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PTS Health Factors
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Contents
Age as a Factor in Flying; Fatigue; Sleep; Medicine; Carbon Monoxide; Cold Weather; Dehydration; Hyperventilation; Hypoxia; Smoking; Coffee; Spatial Disorientation; Stress; Vertigo; Vertigo and Ginger, Nutrition: ...Minihre's Disease; Smoking and Health; ....Drinking and Drugs; ...Pilot Physiology; ...WATER; ...Coca-Cola, ...  Glossary; ...

H. Task: AEROMEDICAL FACTORS

Pilot Operation - 1
References: AC 61-21, AC 67-2; AIM

Ex Explain cause, symptoms, effects, and correction for...

Age as a Factor in Flying
The average General Aviation pilot was 39 years of age in 1990. Pilots over 60 have 2.1 times more accidents than pilots in their 50's. Pilots over 60 are safer than pilots in their 20's and 30's. The accident rate goes up after 60 perhaps due to subtle age-related deterioration in cognitive function. The older you are the dumber you get! My wife agrees.

Older pilots like to think that what has been lost in ability has been made up in experience. By the age of 60 pilots lose some mental and physical abilities. By the age of 50 everyone has some vision loss known as presbyopia. Hardening of the lens causes this. As we age we become less efficient in getting and using oxygen and getting rid of carbon dioxide. Hearing by itself does not affect the ability to fly but it does make a difference in the communications area. Like vision, hearing the higher frequencies drops with age. Physically we become victims of some stiffness of the joints and extremities with age. Dehydration is going to have greater effect with age. We are all different in the way we age and the way our aging affects our flying.

Fatigue
Acute fatigue occurs when a long period passes with a lack of sleep. Chronic fatigue occurs when several acute fatigue periods occur without adequate recovery time between. While some fatigue is related to lack of sleep, not all is. Fatigue can result from inadequate nutrition and over exertion. More information needs to be obtained on fatigue distinguished from sleep as a factor in accidents. Some factors of physical condition are controllable and some are not. Stress is the result of events causing preoccupation, reducing external awareness, and making activities subject to distraction. Stress causes the taking of risks that would otherwise be unacceptable. The mental/physical condition resulting from fatigue and stress may cause the pilot to make unwise decisions.

There are many causes of fatigue: lack of sleep, hypoxia, noise, time zone factors, temperature extremes, dehydration, stress and more. When you are fatigued you are more irritable and easily annoyed, you will suffer for lapses in short term memory, your attention will fixate to the exclusion of all else, your performance skills will decrease and you will be unaware of any impairment.

The causes of fatigue are primarily lack of recent sleep or a chronic sleep deficiency. Additional fatigue arises from our physiological reaction to noise and vibration, illness, hunger, caffeine "down time", unresolved stress, hypoxia, dehydration, errors in judgment and extended mental/physical demands.

What to Expect from Fatigue
Reduced vigilance
Increased temper excursions
Reduced ability to concentrate
Reduce awareness of deviations
Increased rationalization of errors
Increase in ‘know-better’ mistakes
Fatigue increases if you are "doing nothing"
Reduced comprehension of ATC instructions

Subtle Fatigue
This problem often begins with a distraction that causes fixation on an instrument or occurrence. Complex flight operations are the first skills to deteriorate.

Silence prevails
Seat posture relaxes
Bad judgment prevails
Instruments are ignored
Attention and vision fixates
Eye/hand skills begin to fail
Writing becomes less linear
Heading excursions take place
Movements decrease and slow
Clearances cannot be copied in total
Knowing where you are becomes a problem
Pilot accepts what exists as O.K. without checking
External references begin to fade from consciousness

Sleep
The most common cause of diminished alertness and proficiency is lack of sleep. This condition is said to affect 30% of the U.S. population. This may be due to an actual loss of sleep or a change in a sleep pattern called the circadian rhythm. Pilots tend to neglect their need for sleep. The need for sleep is a defining limit to pilot mental capability. You must have sleep or your mind will fail. Once beyond the limit pilot performance deteriorates and can become irrational. Sleep is a restorative and can be both stored and deprived within limits set by the biological clock of the individual. As you grow older you will need less sleep. Jet lag sleep patterns are worse when flying from west to east. Accident rates climb precipitously when your body begins demanding sleep. The average American gets about one hour too little sleep each night.

