Flight Diversion Research Articles

Responsibility of Targeted Actors in the Context of Restrictive Measures: The Case of Belaeronavigatsia

In the context of the Common Foreign and Security Policy (CFSP), the European Union may adopt restrictive measures, also known as sanctions, against natural or legal persons and groups or non-state entities. Such measures are one instrument – among many others – to achieve certain policy goals, including the protection of the Union’s values and the advancement of fundamental rights, democracy, and the rule of law. There are sanctions of different kinds to coerce, constrain, or signal a targeted actor, and they are chosen and combined with a view to implement the most effective strategy. Belaeronavigatsia, a state-owned enterprise engaged in regulating airspace and providing air traffic assistance in Belarus, was deemed responsible for the repression of civil society and democratic opposition following its involvement in a flight diversion that ultimately led to the arrest of an opposition journalist and his companion. As a consequence, the Council froze its assets, a decision the enterprise contested by arguing that it could not be held ‘responsible’ for the referred act, and that the sanction was not in accordance with the principle of proportionality. The judgment in the case Belaeronavigatsia v. Council offers an overview of the main features of restrictive measures, reminds the interpretative criteria for undefined notions in Council’s decisions and then clarifies the terms ‘responsible for the repression’ with a special focus on the element of causation, and assesses the principle of proportionality in an area influenced by political, economic, and social motivations, such as the CFSP. CFSP, restrictive measures, sanctions, freezing of funds, responsibility, causation, proportionality

In-flight medical emergencies and their outcome in a commercial airliner

Introduction: Super-connected modern era facilitated an unprecedented no. of air passages all around the world, simply because the number of people has doubled over the past 50 years culminating to around 4 billion air trips annually. An ever-increasing number of elderly passengers traveling with antecedent medical morbidities resulted in an upsurge in the In-flight Medical Emergencies (IME). Objective: Considering the trend, it was decided to ascertain the type of IMEs based on various organ systems and their outcome aside causes of flight diversion due to IME and types of in-flight medical assistance rendered by onboard physicians and paramedics. Material and Method: Crew safety report from March 1, 2015, to March 31, 2019, in a commercial airline of a Middle-Eastern country was analyzed for IMEs along with allied issues. Results: There were 614 IMEs during the period of study resulting in 01 IME for every 336 flights. About 81% of IMEs occurred during the main cruising phase of the flight. Nine onboard deaths were recorded during the study tenure. Causes of death were two each for Myocardial Infarction (MI) and malignancy, one due to cardiac failure with arrest and uncertain in four cases. The most common IME was syncope (35.5%) followed by trauma (26.8%) and respiratory difficulty (17.3%). Gastrointestinal symptoms accounted for 10% of cases. Diversion of aircraft was carried out on 16 IME incidents. The main causes of diversion were MI, epilepsy, stroke, and Bell’s palsy. Onboard assistance from physicians and nurses was sought in 62 % and 27% of incidents, respectively. Oxygen and onboard medications were used in 74% and 32% of cases correspondingly. Conclusion: There is no comprehensive globally accepted reporting and management of IMEs. Every airline has its own protocols for the same. Onboard healthcare professionals play a key role in the outcome of IMEs.

Learning With Confidence the Likelihood of Flight Diversion Due to Adverse Weather at Destination

When an aircraft is unable to land at its original destination airport, it is diverted to an alternate airport. This event has economic and operational implications for airspace users and airports, as well as negative environmental consequences. Diversions are triggered by many reasons, including adverse weather (e.g., low visibility) or medical emergencies. While the latter are certainly unpredictable, the former could be learned from observed diversions, given the weather at the estimated time of arrival and the landing capabilities of the aircraft and airport. Unfortunately, only airspace users are aware of the reason for the observed diversions. This implies that some (unknown) diversion in the historical data should not be learned by the model because they were triggered by reasons different from adverse weather. This paper presents a gradient boosted decision trees model that learned the likelihood of diversions due to adverse weather from noisy labels using confident learning. Results indicate that this method is effective in pruning of diversions caused by reasons other than adverse weather, and that diversions could be predicted with high precision and moderate recall.

