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The Musculoskeletal and Vestibular Effects of Long Term Repeated Exposure to Sustained High-G

Medical concerns of mechanical loading of biologi-
cal systems during repeated sustained acceleration
exposure of high performance aircraft were ex-
pressed during an AGARD Conference, 24-28 April
1989 (4) entitled "Neck Injury in Advanced Mili-
tary Aircraft Environments". Biological systems
of primary concern were direct effects on the
spine causing neurologic injury and on the oto-
liths of the vestibular system causing disorienta-
tion related pathologies. However, besides these
direct effects, secondary vestibular effects can
occur from cervical pathologies (136). The tech-
nical evaluation and overview of that conference
concluded that "large gaps" exist in our clinical
and biomechanical knowledge of the problems of
neck injury in high performance aircraft. Further
studies on the epidemiology of acute and chronic
neck injury resulting from in-flight 6 were recom-
mended (13, 14).

This Advisory Report (AR) also addresses those
concerns with a definition of the physical dimen-
sions of the environment produced by operational
high performance aircraft relating those to the
potential medical effects of that environment on
those biological systems of interest, a review of
the relevant literature, an identification of the
biological risks, and reconnendations of a specif-
ic course of_action as required to alleviate those
concerns identified in this AR.

Since 1973, high performance aircraft (i.e., F-15)
capable of sustained accelerations that produce
inertial forces routinely of +9 62 have been
operational in the United States Air Force (USAF).
Since that time, many NATO nations and the United
States Navy have put into operations these high 6
aircraft (i.e., F-15, F-16, F-18) as have the
Former Soviet Union (e.g. MIG-29). This G capa-
bility is an increase of 26 over previous high
performance aircraft such as the F-4 that had been
in the USAF inventory for 15 years. Understand-
ably, the medical history of F-4 like pilots may
not be strictly relevant to aircrew of these 96
aircraft.