Accident rates rise in the afternoon and become significant at night. Postponing sleep causes a sleep deficit that as it increases an accident becomes more likely. Jet lag is a type of sleep deficit. A sleep deficit can best be resolved by going to bed early, not by sleeping late. A large deficit cannot be made up in one night. 21% of aircraft accidents cite sleep deficiency as a factor.

When drowsiness occurs you cease to monitor the instruments. You will tend to fixate and drift off mentally. We go into a mental autopilot not thinking of what we are doing. This is the lowest level of alertness. The next level of alertness is one in which you are in constant search-and-scan, seeing what you are looking at, hearing what is said and asking question. This is the flying" mode from pre-flight to shutdown. This gradual deterioration of alertness is best observed in watching others. It can creep up on you and influence your flying without your even noticing. Your alertness rises again when you have located a problem. You focus on it and prepare to execute a solution. This might occur when required to make a crosswind landing. The highest level of alertness is when adrenaline begins to flow and survival becomes a factor.

Medicine
Any over-the-counter medication whose name ends in "ine" should be checked in a flight medical examiner for use before flying. Beware of any medicine that is supposed to make you feel better. At altitude the effects may be damaging to flight safety.

Medicine taken is just as likely, even more likely, to be the basis for grounding a pilot than is the ailment itself. Medicinal side effects are both variable and unpredictable. Virtually all medications have side effects. Never take a medication for the first time and then fly. Make the safe decision if you are sick.

Carbon Monoxide
Is poisoning due to the exhaust fumes resulting from carbon burning with insufficient oxygen to produce complete oxidation. The resulting gas has one atom of carbon and one atom of oxygen. CO is odorless, colorless and cannot be tasted. CO poisoning may not be distinguished from fatigue or hypoxia except that the occurrence can occur at any altitude. Engine exhaust in an aircraft has 7% CO. Very small amounts of CO over a period of time will reduce a pilot’s ability to fly safely. It is the length of exposure as well as the amount that makes the critical difference. Susceptibility to CO poisoning increases with altitude due to the propensity of CO to enter blood. CO is 200 times more attracted to the blood hemoglobin as is oxygen. As little as one part CO to 20,000 (.005%) parts of air is enough to begin the death process of the brain.

Above 10% CO poisoning you will suffer from a headache. Above 20% you will be sleepy and sick to your stomach, HEADACHE, vision and speech problems. You will be incapacitated above 40% and dead at 70%. If you get a headache while flying, open the window and shut off heater.

CO reduces ability of blood to carry oxygen. Symptoms are similar to hypoxia. Headache, drowsiness, dizziness should initially be corrected by opening outside air vents. CO has a half-life in your body of about five hours. It will take a full day to recover. 70% of exhaust system failures result in CO poisoning. CO prevents the hemoglobin from both carrying and releasing oxygen. Antihistamines, alcohol, lack of sleep, or blood deficiency will exacerbate CO poisoning. Prevention of CO poisoning is directly preventable by proper aircraft maintenance. Club aircraft require extra alertness. You might suspect CO exists in your cabin air as soon as you smell some engine exhaust fumes.

Descend
Land ASAP
Use any oxygen
Shut off the heater
Get medical treatment
When in doubt, get on the ground.

Cold Weather
Hot or cold temperatures affect the quality of the preflight. In the winter, as your body cools you tend to mentally and physically slow down. Flying in an unheated aircraft in the winter will drastically decrease your flying efficiency and effectiveness.

Dehydration
Human need for 2-4 quarts of water a day. You become thirsty with a deficit of 1.5 quarts of body fluids or 2% of body weight. The deficit causes a reduction in blood volume and triggers thirst. Thirst arrives too late and can be mollified too easily. At 3% of body weight fluid loss fatigue and weakness occurs. Symptoms are headache, sleepiness, dizziness and weariness. Avoid diuretics such as coffee and alcohol. Don’t rely on thirst as drinking trigger. Measure fluid intake daily.

Ear Block
Caused when the Eustachian tube becomes blocked. Ear block or sinus blockages can cause differential air pressures to exist between cavities of the skull and the exterior. If it is not possible to equalize these pressures by slowing or removing the pressure changes severe pain results. Do not fly if you suspect such a condition exists or above 8,000’ within 24 hours of scuba diving. Gum chewing and jaw movement are preventives. The Valsalva maneuver consists of opening the mouth wide with the jaw wide, as though yawning. Do this over and over because opening the mouth helps open the Eustachian tubes. Next, pinch your nose closed, shutting the mouth, and blow gently as through your nose.

