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Spatial Disorientation in Aviation Mark Peterson BMed DRACOG FRACGP MFM 1.0 Introduction Spatial orientation is an essential precondition for situational awareness in aviation. Sensory perceptions and inferences allow the pilot to form awareness of the meaning and implications of the current situation, and the anticipation of future status essential to safe aviation decision making (Endsley 1999 cited in Rainford, 2006 p.329). Loss of reliable sensory input and inferences, such as contrasting horizon outlines, has contributed to major loss of life in aviation, evidenced by the death of 257 people on board Air New Zealand Flight TE901 on Mt Erebus, Antarctica in 1979 ( Maurino, Reason ,Johnston and Lee, 1995 p.45). Instrument flight condition accidents associated with disorientation, account for 28% of pilot fatalities in general aviation (Li and Baker,1999 cited in Li and Baker ,2007). It is generally regarded as being under reported (Harding and Mills, 1993 p. 88), in part due to the potential for lethality. Aspects of organizational culture may also inhibit reporting of disorientation events (Reinhart p.126). Of the 19 hull losses sustained in the commercial jet accident rate for 2008, 6 were “loss of control” accidents in which spatial disorientation and loss of situational awareness in varied forms were likely to have played a major part, including poor visual references, and initial corrections being in the wrong direction (Burin, 2010 cited in Flight Safety Australia, 2011, and Job, 2011). Human physiology has evolved in a specific terrestrial context which includes a low velocity body in a largely two-dimensional setting; low and non-sustained rates of acceleration;1 G of gravity; daylight ; at sea level partial pressures of oxygen and levels of radiation; with low levels of vibration, and ambient noise. Each of these characteristic are altered in the flight environment. The features of visual and vestibular systems adapted to terrestrial life will be outlined. Error (or risk) producing phenomena due to limitations in normal human physiology in the flight environment, will be discussed. 1 2.0 Spatial orientation, and visuo-vestibular interactions. The perceptual inputs into physiological systems for spatial orientation can be classified as visual, vestibular, and peripheral tissue afferents. All three classes of inputs interact within the brain to form a orientational “construct”. The process is complex, involving interaction of the relevant occipital/ temporal/parietal lobe locations of optic inputs, with vestibular, cerebellar and brainstem information. Both immediate “head reference” and gravitational “earth-reference” must include information and inferences relating to height, direction, position, speed, acceleration, time. The final orientational “construct” is formed in relation to immediate surrounds and their meaning, and most importantly to the earth and its meaning. Confusion of head referenced constructs as being earth referenced is a major cause of disorientation (such as the coriolis illusion). The entire process occurs continuously whilst conscious, as well as being predictive in both time and space. Accurate spatial orientation is the essential precursor to predictive situational awareness essential to safe flight. 2.1 Visual orientation. Visual inputs are usually defined as focal or ambient. Focal vision requires the central macular functions of the retina, has good colour and contrast discrimination and excellent image stabilization. The sensory cells predominant in the foveal and parafoveal areas of the macula are termed “cones”, and are adapted to discrimination of fine detail, to object recognition and identification. Focal vision occurs most efficiently in the central 30 degree field of view, but effective tracking of focal vision can occur at up to 60 degrees angulation of the observer to the object. Radiation of focal visual inputs is via the parvocellular layers of the lateral geniculate body of the thalamus to the ventral aspect of the primary visual (occipital) cortex, adjacent to temporal cortex. The parvocellular system comprises 80% of all optic radiation fibres. The system is termed the “what” system ( 2 Liebowitz HW and Dichigans J,1980 as cited in Davis JR, 2008 p.148) .The lateral geniculate body is of particular interest , as it contains connections to multiple visual, auditory and vestibular inputs that allow integration of information used in the tracking of visual targets . Ambient vision uses the more peripheral location of the retina, has poor colour and contrast discrimation, and is suited to large mobile stimuli and nocturnal vision. The “rods” are the predominant sensory cells in this part of the retina. Ambient type vision projects using the magnocentral pathways via its respective layers of the lateral geniculate nucleus, to the dorsal occipital cortex (motion) and superior temporal cortex (form). It is referred to as the “where” system (Liebowitz et al,1980 as cited in Davis, 2008 p.150). It is also interesting to note that the dorsal occipital cortex has significant projection to the pontine nuclei which project to the cerebellar cortex, aiding integration of visual perception of external movement with the subject’s personal perception of movement ( Davis,2008 p.149) . Ambient visual cues are less useful for distance judgment (see below) such as altitude, speed