Aeromedical Aspects of Findings from Aircraft-Assisted Pilot Suicides in the United States, 1993\u20132002

Civil Aerospace Medical Institute2006PDFTech ReportJohnson, Robert D.Lewis, Russell J.Whinnery, James E.Forster, Estrella M.Civil Aerospace Medical InstituteUnited States. Office of Aerospace MedicineUnited StatesAir pilotsSuicideEpidemiologyToxicologyCrash dataCrash investigationAir transportation crashesDOT/FAA/AM-06/5All aviation accidents are tragic, but few are more avoidable than aircraft-assisted suicide. Aircraft-assisted suicide may precipitate as a result of clinical depression, marital or financial difficulties, or numerous other problems. While aircraft-assisted suicide attempts almost always result in pilot fatalities, they also have the serious and unfortunate potential to cause collateral damage to property and life.Our laboratory was interested in evaluating the epidemiological, toxicological, and aeromedical findings from pilots involved in aircraft-assisted suicides. Case histories, accident information, and the declaration of suicide as the probable cause in the aviation accidents were obtained from the National Transportation Safety Board (NTSB). Toxicological information was obtained from the Civil Aerospace Medical Institute\u2019s Bioaeronautical Sciences Research Laboratory. Other relevant information was obtained from medical certification data systems.Over the 10-year period, 1993-2002, there were 3648 fatal aviation accidents. Of these, the NTSB determined that 16 were aircraft-assisted suicides, 15 were from intentional crashing of an aircraft, and 1 due to a student pilot exiting the aircraft while in-flight. All 16 aircraft were operated as general aviation. All pilots involved in these aircraft-assisted suicides were male, with a median age of 40 (range 15-67) years. The pilot was the sole occupant of each aircraft that was intentionally crashed.Toxicological findings for 7 of the 14 pilots for which test specimens were available were negative for disqualifying substances, whereas 4 contained ethanol at various levels, 2 were found positive for benzodiazepines, 1 positive for marijuana, 1 positive for cocaine, and 1 positive for venlafaxine. None of the airmen had reported intake of these substances during their medical certification process.These limited data indicate that 50% of accidents classified by the NTSB as aircraft-assisted pilot suicide involve at least one, if not more, disqualifying drug(s). However, based on the few cases conclusively attributed to suicide, death by the intentional crashing of an aircraft appears to be an infrequent and uncommon event.119