Hyperventilation
Stress, anxiety and fear cause hyperventilation. The person begins abnormal rapid breathing. Reduction of carbon dioxide causes lightheadedness, suffocation, drowsiness, tingling, and coolness. Leads to incapacitation, spasms, and unconsciousness. Symptoms resemble hypoxia. Can be corrected by controlled breathing in a paper bag.

Hypoxia
An adult will breath in 3,000 gallons (by volume) of air per day. This includes 600 (20% of total) gallons of oxygen. Your blood system has 25+ trillion (12 zeros) red blood cells (hemoglobin). Each one is capable of loading up four oxygen molecules for distribution throughout the body. when returning to the lungs for a refill they unload CO2 first.

Hypoxia is oxygen starvation. Lack of oxygen impairs the whole body but most importantly the brain. The first part of the body to show significant effect from oxygen deficiency is the retina of the eye. Every individual is affected but in different ways and to different degrees. The danger in hypoxia is that it occurs insidiously below the conscious threshold. Hypoxia makes you happy and such happiness in the cockpit is very dangerous. The best warning indicator for hypoxia is the altimeter. You will quickly recover by descent to a lower altitude.

Since hypoxia is due to reduced barometric pressure, low-grade hypoxia begins on takeoff. The percentage of oxygen is same but less is reaching the blood stream. Any stress or increase in activity requires more oxygen, up to 8 times more. Pilot performance deterioration begins at takeoff, as well. Slowed response times and inability to deal with complexities due to hypoxia compromise safety. Noticeable oxygen deficiency effects begins at 4000’ safety margins are beginning to erode. Hypoxic symptoms of difficulty breathing or headache may not be obvious or may not occur at all even though there are the foregoing changes in mental status.

I have seen complete personality changes occur after a couple of hours around 12,000’. Symptoms such as headache, drowsiness, dizziness, euphoria, tingling, perspiration, or belligerence are typical. Tunnel vision and blue fingernails occurs with times as little as 15 minutes above 15,000’. At 16,000’ disorientation, lapses of judgment, loss of impulse control, risk-taking behavior, decreased problem solving abilities, impaired memory, mood disturbances, and lowered coordination are common. Unconsciousness occurs in 10 minutes at 20,000’.

All effects are made worse and happen at lower altitudes with fatigue, age, smoking, health habits, and drinking. Oxygen recommended above 10,000 day and 5,000 night. If oxygen is being used, the pilot must be knowledgeable about the operation of the system and be able to recognize his and the system’s warnings of oxygen deficiency. FARs require oxygen if ½ hour above 12,500’, crew above 14,000’, everybody above 15,000’.

Smoking
The smoking of tobacco is a form of self imposed physical and psychological stress that constitutes an immediate and on-going threat to health and safety. A smoker may deny that drugs are a part of his life. He lies in the face of facts. The whole purpose of a cigarette is to get a nicotine fix. Different from cocaine or heroin? How? The person who smokes is a health and economic hazard to everyone. The residue remains on his person, clothes, possessions, and associates.

Susceptibility to CO poisoning increases with altitude due to the propensity of CO to enter blood. This prevents the blood from being able to transport adequate oxygen to the body’s cells. The hypemic hypoxia of the smoker reduces his oxygen intake by 5-10 % of normal capacity. The fact that smokers are hypoxic means that we can expect smokers to feel anxiety, forgetfulness, irritability, confusion, altered judgment with every cigarette. Judgment, math ability, and reasoning will be affected. The indication is that smokers are more likely to enter into personal arguments and show lack of both good judgment and logical reasoning ability in those arguments. Very small amounts of CO over a period of time will reduce a person’s ability to perform safely. It is the length of exposure as well as the amount that makes the critical difference. This lack of oxygen to the brain impairs judgment and diminishes the ability to make reasoned decisions.

Any onset of sluggishness, warmth, and tightness across the head is an early symptom of CO poisoning. A headache, weakness, dizziness and dimming of vision comes next. You won’t be aware when you lose strength, vomit, convulse, and enter a coma. A breath of fresh air will not revive you. Several days may be required for full recovery. The smoker is betting against a CO impairment that has already occurred and can only become worse. Carbon monoxide and other toxins in tobacco smoke interfere with the oxygen-carrying capacity of red blood cells. Less oxygen means less energy. Smoking causes an accumulation of mucus in the windpipe and bronchial tubes constricts blood vessels and reduces the supply of oxygen to cells.

