Effects of Altitude-Related Hypoxia on Aircrews in Aircraft With Unpressurized Cabins

Introduction: Generally, hypoxia at less than 10,000 ft (3,048 m) has no apparent effect on aircrews. Nevertheless, several hypoxic incidents have been reported in flights below 10,000 ft. A recently introduced pulse oximeter using finger probes allows accurate monitoring of oxygen saturation (SPO2) in the aeromedical environment. Using such a pulse oximeter, in-flight SPO2 levels were evaluated in aircrew in unpressurized aircraft. In addition, career in-flight hypoxic experiences were surveyed. Methods: In-flight SPO2 was measured in aircrews operating UH-60J helicopters at up to 13,000 ft, and 338 aircrew members operating unpressurized cabin aircraft were surveyed concerning possible in-flight hypoxic experiences. Results: In aircrews operating UH-60J helicopters, SPO2 decreased significantly at altitudes over 5,000 ft, most markedly at 13,000 ft (vs. ground level). The survey identified three aircrew members with experiences suggesting hypoxemia at below 5,000 ft. Conclusions: Careful attention should be paid to the possibility of hypoxia in aircrews operating unpressurized cabin aircraft.