INTRODUCTION: Pilots have an increased incidence of cutaneous melanoma compared to the general population; occupational exposure to ultraviolet (UV) radiation is one of several potential risk factors. Cockpit windshields effectively block UVB (280–315 nm) but further analysis is needed for UVA (315–400 nm). The objective of this observational study was to assess transmission of UVA through cockpit windshields and to measure doses of UVA at pilots’ skin under daytime flying conditions.

METHODS: A spectrometer was used to measure in-flight spectral transmission through each of the 6 cockpit windshields in 15 Airbus A320/A321 jets, across 39 flights, most originating in or destined for Auckland, New Zealand. UVA- and UVA1-weighted dose rates were calculated from the recorded data.

RESULTS: All front windshields blocked UVA effectively. Several cockpit side and rear windshields allowed transmission of UVA above approximately 350 nm. Diffuse, scattered light in the cockpit contributed negligible levels of UVA, but direct light through a poorly attenuating windshield allowed UVA1 (340–400 nm) doses of up to 2.29 mW · cm⁻² on exposed skin. The use of shielding blinds on side windshields blocked UVA transmission effectively.

DISCUSSION: Aircraft windshield manufacturers should ensure consistent UVA blocking capability of all cockpit windshields. Pilots should be encouraged to wear sunscreen on exposed skin and use side windshield visors if skin is in the direct light beam. Given the variable performance of cockpit windshields, and increased rates of skin cancer among pilots, further research on other commercial jet aircraft types is recommended.

Emslie NA, Liley JB, Johnston P. Pilot ultraviolet A exposures in the cockpit of flying commercial aircraft. Aerosp Med Hum Perform. 2025; 96(9):803–809.

INTRODUCTION: Military fast jet pilots face significant physical challenges, including high G_z accelerations during dynamic maneuvers. The objectives of this study were threefold: 1) to record pilot movements during real flights, 2) to quantify head and trunk movements under standardized G_z conditions and during basic fighter maneuvers (BFMs), and 3) to categorize compensatory strategies used to mitigate physical strain.

METHODS: A total of 20 Eurofighter pilots (mean age: 28.2 ± 1.4 yr, all men) with >500 h EF2000 flight experience participated in the study. Video footage collected during the execution of a standardized mission card, including predetermined head movements and jet parameters (5, 7, 9 G_z), and free basic fighter maneuvers were analyzed.

RESULTS: During scripted high-G_z maneuvers, 38.5% of pilots prepositioned their head for the up-max movement at 9 G_z. During check six, coping strategies were applied in 35.7% (5 G_z), 30.8% (7 G_z), and 33.3% (9 G_z) of the flights. During basic fighter maneuvers, an average of 63.6 ± 32.1 head movements per session and 27.2 ± 13.7 per set were performed by the pilots. It was observed that end-range movements (e.g., check six) were associated with a greater usage of coping strategies. The most commonly included strategies were the use of support points such as canopy rails.

DISCUSSION: This real-flight study reveals frequent use of anticipatory head positioning and compensatory strategies under high G_z loads, especially during end-range movements. These behaviors appear to serve the purpose of reducing cervical strain and injury risk. The findings underscore the necessity for targeted training and the optimization of ergonomic design in pilot equipment.

Lingscheid R, Albracht K, Goell F, Nuesse R, Rein R, Braunstein B. Real-flight observations of head and trunk movements of fast jet pilots. Aerosp Med Hum Perform. 2025; 96(9):810–818.

INTRODUCTION: This study investigated pilot cognitive engagement patterns across diverse flight conditions using electroencephalography (EEG)-based measurements in a high-fidelity rotary-wing simulation environment.

METHODS: A total of 8 experienced U.S. Army test pilots completed 24 flights across 3 distinct route designs using the National Aeronautics and Space Administration Ames Vertical Motion Simulator, with airspeeds ranging from 120 to 240 kn. Analysis focused on EEG Beta/(Alpha + Theta) ratios as indicators of changing cognitive engagement over time.

RESULTS: Analyses revealed distinct cognitive engagement patterns across routes: highly variable individual responses in routes with changing navigation demands, more consistent cognitive engagement in systematic route designs, and intermediate variability in mixed-demand routes. Airspeed effects on cognitive engagement became particularly pronounced above 200 kn, though these effects varied significantly by route and individual pilot. Temporal analysis demonstrated evolving patterns of cognitive adaptation, with routes eliciting different progression patterns over extended flight periods. Regression analysis showed that EEG Beta/(Alpha+Theta) values increased significantly during all three routes, with mean increases ranging from 0.0051–0.0146.

DISCUSSION: These findings provide quantifiable metrics for optimizing route design, developing personalized training approaches, and implementing real-time monitoring systems for enhanced aviation safety and performance.

D’Alessandro M, Mackie R, Berger T, Ott C, Sullivan C, Barnett J III, Curry I. Cognitive engagement profiling of pilots in high-speed, high-threat scenarios. Aerosp Med Hum Perform. 2025; 96(9):819–828.