The pilot who smokes is a hazard to himself and other pilots. The fact that smokers are hypoxic at relatively low altitudes means that we can expect smoking pilots to feel anxiety, forgetfulness, confusion, irritability, and altered judgment at relatively low altitudes. The applicable question is, should smoking pilots have any more right to fly than drinking pilots? Know your limitations. Don’t fly if you are not 100%.
Smoking
Long term
--Emphysema, heart conditions, cancer likelihood times 20
Short term
Three cigarettes prior to takeoff gives 4% Carbon Monoxide reduces altitude and night tolerance

Coffee
Half of the American population is addicted to coffee. 25% drink ten or more cups a day. Quitting coffee is both difficult and painful. At age 71 I dropped coffee primarily to lower my blood pressure. I had a two-week headache. Now I take afternoon naps. The lure and temptation of coffee still exists.

Coffee has some negatives:
1. Raises the adrenaline level.
2. Linked to heartburn and ulcers.
3. Leading cause of sleep disturbance.
4. Constricts blood vessels of the eyes.
5. Contains at least five cancer causing compounds.
6. Contains pesticides that are not allowed in the U.S.
7. Contributes to iron loss, zinc loss, and sex drive loss.
8. Increases risk of stroke by increasing blood pressure.
9. Blocks adenosine, a brain chemical that calms you down.
10. Can cause panic attacks by increasing lactate in the body.
11. Can addict babies whose mothers drank during pregnancy
12. In conjunction with diet, cold, anti-depressants will dramatically raise blood pressure.
13. Causes excretion of calcium, potassium, magnesium and sodium before being used by the body due to diuretic effect.

Spatial Disorientation
Spatial disorientation is the No. 1 cause of military aviation fatal accidents. Even the best pilot will become disoriented under the right conditions. Effects on inner ear can cause a mentally and physical compelling move in a given direction. This can be the after effect of a gradual turn, spiral, spin, acceleration, leveling off, updraft, false horizon, autokinesis, (lights that move), runway illusions.

Stress
Human performance is mitigated by physical stresses such as fatigue, fitness, sleep, food, age and illness. Psychological stressors such as personal family problems, work load, situational awareness. External dynamic stresses due to weather, turbulence, aircraft performance and time factors. Stress is the result of events that cause preoccupation reducing external awareness and making activities subject to distraction. Stress causes the taking of risks that would otherwise be unacceptable.

Stress in moderate amounts is both necessary and desirable when flying. It prevents boredom and inhibits fatigue. The other extreme of stress leads to panic and impaired capability. Accidents happen when flying requirements exceed capability. Time in the air will decrease capability and lower the stress/panic threshold. 69% of accidents occur in the landing phase of flight operations. This is when time in the air is greatest and the stress/panic threshold lowest.

Whenever excessive tension exists, the ability to make considered judgments deteriorates. The concepts of what is best or safest become an emotional decision based more on fears or concerns rather than realities. Under tension the ability to make correct decisions deteriorates and compounds both the tension and the reliability of the selected solution. The pilot MUST recognize areas of tension and undertake an instructional program to raise a proficiency level to where competence reduces tension. Failure to resolve any tension-producing problem will eventually lead to an unforeseen situation where a decision will produce an accident. The instructional program must expose the student to those tension producing situations before the student goes solo. Stress exposure is a form of stress inoculation.

The most common tension producer is through use of the radio. At a given point in airspace the student knows that he should be prepared to say a given sequence of communication facts. Where to start talking, what to say, in what sequence, and the fear of the unknown ATC create tension. After being lost or disoriented the most dramatic tension producer is x-wind landings, next I would place unfamiliar airports, especially if they are small, followed closely by radio procedure uncertainty. Night flight over unfamiliar terrain certainly raises cockpit temperature. Turbulence produces tension in the best of us as does proximity to the ground. All of these tension producers can be reduced or eliminated by gradual programmed exposure. Stress reduction, according to one expert, can be achieved by only landing at airports and peeing every chance you get.

