Back Pain In Helicopter Aircrew: A Literature Review

Introduction:

Back pain is a prevalent issue among helicopter aircrew due to the nature of their work, which often
involves prolonged periods of sitting and exposure to vibration and other ergonomic factors.
Understanding the causes and effective management strategies for back pain in this population is
crucial for maintaining operational readiness and ensuring the well-being of aircrew members. In this
literature review, we delve into existing research on back pain among helicopter aircrew, examining
its prevalence, risk factors, and potential interventions.

Prevalence of Back Pain:

Studies have consistently shown a high prevalence of back pain among helicopter aircrew. The
demanding nature of their work, which involves frequent exposure to high levels of vibration and
sustained postures during flight, contributes significantly to the development of back pain.
Furthermore, the unique environmental conditions in helicopters, such as confined spaces and limited
ergonomic support, further exacerbate the risk of musculoskeletal discomfort.

Risk Factors:

Several risk factors have been identified for the development of back pain in helicopter aircrew.
Prolonged sitting, inadequate lumbar support, and repetitive movements during flight are primary
contributors to musculoskeletal strain. Additionally, factors such as age, gender, body mass index,
and previous injury history may also influence an individual's susceptibility to back pain.

Interventions and Management Strategies:

Effective management of back pain in helicopter aircrew requires a multifaceted approach that
addresses both ergonomic factors and individual risk factors. Ergonomic interventions, such as
optimizing seat design and providing adequate lumbar support, can help reduce the incidence of back
pain during flight. Moreover, implementing regular stretching exercises, strengthening routines, and
promoting proper lifting techniques can mitigate the risk of musculoskeletal injuries among aircrew
members.

Conclusion:

In conclusion, back pain poses a significant challenge for helicopter aircrew, impacting both their
operational performance and overall well-being. By understanding the underlying causes and
implementing targeted interventions, it is possible to mitigate the risk of back pain and promote a
healthier work environment for aircrew members. Continued research and collaboration are essential
to further advance our understanding of this issue and develop effective prevention and management
strategies.