Assessment of the Impacts of Thunderstorm on Flight Operations at Murtala Mohammed International Airport, Ikeja, Lagos State, Nigeria

The inefficiency of the aviation industry and the persistent rise in aviation hazards have been linked to weather phenomena. As a result, researchers are looking for better solutions to the problem. The study examined the impact of thunderstorms on flight operations at Murtala Mohammed International Airport, Lagos. The data on thunderstorms and flight operations were sourced from Nigerian Meteorological Agency (NiMet) and Nigerian Airspace Management Agency (NAMA) respectively. In order to meet the research target, descriptive statistics (mean, standard deviation, and charts) and inferential statistics (Pearson’s Product Moment Correlation (PPMC) and Regression) were used. The significance level for all inferential analyses was set at 5% (0.05). The study revealed that 77.4% of thunderstorms occurred during the rainy season (April-October) while 22.6% occurred during the dry season (November-March). It also revealed some fluctuating movements of a thunderstorm in the study area. According to the findings, thunderstorms occur most frequently at the airport in June and less frequently in January and December. The study also discovered that thunderstorms at the airport are positively and significantly related to flight delays and cancellations, while the association between flight diversions and thunderstorm occurrence is positive but statistically insignificant. Furthermore, flight delays, flight diversions, and flight cancellations interact positively among themselves. The regression result of the study revealed that a 1% increase in thunderstorm occurrence leads to a 19.4% increase in flight delay, a 7.1% increase in flight cancellation, and a 4.3% increase in flight diversion. As a result, the study presented various regression models that may be utilized to make predictions. The study proposes consistent thunderstorm observation at the airport and steady forecasts using the regression models, based on the findings. However, it further recommends that pilots, air traffic controllers, and meteorologists be trained and retrained so that they can provide better and more efficient services.

The frequency and characteristics of epinephrine use during in-flight allergic events

BackgroundAllergic reactions account for 2% to 4% of medical events in-flight and 5.5% of all medical events in passengers 18 years and under. ObjectiveTo evaluate the incidence of in-flight allergic events including availability, use of epinephrine, and final patient outcome. MethodsWe conducted a retrospective study of the ground-based medical service (GBMS) database from January 2017 to December 2019 for all allergic events and epinephrine utilization. ResultsA total of 140,579 in-flight medical events (IFMEs) were initially retrieved from the period between January, 2017 and December, 2019, of which 4230 (3.0%) unique cases were identified as allergic events. Epinephrine administration was recommended in 398 passengers by GBMS. Of those, 328 (82.4%) ultimately received at least 1 dose of epinephrine. In multivariate analysis, there was a significant difference in the involvement of volunteers (odds ratio [OR], 3.19; P value < .001; 95% confidence interval [CI], 2.43-4.16), availability of autoinjectors (OR, 2; P value < .001; 95% CI, 1.55-2.58), flight diversion (OR, 11.21; P value < .001; 95% CI, 3.60-34.89), and hospital transport (OR, 6.58; P value < .001; 95% CI, 4.62-9.38) between the 2 groups. Passengers older than 12 years of age were at a higher risk for epinephrine administration. In the secondary analysis of 51 airlines that consistently use GBMS for all IFMEs, the incidence of allergic events was found to be 0.91 cases per million passengers. The incidence of severe in-flight allergic emergencies requiring epinephrine administration was 0.08 cases per million passengers or 12.5 million passengers for 1 event. ConclusionIFME requiring epinephrine administration is rare with an incidence rate of 1 event in 12.5 million passengers. The risk for epinephrine administration is higher in passengers more than 12 years of age and is associated with significantly higher flight diversion, hospital transport, and involvement of medical volunteers.

