 10-10
CRT Display
Layout
47. The primary flight display is typically grouped around a central attitude indication, airspeed
and height being displayed on strip indicators and the compass rose being displayed as a segment
rather than a circle. Figure 10-11 shows such a display.

FIGURE 10-11
Primary Flight
Display
48. The navigational display shows a computer generated map of the pre-programmed route,
with a moving aircraft symbol (typically a triangle, the apex of which represents the present
position). Aircraft position is calculated from INS, RNav and air data computer (ADC) inputs. The
aircraft flight profile is programmed in terms of positions and altitudes and displayed accordingly.
49. The combination of the primary flight display and the navigation display is termed the
Electronic Flight Information System (EFIS).

50. Whereas the primary and navigation displays are fairly standard from one manufacturer to
another, the presentation of engine parameters and of aircraft systems status varies considerably in
different aircraft. The principle engine parameters may be displayed on either circular or linear
scales, and may be displayed continuously (like the primary flight and navigation displays) or only
during any ‘change of state’ of the engine parameters. Likewise, secondary engine and associated
systems indications (such as oil pressure, temperature and quantity, and fuel temperature) may be
permanently displayed, or shown as the "default page" of the centralised aircraft systems monitoring
screen, or displayed only when demanded by the pilot or when any of the parameters are
approaching or have exceeded the minimum or the maximum tolerance of normal operation.
51. Where colour coding is used to delineate arcs of a circular scale or segments of a linear scale,
the standard colours will be used (principally green for normal operating range, yellow for the
cautionary range and red for the limit of an operating range). Flashing red scales and/or digits are
normally used as ‘attention getters’.
52. The glass screen engine instrumentation described above is normally termed the Engine
Indicating and Crew Alerting System (EICAS).
53. A sophisticated centralised aircraft monitoring screen will not only identify a system within
which a fault has been detected, but can replace both the emergency checklist and the aircraft manual
by displaying a very much fault focused list of initial and subsequent actions together with status or
flow diagrams of both the system which is malfunctioning and of other interrelated and therefore
affected systems.

Automation and the Longhaul Pilot

54. One of the stated aims of computerisation and automation is to reduce pilot workload.
Another (less often stated) aim is to reduce the flight deck crew size. Whilst crews have been relieved
from many of the laborious tasks of continual adjustment, interpretation and plotting, computers
have introduced a new range of tasks.
55. The Flight Management System, linked to the autopilot can cope with all the handling aspects
of getting the aircraft to its destination, but the pilot must first programme the system with all the en-
route data it needs to do so. Furthermore, the system must be continuously reprogrammed as
parameters change. In congested airspace the non handling pilot may be fully occupied for extended
periods inputting amended data. Conversely, on long oceanic legs the pilots may spend hours during
which no updates are necessary. At such times pilots may well become bored and complacent.
56. Various studies have found that the longer an individual spends monitoring an inactive
situation, the less likely it is that he will respond to a changed situation. For example, the longer a
radar operator watches an empty screen, the more likely that a faint return will be missed.
Obviously, the same principle applies to pilots monitoring a stable automated flight. After
protracted periods of inactivity they are less likely to spot, or respond quickly to, subtle changes.
57. To some extent, the problem can be tackled by avoiding ‘over automation’. Automation
should be used where it can perform better than humans or where the task is so repetitive that
human performance would fall due to loss of interest. Automation should not be used to perform
functions that humans perform well. Consequently, there is a need for flexibility in automated
cockpit design to ensure that functions are properly shared between man and machine.

58. From the individual's Human Performance point of view the automated cockpit offers
considerable advantages over older instrumentation, but also some disadvantages of which the pilot
should be aware. These are summarised below:
Advantages
(a) Improved and more comprehensive presentation of information leading to a better
overall picture and increased situational awareness.
(b) Reduced workload.
Disadvantages
(a) The presentation of comprehensive information, presented in such a convincing
manner, can lead to over-reliance on, and trust in, the presentation. This may result in
a detachment from the ‘real world’. Furthermore, interest in the display capability
itself and in problem-solving can narrow the focus of attention.
(b) The ease of use of automatic systems can result in a reduction of the pilot's own
capability to integrate raw information (‘old fashioned’ instrument flight and
navigation). This is especially true of younger pilots who have had less time and
experience to develop the traditional skills.
(c) Automatic flight and engine management systems can operate in many modes. The
pilot needs to be sure of the capability of the mode selected. A lack of ‘mode
awareness’ means that important information may be missed or that, in the mode
selected, the aircraft does not perform as expected.

