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Physiological Factors (Including Drugs and Alcohol) Affecting Pilot  Performance 

Introduction 

14 CFR part 107 does not allow operation of small UA if the remote PIC, the person manipulating the  controls, or Visual Observer (VO) is unable to safely carry out his or her responsibilities. It is the remote  PIC’s responsibility to ensure all crewmembers are not participating in the operation while impaired.  While drug and alcohol use are known to impair judgment, certain over-the-counter (OTC) medications  and medical conditions could also affect the ability to safely operate a small UA. For example, certain  antihistamines and decongestants may cause drowsiness. We also emphasize that part 107 prohibits a  person from serving as a remote PIC, person manipulating the controls, VO, or other crewmember if he  or she:  

• Has consumed any alcoholic beverage within the preceding 8 hours 

• Is under the influence of alcohol 

• Has a blood alcohol concentration of .04 percent or greater 

• Is using a drug that affects the person’s mental or physical capabilities.  

There are certain medical conditions, such as epilepsy, may also create a risk to operations. It is the  remote PIC’s responsibility to determine that their medical condition is under control and they can  safely conduct a small UA operation. 

Physiological/Medical Factors that Affect Pilot Performance 

Important medical factors that a pilot should be aware of include the following: • hyperventilation  

• stress 

• fatigue 

• dehydration 

• heatstroke 

• the effects of alcohol and drugs  

Hyperventilation  

Hyperventilation is the excessive rate and depth of respiration leading to abnormal loss of carbon  dioxide from the blood. This condition occurs more often among pilots than is generally recognized.  It seldom incapacitates completely, but it causes disturbing symptoms that can alarm the  uninformed pilot. In such cases, increased breathing rate and anxiety further aggravate the  problem. Hyperventilation can lead to unconsciousness due to the respiratory system’s overriding  mechanism to regain control of breathing. Pilots encountering an unexpected stressful situation  may subconsciously increase their breathing rate. 

Common symptoms of hyperventilation include:  

• Visual impairment  

• Unconsciousness  

• Lightheaded or dizzy sensation  

• Tingling sensations 

• Hot and cold sensations 

 • Muscle spasms 

The treatment for hyperventilation involves restoring the proper carbon dioxide level in the body.  Breathing normally is both the best prevention and the best cure for hyperventilation. In addition to  slowing the breathing rate, breathing into a paper bag or talking aloud helps to overcome  hyperventilation. Recovery is usually rapid once the breathing rate is returned to normal. 

Stress  

Stress is the body’s response to physical and psychological demands placed upon it. The body’s  reaction to stress includes releasing chemical hormones (such as adrenaline) into the blood and  increasing metabolism to provide more energy to the muscles. Blood sugar, heart rate, respiration,  blood pressure, and perspiration all increase. The term “stressor” is used to describe an element  that causes an individual to experience stress. Examples of stressors include physical stress (noise or  vibration), physiological stress (fatigue), and psychological stress (difficult work or personal  situations).  

Stress falls into two broad categories: acute (short term) and chronic (long term). Acute stress  involves an immediate threat that is perceived as danger. This is the type of stress that triggers a  “fight or flight” response in an individual, whether the threat is real or imagined. Normally, a healthy  person can cope with acute stress and prevent stress overload. However, ongoing acute stress can  develop into chronic stress.  

Chronic stress can be defined as a level of stress that presents an intolerable burden, exceeds the  ability of an individual to cope, and causes individual performance to fall sharply. Unrelenting  psychological pressures, such as loneliness, financial worries, and relationship or work problems can  produce a cumulative level of stress that exceeds a person’s ability to cope with the situation. When  stress reaches these levels, performance falls off rapidly. Pilots experiencing this level of stress are  not safe and should not exercise their airman privileges. Pilots who suspect they are suffering from  chronic stress should consult a physician. 

Fatigue 

Fatigue is frequently associated with pilot error. Some of the effects of fatigue include degradation  of attention and concentration, impaired coordination, and decreased ability to communicate.  These factors seriously influence the ability to make effective decisions. Physical fatigue results from  sleep loss, exercise, or physical work. Factors such as stress and prolonged performance of cognitive  work result in mental fatigue.  

Like stress, fatigue falls into two broad categories: acute and chronic. Acute fatigue is short term and  is a normal occurrence in everyday living. It is the kind of tiredness people feel after a period of  strenuous effort, excitement, or lack of sleep. Rest after exertion and 8 hours of sound sleep  ordinarily cures this condition.  