Vertigo
Unrecognized spatial disorientation is caused by some combination of channeled attention, distraction and target fixation. These most often occur in conjunction with loss of situational awareness due to excessive workload. A 10-degree bank with only the approach lights visible can cause an illusion that the lights are sloping from above. 

Recognized spatial disorientation is when the pilot is aware of his disorientation and should be able to work through a recovery sequence by establishing recommended power and attitude changes. Pilots have, over the radio, acknowledged their vertigo and inability to overcome it prior to crashing.

Incapacitating spatial disorientation occurs when the motion of aircraft is so severe that pilot may be incapable of rationally perceiving and processing information and making decisions. May cause nystagmus (trembling of the eyes) which makes reading of instruments impossible. Rare but can occur in extremes of weather or flight conditions. Other types of spatial disorientation are illusions such as caused by runway/cloud sizes, shapes, or slope.

Vertigo is the #1 cause of Air Force fatal accidents. Vision is the pre-installed vertigo preventative. A moments glance out-the-window is all it takes. This will overcome any sensations from other sources. However, without vision, the organs of balance in the inner ear take over. The semicircular canals approximate the three axes. They contain a fluid that stimulates our senses of angular acceleration in these axes. The otolith organs establish our sense of uprightness. Tiny stones affect hair sensors in reaction to "gravity". Otoliths sense linear accelerations, not angular accelerations, and regardless of the direction interpret such accelerations as gravity. In our muscles and joints we have sensors which give additional information about push or pull. Unless one or all of these sensors are confirmed by vision we are on our way to vertigo.

Vertigo is an hallucination of movement where rotation is sensed where no rotation exists.  The hairs of the ear canals sense movement that cannot be confirmed by eyesight. Reactions to non-confirmed sensory input causes loss of aircraft control.
It is the body fooling the eyes. Vertigo can occur in as little as 20 seconds of conflict. Reading while in motion will cause an inner-ear/eye conflict

Vertigo and Ginger
The medical community is sort of divided on whether ginger is effective. There's some research like the abstract below on the pro side, but other articles have been unable to identify a reliable relationship between ginger and the prevention of motion sickness.

FWIW, I've used 1/8 teaspoon dissolved in 8 oz of water at sea off the coast of the Outer Banks, the graveyard of the Atlantic, in roiling seas following a hurricane, and it seemed to work for me.
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Effects of ginger on motion sickness and gastric slow-wave dysrhythmias induced by circular vection.

Ginger has long been used as an alternative medication to prevent motion sickness. The mechanism of its action, however, is unknown. We hypothesize that ginger ameliorates the nausea associated with motion sickness by preventing the development of gastric dysrhythmias and the elevation of plasma vasopressin. Thirteen volunteers with a history of motion sickness underwent circular vection, during which nausea (scored 0-3, i.e., none to severe), electrogastrographic recordings, and plasma vasopressin levels were assessed with or without ginger pretreatment in a crossover-design, double-blind, randomized placebo-controlled study.

Circular vection induced a maximal nausea score of 2.5 +/- 0.2 and increased tachygastric activity and plasma vasopressin. Pretreatment with ginger (1,000 and 2,000 mg) reduced the nausea, tachygastria, and plasma vasopressin. Ginger also prolonged the latency before nausea onset and shortened the recovery time after vection cessation. Intravenous vasopressin infusion at 0.1 and 0.2 U/min induced nausea and increased bradygastric activity; ginger pretreatment (2,000 mg) affected neither. Ginger effectively reduces nausea, tachygastric activity, and vasopressin release induced by circular vection. In this manner, ginger may act as a novel agent in the prevention and treatment of motion sickness.

Nutrition
Food when converted into glucose is the source of brain energy. Glucose cannot be stored. As blood sugar it requires constant renewal. If glucose is not renewed the body and the mind shows evidence of fatigue, mental confusion, faintness, headache, memory loss, dizziness, vision problem, cold hands and feet.

Reduced blood pressure, tension, depression and hunger are all symptoms of hypoglycemia. This can be caused by the lack of a balanced meal within the past five hours. Ten hours without food will severely affect decision-making ability, alertness, coordination, and perception. Skipping breakfast causes fasting hypoglycemia. All hypoglycemia types can be aggravated by other physiological factors.

