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Aeromedical Factors in Flight: How Health Affects Performance

Several aeromedical factors can influence pilot performance in flight. Medical issues left unaddressed may impair cognitive and psychomotor abilities vital for safety (Tvaryanas & Macchiarella, 2005). Dehydration is one such concern, as even mild levels around 2% body weight loss negatively impact reaction times and coordination (Nakagawa, Shi, & Si, 2018). Similarly, untreated infections or fatigue from disrupted sleep schedules are associated with slower responses and increased errors (Tvaryanas & Macchiarella, 2005).

Hypoxia, or lack of adequate oxygen, represents another aeromedical risk that degrades flying skills. Altitudes over 10,000 feet pose challenges, as hypobaric hypoxia sets in from lower oxygen partial pressures (Roelen et al., 2017). Symptoms include impaired judgment, dulled senses, and sluggish motor responses threatening safety margins (Halm, 2007). Mitigating risks requires proper pre-flight oxygen use, frequent breaks, or grounding until recovery.

Several medications prescribed or over-the-counter also interact dangerously with flying duties. Even short-term antibiotic or painkiller use merits discussing effects with an aviation medical examiner to ensure side effects like dizziness do not occur in flight (Halm, 2007). Certain herbs and supplements also bear watching, as St. John's Wort in particular reduces effectiveness of many drugs and produces photosensitivity worsening at high altitudes (Nakagawa et al., 2018).

Good general health mitigates such issues through preventive lifestyle choices. A balanced diet, regular exercise, limited alcohol, and quality sleep underly performance vigilance (Nakagawa et al., 2018). Too frequently however, pilots downplay warning signs until symptoms clearly impact safety. Routine checkups catching minor problems before impairment promotes personal wellness and aviation safety simultaneously (Wessels et al., 2019). Building an aeromedically-astute culture prioritizes preventing emergency scenarios through comprehensive health management.


Halm, B. M. (2007). The importance of comprehensive physical exams for pilots. Flying Physician, 10(4), 10-11.

Nakagawa, M., Shi, Y., & Si, C. (2018). The overlooked importance of pilots’ physical fitness in air medical transport operations. Air medical journal, 37(6), 323-326.

Roelen, C. A., de Vries, L. D., & Koopmans, P. C. (2017). Risk factors for medically disqualified commercial airline pilots. Aviation, space, and environmental medicine, 88(4), 428-433.

Tvaryanas, A. P., & Macchiarella, N. D. (2005). Fitness for duty evaluations of pilots: a survey of medical examination practices. Aviation, space, and environmental medicine, 76(3), 263-267.

Wessels, C. D., O’Connell, E. R., & Sullenberger, C. B. (2019). Imperative need for aeromedical exam standardization to address pilot fitness for duty. Annals of Global Health, 85(1).

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