A special type of acute fatigue is skill fatigue. This type of fatigue has two main effects on  performance:  

• Timing disruption—appearing to perform a task as usual, but the timing of each component is slightly off. This makes the pattern of the operation less smooth because the pilot performs each component as though it were separate, instead of part of an integrated activity.

• Disruption of the perceptual field—concentrating attention upon movements or objects in the center of vision and neglecting those in the periphery. This is accompanied by loss of accuracy and smoothness in control movements.  

Acute fatigue has many causes, but the following are among the most important for the pilot:  • Mild hypoxia (oxygen deficiency)  

• Physical stress  

• Psychological stress  

• Depletion of physical energy resulting from psychological stress  

• Sustained psychological stress  

Acute fatigue can be prevented by proper diet and adequate rest and sleep. A well-balanced diet  prevents the body from needing to consume its own tissues as an energy source. Adequate rest  maintains the body’s store of vital energy. 

Chronic fatigue, extending over a long period of time, usually has psychological roots, although an  underlying disease is sometimes responsible. Continuous high-stress levels produce chronic fatigue.  Chronic fatigue is not relieved by proper diet and adequate rest and sleep and usually requires  treatment by a physician. An individual may experience this condition in the form of weakness,  tiredness, palpitations of the heart, breathlessness, headaches, or irritability. Sometimes chronic  fatigue even creates stomach or intestinal problems and generalized aches and pains throughout  the body. When the condition becomes serious enough, it leads to emotional illness.  

If suffering from acute fatigue, a remote pilot should not operate a small UA. If fatigue occurs during  the operation of a small UA, no amount of training or experience can overcome the detrimental effects. Getting adequate rest is the only way to prevent fatigue from occurring. Avoid flying a small  UA without a full night’s rest, after working excessive hours, or after an especially exhausting or  stressful day. Remote pilots who suspect they are suffering from chronic fatigue should consult a  physician. 

Dehydration  

Dehydration is the term given to a critical loss of water from the body. Causes of dehydration are  hot temperatures, wind, humidity, and diuretic drinks—coffee, tea, alcohol, and caffeinated soft  drinks. Some common signs of dehydration are headache, fatigue, cramps, sleepiness, and dizziness.  

The first noticeable effect of dehydration is fatigue, which in turn makes top physical and mental  performance difficult, if not impossible. Flying a small UA for long periods in hot summer  temperatures or at high altitudes increases the susceptibility to dehydration because these  conditions tend to increase the rate of water loss from the body.  

To help prevent dehydration, drink two to four quarts of water every 24 hours. Since each person is  physiologically different, this is only a guide. Most people are aware of the eight-glasses-a-day  guide: If each glass of water is eight ounces, this equates to 64 ounces, which is two quarts. If this  fluid is not replaced, fatigue progresses to dizziness, weakness, nausea, tingling of hands and feet,  abdominal cramps, and extreme thirst.  

The key for pilots is to be continually aware of their condition. Most people become thirsty with a  1.5 quart deficit or a loss of 2 percent of total body weight. This level of dehydration triggers the  “thirst mechanism.” The problem is that the thirst mechanism arrives too late and is turned off too easily. A small amount of fluid in the mouth turns this mechanism off and the replacement of  needed body fluid is delayed.  

Other steps to prevent dehydration include:  

• Carrying a container in order to measure daily water intake.  

• Staying ahead—not relying on the thirst sensation as an alarm. If plain water is not preferred, add some sport drink flavoring to make it more acceptable.  

• Limiting daily intake of caffeine and alcohol (both are diuretics and stimulate increased production of urine). 

Heatstroke 

Heatstroke is a condition caused by any inability of the body to control its temperature. Onset of  this condition may be recognized by the symptoms of dehydration, but also has been known to be  recognized only upon complete collapse. 

To prevent these symptoms, it is recommended that an ample supply of water be carried and used  at frequent intervals, whether thirsty or not. The body normally absorbs water at a rate of 1.2 to 1.5  quarts per hour. Individuals should drink one quart per hour for severe heat stress conditions or one  pint per hour for moderate stress conditions. For more information on water consumption, refer to  the “Dehydration” section of this chapter. 

Drugs 

The Federal Aviation Regulations include no specific references to medication usage. Title 14 of the  CFR prohibits acting as PIC or in any other capacity as a required pilot flight crewmember, while that  person: 

1. Knows or has reason to know of any medical condition that would make the person unable to  meet the requirement for the medical certificate necessary for the pilot operation, or  2. Is taking medication or receiving other treatment for a medical condition that results in the  person being unable to meet the requirements for the medical certificate necessary for the  pilot operation.

