Only 1 of the 229 passengers and crew members killed when Swissair Flight 111 crashed off Nova Scotia in September was visually identifiable. Identifying everyone else on board involved medical and dental detective work of the first order.
The purpose of this study was to determine the prevalence of acute distress-that is, clinically significant posttraumatic stress symptoms (PTSS) and depression-and to identify predictors of each in a sample of people who witnessed a fatal aircraft collision at the 2005 Saskatchewan Centennial Air Show.
Air Show attendees (N = 157) were recruited by advertisements in the local media and completed an Internet-administered battery of questionnaires.
Based on previously established cut-offs, 22 percent respondents had clinically significant PTSS and 24 percent had clinically significant depressive symptoms. Clinically significant symptoms were associated with posttrauma impairment in social and occupational functioning. Acute distress was associated with several variables, including aspects of Air Show trauma exposure, severity of prior trauma exposure, low posttrauma social support (ie, negative responses by others), indices of poor coping (eg, intolerance of uncertainty, rumination about the trauma), and elevated scores on anxiety sensitivity, the personality trait of absorption, and dissociative tendencies.
Results suggest that clinically significant acute distress is common in the aftermath of witnessed trauma. The statistical predictors (correlates) of acute distress were generally consistent with the results of studies of other forms of trauma. People with elevated scores on theoretical vulnerability factors (eg, elevated anxiety sensitivity) were particularly likely to develop acute distress.
A hypothetical aircraft accident scenario is described in which the pilot survives but some of the passengers are fatally injured. Information is provided on the acute situational anxiety that may occur in aircrew after any aviation accident, especially one in which lives are lost. A course of action is discussed which encourages early recognition and treatment of the potentially debilitating phenomenon termed "post-accident anxiety syndrome".
BACKGROUND: When entering the profession, pilots need to be in better health than the general population. During their careers they are under close medical supervision, which could influence their life-long mortality. METHODS: The cohort was established from the files of the Norwegian Civil Aviation Administration and included people who had valid licenses as commercial pilots between 1946 and 1994. Basic data about their flight careers were recorded. The cohort was linked to the Cause of Death Registry. The observed number of deaths was compared with those expected, based on national rates. RESULTS: A group of 3707 male pilots was followed over 70,832 person-years. There were 342 deaths vs. 362.8 expected, with a standardized mortality ratio (SMR) of 0.94, and a 95% confidence interval (95% CI) of 0.85-1.05. Aircraft accidents with 97 deaths had a major influence on total mortality and the SMR for all other causes was 0.68 (95% CI 0.59-0.77). The SMR for cancer was 0.89 (95% CI 0.71-1.11) and for circulatory diseases 0.53 (95% CI 0.42-0.67). The highest SMR for total mortality in pilots
Aircraft assisted suicides were studied in the United States, United Kingdom, Germany, and Finland during 1956-2012 by means of literature search and accident case analysis. According to our study the frequency varied slightly between the studies. Overall, the new estimate of aircraft assisted suicides in the United States in a 20-yr period (1993-2012) is 0.33% (95% CI 0.21-0.49) (24/7244). In the detailed accident case analysis, it was found that in five out of the eight cases from the United States, someone knew of prior suicidal ideation before the aircraft assisted fatality. The caveats of standard medico-legal autopsy and accident investigation methods in investigation of suspected aircraft assisted suicides are discussed. It is suggested that a psychological autopsy should be performed in all such cases. Also the social context and possibilities of the prevention of aviation-related suicides were analyzed. In addition, some recent aircraft assisted suicides carried out using commercial aircraft during scheduled services and causing many casualties are discussed.