Epidemiological Aspects of Tsutsugamushi Disease (Scrub Typhus) Outbreaks in Republic of Korea and Japan / 항공우주의학회지

Purpose@#The purpose of this paper is to study the epidemiologic series of Tsutsugamushi disease (TD), also known as scrub typhus in the Republic of Korea (Korea) and Japan. @*Methods@#We investigated raw data of TD outbreaks from the National Notifiable Disease Surveillance System of the Korea Diseases Control and Prevention Agency in Korea, and the National Institute of Infectious Diseases in Japan, 2016 to 2020. @*Results@#There were 36,785 cases of TD with a cumulative infectious rate (CIR) of 14.3 per 100,000 populations in Korea from 2016 to 2020. During the same period in Japan, there were 2,350 cases with a CIR of 0.4. When compared, Korea was much higher than that in Japan (P<0.01). In Korea, more females (60.2% of total cases) were infected than males (39.8%), while there was a significant difference between males (58.8%) and females (41.2%) in Japan, respectively (P<0.01). @*Conclusion@#These differences in TD risk factors reflect differences of vectors/hosts, climate, and geographical and cultural characteristics between the two countries. The surveillance of TD, primarily a zoonotic disease, should be continued in order to obtain a better understanding of its current status. Moreover, guidelines for the prevention of TD, and its control measures should be more established.

Analysis of Three Years of Airmen Medical Certificate for Preparing Aviation-related Health Promotion Plan / 항공우주의학회지

In accordance with ICAO SARPs, the states should implement appropriate aviation-related health promotion for airmen subject to an aviation medical examination to reduce future medical risks to flight safety. We aimed to analyze the results of the aviation medical examination to use as objective evidence for establishing an aviationrelated health promotion plan. The results of the final issuance of airmen medical certificate from 2015~2017 were collected from the e-sky computer system. The 30 cases (0.3%) in 2015, 22 cases (0.2%) in 2016, 38 cases (0.3%) in 2017 were unfit for flight duty. The 34 unfit out of the total 90 cases were renewal physical examinations. The cardiovascular disease was most commonly in 11 cases, followed by 8 tumors, 4 psychiatric diseases, 3 ophthalmic diseases, 2 respiratory diseases, 2 neurologic diseases, 2 otolaryngological diseases, 1 endocrine disease and 1 digestive disease. The results of this study can be used as objective data in aviation-related health promotion plan. The health promotion activities based on objective data can contribute to improving aviation safety by improving the lifestyles of airmen.

An Overview of In-flight Medical Care / 항공우주의학회지

Medical issues in the air such as in-flight deaths, diversions, deliveries have gained increasing publicity. In-flight medical emergencies are expected to increase because air travel continues to expand and as more elderly or invalid passengers often wish to fly long distances. The protection of passenger health is an important obligation of airlines. Most airlines have prepared many resources for in-flight medical care. Resources may include emergency medical kits including medications, portable oxygen bottles and automated external defibrillator (AED), trained flight attendants with available in-flight medical care. Furthermore, air to ground communication systems are prepared. Although the number of serious medical events is very small, despite increased airline's efforts, physician passengers are occasionally called upon to care for the ill or injured passengers at any time. Medical liability has always been in the mind of physicians called upon to treat a patient in-flight. Therefore, fear of liability is cited as a major reason for physicians reluctance to offer assistance. New legislation that would require all commercial flights to carry AEDs should also include a "Good Samaritan" provision that exempts from liability physicians who step forward to offer assistance in-flight medical emergency. Physicians take an important role in case of in-flight medical emergencies. This paper describes the multiple in-flight resources to be used by physician passengers who is called upon to help passengers in the cabin.

Operational Status of Airman Medical Examinations in Korea / 항공우주의학회지

OBJECTIVES: International Civil Aviation Organization (ICAO) strongly supports that AME (Aviation Medical Examiner) system. AMEs are private physicians, trained and authorized by the government to perform airman medical examinations and to issue or deny medical certificates. In Korea, AME system was introduced in 2000. As of December 31, 2006, there were 48 AMEs in Korea. Applications for airman medical certificate which contain the results of the medical examination conducted by an AME, are typically forwarded to the advisory committee of Aerospace Medical Association of Korea. With a increasing demand for air travel, the number of civil airman population has increased, as a result, airman medical examinations have also increased. Although the number of airman medical examinations are increasing, research related to this field is nil. The purpose of this study was to examine the operational status of airman medical examinations in the calendar year 2006. METHODS: The data were based on the total reported applications of airmen medical certificate collected in the Aerospace Medical Association of Korea in the calendar year 2006. And all data were examined according to the three categories, which are fit, waiver, and deny. RESULTS: The total data were 5,713 airman medical examinations which were collected in the calendar year of 2006. This total included 5,292 applications for first class, 162 for second class, and 216 for third class medical certificates. The number of medical certificate issued were 5,010 as fit, 680 as waivers, and 23 as denials. The majority for waivers was consisted of cardiovascular diseases, otorhinolaryngologic and ophthalmologic diseases. Denials were due to phoria, refractive eye surgery, diabetes, and/or coronary artery disease. CONCLUSION: Some of the denials were made because of the failure to submit required subsequent evaluation reports to the advisory committee of Aerospace Medical Association of Korea. The consequence of negligent or wrongful certification which would permit an unqualified person to take the controls of an aircraft. may result in mishap. For proper issuance of airman medical certificate, the establishment of a guidebook for AME is necessary and database of previous medical records is required. Aeromedical standard is an important factor in flight safety. Therefore, in order to update on aeromedical standards in accordance with evidence-based medicine, more aeromedical research is required and its research findings should be reflected in the revision of standards of airman medical examination in the future.