Statistical Analysis of Weather Parameters for Sustainable Flight Operation in Nigeria

Abstract The recent complications in the weather system, which oftentimes lead to flight cancellation, delay and diversion have become a critical issue in Nigeria. This study however considers the weather related parameters and their impacts on flight disruption in the country. Weather data (on thunderstorm, wind speed and direction, visibility and cloud cover) and flight data (delay, cancellation and diversion) were collected from Murtala International Airport, Ikeja-Lagos, Nigeria. The data covered the period between 2005 and 2020. However, Regional Climate Models (RCMs) were also used to run climate data projections between year 2020 and 2035 in the study region. The study employed Statistical Package for Social Sciences (SPSS) software for the descriptive and inferential analysis. Time series analysis, Pearson Moment Correlation for interrelationship among the weather parameters and the flight disruption data, and multiple linear regression analysis were applied to determine the influence of weather parameters on flight disruption data. Results show that cloud cover and high visibility are negatively correlated. Wind speed has positive relationship with wind direction; and an inverse relationship between visibility, thunderstorm, and fog. Direct relationship exists between highest visibility and thick dust, wind speed and cloud cover. Thick dust, wind speed and cloud cover indicate increased visibility level in the study area. Flight delay is prominent over flight diversion and cancellation, which indicates their relevance in air traffic of the study area. The prediction model indicates high degree of cloud cover at the beginning of every year and later declines sharply in 2035, the visibility flattens out by the year 2025, and low pattern of thick dust was calculated in the same pattern in 2011, 2016 and 2027. Based on this conclusion, the study recommends accurate weather reporting and strict compliance to safety regulations, and attention should be paid to changing pattern of weather parameters in order to minimize fight related disasters.

United States Sanctions Belarus for Diversion of Ryanair Flight and Ongoing Repression

On May 23, 2021, Belarusian authorities forced a Ryanair flight from Athens, Greece to Vilnius, Lithuania to land in Minsk in response to a false bomb threat and then arrested Roman Protasevich, an exiled journalist onboard the flight. The United States joined much of the international community in condemning the flight's diversion and imposing additional sanctions on Belarusian President Alexander Lukashenko's regime, adding to those levied throughout the last year due to Lukashenko's repression of opposition figures and others who have protested the results of the August 2020 Belarusian election.

A Comparison of In-flight and Ground-Based Emergency Medical Events on the Clinical Demand for Outreach Medical Services at Taoyuan International Airport, Taiwan.

Background: Limited information is available covering all medical events managed by the airport-based outreach medical service. This study explores the clinical demand for emergency medical outreach services at Taoyuan International Airport (TIA), Taiwan.Methods: Electronic medical records collected from TIA medical outreach services from 2017 to 2018, included passengers' profiles, flight information, events location, chief complaints, diagnosis (using ICD-9 -CM codes), and management outcomes. Medical events distribution was stratified by location and ages, and were compared statistically.Results: Among 1,501 eligible records, there were 81.8% ground-based emergency medical events (GBME), 16.9% in-flight medical events (IFME) managed after scheduled landing, and 1.3% IFME leading to unscheduled diversion or re-entry to TIA. The top three GBME diagnoses were associated with neurological (23.3%), gastrointestinal (21.2%), and trauma-related (19.3%) conditions. The top three IFME diagnosis that prompted unscheduled landings via flight diversion or re-entry were neurological (47.4%), psychological (15.8%), and cardiovascular (10.5%). The chief complaints that prompted unscheduled landings were mostly related to neurological (42.1%), cardiovascular (26.3%), and out-of-hospital cardiac arrest (OHCA) (10.5%) symptoms. A higher frequency of IFME events due to dermatologic causes in patients aged ≤ 18 years compared with adults and older adults (19 vs. 1.5% and 0, respectively); and a higher frequency of IFME due to cardiovascular causes in adults ≥ 65 years compared with patients aged ≤ 65 (15.1 vs. 9%). Among all IFME patients, six out-of-hospital deaths occurred among passengers from scheduled landings and two deaths occurred among 18 IFME passengers who were transferred to local hospitals from flight diversion or re-entry. A statistically significant difference in outcomes and short-term follow-up status was found between patients with IFME and those with GBME (p < 0.001).Conclusion: Ground-based emergency medical events exceeded in-flight medical events at TIA. The most frequent events were related to neurological, gastrointestinal symptoms, or trauma. Results of this study may provide useful information for training medical outreach staff and preparing medical supplies to meet the clinical demand for airport medical outreach services.

