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Drugs and Alcohol Found in Fatal Civil Aviation Accidents between 1989 and 1993

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    • Abstract:
      The FAA Office of Aerospace Medicine's Civil Aerospace Medical Institute (CAMI) is tasked under public law 100-591 [H.R. 46861; November 3, 1988, AVIATION SAFETY RESEARCH ACT OF 1988 to conduct toxicology tests on aviation accidents and determine the effects of drugs on human performance. It is important for the FAA to identify the extent to which drugs and alcohol are being used by pilots involved in aviation accidents so that the FAA can take steps to prevent pilots from using drugs or alcohol, which could impair their ability to fly an aircraft. The toxicology reports prepared by the CAMI Forensic Toxicology Research Section are used by the FAA and the National Transportation Safety Board to determine the cause of aviation accidents and evaluate present FAA regulations.

      Methods: Specimens (blood, urine, liver, kidney, vitreous, and other bodily specimens) were collected by pathologists near the accident and placed in evidence containers provided by CAMI. These samples were refrigerated and shipped by overnight air. Upon receipt, the specimens were inventoried and accessioned for the analysis of drugs, alcohol, carbon monoxide, and cyanide. All data collected by the laboratory were electronically entered into a computer for future analysis. The data bass was searched using a program developed by the Forensic Toxicology Research Section. The data base was sorted based on the class of drug, controlled dangerous substance schedules I and II, controlled dangerous substance schedules III-V, prescription drugs, over-the-counter drugs, and alcohol.

      Results: The Toxicology and Accident Research Laboratory received specimens from 1845 pilots for postmortem toxicology analysis between 1989 to 1993. Controlled dangerous substances, CDSs (schedules I and 11), were found in 74 of the pilots analyzed. Controlled dangerous substances (schedules III - V) were found in 28 of the pilots tested. Prescription drugs were found in 110 of the pilots analyzed. Over-the-counter drugs were found in 207 of the pilots analyzed. Alcohol at or above the legal limit of 0.04% was found in 146 pilots analyzed. The reported number of positive drug cases has doubled over the past 5 years.

      Conclusions: Over-the-counter medications are the most frequently found drugs in fatal aviation accidents and many of these drugs, or the medical conditions for which they are being used, could impair a pilot's ability to safely fly an aircraft. The increased number of positive cases found in this research is most likely the result of improved methods of analysis, rather than an increase in the use of drugs. The low incidence of CDS III-V drugs found in fatal aviation accidents may be a result of the difficulty in finding and identifying the new benzodiazepines commonly prescribed in this class.

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