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Medication And Aircraft Maintainers

Flying Safety, June, 2001 by Bill Sneeder

When thinking about aircraft mishaps and their causes, we tend to focus on the pilot. After all, he's in the driver's seat, there to troubleshoot any problems that may arise, and he's expected to bring the "on-loan" aircraft back to base, in one piece, after a mission. If a mishap occurs, investigators look for causes related to pilot error along with evidence of mechanical failure, weather factors, runway condition and ATC issues. Reviews of data from civilian general aviation, commercial air and military aircraft mishaps show that the two most often cited causal issues are pilot error and mechanical/logistic factors.

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Aircraft maintainers--jet engine mechanics, avionics, environmental and life support technicians, dedicated aircraft crew chiefs and others--have direct input into the reliable function of aircraft system components and the overall aircraft. We don't know, however, what role maintainer human factors play in mishaps associated with mechanical issues like engine or flight control failures. The cause of a mechanical-related mishap is often obvious. The part wore out before its service life expired, or it failed due to an unanticipated performance stress, etc. In other cases, human error played a role when someone forgot, overlooked or incorrectly installed or serviced something on the aircraft. Documented cases include incorrectly installed fuel sensors, flight control sensors or engine parts, forgotten tools, and overlooked items in the aircraft forms. So, the question arises: Do some instances of improper maintenance occur due to the influence of maintainer human factors issues, such as self-imposed stress (drug or alcohol use, poor diet, improper rest), fatigue, poor concentration, shift-work problems, inadequate training or lack of motivation?

Aircrew are closely scrutinized by their flight surgeons for illness and monitored while taking any medications. Those who fail the scrutiny are usually grounded from flying duties. In contrast, a maintainer's physician may not make the connection between an illness or medication and the impact on the maintainer's ability to perform his or her job of repairing and inspecting their aircraft with optimum attention and diligence. Compromise of the maintainer's duty performance has the potential for endangering an aircrew and damaging aircraft and equipment.

What We Learned

Because of their important role in safe flight operations, researchers wanted to know if maintainers were returning to regular duty while taking physician-prescribed or self-prescribed medication (for a self-diagnosed ailment) that had a potential to impair their ability to perform critical tasks. Studies of medications such as antihistamines (e.g., Benadryl[R]), which are used to treat allergies and may cause drowsiness, have shown that they reduce scores on various motor skills and thinking performance tests.

In one study, a group of 214 USAF aircraft maintainers representing various specialties completed an anonymous questionnaire regarding medication and duty performance. Of the 83 airmen who recalled treatment by a physician or who had self-medicated during the six months preceding the questionnaire, 39 had taken medication with potential side-effects such as drowsiness. These medications included antihistamines (Benadryl[R], Atarax[R]), certain common cold preparations (Contac[R], Dimetapp[R], Nyquil[R]), pain relievers (Tylenol[R] with codeine), muscle relaxants (Flexeril[R]) and digestive tract symptom relievers (Donnatal[R], Lomotil[R]). About 67% (26) of these individuals returned to work without any reported duty limitation status. More importantly, among the 29 who experienced actual drowsiness side effects, 65% (19) returned to work while on the medication.

What It Means

Apparently, some maintainers in this group returned to their regular duties--servicing, repairing and inspecting various aircraft components--while impaired. Not only was there impairment due to the medications the individuals took but, combined with the symptoms of the underlying ailment, the effect of the medication was likely compounded. Self-medication is most worrisome because maintainers and other non-flying operations personnel don't have the benefit of a physician to help determine if a medication is safe to take while doing their particular job. Even the most seemingly harmless over-the-counter medication can carry hidden risks, including cross-reaction with other medications and exacerbation of pre-existing medical conditions. For example, scientific studies have shown that, as with alcohol, sedating antihistamines may even cause performance impairment in the absence of drowsiness, without the worker realizing it.

To put things in context, however, there have been no documented Class A, B or C mishaps in the USAF directly linking a maintenance error to impairment caused by a prescribed or over-the-counter medication (mainly because we historically haven't looked at the effects of these medications on maintenance personnel). But the safety issue remains: Any medication you take, over-the-counter or prescription, may be detrimental to performance, including attention, memory, vigilance and motivation. Mistakes that result from ground crew human factors create a risk for loss of life or serious injury, and they can be dramatically costly in terms of equipment damage, with direct impact on flight operations during training and combat.

Transportation Industry

Medication And Aircraft Maintainers

Flying Safety, June, 2001 by Bill Sneeder

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