The global incidence of in-flight medical emergencies: A systematic review and meta-analysis of approximately 1.5 billion airline passengers.

Medical emergencies during short- or long-haul commercial airline flights have become more commonplace due to the aviation industry's contemporary growth, the popularization of commercial flights, and an increased aging of air travelers with significant comorbidities. However, the precise incidence of onboard medical events on commercial airlines and the most common medical conditions is unclear. In this systematic review and meta-analysis, we explored the incidence of in-flight medical emergencies among airline passengers and estimated the incidence rate by physiological body system, or organ class/syndrome for emergencies that may be associated with different body systems. We limited our search to cohort studies published between 1945 to October 31, 2020 in MEDLINE, Embase, Cochrane Library and official reports from the Federal Aviation Administration/International Air Transport Association, regardless of the language of publication. Only studies that evaluated the overall frequency of onboard medical events on commercial air carriers (in which they also presented the total number of annual revenue passengers) and the frequency of events by physiological body systems or organ class/syndrome were included. We excluded case reports and case series, systematic or narrative reviews, and studies addressing specific health-related conditions. Two independent investigators performed first- and second-phase study screening, abstracted data, and appraised risk of bias. We rated the certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Using a quality effect model, we meta-analyzed data associated with the incidence of in-flight medical emergencies, all-cause fatality, incidence of medical events by medical condition category, frequency of en-route diversion, presence of medical personnel on board, and the use of an automatic external defibrillator. We also extracted data regarding the cost of flight diversion. Of 18 individual studies with approximately 1.5 billion passengers, 11 reported the overall incidence of in-flight medical emergencies. Low certainty of evidence suggested that the global incidence of in-flight medical emergencies was 18.2 events per million passengers (95% CI 0.5 to 53.4 per million; I2 = 100%, P < 0.001, very low certainty), and an all-cause mortality rate was 0.21 per million passengers (95% CI 0 to 0.76 per million; I2 = 99%, P < 0.001, low certainty). The four most common categories of medical conditions or syndromes during flight were syncope, gastrointestinal events, respiratory and neurological diagnostic groups. The diversion rate was 11.1 per 100,000 flights (95% CI 5.9 to17.6 per 100,000 flights; I2 = 97%, P < 0.001), with an average cost ranging from $15,000 to $893,000 per unplanned emergency landing across studies which examined this outcome. In-flight medical events on commercial travels are extremely low with a corresponding very low in-flight mortality rate. Associated costs derived from en-route diversion might significantly influence airlines' budgetary equilibrium. Novel and modern standardized reporting systems or platforms should be internationally provided and enforced by health and aviation authorities to obtain higher quality patient-passengers datasets. Onboard volunteer medical providers must be aware of everyday life-threatening events during commercial flights and should consider the establishment of a connection between the aircraft and ground-based medical advisory services while assisting in-flight medical events.