and ascent/descent, but are highly effective in overall visual orientation in terrestrial contexts, and in VFR flight. The cornea provides the majority of refractive power required for distance vision, with the lens providing lesser refractive power, primarily for close visual accommodation. In addition, it is noteworthy that the optic nerve sends a branch to the superior colliculus in the midbrain, which initiates and regulates orientation movements of the head, eyes and neck. Far distance cues that have evolved over evolution and during the course of an individual experience, are primarily monocular, while close distance cues ( personal and immediate space less than 10 m and 60 m respectively) are binocular. The risk producing aspects of terrestrially originated distance cues will be discussed later on. 2.2 Vestibular Orientation The main systems for vestibular orientation are the semicircular canals (SCC’s) for angular motion and the otoliths ( utricle and saccule) which sit below the SCC’s , for linear acceleration and gravity 3 The semicircular canals consist of 3 ducts bilaterally – posterior, anterior and lateral – of circular canal structures containing hair-like sensory cells superimposed by a gelatinous cupula. Each canal has a basal ampulla, which is maximally stimulated by acceleration in the relevant plane of each canal. All movement stimulates at least 2 of the 3 SCC’s, or contralateral canals on each side of the head. The inertial resistance of the cupula endolymph stimulates the hair-like receptors of the SCC’s during relative movement of the structure. Sensory signals are sent to the ampullary nerves, and thence to the vestibular nerve via the vestibular nuclei (Davis, 2008 p.152). Central integration of the signals from the 3 canals gives inferred information relating to yaw, pitch and roll, despite the axes of the canals not being specifically in those planes with respect to the attitude of the head. The thresholds for signal are highly receptive, being reported as 0.5 degrees/sec ( squared) for angular motion in the semicircular canls, and 0.1 m/sec ( squared) for linear acceleration in the otoliths (Rainford, 2006 p 295). The system is accurate for terrestrial use with typical short motions. Errors typical in the aviation environment may be produced with steady speed of rotation for more than a few seconds, or steady increase or decrease in rate of turn. As soon as the rate of rotations of the cupula becomes constant, it will register as having returned to neutral position, and at 10-15 secs of roll, no signal is perceived. Roll cessation after approx 20-30 seconds of motion produces a recovery error in which a false impression ( equal intensity) of movement in the opposite direction may arise. In the aviation environment, this false impression is resolved with continued straight and level flight (Rainford ,2006 p.297). The otoliths (utricle and saccule) sit beneath and attached to the SCC’s. There are two sets, right and left, and the utricles are horizontal in the upright head, with the saccules being vertical. The otoliths are responsible for sensory information relating to acceleration in the the respective plane of the macular cells within each organ. Myelinated fibres then provide signals to the utricular and saccular nerves, and thence the vestibular nerves via the vestibular nuclei (Rainford, 2006 p. 295). Its noteworthy that unusual combinations of force in the aviation environment may cause otolith mediated perceptual error. Gx acceleration or deceleration may be misinterpreted as having a component of pitch axis alteration. Major risks occur in the aviation environment at take–off (especially at night and especially in high 4 performance aircraft) when the false “pitch up” perception leads to pilots enacting inappropriate “pitch down” commands. This can only be overcome by pilots consciously overriding otolith-mediated pitch information with visual instrument observed rate of climb/air speed and pitch attitude information. In practice this amounts to mentally or verbally rehearsing the possible dangers of night take offs during taxiing, take-off roll, and in early climb when not clear of obstacles, in order to give appropriate primacy to internal instrument cues. In terrestrial environments and in 2 dimensions, these misperceptions are not as dangerous. 2.3 Visuo-vestibular interactions. Very close physiological interaction occurs between visual and vestibular systems. Smooth eye movements such as pursuit, use vestibular and cerebellar input via brainstem reflexes, as well as ocular motor cranial nerves nuclei to coordinate eye attention to a target. The vestibulo-ocular reflex is fundamental to survival in the terrestrial environment where running and vibration from human movement degrade target tracking .The reflex occurs with the slow component of the reflex being the ocular tracking aspect, whilst the rapid component being vestibular input , initiated in the semicircular canals. In the flying environment, prolonged spins or rolls leave the vestibular component of the reflex accurate only in the initial phases. Degradation of object tracking subsequently occurs, both inside and outside the aircraft (Rainford, 2006 p.304). Powerful mechanisms stabilise the retinal image as long as the relative motion of the target to the subject is less than 60 degrees. At relative angular disparity above 60 degrees, saccadic eye movement and/or voluntary head movement is required. Saccadic eye movement is either reflex or voluntary, assisting ambient peripheral visual tracking when smooth pursuit eye movements cannot stabilize the retinal image. An additional interaction between the visual and vestibular system occurs when linear acceleration induces eye movements via otolith stimulation – this reflex is less accurate than both smooth pursuit or saccadic eye movements. 