ARTICLE T- Septa,,.nber 5 6. Subject: Conference an Aircrew Viability and Perforinance lfoniltloring. to- ]Life Sciencer,: Research Advisory Group.. -:@1A. Backqround Information: 1. Over the past 15 2years considerable interest and effort has i.periodically been focussed on the problem of determining,:as a functi -4'of time and place in the flight path, the precise state of an aircrew members consciousnass,and purposeful responsiveness. -7iAlthough a wide range ail,psychophysiologic parameters have been ;.'studied and many differe@t technics of remo2te monitoring have 2'been attempted, k=* the fact remains that to date ,,there is no proven operationally ur=uable system available. 2. Currently the only raliable (reasonably) means of!, the pilotis state of:functional responsiveness @is by voice communications with him throug2h the radio link. I ,!;If for any reason voice communications are lost by virtue of @range, spherics, power'failure or 'things happening too fast 11 in the cockpit for the,pilot to Use the radio' then, in the ievent of a fatal accident, the true status of the.pilot throughout -.-:@'the terminal emergency period may never be knotin.' It is a'well-known ,fact that a significant Per cent3ge of fatal accidents are listed !-,,,as 'couse unknown.' As a:corolla.'-y to this latter.fact is,the ,rather dubious indirect inference which is drawn to the factor of 'Pilot erro.-I or 'hypoxial-as@being the basic Lcausative factor!, !all 2of which might well tonstitute a completely ar*.-oneous,conclusion. 3. Newcomers to the,rieio or' physio@ogic monitoring 'are frequent 171,perplexed as to why, with all of;the work going an in NASA, DOD ';NIH R&D groups, we have yet to fly an operationally proven and 1-1@rel2iable system. The simplest reply to such a query is %'.o:sta a a ,Ino system thus far has been able,to satisfy all the requirements ,(and constraints imposed) set by@:such factors as;@pilot comfort'. &I :mobility; aircraft electronics &,pomer supply; reliability ol' ..@the indicat o theiman dr(s) provided t itor.at his observation post.' --!It is unfortunately true.that with all of the equipment, personnel -.-@and flying hours availa'bie to those of us: in the Armed Services, ,we h3ve yet to justify and mount.a pr:gam which, over a period :.'iof reasoble time, would give us a usable solution to this very 4. 2llmpor6ant problem. Perhaps, with the newly-i-njected interest Z..;.of the FAA and the Commercial Airlines generated by rotthcoming ;flight test and bperational use of the SuperSonic Transport, ;.we may be able to focalize our interests and integrate our ':rssources in a more productive program than we have had in the 6post. 'Z 0 1 TO.-, ARTICLE 7!0. 10 rl T DirF!c,6,i,ons of C ur:ent Proorzmse 2 1* Prev!Lcus reference has breen made' @,hel to the fact that:,, at & present time there are a large number of@ hich programs underway w )nt rious degrees of infere6ce in this Particular problem. C2C a 1 Fh ya N/@SA co inues to support a broad s'pec'ru;i of research and davelope= ment in this area of physiological monitoring and data retrbeval, mu of which has, at the very laaa'6,what could be calledlnegative valual to this specific requirementf since their operet4onal and Scientific broader-based@than thi one. The term Inegativervaluet is applied only in the co s Particl-ua ntext that we can use the results of their R & D Programs as indicators that, certain avenues of approach are niether feasiblei 2 or practic:l for our specific objectives., These areas Of investigation are camcern'@ed CiP811Y with the sensing'of a fairly large amount of pscyho-physioloc data which when properly coded,, icross-referenced@and integrated can be stored on board, read out on a rapid time sequence or;2used i indavidually and/or collectively to signal a significant;;:hange in viability or performance I . to-ground monitors or other companion crew members. This isn't at all to say that if a simple type of viability or performance indicator based upon a new principle were':devel2oped thay would have no use for itv but rather that because of their broad operational requirementsf!they must work toward mo re comPIcated and sophisticalted systems than@'this objective oesprtsents. 2. In a similar se :DOD aerospace medical efforts in 2 the biatelemetry field are largely directeds toward the Irather complex and sop histical.-ad systems of p B'rsonal monitoring' as are envisioned as being required for the:MOL program. Although o@e fi I considerable disperse interest elxpressed!by opera-"6,ional flight surgeo assigned to flight eq4-- test'ac'tivitiesiand in some AF special projects,,, one doesnot find amo large scale interett-backed up by 1 financial support withind'ihe ffIR&O commands for:a device of i such seeming simpltitiy. One might even 'sav that:the operational people can, in effect, ;ee no just2ificat: ion a capability. in o@veloping such 3. If one then looks over "nto t linicall! intensive care monitori 1 he ul the ng prc)iects supported by NIH, there is found virtually the same type Of closely contai2ned interest and directions; namely the-attainment of a reliable capability to sense and display with grebb rapidity, mingto and detailed chaanges occurring in a patient who already is in a state!of criticality. -- and therefore represents no true gnalogue of our-human catiFl5bF-ribntl in his operational environment and 2milieu. Again, as in the case, of the NASA and DOD work, their is undoubtodlp some guidance which we can obtain from the NIH work which may prove of value but at the same time the glib coordinators must realize that there is no direct and easy extrapolation from the sick room to an air craft nor from a severely ill or damaged patient to the (ini-tially) healthy air crew f0R member. -- ---------- ':&)ITOr A,?TICL.