Altitude can incapacitate a pilot through dehydration. Increase your fluid intake prior to and during flight. What you eat is just as important as just eating. Reactive hypoglycemia can cause lack of consciousness. This is a reaction to the doughnut/candy bar meal. The student pilot who does not eat because of possible airsickness is endangering himself if flying solo. High sugar meals cause the pancreas to create excess insulin. Insulin allows the body to use sugar. Too much insulin and deplete sugar to such a low level as to incapacitate the body and mind. Adding caffeine, alcohol and nicotine acerbates the problem. Flying should be preceded by a balanced meal. Neuronutriments are the vitamins and minerals that the body can change into neurotransmitters. Trace minerals such as potassium, zinc, iron, and chromium are essential to control the body’s sugar burning process. The more balanced our meals the better will be our mental functioning and memory.

Minihre's Disease.
The symptoms are dizziness, ringing in the ear and progressive deafness, especially among lower frequency tones. Episodes can last from under an hour to as long as two days. Usually, the disease starts in one ear and may progress to the other. Researchers believe that the problem often begins in the tissue that lines canals of the inner ear, the place where sensory organs for balance and hearing reside. This tissue manufactures and filters the fluid that fills the inner ear. Too much fluid within the canals can cause nerve fibers within the canals to become distorted and over stimulated. The symptoms of Minihre's disease can be treated with drugs to control vertigo, diuretics to curb fluid build-up in the inner ear, and sometimes surgery

In 1861, the French physician Prosper Minihre published his first report about a malady of the inner ear that eventually became known as Minihre's disease. The symptoms are dizziness, ringing in the ear and progressive deafness, especially among lower frequency tones. Episodes can last from under an hour to as long as two days. Usually, the disease starts in one ear and may progress to the other. Researchers believe that the problem often begins in the tissue that lines canals of the inner ear, the place where sensory organs for balance and hearing reside. This tissue manufactures and filters the fluid that fills the inner ear. Too much fluid within the canals can cause nerve fibers within the canals to become distorted and over-stimulated. The symptoms of Minihre's disease can be treated with drugs to control vertigo, diuretics to curb fluid build-up in the inner ear, and sometimes surgery.

Smoking and Health
Scotland's leading ophthalmologist, Sir Stewart Duke-Elder, wrote a classic manual for eye surgeons, entitled "Textbook of Ophthalmology." Duke-Elder, who was born on this date in 1898, was one of the first doctors to link tobacco to a visual defect. The condition, known as "tobacco amblyopia," impairs the eye's ability to see green and red. "The patient, usually a man of a little over 50, complains for some weeks his sight has gradually and without apparent reason failed, so that now he finds difficulty in reading or doing fine work; he sees a mist before his eyes hanging in front of everything he looks at," he wrote. However, once the patient quit smoking, the condition could be easily treated with vitamin B-12 and brewer's yeast. Duke-Elder died in 1978.

Smoking is considered such a high risk factor that the US Preventive Services Task force, the panel of experts who advise on medical screenings, recently announced that all male smokers and even those who once smoked should have an initial ultrasound screening for of blood system.

An aneurysm develops when a section of a blood vessel thins and, as a result, the weakened wall begins to balloon (picture the ballooning of an aging tire). Although an aortic aneurysm can develop in the upper chest (called a thoracic aortic aneurysm), by far the most common aneurysm is an AAA. Normally the aorta is between 1.5 to 2 centimeters (cm) wide. It is considered an aneurysm if a section of the aorta becomes at least 3 cm wide. Danger of rupture, however, doesn't develop until an aneurysm reaches approximately 5 cm. A ruptured aneurysm is a red-flag, life-threatening emergency (symptoms include light-headedness, confusion, weakness, fainting, rapid heartbeat and numbness or tingling) and requires being rushed to the nearest emergency room for treatment.

You need to report it to the FAA's Internal Security and Investigation Division (formerly the Civil Aviation Security Division) within 60 days of the date it occurred, according to FAA regulation 14 CFR Part 61 Section 61.15 "Offenses involving alcohol or drugs" It doesn't matter if the charges are later dismissed or reduced to a lesser charge. If your driver's license was suspended for an alcohol or drug action in any form, you must report it, even if your driver's license was suspended for only a few hours (i.e., withheld by law enforcement, which includes not letting you drive home or requiring another person to drive you home). Additionally, at the time of your next FAA medical exam/review, you are required to report the DUI to the FAA's Aerospace Medical Certification Division. More information is available online ( http://www.aopa.org/members/files/medical/far61-15.html ).

