Volanti Subvenimus: Challenges in monitoring and maintaining the health of pilots engaged in telewarfare
Editor's Note: We delayed posting this editorial which was outside our usual source for noting veterans' health but when we picked up todays' New York Times, the front page highlights another series about the use of this technology. The editorial's source is the Armed Forces Health Surveillance Center. Volanti Subvenimus translates from the Latin to: To care for those who fly.
by Hernando J. Ortega, Jr.
Author: Brigadier Lance Mans, Deputy Director, NATO Special Operations Coordination Centre
The growth in the use of remotely piloted aircraft (RPA), also referred to as unmanned aerial vehicles or "drones", has had a significant impact on overseas contingency operations. As noted by Drs. Otto and Webber in this issue of the Medical Surveillance Monthly Report, RPA operations began in earnest after the 9/11 terrorist attacks on the World Trade Center. At that time, very little was known about the stressors of, or the requirements for, these operations. Demand for RPA pilots has been increasing and currently, the Air Force is training more RPA pilots than fighter and bomber pilots combined. Although RPA are oft en referred to as being unmanned, these systems require the support of teams of highly trained and experienced service members on the ground, including the RPA pilot.
As advances in technology have enabled pilots to control aircraft without physically accompanying them, distinct challenges have emerged as a result of removing pilots from the physical battlespace. Traditionally, military operations have been expeditionary in nature, with large numbers of service members deployed overseas. This deployment paradigm often fosters the development of organizational identity and unit cohesion, both of which have been demonstrated to help service members cope with the stresses of combat. However, these elements are lacking in RPA pilots. In addition, RPA pilots face unique stressors related to the impact of fighting a war at the office and going home to a family at night. Last, the continually increasing demand for RPA support has lead to manning issues; RPA pilots are faced with rotating shift s and long hours which contribute to stress, sleep issues, and other negative consequences.
In 2008, stories began to emerge in the lay press about “war stress” among RPA pilots in the Air National Guard and media
reports have continued to appear regarding mental health issues in this community. These reports cited research by the US Air Force School of Aerospace Medicine (USAFSAM) and the Performance Enhancement Directorate. In 2006, Dr. Anthony Tvaryanas and colleagues conducted the first comprehensive analysis of the human stressors involved in RPA operations. Continued surveillance and
research into the health and well-being of RPA pilots have offered flight surgeons and line leaders improved insight into their
mental health needs. This information has also informed policy changes such as the dedication of additional mental health
resources to this community. Against this backdrop, Drs. Otto and Webber have objectively quantified the state of RPA pilots with regard to mental health (MH) endpoints (as represented by ICD-9-CM diagnoses assigned by medical providers). Their results demonstrate that Air Force RPA pilots are receiving mental health diagnoses at rates equivalent to other Air Force pilots who have deployed and at lower rates than other Air Force personnel.
The findings of this study validate several key principles of human performance developed and applied by aerospace medicine since its inception in the early 20th century. For example, the rigorous selection process aviators undergo and the ongoing operational medical support they receive are two factors (of several) which likely impact their health and operational performance; sustained vigilance and application of these principles will continue to be the cornerstone of maintaining health and optimal performance of the "human weapon system" involved in aerial combat, no matter how combat is prosecuted.
Author affiliation: Aerospace Medicine Division, Air Education and Training Command, Randolph AFB, TX.
MSMR (Medical Surveillance Monthly Report) Vol. 20 No. 3 March 2013
The report itself is Mental Health Diagnoses and Counseling Among Pilots of Remotely Piloted Aircraft in the United States Air Force (PDF). Authors are Jean L. Otto, DrPH, MPH; Bryant J. Webber, MD (Capt, USAF)
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