(d) Finally, and in the context of the first disadvantage listed, it should be remembered
that current automatic displays present the ‘best guess’ solutions (to navigation
problems for example). The pilot may not therefore have any immediate guidance as
to the reliability of the information presented.
Automation Studies
59. The Institute of Aviation Medicine has conducted a study of pilots' attitudes to automation in
modern aircraft via the pages of its Human Factors broadsheet FEEDBACK. What follows are some
excerpts from both pilot and IAM responses.
Handling Skills/Recency
60. Many of you seemed concerned about erosion of handling skills.
61. There IS a loss of motor skills after flying advanced aircraft for a while (and not just
advancing age!) - if the landing is to be an awkward one (crosswinds or typhoon conditions etc) the
sensible blokes hand fly early. Ditto for a visual circuit. It's too easy to get separated from the real
world with automatics unless you are very careful. Younger pilots identify more easily with the
computers, but have an unfortunate tendency to just "follow the magenta line". But automation is
the future and we must all learn to control it (and enjoy it). And I know he can't come back, but I
DO miss my F/E!
Workload
62. Automation is supposed to reduce workload and, although this is what most of you say, there
are others out there with different ideas.....

63. "Automation decreases workload at low workload phases" - true. My point here is that I
believe that the automated flight deck does just the opposite of what it should do! It DECREASES
workload at LOW workload phases and INCREASES it as HIGH workload phases. That's why I
fall asleep in the cruise day and night (mostly night). Furthermore the concentration required at
difficult approach phases can be so enormous that many pilots abandon the automatics just when
they most need them simply because they don't have the spare capacity to use them!
64. ..... and some of you know why it's a problem.
65. Many pilots either do not understand, or will not accept, the FACT that aircraft of this type
are MEANT to be flown automatically for ALL phases of flight, including the take-off and landing.
These pilots do not realise that when they hand fly they put the aircraft into an ABNORMAL
configuration, and cause an immediate and dramatic increase in the workload of the other pilot.
Also by hand flying during the departure and approach phases of flight, pilots do not acquire the
very different skills needed to operate the aircraft's automated navigational systems. The often heard
complaint of a high workload is real but is self imposed!
Inexperience
66. Moving on from lack of trust to lack of experience. Pilots of both highly automated and not-
so-highly automated aircraft voiced opinions on this issue.
67. Automation is here to stay. We'd be foolish to deny this. For experienced pilots, automation
is a useful and stress-reducing tool, albeit with limitations (particularly on the 757 is the lack of
SYSTEMS information in flight). Using excellent automatics in adverse weather is a definite plus for
air safety.

68. But, and it's a big but, I'm worried that INEXPERIENCED pilots (straight out of training
school) will not be able quickly to gain a mature sense of airmanship BECAUSE the automatics tend
to loom too large in the way they operate the aircraft. The automatics smooth over their
inexperience and, I think, instil in them a false sense of how good they are at operating the aircraft.

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040 HUMAN PERFORMANCE &

© G LONGHURST 1999 All Rights Reserved Worldwide

EDITION 1.01.00 COPYRIGHT © 1999 G LONGHURST

© G LONGHURST 1999 All Rights Reserved Worldwide

© G LONGHURST 1999 All Rights Reserved Worldwide

© G LONGHURST 1999 All Rights Reserved Worldwide

© G LONGHURST 1999 All Rights Reserved Worldwide

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The SHEL Concept

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The Respiratory System

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The Respiratory System

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Chapter 1 Page 3 © G LONGHURST 1999 All Rights Reserved Worldwide

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The normal respiratory rate is 12 – 20 breaths per minute.

6. The breathing process is illustrated at Figure 1-3.

Chapter 1 Page 5 © G LONGHURST 1999 All Rights Reserved Worldwide

The Circulatory System

Chapter 1 Page 6 © G LONGHURST 1999 All Rights Reserved Worldwide

Chapter 1 Page 7 © G LONGHURST 1999 All Rights Reserved Worldwide

Chapter 1 Page 8 © G LONGHURST 1999 All Rights Reserved Worldwide

The Anatomy of the Ear

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Chapter 1 Page 10 © G LONGHURST 1999 All Rights Reserved Worldwide

Chapter 1 Page 11 © G LONGHURST 1999 All Rights Reserved Worldwide

The Anatomy of the Eye

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Chapter 1 Page 14 © G LONGHURST 1999 All Rights Reserved Worldwide

Chapter 1 Page 15 © G LONGHURST 1999 All Rights Reserved Worldwide

Chapter 1 Page 16 © G LONGHURST 1999 All Rights Reserved Worldwide

The Need for Oxygen

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2 The Need for Oxygen

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Mean sea level pressure 1013 hPa (Hectopascals)

In other words PV = constant,

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In other words --P- = constant,

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Chapter 2 Page 4 © G LONGHURST 1999 All Rights Reserved Worldwide

Oxygen - Effects of Altitude

Chapter 2 Page 5 © G LONGHURST 1999 All Rights Reserved Worldwide

9. In order to maintain a partial pressure of oxygen approximately equivalent to MSL

Chapter 2 Page 6 © G LONGHURST 1999 All Rights Reserved Worldwide

Above 40,000 feet Pressure breathing of 100% oxygen is required.

Chapter 2 Page 7 © G LONGHURST 1999 All Rights Reserved Worldwide

Chapter 2 Page 8 © G LONGHURST 1999 All Rights Reserved Worldwide

Chapter 2 Page 9 © G LONGHURST 1999 All Rights Reserved Worldwide

Time of Useful Consciousness

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Chapter 2 Page 11 © G LONGHURST 1999 All Rights Reserved Worldwide