Pilot Physiology
I’M SAFE
Illness, medication, stress, alcohol, fatigue, emotion
Fatigue, Stress. Drugs
--Judgment
--Speed and strength of reflexes reduced
--Inhibitions and worries lessen
--Skill reactions and coordination
--Insight into existing capabilities
--Comprehension and fine attention
--Efficiency of eye movement and hearing
--Sense of responsibility
--Relevance of response
--Ability to see under dim light
--Memory and reasoning ability
--Altered perception of situation

WATER
1. 75% of Americans are chronically dehydrated.
2. In 37% of Americans, the thirst mechanism is so weak that it is often mistaken for hunger.
3. Even MILD dehydration will slow down one's metabolism as much as 3%.
4. One glass of water will shut down midnight hunger pangs for almost 100% of the dieters studied in a University of Washington study.
5. Lack of water, the #1 trigger of daytime fatigue.
6. Preliminary research indicates that 8-10 glasses of water a day could significantly ease back and joint pain for up to 80% of sufferers.
7. A mere 2% drop in body water can trigger fuzzy short-term memory, trouble with basic math, and difficulty focusing on the computer screen or on a printed page.
8. Drinking 5 glasses of water daily decreases the risk of colon cancer by 45%, plus it can slash the risk of breast cancer by 79%, and one is 50% less likely to develop bladder cancer.

Coca-Cola
1. The active ingredient in Coke is phosphoric acid. Its pH is 2.8. It will dissolve a nail in about 4 days. Phosphoric acid also leaches calcium from bones and is a major contributor to the rising increase in osteoporosis.
2. To carry Coca-Cola syrup (the concentrate) the commercial truck must use the Hazardous material place cards reserved for Highly corrosive materials.
3. The distributors of coke have been using it to clean the engines of their trucks for about 20 years!
Now the question is, would you like a coke or a glass of water?
4. In many states (in the USA) the highway patrol carries two gallons of coke in the truck to remove blood from the highway after a car accident.
5. You can put a T-bone steak in a bowl of coke and it will be gone in 2 days.
6. To clean a toilet: Pour a can of Coca-Cola into the toilet bowl and let the "real thing" sit for one hour, then flush clean. The citric acid in Coke removes stains from vitreous China.
7. To remove rust spots from chrome car bumpers: Rub the bumper with a rumpled-up piece of Reynolds Wrap aluminum foil dipped in Coca-Cola.
8. To clean corrosion from car battery terminals: Pour a can of Coca-Cola over the terminals to bubble away the corrosion.
9. To loosen a rusted bolt: Applying a cloth soaked in Coca-Cola to the rusted bolt for several minutes.
10. To bake a moist ham: Empty a can of Coca-Cola into the baking pan, wrap the ham in aluminum foil, and bake. Thirty minutes before the ham is finished, remove the foil, allowing the drippings to mix with the Coke for a sumptuous brown gravy.
11. To remove grease from clothes: Empty a can of coke into a load of greasy clothes, add detergent, and run through a regular cycle. The Coca-Cola will help loosen grease stains.
12. It will also clean road haze from your windshield.

Glossary
Accommodation, (visual) — The time required to focus on a distant object after looking at the instrument panel.

Anxiety — Mental discomfort that arises from the fear of anything, real or imagined. Anxiety may have a significant effect on your physical actions and on the ability to learn perform from problematic perceptions.

Dark Adaptation — The ability of the rods in the eye to detect images in the dark by creating a chemical called rhodopsin, or visual purple. As visual purple is formed, the rods can take up to 30 minutes to fully adapt to the dark. Can be destroyed in seconds. Ability decreases with age.(GW)

Empty Field Myopia — Usually occurs when flying above the clouds, or in a haze layer, that provides nothing specific to focus on outside the aircraft. When conditions are hazy, the eyes can relax and focus 10 to 30 feet ahead of the aircraft.

Signal-to-Noise Ratio (SNR) — The ratio of the amplitude of the desired signal to the amplitude of noise signals at a given point in time.

Stress — The body’s and mind’s response to demands placed on it. (1) Physical: the physical response to stressors such as heat, noise, and vibration; (2) Physiological: the response to stressors such as fatigue, lack of sleep, and missed meals; and (3) Emotional: the body’s response to social or emotional stressors, such as peer pressure or marital problems, fear, euphoria, anger, etc.

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