Managing In-flight Medical Emergency

In-flight medical emergencies are likely to increase as air travel continues to grow and as more elderly passengers with preexisting diseases fly long distances. Unscheduled landing for a medical reason is a serious situation for commercial air carriers. The common causes of unscheduled landings are cardiac and neurological problems. Physician passengers might be called upon to help ill or injured passengers at any time. Physicians play an important role in in-flight medical emergencies. Most airlines have installed the emergency medical kits and automated external defibrillator (AED), ambu bag, intubation set, etc. The management of in-flight medical emergences requires the assistance from welltrained crew, adequate medical equipments and medications, availability of physician passengers, and ground medical communications. This article summarizes the in-flight resources available for physician passengers when called upon for medical emergencies while on board.

Medical Guidelines for Air Travel Patients to Physicians

With a steady economic growth and the advancement of aircraft design, the demand to travel by air has constantly been on the rise. So much to the fact that there are more than 10 billion people traveling all over the world by aircraft. This demand will continue to rise so long as air travel continues to surpass other methods of transportation in aspects such as speed, comfort, safety, etc. There are about seven million tourists who travel abroad annually in our nation, thus airline travel has become one of the most popular forms of public transport. However, some people travel on flights without considering their state of health and risk suffering from a health ailment while on board. The cabin environment of a modernized aircraft preserves conditions similar to that on the ground, thereby making the travelers feel comfortable. But sometimes people with chronic diseases can make their health condition worse due to long distance flight travel. Traveling overseas among the elder generation has increased, and cases involving patients traveling abroad to receive better medical treatment has increased as well. In advanced countries, the air ambulance system is well prepared, but in Korea we can only transfer patients by commercial airlines based on the destination. This is especially typical in Jeju where there are no alternative ways. Helping an emergency patient inside the cabin is not a simple matter, and therefore it is best to avoid the situation. To be prepared for emergencies, each aircraft has an Emergency Medical Kit, First Aid Kit and Automated External Defibrillator (AED) inside the cabin. Each airline is also developing curriculums for teaching First Aid and training their flight attendants to properly use the Kit, AED and how to give First Aid. If there is a patient with a critical illness, generally the aircraft would land at the closest airport instead of the destination in an attempt to save the precious life. But, it would be more effective to be prepared with a contingency plan beforehand, instead of thereafter. If physicians and patients take more concerns regarding airline travel and kept in close communication with the airlines, some inflight medical emergencies in the cabin can be prevented. A patient who is planning to travel by air would want to receive some aero-medical information from their physicians. It is necessary to understand the cabin environment and to receive information on airline travel myths, the maximum amount of safe time for traveling, and steps to prepare before they leave. In this article, as a physician, I will review the medical guidelines to prevent unexpected accidents or inflight emergencies, and also to have some aviation medicine knowledge to help those on board.

Medical Guidelines for Air Travel Patients to Physicians

With a steady economic growth and the advancement of aircraft design, the demand to travel by air has constantly been on the rise. So much to the fact that there are more than 10 billion people traveling all over the world by aircraft. This demand will continue to rise so long as air travel continues to surpass other methods of transportation in aspects such as speed, comfort, safety, etc. There are about seven million tourists who travel abroad annually in our nation, thus airline travel has become one of the most popular forms of public transport. However, some people travel on flights without considering their state of health and risk suffering from a health ailment while on board. The cabin environment of a modernized aircraft preserves conditions similar to that on the ground, thereby making the travelers feel comfortable. But sometimes people with chronic diseases can make their health condition worse due to long distance flight travel. Traveling overseas among the elder generation has increased, and cases involving patients traveling abroad to receive better medical treatment has increased as well. In advanced countries, the air ambulance system is well prepared, but in Korea we can only transfer patients by commercial airlines based on the destination. This is especially typical in Jeju where there are no alternative ways. Helping an emergency patient inside the cabin is not a simple matter, and therefore it is best to avoid the situation. To be prepared for emergencies, each aircraft has an Emergency Medical Kit, First Aid Kit and Automated External Defibrillator (AED) inside the cabin. Each airline is also developing curriculums for teaching First Aid and training their flight attendants to properly use the Kit, AED and how to give First Aid. If there is a patient with a critical illness, generally the aircraft would land at the closest airport instead of the destination in an attempt to save the precious life. But, it would be more effective to be prepared with a contingency plan beforehand, instead of thereafter. If physicians and patients take more concerns regarding airline travel and kept in close communication with the airlines, some inflight medical emergencies in the cabin can be prevented. A patient who is planning to travel by air would want to receive some aero-medical information from their physicians. It is necessary to understand the cabin environment and to receive information on airline travel myths, the maximum amount of safe time for traveling, and steps to prepare before they leave. In this article, as a physician, I will review the medical guidelines to prevent unexpected accidents or inflight emergencies, and also to have some aviation medicine knowledge to help those on board.

What is the Point of the Economy Class Syndrome?

No abstract available.

Recent Review of the Traveller's Thrombosis

No abstract available.