Death in the Cockpit

How many aircraft accidents are the result of heart attacks suffered by pilots? The question may never be answered accurately, but Dr. George W. Manning, a consultant to the Royal Canadian Air Force, produced some firm figures from one of the longest and most comprehensive studies of the subject ever made. The strong implication, he told the American College of Cardiology, is that there are more such accidents than can be proved after the event, and a rigorous schedule of annual electrocardiograms for all pilots is a good warning system.

The R.C.A.F. began its ECG program 25 years ago. Among 21,000 aircrew applicants were 99 young men whom the ECG disqualified from pilot training. When these men were carefully reexamined, the doctors found that no fewer than half of them had other abnormalities that previously had escaped detection. It was the ECG that raised the warning flag.

In a five-year study of the R.C.A.F.'s fatal accidents, said Dr. Manning, postmortem examination of the heart was possible in 24 cases, and eight pilots were found to have had coronary artery disease severe enough to be considered a probable cause of the accident. More significantly, said Dr. Manning, four of these eight had previously shown ECG abnormalities, even though the trouble had not been severe enough to ground them immediately.

The advantage of annual ECGs is that they enable cardiologists to spot minute but progressive changes. A 42-year-old transport pilot who had been ferrying 137 passengers to and from Europe was recently grounded because of minor but disquieting ECG changes. To make sure that there was no injustice to him, his case was reviewed by not only Canadian but by U.S. and United Kingdom cardiologists. He stayed on the ground.

Since 1955, when the Joint Committee on Aviation Pathology of the Armed Forces Institute of Pathology in Washington began recording cases of pilot death at the controls, the lethal list has grown to 20. Sometimes it is possible for an alert copilot to take over the controls and save the plane. But if the pilot's attack occurs during the final approach--in those tense seconds just before a plane touches down--it may be too late for anyone to help. And if there is only one pilot, as in many military and private planes, one heart attack is decisive.

This file is automatically generated by a robot program, so reader's discretion is required.