In-Flight musculoskeletal symptoms in UK military rotary-wing aircrew: Examining the impact

Transcription

1 In-Flight musculoskeletal symptoms in UK military rotary-wing aircrew: Examining the impact Flt Lt Rich Vail, Flight Research Physiotherapist Sqn Ldr Bonnie Posselt, Special Registrar in Aviation and Space Medicine Wg Cdr Pete Hodkinson, Consultant in Aviation and Space Medicine RAF Centre of Aviation Medicine, UK

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3 During a medium level transit from Pembrey range in South Wales to RAF Odiham HP had his NVD system attached to his helmet with DNVD attached but had NVGs folded up. They were attached incase needed but due to fading daylight the transit was flown at medium level. After 90 minutes of flying the aircraft was landed and the HP experienced severe discomfort and moderate pain for the next 12 hours in his neck and between his shoulder blades. Chinook Pilot Whilst attempting to conduct look out from the cabin (seat position 1 B facing forward) the crewman's head continuously came into contact with the cabin trim above the starboard door. This causes the crewman to stoop into an unnatural position resulting pain in the neck and back. The constant contact with the cabin trim also loosens the strapping and padding with in the helmet making the helmet lose on the head and the NVG to eye relief alignment to move. Wild cat crewman The aircraft was in the low level cruise. On looking rearward into the cabin, the LHS saw that the crewman had fallen out of the right hand door therefore he immediately took control and reduced speed. The crewman informed the crew that he was OK and braced on top of the sponson..landed as soon as possible. Chinook Crew

4 After approximately 20 minutes of the student conducting grappling from cargo door, student complained of painful back spasms rendering him unable to continue with task. Student re-seated from dispatcher harness and aircraft RTB. Merlin Crew During a night flying sortie conducted in the visual circuit on the airfield, the rear seat pilot complained of pain due to an helmet position and fit. This pain started approximately 25 minutes into the sortie and the decision was made to cease the sortie. The aircraft was landed 5 mins later with the front seat pilot as the handling pilot. Apache pilot On the IP to target run, the lead aircraft came under contact ahead of our aircraft. At that time, the captain broke right to evade the contact. No 2 came under contact and within an instant, the co pilot shouted out as something had hit him in the right hand causing an injury... the captain elected to break off the pick up and route back to Bastion. Chinook Pilot

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6 Prevalence? 57% British RW aircrew report flight related neck pain (Wickes & Greeves, 2006) 82% British RN RW aircrew back-pain prevalence in 12-months (Sheard et al, 1996) 80% British RW pilots report back pain over a 1yr period (Bridger et al, 2002) ALMs 69% more likely to suffer neck pain if they use NVGs (Wickes & Greeves, 2006) Wickes SJ & Greeves JP. Prevalence & associated factors of flight-related neck pain. QinetiQ; 2006:01069 Sheard SC, Pethybridge RJ, Wright JM et al. Back pain in aircrew an initial survey. Aviat Space Environ Med 1996; 67: Bridger RS, Groom MR, Jones H et al. task & postural factors are related to back pain in helicopter pilots. Aviat Space Environ Med 2002; 73:

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8 SO WHAT?

9 SO WHAT? - Individual issue? - Performance issue? - Operational issue? - Flight safety issue? All have potential financial cost

10 Search terms: pain OR injury OR symptom, muscl OR skeleta OR lumbar OR neck, distraction OR sortie OR abort total RW DASORs 2278 contain search terms Codified: MSKS - able to continue in role Exclude: duplicates;ground/non-flying;nona/c; 205 narratives related to MSKS MSKS - unable to continue role Role Body area Perceived causation

11 Rotary-wing flight-related MSKS No. of DASORs /10-06/10 07/10-12/10 01/11-06/11 07/11-12/11 01/12-06/12 07/12-12/12 01/13-07/13-01/14-06/13 12/13 06/14 Month/ Year 07/14-12/14 01/15-06/15 07/15-12/15 01/16-06/16 07/16-12/16 01/17-06/17

12 How did MSK symptoms affect crews ability to continue primary role? Able to continue in role Unable to continue in role Pilot 65% Rearcrew 26% 27% Pilot Rearcrew 55% n=150 Winchman 9% n=55 Winch man 18%

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14 Perceived Severity of Safety Incident High 6% Medium 31% Negligible 11% Low 52%

15 40 Cause attributed to MSK symptoms % Overall %MSK symptom- able to continue role % % MSK symptom unable to continue role

16 40 What body regions were affected? % Overall 25 % MSK Symptom - able to continue role 20 % % MSK Symptom - unable to continue role All Lumbar All Lower limb All Neck All Upper/L Head All whole body Trunk Pelvis Other

17 Limitations Under reporting still common Analysis may represent an underestimate Selection bias of aircrew reporting Recording bias of author (only single coder)

18 Discussion / Summary Points ~2% of rotary-wing safety reports involved musculoskeletal symptoms in aircrew Flight-related MSK symptoms can affect the ability of rotary wing aircrew to carry out their in-flight role. Distraction was the most common perceived effect and 6% reported a requirement to alter planned sortie. Rear crew and winch operators reported a greater proportion of MSK symptoms resulting in being unable to continue their in-flight role. Ergonomics and equipment were perceived to be the most frequent cause of reported symptoms.

19 Discussion / Summary Points What IS the best way to evaluate the impact of MSKS in aircrew? What interventions / solutions best suited to minimise the problem?

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