Further, 14 CFR part 107 and 14 CFR part 91, sections 91.17 and 91.19 prohibit the use of any drug  that affects the person’s faculties in any way contrary to safety.  

There are several thousand medications currently approved by the U.S. Food and Drug  Administration (FDA), not including OTC drugs. Virtually all medications have the potential for  adverse side effects in some people. Additionally, herbal and dietary supplements, sport and energy  boosters, and some other “natural” products are derived from substances often found in  medications that could also have adverse side effects. While some individuals experience no side  effects with a particular drug or product, others may be noticeably affected. The FAA regularly  reviews FDA and other data to assure that medications found acceptable for aviation duties do not  pose an adverse safety risk.  

Some of the most commonly used OTC drugs, antihistamines and decongestants, have the potential  to cause noticeable adverse side effects, including drowsiness and cognitive deficits. The symptoms  associated with common upper respiratory infections, including the common cold, often suppress a  pilot’s desire to fly, and treating symptoms with a drug that causes adverse side effects only  compounds the problem. Particularly, medications containing diphenhydramine (e.g., Benadryl) are   known to cause drowsiness and have a prolonged half-life, meaning the drugs stay in one’s system  for an extended time, which lengthens the time that side effects are present.  

Prior to each and every flight, all pilots must do a proper physical self-assessment to ensure safety.  A great mnemonic is IMSAFE, which stands for Illness, Medication, Stress, Alcohol, Fatigue, and  Emotion.  

For the medication component of IMSAFE, pilots need to ask themselves, “Am I taking any  medicines that might affect my judgment or make me drowsy? For any new medication, OTC or  prescribed, you should wait at least 48 hours after the first dose before flying to determine you do  not have any adverse side effects that would make it unsafe to operate an aircraft. In addition to  medication questions, pilots should also consider the following: 

• Do not take any unnecessary or elective medications. 

• Make sure you eat regular balanced meals. 

• Bring a snack. 

• Maintain good hydration – bring plenty of water. 

• Ensure adequate sleep the night prior to the flight. 

• Stay physically fit. 

Alcohol 

Alcohol impairs the efficiency of the human body.  [Figure 9-1] Studies have shown that consuming  alcohol is closely linked to performance deterioration.  Pilots must make hundreds of decisions, some of them  time-critical, during the course of a flight. The safe  outcome of any flight depends on the ability to make  the correct decisions and take the appropriate actions  during routine occurrences, as well as abnormal  situations. The influence of alcohol drastically reduces  the chances of completing a flight without incident.  Even in small amounts, alcohol can impair judgment,  decrease sense of responsibility, affect coordination,  constrict visual field, diminish memory, reduce  reasoning ability, and lower attention span. As little as  one ounce of alcohol can decrease the speed and  strength of muscular reflexes, lessen the efficiency of  eye movements while reading, and increase the  frequency at which errors are committed.  Impairments in vision and hearing can occur from  consuming as little as one drink.  

Figure 9-1. Impairment scale with alcohol use.

While experiencing a hangover, a pilot is still under  the influence of alcohol. Although a pilot may think he  or she is functioning normally, motor and mental  response impairment is still present. Considerable  amounts of alcohol can remain in the body for over 16  hours, so pilots should be cautious about flying too soon after drinking. 


Intoxication is determined by the amount of alcohol in the bloodstream. This is usually measured as  a percentage by weight in the blood. 14 CFR part 91 requires that blood alcohol level be less than  .04 percent and that 8 hours pass between drinking alcohol and piloting an aircraft. A pilot with a  blood alcohol level of .04 percent or greater after 8 hours cannot fly until the blood alcohol falls  below that amount. Even though blood alcohol may be well below .04 percent, a pilot cannot fly  sooner than 8 hours after drinking alcohol. Although the regulations are quite specific, it is a good  idea to be more conservative than the regulations. 

Vision and Flight  

The more a pilot understands about the eyes and how they function, the easier it is to use vision  effectively and compensate for potential problems. 

Scanning Techniques  

To scan effectively, pilots must look from right to left or left to right. They should begin scanning at  the greatest distance an object can be perceived (top) and move inward toward the position of the  aircraft (bottom). For each stop, an area approximately 30° wide should be scanned. The duration of  each stop is based on the degree of detail that is required, but no stop should last longer than 2 to 3  seconds. When moving from one viewing point to the next, pilots should overlap the previous field  of view by 10°. [Figure 9-2] 

Figure 9-2. Scanning techniques.