Beyond Contrail Avoidance: Efficacy of Flight Altitude Changes to Minimise Contrail Climate Forcing

Contrail cirrus introduce a short-lived but significant climate forcing that could be mitigated by small changes in aircraft cruising altitudes. This paper extends a recent study to evaluate the efficacy of several vertical flight diversion strategies to mitigate contrail climate forcing, and estimates impacts to air traffic management (ATM). We use six one-week periods of flight track data in the airspace above Japan (between May 2012 and March 2013), and simulate contrails using the contrail cirrus prediction model (CoCiP). Previous studies have predominantly optimised a diversion of every contrail-forming flight to minimise its formation or radiative forcing. However, our results show that these strategies produce a suboptimal outcome because most contrails have a short lifetime, and some have a cooling effect. Instead, a strategy that reroutes 15.3% of flights to avoid long-lived warming contrails, while allowing for cooling contrails, reduces the contrail energy forcing (EFcontrail) by 105% [91.8, 125%] with a total fuel penalty of 0.70% [0.66, 0.73%]. A minimum EFtotal strategy (contrails + CO2), diverting 20.1% of flights, reduces the EFcontrail by the same magnitude but also reduces the total fuel consumption by 0.40% [0.31, 0.47%]. For the diversion strategies explored, between 9% and 14% of diversions lead to a loss of separation standards between flights, demonstrating a modest scale of ATM impacts. These results show that small changes in flight altitudes are an opportunity for aviation to significantly and rapidly reduce its effect on the climate.

A New Method of Calculating the Attainable Life and Reliability in Aerospace Bearings

The aviation industry made significant progress improving reliability, efficiency and performance throughout the last decades. Especially aircraft engines and helicopter transmission systems contributed significantly to these improvements. The kerosene consumption decreased by 70 % and the CO2 emissions due to air transport decreased by 30 % per passenger kilometer within the last 20 years. Simultaneously, the flight safety was increased with aircraft engine in-flight-shut-downs as low as 1 ppm and „unscheduled engine removals” as low as 4 ppm. Flight safety is equal to the reliability of the systems in service. Failure of these systems directly leads to exposure of human life. Among the most critical aviation systems are aircraft engines including the rolling element bearings which support the rotors. A serious damage to the aircraft engine main shaft bearings during flight requires shout-down of the engine to avoid a further damage escalation subsequently leading to engine fire. Today, it is a requirement for aircraft to operate with one engine shut down. However, each in-flight-engine-shut-down typically is connected with flight diversion or abort and immediate landing. Inflight-shut-downs translate into increased risk for passengers and crew and substantial on cost. Therefore, rolling element bearings for aircraft engines are developed – similar to other aircraft engine components – targeting a reliability of nearly 100 % over an operation time of more than 10 000 hours prior to overhaul. To achieve this requirement despite the extreme operating conditions such as high speed and temperatures occurring in gas turbines, special high-performance materials are used for the rolling bearing components which are partially integrated in surrounding engine parts like shafts and housings. These special conditions - deviating from conventional industrial rolling element bearing applications - are currently not sufficiently considered in the standardized method of calculating the bearing life per ISO 281. A new method of calculating the attainable life of rolling elements bearing in aerospace applications is presented. This method considers the special aerospace conditions and materials and thus enables a higher reliability of the theoretical analysis and life prediction.

New Method of Calculating the Attainable Life and Reliability in Aerospace Bearings

The aviation industry made significant progress improving reliability, efficiency and performance throughout the last decades. Especially aircraft engines and helicopter transmission systems contributed significantly to these improvements. The kerosene consumption decreased by 70 % and the CO2 emissions due to air transport decreased by 30 % per passenger kilometer within the last 20 years. Simultaneously, the flight safety was increased with aircraft engine in-flight-shut-downs as low as 1 ppm and „unscheduled engine removals” as low as 4 ppm. Flight safety is equal to the reliability of the systems in service. Failure of these systems directly leads to exposure of human life. Among the most critical aviation systems are aircraft engines including the rolling element bearings which support the rotors. A serious damage to the aircraft engine main shaft bearings during flight requires shout-down of the engine to avoid a further damage escalation subsequently leading to engine fire. Today, it is a requirement for aircraft to operate with one engine shut down. However, each in-flight-engine-shut-down typically is connected with flight diversion or abort and immediate landing. Inflight-shut-downs translate into increased risk for passengers and crew and substantial on cost. Therefore, rolling element bearings for aircraft engines are developed – similar to other aircraft engine components – targeting a reliability of nearly 100 % over an operation time of more than 10 000 hours prior to overhaul. To achieve this requirement despite the extreme operating conditions such as high speed and temperatures occurring in gas turbines, special high-performance materials are used for the rolling bearing components which are partially integrated in surrounding engine parts like shafts and housings. These special conditions - deviating from conventional industrial rolling element bearing applications - are currently not sufficiently considered in the standardized method of calculating the bearing life per ISO 281. A new method of calculating the attainable life of rolling elements bearing in aerospace applications is presented. This method considers the special aerospace conditions and materials and thus enables a higher reliability of the theoretical analysis and life prediction.