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Likewise, adjustments must allow for full anthropometric ranges. European Agency for Safety and
Health at Work 2002. There are several actions that could trigger this block including submitting a
certain word or phrase, a SQL command or malformed data. Candle burning at both ends only
allows ” adjust maadi ” methodology that permits limited possiblity of addressing most of relevant
causal factors highlighted in the article. In one trial, fi xed-wing, not helicopter pilots, received the
most benefi t from lumbar supports (fatigue relief, less pain, improved comfort), with authors
suggesting they were able to more consis-tently sit upright and capitalize on the benefi ts as opposed
to the helicopter pilots ( 69 ). Bongers et al. ( 8 ) associated high fl ight hours per day and total hours
of fl ight time with in-creased back pain (transient and chronic pain, respec-tively). One study
looking at military aircrews in a deployed setting postulated body armor as a contribut-ing factor to
aircrew pain in some anatomic locations ( 57 ). In the Canadian Forces, it remains the second most
common cause of opera-tional grounding ( 88 ), whereas a survey of Australian military helicopter
pilots revealed that only a startling minority (8%) were back pain free ( 86 ). Note that these criteria
do not represent other nonwork-related physical or psychosocial factors that may also be associated
with back pain. The duress under which the crew must have operated that flight can be understood if
not condoned. Other investigators have noted increased (four times higher) prevalence of lytic
spondylolisthesis in helicopter pilots compared to cadets and transport pilots ( 30 ). Once these
patients have been iden-tifi ed and treated (or dispositioned to appropriate specialists), one can
expect about 90% of acute episodes of uncomplicated back pain to resolve within weeks with close
to 10% going on to develop chronic pain ( 3,23,73 ). The front CPG seat allows for a more upright,
neutral posture with sidearm cyclic and collec-tive. Quality of sleep is highly undervalued in this
industry. Technical Memorandum: 108838. 32. Gearhart JR. Response of the skeletal system to
helicopter-unique vibration. Occupational health guidelines for the management of low back pain at
work — evidence review. Helicopters operate from dispersed locations, often out of reach of the
kind of accommodation available to their airline counterparts. Divya Kanojiya Emergency-First-Aid-
Made-Easy-Training-Presentation.pptx Emergency-First-Aid-Made-Easy-Training-Presentation.pptx
DrSathishMS1 Report Back from San Antonio Breast Cancer Symposium (SABCS) 2023: Spotlight.
Flight surgeons should be familiar with this prevalent issue and future research must address
longitudinal cohort studies with clear defi nitions, relevant and valid exposure data, dose-response
detail, and control for contributing factors and confounders. Sheard and colleagues ( 80 ) found a
high 12-mo preva-lence of back pain among British Royal Navy RW aircrew (82%) vs. Low back
pain, active component, U.S. Armed Forces, 2000-2009. In a recent study, Kasin and colleagues ( 44
) devel-oped a protocol for measuring WBV and performed a risk assessment processing vibration
root mean square values with time spent per various operational fl ight maneuvers for six different
military and civilian heli-copters. An increase in bodyweight, decrease in energy levels, and increase
in joint wear and tear encourages the pilot to take more time off work and spend time at the doctor’s
office. GERIATRIC PHARMACOLOGY Geriatric pharmacology is a specialized field focusing.
These limited physical criteria place a host of occupations at risk (e.g., pro-fessional drivers, dentists,
farmers, heavy equipment op-erators, miners, offi cer workers, and many others), including
helicopter aircrew. The limits are comparable, the service conditions are not. Furthermore, there are
several contact points between the pilot and the aircraft; hands, feet, low back and pelvis regions.
The problem is complex with likely important factors including maladaptive posture, vibration, and
other physical and psychosocial factors. Without any current regulation here that mandates PBN,
TCAS, EGPWS or ADS-B, the temptation for cutting corners or getting one-up on a fellow flier is
high. There have also been many advocating for better seat design ( 20,34,63 ), improved fl ight
control geometry ( 11,20,79 ), and larger related issues of overall cockpit ergonomic redress (
10,80,86 ).
A case-control study of 5095 U.S. Navy pilots and aircrew showed aircrew, not pilots, to have a
higher risk of diagnosed back problems by physical exam for both helicopters and fi xed-wing
aircraft ( 81 ). Avaliable format in PDF, EPUB, MOBI, KINDLE, E-BOOK and AUDIOBOOK.
Furthermore, the nature of many aircrew to minimize or under-report a medical issue or perfor-
mance defi cit should highlight the importance of a good fl ight surgeon-aircrew relationship.
Growth of helicopters has been sluggish owing to many issues, some of which I had covered in an
earlier story. There is a considerable body of scientific literature devoted to the problem, including
epidemiologic and experimental studies addressing prevalence, characteristics, primary etiology, and
contributing factors. That is why you also provided with basic knowledge, how to deal emergency
situations like bad weather, plane on fire and many more. Fitzgerald JG. An approach to the problem
of backache in aircrew. Beads of perspiration streamed down his cheeks as he held a routeing chart
in his left hand, juggled around with radio frequencies, read back a complicated departure
instruction, and lifted off with no help from man or machine. It ’ s often used as an imprecise “
catch-all ” term for pain or discomfort that may represent a whole host of pathologies ranging from
the (usually) minor and self-limiting through the emergent and life-threatening. This is the zone most
prone to dangerous encounters between rotors, weather and terrain. Neuilly-sur-Seine, France:
NATO Advisory Group for Aerospace Research and Development (AGARD); 1986. In studying 163
helicopter pilots versus 297 nonfl ying offi cer controls, Bongers et al. ( 8 ) determined that transient
pain was associated with hours of fl ight per day, while chronic pain was associated with total hours
of fl ight time (sig-nifi cantly higher prevalence of chronic pain for. 2000 h). The authors attributed
this to accumulative vibration dose and posture (subjectively reported), concomitantly. There are
several actions that could trigger this block including submitting a certain word or phrase, a SQL
command or malformed data. Military pilots suffering chronic back and neck problems. Data
suggested that more serious, chronic back pain develops with increasing vibration dose or total fl
