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    Altitude chamber training (ACT) poses risks, with middle ear barotrauma being most common. Decompression sickness (DCS) is a significant concern, necessitating standardized protocols to enhance aircrew safety during hypobaric hypoxic training.

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    Area of Science:

    • Aerospace Medicine
    • Physiology
    • Occupational Health

    Background:

    • Altitude chambers simulate hypobaric hypoxic environments for aircrew training.
    • Potential adverse effects during altitude chamber training (ACT), particularly decompression sickness (DCS), pose significant risks to aircrew safety.
    • This study aimed to assess the incidence and types of adverse effects during ACT at the Israeli Air Force (IAF) facility.

    Approach:

    • Retrospective review of 1627 individuals' records from IAF altitude chamber training between 2015 and 2019.
    • Extraction of data on adverse effects and training safety.
    • Comparative literature review of ACT adverse effect rates.

    Key Points:

    • The overall risk rate for adverse effects in the IAF was 5.59%, with 91 cases recorded.
    • Middle ear and sinus barotrauma were the most frequent adverse events (69.3%), followed by breathing problems (14.3%) and DCS (9.9%).
    • Decompression sickness (DCS) represents a critical concern requiring focused risk mitigation strategies.

    Conclusions:

    • Standardized protocols for ACT are recommended to mitigate risks.
    • Proposed protocol includes a 45-minute preoxygenation period, a maximal ascent rate of 3000 ft/min, and a maximum altitude of 25,000 ft for fixed-wing trainees.
    • Implementing these recommendations can enhance safety during aircrew training in hypobaric hypoxic environments.