Demystifying airline syncope.

Syncope forms a major part of medical in-flight emergencies contributing one-in-four in-flight medical events accounting to 70% of flight diversions. In such patients, it is important to elucidate the pathophysiology of syncope prior to diversion. Postural hypotension is the most common etiology of in-flight syncopal events. However, individuals without any underlying autonomic dysfunction can still experience syncope from hypoxia also known as airline syncope. Initial steps in managing such patients include positioning followed by the airway, breathing and circulation of resuscitation. These interventions need to be in close coordination with ground control to determine decision for flight diversion. Interventions which have been tried for prevention include mental challenge and increased salt and fluid intake. The current paper enhances the understanding of airline syncope by summarizing the associated pathophysiologic mechanisms and the management medical personnel can initiate with limited resources.

Experiences and Attitudes of International Travelers with Cardiovascular Disease: A Qualitative Analysis.

Cardiovascular disease (CVD) is the leading cause of death among international travelers. It is unknown whether CVD is a barrier to international travel. The purpose of this study was to describe the travel experiences of a cohort of individuals with CVD, to identify their perceived barriers to travel, and to generate recommendations for CVD travelers, medical practitioners, and the travel industry. Semi-structured interviews were conducted with CVD patients who had attended either a regional, structured, multidisciplinary CVD prevention program or a cardiac rehabilitation program. Coding and thematic analysis of the transcripts were supported by NVivo® computer software. Peer debriefing with an independent researcher was undertaken. Demographic and clinical data such as gender, age, and types of cardiovascular condition were also recorded. Twelve patients (eight males), with a mean age of 68 ± 7.58 years, agreed to semi-structured interviews (26-78 minutes duration). The key themes emerging from the interviews included altered travel perception, accessing medical care overseas, issues with medications, medical device concerns at airports, restricted leisure travel activities, and optimal self-care. All interviewees perceived a health benefit to travel and did not regard CVD as a significant barrier to international travel. Certain cardiovascular conditions precipitated more travel anxiety. These findings highlight the unique experiences of CVD patients when engaging in international travel. Cardiovascular disease optimization and responsible travel health behaviors would facilitate medically uneventful overseas travel. The results may inform pretravel health advice given to CVD travelers. Further studies on issues relating to air travel in CVD are warranted.

