Self-Assessed Preferred Retraining Intervals of Helicopter Underwater Egress Training (HUET).

BACKGROUND: Royal Netherlands Air Force (RNLAF) helicopter aircrew get Helicopter Underwater Egress Training (HUET) using a Modular Egress Training Simulator (METS™) in order to be prepared for escaping the aircraft when ditching into water. In the current situation the retraining intervals are only chosen on an arbitrary basis for different backgrounds of the crew (maritime and regular flight crew). The frequency of refresher training depends on the expected degree of retention, but evidence-based research on required intervals between refresher courses is scarce. Ideally, training should be based on the amount of retention of acquired competencies.METHODS: Retrospective questionnaires were filled in by 132 helicopter aircrew who followed the HUET course(s) at the Survival Evasion Resistance and Escape (SERE) school in Gilze-Rijen (Netherlands). They assessed themselves on competencies and gave their opinion on the preferred interval.RESULTS: Maritime crew report increasing competence levels with the number of refresher courses followed. According to the opinion of all aircrew, retraining intervals may take longer than 18 (first refresher) to 30 mo (fourth refresher). Maritime and regular flight crew differ in preferred retraining intervals (up to 22 mo and up to 33 mo, respectively).DISCUSSION: This study provides indications to reconsider the retraining interval and to differentiate between maritime and regular flight crew based on aircrew's opinions and self-assessments. As competence levels still increase with the number of courses followed, it is recommended to reconsider the current fixed intervals of once a year or once every 3 yr for maritime and regular flight crew, respectively.Bottenheft C, Oprins EAPB, Houben MMJ, Meeuwsen T, Valk PJL. Self-assessed preferred retraining intervals of Helicopter Underwater Egress Training (HUET). Aerosp Med Hum Perform. 2019; 90(9):800-806.

Fitness to Fly Testing in Patients with Congenital Heart and Lung Disease.

BACKGROUND: During commercial air travel passengers are exposed to a low ambient cabin pressure, comparable to altitudes of 5000 to 8000 ft (1524 to 2438 m). In healthy passengers this causes a fall in partial pressure of oxygen, which results in relative hypoxemia, usually without symptoms. Patients with congenital heart or lung disease may experience more severe hypoxemia during air travel. This systematic review provides an overview of the current literature focusing on whether it is safe for patients with congenital heart or lung disease to fly. METHODS: The Pubmed database was searched and all studies carried out at an (simulated) altitude of 5000-8000 ft (1524-2438 m) for a short time period (several hours) and related to patients with congenital heart or lung disease were reviewed. RESULTS: Included were 11 studies. These studies examined patients with cystic fibrosis, neonatal (chronic) lung disease and congenital (a)cyanotic heart disease during a hypoxic challenge test, in a hypobaric chamber, during commercial air travel, or in the mountains. Peripheral/arterial saturation, blood gases, lung function, and/or the occurrence of symptoms were listed. DISCUSSION: Based on the current literature, it can be concluded that air travel is safe for most patients. However, those at risk of hypoxia can benefit from supplemental in-flight oxygen. Therefore, patients with congenital heart and lung disease should be evaluated carefully prior to air travel to select the patients at risk for hypoxia using the current studies and guidelines.

Neck pain in military helicopter pilots: prevalence and associated factors.

Our aim is to estimate the self-reported one-year prevalence of neck pain in military helicopter pilots and to compare work-related, individual, and health-related factors in the pilots with (neck pain group) and without (reference group) regular or continuous neck pain. A questionnaire was completed by 75% (n = 113) of all military helicopter pilots of the Royal Netherlands Air Force and Navy. The reported one-year prevalence of any neck pain was 43%, and 20% for regular or continuous neck pain. Besides some significant differences in individual and health-related factors (also often reported in the general population), flying hours were significantly higher in pilots with neck pain compared to their colleagues without neck pain. The findings in this study suggest that neck pain in military helicopter pilots is a significant occupational problem and may be a consequence of longer exposure to flying.

The effect of intermittent training in hypobaric hypoxia on sea-level exercise: a cross-over study in humans.

The purpose of this study was to examine the effect of intermittent training in a hypobaric chamber on physical exercise at sea level. Over a 10 day period, 16 male triathletes trained for 2 h each day on a cycle ergometer placed in a hypobaric chamber. Training intensity was at 60%-70% of the heart rate reserve. There were 8 subjects who trained at a simulated altitude of 2,500 m, the other 8 trained at sea level. A year later, a cross-over study took place. Baseline measurements were made on a cycle ergometer at sea level, which included an incremental test until exhaustion and a Wingate Anaerobic Test. Altogether, 12 subjects completed the cross-over study. At 9 days after training in hypoxia, significant increases were seen in maximal power output (.W(max))(5.2%), anaerobic mean power (4.1%), and anaerobic peak power (3.8%). A non-significant increase in maximal oxygen uptake (.VO(2max)) of 1.9% was observed. At 9 days after training at sea level, no significant changes were seen in .W(max)(2.1%), .VO(2max) (2.0%), anaerobic mean power (0.2%) and anaerobic peak power (0.2%). When comparing the results of the two training regimes, the anaerobic mean power was the only variable that showed a significantly larger increase as a result of training at altitude. And, although the differences in percentage change between the two training protocols were not significant, they were substantial for as well as for anaerobic peak power. The results of this study indicate that intermittent hypobaric training can improve the anaerobic energy supplying system, and also, to a lesser extent, the aerobic system. It can be concluded that the overall results of the cross-over study showed predominantly improvements in the anaerobic metabolism at variance with the previous study of our own group, where the relative .VO(2max) and .W(max) increased by 7%.