RACGP Specific Interests Aerospace Medicine
‘Aerospace medicine has been an international specialty almost since the Wright brothers began flying in 1903,’ says Dr Kate Manderson (pictured), Chair of the newly established RACGP Specific Interests Aerospace Medicine.
‘During the world wars, as aircraft became more complex and operated in a more challenging environment with altitude and pressure, we started to recognise that human performance was a bigger and bigger issue in terms of losing aircraft through crashing or losing battles,’ she said.
Flying is becoming very common; 4.6 billion passengers are expected to fly this year.
Consequently, aerospace medicine is becoming increasingly important.
Combining medicine and flying has been an abiding interest for Dr Manderson, who began working in this field in 2002 after becoming a medical officer in the navy. Her interest is now being shared by many GPs.
The move came after the Civil Aviation Safety Authority (CASA) relaxed rules around medical examinations for pilots of small planes flying at low altitude.
‘When that decision was made, we thought it would be appropriate to have a professional network for doctors who sign off on fitness-to-fly [documents],’ Dr Manderson said.
Dr Manderson is also president of the Australasian Society of Aerospace Medicine (ASAM), founded 70 years ago.
Dr Manderson describes aerospace medicine as a growth area. At the moment, 75% of the work for Designated Aviation Medical Examiners is providing medical advice and assessments to pilots and air traffic controllers. But passenger fitness-to-fly will be an increasing issue for GPs, Dr Manderson predicts, with ultra-long distance flights now available.
‘In the last 10 to 15 years, global aviation has grown exponentially,’ Dr Manderson said.
‘Getting on a plane is what getting on the train or bus used to be. That means people with health problems – our patients – will be on the plane.
‘With [ultra-long] flights with no option to get off, and no inflight medical support – what happens if there’s a problem? It’s an increasing issue for airline medical departments.
Passengers with health complaints can be directly affected by the flight environment. The internationally mandated cabin pressure is the equivalent of 8000 feet (around 2.4 km).
That means some people may struggle with the lower oxygen intake. Other issues include pain from trapped gases, such as inside a tooth after a dental procedure.
In coming years, Dr Manderson expects the ‘space’ part of aerospace medicine to come to the fore. ‘Space medicine is on the horizon. That’s a really fascinating thing, to watch that bubble to the surface,’ she said.
With the launch of the Australian Space Agency last year, Dr Manderson predicts that aerospace medicine will be a key area of interest for many.
'We’re not about to launch shuttles or missions to Mars. What we are going to be doing is value adding in niche areas with a high level of expertise,’ she said. Join RACGP Specific Interests Aerospace Medicine.
This article was first published on the RACGP’s newsGP and reproduced in part with its permission.
Aerospace medicine on shareGP
RACGP Specific Interests Aerospace Medicine has a shareGP group. This is an area for RACGP members with an interest in this area to share articles and research, discuss clinical practice and collaborate on projects.
Aerospace medicine in the news
Space medicine and the legacy of Project Apollo
The protection of the Apollo crews from the harsh environment of space was a formidable challenge. In the 1960s, human space flight was a genuine leap into the unknown and NASA flight surgeons were still unsure what hazards the space environment might present. Scientists could only guess at the likely consequences of extraterrestrial expeditions. They knew something of the nature of the physical environment – the high vacuum, its thermodynamics, the radiation and weightlessness, but precisely how this environment would interact with human physiology is unknown.
In this article in The Lancet, Dr Kevin Fong a doctor with a special interest in space medicine examines the health challenges of space travel and the legacy of the first moon landing on medicine and the understanding of human physiology exposed to extreme conditions. (Fong, K. Moon landing: Space medicine and the legacy of Project Apollo. Lancet 2019;394(10194):205–207. doi:10.1016/S0140-6736(19)31568-5.)
Challenges and opportunities of civilian space travel
The advent of civilian travel in space, along with fast-growing commercial ventures and talk of NASA resuming manned missions to the moon within the next decade, will open up new avenues for medical research and discovery.
The Mayo Clinic has made important contributions to space medicine and research since the space program began in the 1950s and with aeronautical research during the Second World War era. Mayo Clinic is now positioning itself to play a major role in space medicine advances as the US prepares for a possible return to the moon 50 years after Apollo 11.
‘Civilian spaceflight is a new frontier … there is a paradigm shift from highly trained, exceptionally fit astronauts to the broader public. There are a lot of unknowns and reasons to be cautious,’ said Dr Jan Stepanek, Director Aerospace Medicine at the Mayo Clinic Arizona campus. (Punsky, K. Mayo Clinic aerospace medicine experts look ahead 50 Years after Apollo 11 Mayo Clinic News Network 13 May 2019.)
Aviation medical centre for pilots and air traffic controllers opened
The Singapore government has established a new aviation medical centre to support the health needs of Singapore’s aviation workforce at the Changi General Hospital. Opened in June this year, the Changi Aviation Medicine Centre (CAMC) will cater to pilots, air traffic controllers, as well as ground support staff. (Tiah, C. New aviation medical centre for pilots and air traffic controllers launched. CNA 11 June 2019.)