Aviation Toxicology

Abstract

There has been an increasing interest and awareness of the effects of prescription and illicit drugs on pilot performance with the concomitant rise in the use of prescription medications and the frequency of air travel. Aviation toxicology addresses the effects of prescription and illicit drugs on pilot performance as well as the contribution of these agents to the cause or manner of death in aviation fatalities. Specimen collection, specimen suitability and analytical techniques for the investigation of the role of carbon monoxide, hydrogen cyanide, ethanol, drugs of abuse and so on in aviation accidents are discussed. The prevalence of use and impairing effects of commonly encountered drugs such as ethanol, antihistamines, antidepressants, cannabinoids and opiates are outlined. Issues in toxicological interpretation, including the delineation of post‐mortem from ante‐mortem ethanol, the analysis of glucose and post‐mortem drug redistribution, are presented. Some unique challenges in aviation toxicology, such as the identification of admixed specimens and the genetic variability in the degree of drug‐induced impairment, as well as future opportunities for research, are discussed in the concluding portion of the chapter.