Benzodiazepine Use in Pilots of Civil Aviation Accidents: 1990-2008 Toxicology and Autopsy Findings

Botch S, Johnson R, Ricaurte E, Selensky M

FAA Office of Aerospace Medicine - Civil Aerospace Medical Institute

关键词: Forensic Toxicology;    Pilots;    Benzodiazepines;    Aircraft Accident Investigation;   

RP-ID  :  DOT/FAA/AM-11/02

美国|英语

来源: Federal Aviation Administration

【 摘 要 】

IntroductionBenzodiazepine medications have a long history of abuse. They are categorized as central nervous system depressants, and there are currently 15 different benzodiazepines prescribed in the United States and an additional 20 in other countries. The side effects of these medications include drowsiness, dizziness, decreased alertness, and/or memory loss, which can lead to impairment and a decreased ability to properly control an aircraft. The presence of these medications in postmortem specimens of aviation accident victims can help determine the cause of the accident and, potentially, result in serious legal consequences. Our laboratory is in a unique position because a medical history is available to investigators for most certified pilots. With this in mind, we compared benzodiazepine compounds found following postmortem analysis with the available medical history for each victim. This evaluation was conducted to determine if these records supported the use of such medications or if the aviators were taking the compounds without the approval of their aviation medical examiners or possibly abusing the substances. In addition, a medical review of the autopsy records was also conducted. Method:Toxicological information from analyses was retrieved from the Civil Aerospace Medical Institute's (CAMI's) Forensic Toxicology Research Laboratory database. Case histories and accident information were obtained from the National Transportation Safety Board. Medical histories were obtained from the FAA's medical certification database and CAMI's autopsy team database. Results and Discussion:Over the examined time period (1990-2008), there were 6,062 fatal aviation accident cases received at CAMI, and 96 (~1.6%) pilots were found positive for a benzodiazepine. In ~74% of pilots found positive for benzodiazepine(s), it was determined that another compound was detected and more than one additional compound was often present. Fatal aviation accidents involving pilots who had taken a benzodiazepine compound prior to the flight are an infrequent event; however, concomitant use of more than one compound with benzodiazepines is common. This study highlights the use of benzodiazepine over the examined time period in the pilot community and presents a variety of demographic information about the pilots involved in such accidents.