INTRODUCTION: A 264-d isolation simulation, SFINCSS-99, was conducted in Moscow to replicate typical scenarios on an orbital space station. One long-term group of four Russian crewmembers occupied the isolation complex for most of the duration (240 d), while two international groups of four each spent 110 d successively at the complex. Additionally, there were several short visits by medical personnel. The main objective of this paper is to investigate group and individual behavioral dynamics, particularly the intercultural challenges faced during long-duration isolation, using insights from crewmembers’ diaries.

METHODS: A variety of instruments and training activities, employed before, during, and after the mission, formed this multifaceted experiment. One key component, crewmembers’ diaries, is the primary data source for this analysis.

RESULTS: While unstructured instruments can be challenging to analyze, these diaries proved especially useful for studying group dynamics and identifying behavioral and intercultural issues. The crewmembers found our unstructured formats, such as these journals and post-mission interviews, to be a more effective means of expressing themselves compared to structured instruments.

DISCUSSION: Personal journals, open-ended questions, and the freedom from constraints typically imposed by feedback instruments used for quantitative analysis are invaluable for observing and expressing crewmembers’ psychological status, as well as inter-crew and intercultural dynamics. Personal journals can also provide a basis for constructive intervention by ground personnel, researchers, or psychologists. Insights from this study can be applied to current challenges, such as the adoption of self-isolation as prevention against spread of COVID-19.

Kass JR, Kass R. Gleaning from diaries in long-duration isolation. Aerosp Med Hum Perform. 2025; 96(9):829–840.

INTRODUCTION: The rapidly expanding commercial spaceflight (CSF) market has fueled increasing interest in spaceflight experiences among individuals without professional astronaut qualifications. Such individuals may present with a range of medical conditions that add uncertainties to medical preparation and risk assessment for spaceflight. As the ear, nose, and throat (ENT) working group of the Aerospace Medical Association Ad Hoc Committee on Commercial Spaceflight, we conducted a scoping review to assess the available biomedical literature for ENT and neuro-vestibular conditions and physiology pertinent to spaceflight for nonprofessional space travelers.

METHODS: The scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses. The initial database search produced 3232 articles. This set was reduced to 142 relevant publications through a rigorous two-reviewer filtering process using strict inclusion and exclusion criteria.

DISCUSSION: Motion sickness and spatial disorientation were the most common topics of the final set of articles. In contrast, there was limited material on other relevant ENT topics such as hearing loss, sino-nasal dysfunction, and conditions of the pharynx. It becomes clear from this scoping review that the path forward in providing guidance for optimal medical management of CSF passengers will involve the integration of modern biomedical research findings with the accumulated clinical expertise in the civil and military aeromedical communities. We recommend building an industry-wide CSF medical database to address care gaps and improve specialized aerospace medical knowledge.

Panic H, Wexler D, Stephanian B, Correia JP, Sides M, Hoffman T. Otolaryngological and neuro-vestibular considerations for commercial spaceflight. Aerosp Med Hum Perform. 2025; 96(9):841–850.

INTRODUCTION: There has been long-standing interest in the physiological and psychological effects of mild hypoxia on aircrew, but to date there is no psychometrically valid self-report measure of subjective symptoms.

METHODS: To address this gap, we developed a self-report scale along three dimensions of impairment: cognitive, sensory and affective. We administered this scale to active and retired aircrew (N = 354) with on average 25.04 yr (SD = 11.27) of military service and subjected their responses to exploratory factor analysis using Maximum Likelihood Estimation, followed by reliability analysis to determine cohesiveness of associated items.

RESULTS: We provide initial psychometric validation for our 12-item scale’s three-dimensional structure. The internal consistency reliability of the cognitive, sensory, and affective factors was 0.90, 0.75, and 0.85, respectively.

DISCUSSION: Going forward, the consistent use of this instrument will likely reduce the methodological variability in measuring the symptoms of mild hypoxia in the literature.

Vartanian O, Bouak F, Lam Q, Miles R. Initial psychometric validation of a self-report measure of the symptoms of mild hypoxic hypoxia. Aerosp Med Hum Perform. 2025; 96(9):851–856.

INTRODUCTION: Aviation peer support programs (PSPs)—comprised of trained volunteers of the same professional background who offer confidential, nonjudgmental support to fellow aviation personnel dealing with stress from any source—have been forwarded as a solution to address mental healthcare avoidance based on expert opinion that PSPs are of sufficient safety and effectiveness. There is a growing interest in data collection in PSPs for a range of reasons as driven by European Union Aviation Safety Agency regulation requirements and an international interest in incorporating mental health functions into an aviation safety management system as outlined in the Federal Aviation Administration Aviation Rulemaking Committee on Mental Health. The current commentary provides recommended practices for data collection in aviation peer support programs guided by a novel bioethical framework.

Hoffman W, De Rooy D, Bekker A, Bor R, Fielding D, Snyder Q. Recommended practices related to data collection in aviation peer support programs. Aerosp Med Hum Perform. 2025; 96(9):857–860.