Aerospace Health and Safety: Today and the Future

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Aviation plays vital roles in commerce, defense, science and leisure travel. Irrespective of the purpose of flight, crew and passengers are challenged by exposure to a variety of environmental conditions that can differ widely from work and travel environments on the surface of the Earth. With anticipated changes in aviation and space technology, new challenges to health and safety of crew and passengers can be expected. In this Research Topic, we welcome contributions from those whose work and interests are relevant to the health and safety of crew and passengers. This includes, but is not limited to, health and safety professionals, FAA examiners, corporate medical officers, aerospace and occupational physicians, physiologists, military and scientific team members, public health professionals, as well as engineers who are tasked with crew and passenger health and safety design projects. While 4.1 billion passengers fly on commercial airlines annually (and this figure is even higher when taking into account privately owned aircraft and military flight), for the most part aviation is safe. Passengers do arrive at their destinations with little concern to their own well-being and flight is generally well tolerated. However, older flyers, people with (diagnosed or undiagnosed) preexisting disease, and other vulnerable passengers (such as young children and pregnant women) may be at risk of complications and crew may be at special risk due to the frequency and duration of their many flight-related exposures. Health and safety issues for crew and passengers include but are not limited to: potentially severe circadian rhythm disruption, potential health effects of low-level cosmic ionizing radiation exposure at altitude, reduced oxygen delivery and tissue hypoxia at cabin pressurization, cabin air contamination by engine gases, toxic materials used in uniforms and some cabin seat materials, occupational noise, pesticides used for cabin disinsection, lack of adequate crew rest on layovers or between flights, cardiovascular demands of flight and effects of flight-related dehydration, the current absence of screening protocols especially in the context of a rising number of elderly and vulnerable flyers, lack of healthy nutrition at airports and in flight, availability of food and hydration as well as adequate cabin temperature under delay conditions, effects of alcohol use on flight-related physiological and behavioral health risks, anxiety and psychological distress associated with air travel, the effects of long-haul or ultra-long-haul flights on thromboembolic events as well as smoking cessation efforts and related psychological outcomes, job-related stress and harassment among crew. Cosmic ionizing and non-ionizing radiation exposure have drawn attention as have historic exposures of crew and passengers to second-hand cigarette smoke. The threat of political and interpersonal violence and altercations involving aviation cannot be overlooked. On-board medical emergencies run a wide gamut and the capacity to respond becomes more problematic as the duration of flights becomes longer or in the case of flight over oceans and the poles. In addition, in-flight and post flight embolisms and myocardial infarctions are more prevalent than might be expected. We hence encourage manuscripts that address in-flight medical response, including the capabilities on different types of aircraft on potential interventions by crew and medical volunteers. In addition, aviation as a vector for the carriage of disease is a significant concern to public health and security of populations world-wide, and we welcome submissions regarding infectious disease epidemiology and medicine as it relates to air travel. Insects and occasional unplanned travel by birds and rodents can present additional public health concerns. We are approaching an era where space travel may soon be increasingly common. Future flights for near-Earth orbit by leisure travelers and as well as travel to the moon and Mars raise a host of new questions with health and safety implications. What are the proposed health and safety accommodations going to be? Who will be allowed to travel? Perhaps the most interesting question is - who will make the rules?