ight time, complicating individual assessment since the two are highly corre-lated. Over-the-counter
medications: use in general and special populations, therapeutic errors, misuse, storage and disposal.
2011; retrieved 24 October 2011 from. 2. Ang BO, Monnier A, Harms-Ringdahl K. Attributes of
poor flight planning, violation of SOP, flying indiscipline, etc were heaped on the deceased pilots
(both ex-Indian Army) by the AAIB. It may very well be that aircrew developing chronic pain may
not be representative of the classic “ idiopathic ” back pain with specifi c pa-thology causing the
chronic symptoms (e.g., degenera-tive osteoarthritis, discogenic disease). A survey of 648 U.S. Navy
aviators was worse: 88.1% of respondents reported pain on at least half of their fl ights, while a
third admitted pain was affecting situational awareness ( 63 ). Bridger and colleagues ( 11 ) noted
that lumbar support users as a group did not report lower levels of pain than nonusers. New York:
McGraw-Hill, Inc.; 2007. 42. Hulshof C, van Zanten BV. Vibration — measurement, control and
standards. 2008; retrieved 17 October 2011 from. 13. Carter JT, Birrell LN. Emergency-First-Aid-
Made-Easy-Training-Presentation.pptx Emergency-First-Aid-Made-Easy-Training-Presentation.pptx
Report Back from San Antonio Breast Cancer Symposium (SABCS) 2023: Spotlight. While it may
not, in and of itself, cause the whole of the problem, it is likely contributory (and not restricted to
helicopters). Leadership from the 23rd Wing and the 347th Rescue Group were present at Moody
AFB for the aircraft’s arrival. This design forces helicopter pilots to assume a unique. The ideal
positioning of the core involves aligning the extremities with the spine where minimal mechanical
stress is applied to the soft tissues (i.e., muscles, ligaments, tendons, capsule, etc.), bones and joints.
Incorrect alignment produces additional mechanical demands on the supporting structures and
creates wear and tear in the joints. With more evidence for the former, it remains likely that both, as
well as other factors, may have a contributory and perhaps integrative or concerted role. It is perhaps
expected that incident presentations or prevalence of back pain among aircrew would increase with
fl ight hours (i.e., more exposure). Shanahan ( 79 ) noted a logarithmic-type growth association
between percentage of pilots with back pain symptoms and total Page 11. Houston, TX: Air Force
Institute of Technology, Houston School of Public Health; 1997.
Using air mattress or hanging stretcher for cas-evac. Furthermore, there are several contact points
between the pilot and the aircraft; hands, feet, low back and pelvis regions. It is recommended to
utilize cushions that dampen the effects of vibrations that occur in a single flight. Sikorsky boasts
that the Jolly Green II is “significantly more capable and reliable than its predecessor”, the HH-60G,
with its extended range and enhanced survivability. The collective lever, operated with the left hand,
collectively changes the angle of incidence on all rotor blades contributing to total force vector and
lift. Report No: DCIEM-88-RR-12. 70. Punnett L, Pruss-Ustun A, Nelson DI, Fingerhut MA, Leigh
J, et al. How come we condone FDTL exceedance so lightly when research has conclusively
established that performance impairment caused due to fatigue is similar to that of having consumed
alcohol. Do you want to add this slice to your McFatigue sandwich. Lis and colleagues ( 53 ) specifi
cally assessed the association between sitting and low back pain, fi nding that overall, among all
occupa-tions, sitting alone as an independent risk factor was controversial. Flight surgeons should be
familiar with this prevalent issue and future research must address longitudinal cohort studies with
clear definitions, relevant and valid exposure data, dose-response detail, and control for contributing
factors and confounders. Page 5. This work is original, has not been published elsewhere, and is not
currently under consideration by another journal. Once these patients have been iden-tifi ed and
treated (or dispositioned to appropriate specialists), one can expect about 90% of acute episodes of
uncomplicated back pain to resolve within weeks with close to 10% going on to develop chronic
pain ( 3,23,73 ). The prevalence and characteristics of chronic widespread pain in the general
population. Muscle fatigue, whether by asymmetric posture or vibration, has been suggested as a
causative role in helicopter-related back pain ( 8,10,61 ). The problem is not limited to pilots. “ The
plight of pilots should not allow that of other members of the crew to be forgotten, ” cautions
Delahaye ( 20 ), specifi cally citing the fl ight engineer in certain airframes. When such force
modernization upgrades are entertained, they should include seat and cockpit ergonomic con-
siderations for aircrew. The action you just performed triggered the security solution. Ergonomic
concerns for fighter pilots are more related to. Military pilots suffering chronic back and neck
problems. In this group, 28.4% admitted to rushing missions and some (7.5%) had even refused
missions secondary to back pain. The infl uence of personal variables on work-related low-back
disorders and implications for future research. Also, improper positioning of the pelvis creates
excessive anterior tilt (top of the pelvis rotates forward), which is common among pilots during
prolonged sitting in aircraft. Interestingly, in this study, helicopter pilots had similar prevalence of
back pain unassociated with fl ight to their counterparts, with the authors sug-gesting a transient fl
ight-related effect. Delahaye and colleagues ( 20 ) also described higher incidence among aircrew
with higher hours, though he notes that the thresholds for pain (both typi-cal and chronic) vary
widely in the literature. Such en-demicity should not surprise fl ight surgeons who care for this
population, especially given the occupational risks associated with such pain — namely, a static
seated en-vironment with pathophysical posture and vibration. Flight surgeons should be familiar
with this prevalent issue and future research must address longitudinal cohort studies with clear defi
nitions, relevant and valid exposure data, dose-response detail, and control for contributing factors
and confounders. Fatigue cannot be given a casual treatment, even if the direct cause of the accident
may appear to lie elsewhere. Principal resonance frequencies (and the associated tissue axial and
shear deformations) change with posture and biodynamic models must incorporate this complexity
to be properly predictive ( 46 ). While sitting for long periods, practise tilting the top part of the
pelvis backwards and tightening up the abdominals for two minutes every 20 minutes. The flight
sitting posture and vibrations produced by the aircraft are identified as high risk factors for LBP.