INTRODUCTION:United Kingdom regulations mandate hemoglobin (Hb) testing at each commercial (Class 1) pilot medical examination. The utility of point-of-care finger-prick capillary Hb in determining aeromedical certification outcomes remains unquantified. METHODS:A retrospective review was conducted of all initial Class 1 medical examinations recorded in the UK Civil Aviation Authority medical records system from April 2021 to March 2025. Applicants with capillary Hb outside thresholds (male <115 g · L-1, female <105 g · L-1, all >180 g · L-1) were identified. Clinical pathways, confirmatory testing, and fitness outcomes were analyzed. RESULTS:Of 3353 applicants, 48 (1.43%; 95% confidence interval 1.08-1.89) had abnormal capillary Hb (33 high, 15 low). Of those, 35 (73%) were certified fit, 1 (2%) was assessed as unfit due to predeclared sickle cell disease, and 12 (25%) were lost to follow-up prior to fitness determination. Only 3 of 36 applicants receiving a fitness outcome were assessed as unfit or required treatment before certification (positive predictive value 8.3%; 95% confidence interval 2.9-21.8%). Among 13 applicants undergoing confirmatory venous testing, 12 returned normal results. No cases of polycythemia were identified. DISCUSSION:Capillary Hb screening did not identify conditions leading to unfit assessment beyond predeclared disease. The sole unfit determination resulted from a disqualifying history before testing. Two applicants (0.06%) required treatment before certification; whether these would have been detected through clinical evaluation alone is uncertain. These findings suggest limited utility for this screening practice in asymptomatic initial pilot applicants, though value in serial assessments of established pilots warrants further investigation. MacMillan PP. Routine capillary hemoglobin testing in United Kingdom commercial pilot applicants. Aerosp Med Hum Perform. 2026; 97(8):601-606.
INTRODUCTION:An optimal spatial orientation is essential for pilots. Therefore, pilot applicants in the Royal Danish Air Force undergo various ear-nose-throat evaluations. It is recommended to avoid alcohol for a minimum of 24 h before evaluation. No recommendation has been made regarding nicotine and, with the increasing availability of nicotine through pouches and other products, it is therefore relevant to examine its impact on vestibular function, particularly on nystagmus, which plays a key role in clinical vestibular assessment. METHODS:We conducted a structured literature search using PubMed and Cochrane Library as the primary databases in 2025 and 2026. The search strategy used a combination of keywords and MeSH terms and criteria for inclusion and exclusion were made. RESULTS:In total, 22 studies were included looking at nicotine's effect on the vestibular system. Overall, the studies showed an impact on the vestibular system and the induction of nystagmus through different delivery methods of nicotine. The effects of nicotine on nystagmus appear within minutes and can persist for up to 30 min, and nicotine blood concentrations are measurable more than 2 h after exposure. DISCUSSION:We suggest that pilot applicants be advised to abstain from nicotine products for a specified period of 12-24 h before undergoing ear-nose-throat examinations to minimize test interference. Further studies are needed to uncover the effect nicotine can have on in-flight performance. Kahlhofen N, Lindgaard K. Nicotine effects on vestibular function in pilot selection. Aerosp Med Hum Perform. 2026; 97(8):638-643.
INTRODUCTION:Modern DNA technologies have substantially advanced disaster victim identification. The advances are summarized while stressing privacy, security, and psychological values of victim identification. Identification of victims in fatal aircraft accidents demonstrated the effectiveness of DNA profiling. Initially based on minisatellite or microsatellite loci (i.e., short tandem repeats), DNA analyses are moving toward high-throughput massively parallel sequencing (MPS) that enables analysis of genome-wide single nucleotide polymorphisms, permitting typing of highly degraded samples with increased sensitivity. MPS has made it possible to analyze highly degraded samples. Adoption of MPS also has led to the emergence of a new discipline for human identification known as forensic genetic genealogy. Compared with short tandem repeat typing and mitochondrial DNA sequencing, forensic genetic genealogy substantially expands the analytical space for identification of human remains. The elements of data privacy and security with mass disasters are also important considerations for adopting this technology. Vuorio A, Sajantila A, Bor R, Budowle B. Advances in aircraft accident disaster victim identification using DNA techniques. Aerosp Med Hum Perform. 2026; 97(8):648-650.
INTRODUCTION:Fatigue poses a significant safety risk in helicopter operations; however, subjective assessments of fatigue based on an individual's perception, awareness, and insight, such as self-perceived tiredness, may not accurately reflect objective performance impairment as identified by standardized tests or measurement tools. In this context, the present study investigated the relationship between subjective drowsiness and objective alertness performance among helicopter pilots during operational tasks using a computerized psychomotor vigilance task (PVT). METHODS:This observational field study initially included 20 helicopter pilots. Complete pre- and postflight measurements were available for 15 pilots and were included in the final analysis. Subjective sleepiness was assessed before testing using the Karolinska Sleepiness Scale. Objective alertness was measured pre- and postflight using a PVT; mean reaction time (ms) was used as the primary outcome variable. RESULTS:The mean subjective sleepiness score was 3.98 ± 1.27 (range: 2.0-6.9). Mean PVT reaction time increased from 461.2 ± 118.1 ms preflight to 516.3 ± 100.8 ms postflight (an 11.9% increase), reaching statistical significance with a medium-to-large effect size (Cohen's dz = 0.65). Considerable interindividual variability was observed. Correlation analysis revealed a weak association between subjective sleepiness and postflight PVT reaction time (r = 0.16, P = 0.573), with prolonged reaction times observed in some pilots reporting low subjective sleepiness. DISCUSSION:Combining objective alertness measures with subjective scales may improve fatigue risk management. Gevrek I, Eroglu C. Psychomotor alertness and subjective fatigue in helicopter pilots. Aerosp Med Hum Perform. 2026; 97(8):633-637.