Enhancement of the diversion airport selection methodology

The paper deals with the airlines diversion management as this entails a complex decision-making process that comes into action during the adverse events, preventing the execution of the regular flight operations. Diverting from the intended route can be caused by several reasons both when the safety of the flight or the wellbeing of the passengers is concerned. The most frequent reasons to divert a flight are the repugnant weather, medical emergency or the technical fault. A flight diversion can severely disrupt the passenger’s comfort, jeopardize the fleet or the crew planning and is generally accompanied with the significant expenses. The intention of every airline in a case of a diversion is to assure the fastest turnaround time and/or provide the passengers with the highest level of services to mitigate the negative effects. A wrong selection of an alternate airport, that is not having enough capacity, personnel or material resources to handle a flight diversion in a timely manner can negatively influence the airline in several ways. Both strategic and tactical diversion management process is a collaborative decision-making procedure, heavily dependent on the base of the information available, where the main actors are not only flight crew and the airline Operational Control Centre but also the Air Traffic Controller, airport operators and the local service providers. Airline strategic diversion planning shall comprehend a well-defined data set and its data quality procedures shall ensure the information accuracy in the pre-tactical phase. The consequent real time data processing can enhance the decision-making process in a tactical phase of the flight diversion. The data and information required comprise of available airport capacities and other relevant ground resources needed to handle a diverted flight. As stated, such data and information are mostly tactically critical, therefore continuous monitoring and updating shall be ensured. The paper suggests that the overall data management is managed via a local Airport Operations Center, which will assure provision of actual airport diversion capabilities (incl. weather situation) needed for accommodation of an affected flight.

Aviation Nursing and in-Flight Medical Emergencies: Aeromedical Consideration

People travel on commercial Aircraft worldwide on medical, social and economic indications. Although civil aviation industry acts as a fulcrum for the booming Medical Tourism, it encounters increasing number of in-flight medical emergencies in the recent years. Inflight medical events are potentially a significant problem due to aircraft at 30000 feet far from advanced medical care, restricted cabin space and resources. Several studies have shown that every day 0.7 to 3% in-flight medical events occur on board worldwide. Data collected by the Directorate General of Civil Aviation show that between August 2012 and August 2013, there was a total of 46 emergency landings, 38 were because of medical emergencies. The aim of this paper is (i) To assess the present system of cabin crew trained to meet the challenges of in-flight medical emergencies (ii) To evaluate the scientific soundness of Aviation Nursing in future. The objective is (1) To institute proper pre and post medical care in the event of any in-flight medical emergency (2) To reduce the incidence of flight diversion and emergency landing. Reviewing various literatures it was found that many authors have highlighted medical management by the trained cabin crew with the help of physician / paramedics on board, but this author raise one genuine doubt that all physicians on board would not be willing to come forward for such emergencies, it should not be an obligatory favour to tackle medical emergencies on board. Further, no published studies have touched upon the need of ‘Aviation Nursing’ /flight nurse for in flight medical emergencies.

Stroke in Commercial Flights.

Stroke on board aircraft has been reported in retrospective case series, mainly focusing on economy class stroke syndrome. Data on the actual incidence, pathogenesis, and prognosis of stroke in commercial flights are lacking. A prospective registry was designed to include all consecutive patients referred from an international airport (40 million passengers a year) to our hospital with a diagnosis of ischemic stroke or transient ischemic attack and onset of symptoms during a flight or immediately after landing. Forty-four patients (32 ischemic strokes and 12 transient ischemic attacks) were included over a 76-month period (January 2008 to April 2014). The estimated incidence of stroke was 1 stroke in 35 000 flights. Pathogeneses of stroke or transient ischemic attack were atherothrombotic in 16 (36%), economy class stroke syndrome in 8 (18%), cardioembolic in 7 (16%), arterial dissection in 4 (9%), lacunar stroke in 4 (9%), and undetermined in 5 (12%) patients. Carotid stenosis >70% was found in 12 (27%) of the patients. Overall prognosis was good, and thrombolysis was applied in 44% of the cases. The most common reason for not treating patients who had experienced stroke onset midflight was the delay in reaching the hospital. Only 1 patient with symptom onset during the flight prompted a flight diversion. We found a low incidence of stroke in the setting of air travel. Economy class stroke syndrome and arterial dissection were well represented in our sample. However, the main pathogenesis was atherothrombosis with a high proportion of patients with high carotid stenosis.

Pulmonary Artery Pressure Response to Simulated Air Travel in a Hypobaric Chamber.

