First-Generation H1 Antihistamines Found in Pilot Fatalities of Civil Aviation Accidents, 1990–2005
Sen A, Akin A, Craft KJ, Canfield DV, Chaturvedi AK. First-generation H1 antihistamines found in pilot fatalities of civil aviation accidents, 1990–2005. Aviat Space Environ Med 2007; 78:514–522.
Introduction: First-generation H1-receptor antagonists are popularly used for alleviating allergy and cold symptoms, but these antihistaminics cause drowsiness and sedation. Such side effects could impair performance and, thus, could be the cause or a factor in accidents. Therefore, the prevalence of these antagonists was evaluated in aviation accident pilot fatalities. Methods: The Civil Aerospace Medical Institute’s (CAMI’s) Toxicology Database was examined for the presence of the first-generation antihistamines in pilot fatalities of civil aircraft accidents that occurred during a 16-yr (1990–2005) period. Results: Of 5383 fatal aviation accidents from which CAMI received specimens, there were 338 accidents wherein pilot fatalities (cases) were found to contain brompheniramine, chlorpheniramine, diphenhydramine, doxylamine, pheniramine, phenyltoloxamine, promethazine, and triprolidine. Of the 338 accidents, 304 were general aviation accidents, and 175 of the 338 pilots held private pilot airman certificates. Antihistamines were detected alone in 103 fatalities (1 antihistamine in 94 and 2 antihistamines in 9), while other drug(s) and/or ethanol were also present in an additional 235 fatalities. The antihistamines were found in approximately 4 and 11% of the fatalities/accidents in 1990 and in 2004, respectively. The use of antihistamine(s) was determined by the National Transportation Safety Board to be the cause of 13 and a factor in 50 of the 338 accidents. Conclusions: There was an overall increasing trend in the use of antihistamines by aviators during the 16-yr span. Blood levels of the antihistaminics were in the sub-therapeutic to toxic range. Findings from this study will be useful in investigating future accidents involving antihistamines.
Introduction: First-generation H1-receptor antagonists are popularly used for alleviating allergy and cold symptoms, but these antihistaminics cause drowsiness and sedation. Such side effects could impair performance and, thus, could be the cause or a factor in accidents. Therefore, the prevalence of these antagonists was evaluated in aviation accident pilot fatalities. Methods: The Civil Aerospace Medical Institute’s (CAMI’s) Toxicology Database was examined for the presence of the first-generation antihistamines in pilot fatalities of civil aircraft accidents that occurred during a 16-yr (1990–2005) period. Results: Of 5383 fatal aviation accidents from which CAMI received specimens, there were 338 accidents wherein pilot fatalities (cases) were found to contain brompheniramine, chlorpheniramine, diphenhydramine, doxylamine, pheniramine, phenyltoloxamine, promethazine, and triprolidine. Of the 338 accidents, 304 were general aviation accidents, and 175 of the 338 pilots held private pilot airman certificates. Antihistamines were detected alone in 103 fatalities (1 antihistamine in 94 and 2 antihistamines in 9), while other drug(s) and/or ethanol were also present in an additional 235 fatalities. The antihistamines were found in approximately 4 and 11% of the fatalities/accidents in 1990 and in 2004, respectively. The use of antihistamine(s) was determined by the National Transportation Safety Board to be the cause of 13 and a factor in 50 of the 338 accidents. Conclusions: There was an overall increasing trend in the use of antihistamines by aviators during the 16-yr span. Blood levels of the antihistaminics were in the sub-therapeutic to toxic range. Findings from this study will be useful in investigating future accidents involving antihistamines.
Keywords: antihistaminics; aviation accident investigation; forensic sciences; toxicology
Document Type: Research Article
Publication date: 01 May 2007
- The peer-reviewed monthly journal, Aviation, Space, and Environmental Medicine (ASEM) provides contact with physicians, life scientists, bioengineers, and medical specialists working in both basic medical research and in its clinical applications. It is the most used and cited journal in its field. ASEM is distributed to more than 80 nations.
To access volumes 86 to present, please click here. - Information for Authors
- Submit a Paper
- Subscribe to this Title
- Membership Information
- Information for Advertisers
- Submit Articles
- Ingenta Connect is not responsible for the content or availability of external websites
- Access Key
- Free content
- Partial Free content
- New content
- Open access content
- Partial Open access content
- Subscribed content
- Partial Subscribed content
- Free trial content