Herbal preparations: a primer for the aeromedical physician

Area of Science:

• Aviation toxicology
• Herbal medicine safety
• Aeromedical safety

Background:

• Herbal preparations are widely used, with potential risks yet unknown among aviators.
• Current regulations do not require disclosure or inquiry into aviator use of botanical supplements.
• Assessing the safety of botanical products for aviators is crucial for aviation safety.

Purpose of the Study:

• Identify botanical preparations posing risks to aviator and aviation safety.
• Determine the prevalence of dietary supplement use among aviators.
• Develop a method for assessing the suitability of botanical products for aviator use.

Main Methods:

• Analyzed toxicological data from 3177 mishap pilots (1989-1997).
• Screened for ephedrine as an indicator of botanical substance use.
• Reviewed literature on botanical agents' risks to aviator health and aviation safety.

Main Results:

• Ephedrine was the only routinely screened substance linked to botanical use.
• Positive ephedrine results increased significantly, while similar non-botanical substances decreased.
• Many legal botanical agents can cause incapacitation via cardiovascular or neuropsychiatric effects.

Conclusions:

• Aviator use of risky botanical products is increasing.
• These products pose significant risks of incapacitation and adverse health effects.
• Flight surgeons need to actively identify use and manage risks to flight safety.