Hypoxia-induced elevation in pulmonary artery pressure during air travel may contribute to the worldwide burden of in-flight medical emergencies. The pulmonary artery pressure response may be greater in older passengers, who are more likely to require flight diversion due to a medical event. Understanding these effects may ultimately improve the safety of air travel. We studied 16 healthy volunteers, consisting of a younger group (aged <25 yr) and an older group (aged >60 yr). Using a hypobaric chamber, subjects undertook a 2-h simulated flight at the maximum cabin pressure altitude for commercial airline flights (8000 ft; 2438 m). Higher and lower altitudes within the aeromedical range were also explored. Systolic pulmonary artery pressure (sPAP) was assessed by Doppler echocardiography. There was a progressive increase in sPAP which appeared to be biphasic, with a small initial increase and a larger subsequent rise. Overall, sPAP increased by 5±1 mmHg from baseline to 35±1 mmHg at 8000 ft, an increase of 18%. The sPAP response to 8000 ft was greater in the older group than the younger group. This study confirms that pulmonary artery pressure increases during simulated air travel, and provides preliminary evidence that this response is greater in older people. Advancing age may increase in-flight susceptibility to adverse pulmonary vascular responses in passengers, aircrew, and aeromedical patients.

THE PROJECT OF ADAPTATION OF AIRPORT TO EXECUTING THE IRREGULAR SERVICE OF AIRPLANE AIRBUS 380

The aircraft Airbus A380 is the biggest aircraft in present time. Many airports need to adapt their airside infrastructure. The main duties concerns upgrading runways, and taxiways, relocating taxiways and even relocating aircraft stands and buildings to provide sufficient wings clearance. There are many hubs in the world, which must rebuild elements of infrastructures for A380. Besides these large hub and main base airports, there are other airports around the world that will experience A380 operations. The operating frequency could be either on regular basis, such as one or two scheduled arrivals a day, but also may be a much lower frequency such as for a flight diversion. Such diversions could be either due to the unavailability of the destination airport (because of weather or operational issues) or because of an in-flight emergency. It is in the interest of in-flight safety to have a reasonable number of alternate airports and runways available in addition to the scheduled ones. Aircraft operations regulations make a distinction between destination alternate aerodromes, other alternate aerodromes required to be adequate (e.g. in JAR-OPS 1) and in-flight diversion aerodromes. For those alternate airports, large-scale changes to their existing airside infrastructure would be financially excessive and never be economical. On the other hand, especially in the case of a filed alternate, a minimum should be done to properly handle the aircraft and its passengers. In paper is presented necessary requirements to service of airplane the Airbus A380. It is presented on examples of Chopin’s airport in Warsaw. Service of this type of airplane requires adaptation of parameters of runway, taxiway and ground operations.

Development of intensity based fog climatological information system (daily and hourly) at IGI airport, New Delhi for use in fog forecasting and aviation

The main objective of the present paper is to make a microclimatological study of occurrence of fog of different intensities at Indira Gandhi International (IGI) airport, New Delhi which includes their date-wise climatological probabilities and their corresponding total number of hours of occurrence for 62-days of peak winter from 1st December to 31st January by using hourly visibility data for the period of 1981-2005. Their hourly climatology has been discussed separately for both months using same data for understanding their diurnal variations. Both the computations have been done to find most vulnerable periods with exact dates and timings when both duration and intensity of the fog are very high and hazardous for aviation. Corresponding 10-days and 3-hourly climatology of cumulative fog occurrences are computed to identify a period when fog related flight diversion risk is highest. For better understanding of their variability, dates of extreme hours of occurrences of a particular fog type amongst occurrences of all dates for the period during both months have also been documented. These climatological informations can be used by various airlines for planning flight operation and action for establishment of fog dissipation mechanism. Finally, fogprobability matrices of various intensities based on these climatological data have been presented with dates in first column and hours in the first row for all 62 days of December and January and for all 24 hours of each day giving date and hour wise climatological probability of their occurrences which can be used at IGI as climatological tool for forecasting of fog of various intensity and expected climatological period.