- @.10. T-,-r C. Summary of Curre nt st3tus- 1. There is no (kn:own) RD:'& T program 2in the field of phsy"oloc Cal monitoring which h3s.as its principal objective, the ability to reliably d6ermine the functional and responsive state of the aircrew member under operational'conditions, .2 The obje' ctives @of on-going NASA!Iand 000@programs in th 2 is. area of biotechnology are primadily directed toward; a. improving the quality and quantity of.bia-signals' b. integrating and @automatizing 'Certain bio-variables in order to provide!more significant and readily interpretable real time information@to the ground medical mo2nitors for flight,safety decisions. C. to facilitate and validate the read-out,and a.rge amounts of in-flight ps cho- interpretation of 1. physiological data @for bbth.short and long range research studies. 2 d. to provide greater comfoit and mobility to the flight crew' in wearing the bio-sensot rigs. valid -L-:j I I e. to oplomize the :amount Of/bio-information' handled within the @prescribed limitations of power, band-width an2d recording modes available. 3. The objectives!of on-gaina_ programs,in this area being prosecuted under the aegis of the Government! Health Agencies are primarily directed tc;uard the improvement in the institutionalized care of the sick pericularly under:critical conditions requiring 'intensive care.11 4._Fringe areas of interest such as are gawdd-expressed in a wide variety'of uncoordinated projects and programs are found in such:fields as; sport: medicine- industrial health & hygeine;.parachuting & sky diving@Lnd undermater exploration and habitation. The principal results to date of these programs which have some5 ancillary bearing on our specific objective are: a. the improvement of the wearability of the bio- monitoring rigs by individuals working (or pilaying)' under a wide variety of/activities. environmental conditioms and EDITCP frTICL" ' @io. r--- @-r-T I b. in general, the data obtained through the use of thesei various rigs have-been of'poor quality with poor signal tc)' no2ise ratios with all of them suffering from the same set of factors, name'Ly: e'xcessive'mobility and poor conductance of the body sensors; excessive interference from a louts;-de.' noise sources; inadequate transmitting power available and ccncomil@ant poor receptivity and signal discrminati-on at the dis2play and/or recording station. c. In those experiments from which interpretable data has been obtained the principal conclusions reached have been 7i' 03 rO'LlOWS: man generaliy @iiuw5 a wide@ variation in physiological systems response (pulse resp) 2 throughout his daily activities than previously. held. ii - the anticipation of a difficult or potentially hazardous task@'evokes greater response than in the S'ubsequent;actuall. perfo-.zmance of it. iii -:@Training, past experience and a 42ood indsx'of physical fitness significantly reduce the d@graa of ':response; 'lessen the total body burden'. D. Proposed Work to be Carried Out at iiia o 1 c:-i L e n L p- Z' 1. Through his past 4-5 y'sars work in the Cardio-vascular 2 Labora'6bry u@iit within the FAA CL-RI complex which has since been disbanded with putial relocation at has ddvsloped a highly skillad ",-eam of scientists and tschnicibns- capable of carrying out':extensive and detailed studies ar.c3rdia- respi-atery function. Equipment and instrumentation provj2ldes for a wide range of functional studies under@both normal and stressful si.tuations, with complete facilities for@data retrieval and correlation. In addition to his o-xn team, he has the privilege cialized biomedical of calling upon additional experts in spa fields for guidance from the faculty members of the 3 Medical Cemter. His program of contiuad research is being partially suppotted by T.' 7. r i 2. Subj3ct population for use by Dr. '@group in 'their furthgr experimental studi--s is largely cornposed of :flying personnel and air trafo'ic controlgrs, the majority of whom;! have baen followed2 by '%"he for at least 4 years. A%'Jditi:3nal ,subjects are readily available from the student body and also .--;,as volunteers fro,-,i the local govern-ment a=ga6;-zations. -ii 3. Within the above subject pbpulation group are a number of individuals with proven coronary disease who have been quite i: iextensively studied on a cont:bn2uing basis. Displaying a wide i .vari3ty of 'patterns' of cardio-vascular malfunction in the form /,,of blectro-mechanical and acoustical abnormalities, they provide template of sorts against which can be measured certain patterns --Iiof early changes in 'normal' individuals whyckhay prove useful in predicting 'pre-coronary' susceptibility, 4. Based on a pr2emise-that these same early, abnormal responses 1,@ifound in both aged pilots and those with coronary disease might be .indicative of degraded cardia-vascu'Lar function in a younger ".."individual with poor, intrinsic strass-response characteristics, :it would appear feasibleland potentially valuable to join with this group, in the Furtherance of.our own studies. 52. In addition, (to the r'eason given in #4 above) it wouldi ibe equally valuable for ito have immediately available, a 1.@@icomplately equipped and operating laboratory research facility I lwhich would allow a quick reacting capability to asses and evaluate izinew technics and procedures for possible fur"@her devakopement !and opera'6,ioaal trial.