5 2.4 Other inputs into spatial awareness – peripheral tissue afferents Skin, muscles, tendons, ligaments and joint capsules generate proprioceptive and tension afferent signals, usually supplied via the dorsal columns of the spinal cord to brainstem, pons, midbrain , cerebellar and thalamic centres integrating sensory signals for spatial orientation. In addition, sensory signals in the ocular muscles generate signals used for assisting conjugate gaze (mediated by the longitudinal fasciculus for the 6th nerve axis) and tracking. Auditory signals, while important for orientation in the terrestrial environment, are of limited usefulness for spatial in the noisy and artificial environment of aviation, apart from use in communications. 3.0 Spacial Disorientation (SD) Spacial disorientation is the subject of detailed attention in aviation and is the primary cause of more than 15% of all aviation accidents (Reinhart ,2008 p.126). It is regarded by aviation safety authority Tony Kern (1998, p.263)) as one of four “killing conditions”, (alongside unexpected weather deterioration, low flying, and mid-mission planning changes) that can be addressed by training and flight discipline. A case-control study of 72 accidents revealed that an initial license acquired above age 25 years, and not having an instrument rating are each associated with a 4-fold increased risk of being in a general aviation crash in instrument meteorological conditions (Groff and Price, 2006). Reporting of SD is likely to vary inversely according to its lethality , and is also influenced by organizational culture and training habits of the reporting group. As of 2003, the USAF and RAF reports of the various types of SD in military flight vary significantly (Mathews et al 2003 and Holmes et al 2003 cited in Rainford 2006, p.435). The majority SD incidents leading to accidents are “Type 1”, or unrecognized by the pilot (Rainford, 2006 p.436). Unlike earthbound situations, the flight environment is three dimensional, with an additional time dimension having significant 6 implications, due to velocities, altitudes and energies far higher than those experienced during terrestrial evolution. High and sustained rates of acceleration, multiples of basal gravity, night and non visual conditions, hypoxic environments, low humidity, high daytime light and radiation, and high levels of vibration and ambient noise, all contribute to the malfunction of normal physiology and perception. The classification of spatial disorientation is somewhat arbitary, as all sensory inputs ultimately integrate in brainstem, pons, midbrain, thalamus and cortical structures to produce mental orientation constructs. The limitations of terrestrial orientation mechanisms in the flight environment are practically grouped below, as they are experienced in the flight environment, and by major visual and vestibular mechanisms. 3.1 Visual Disorientation The flight environment encompasses high speed motion in the dark or at times almost zero visibility , in 3 dimensions with a big bang at the end if one gets it wrong. Almost without exception, general visual orientation is the most reliable source of orientation both within and without the cockpit. Focal tracking is limited largely by the velocities inherent in flight, rendering objects far away more significant than would be the case in normal daily life. The sky has less detail and interest, lacking the habitual monocular distance cues that orientate us in our developing years. Seemingly minor details at hugely varying focal lengths, such as written text combined with dark or distant horizon scanning, often in low or overstimulated performance settings, can impact irreversibly on aircraft safety. Visual tasks in flight engender aspects of fascination , fixation and distraction (Davis,2008 p667) that can disrupt rational prioritization of tasks, of which being oriented and “flying the aircraft” is always the primary duty. On the ground one can always sit down a forget about gravity and altitude for a while, but in flight , and especially in non dual flying (despite the illusory calm of the autopilot), disaster is always just a few seconds away. The major contributors to visual disorientation in the flight environment are discussed below, although occulogyral and occulogravic illusions are addressed later, under vestibular illusions. 3.1.1 Focal Object tracking errors. 7 The inadequacies of focal scanning and visual acuity in the aviation setting are very evident in object tracking and collision situations. Such cues are not always well suited to the non terrestrial velocities of the flight environment. Size and angular constancy can be misleading. A collision from peripheral locations will maintain the same angular location in the visual field until impact . Focally processed object size remains quite small until late in the collision process, giving misleading monocular cues, insufficient to predict and avoid collision in the remaining reaction time (Green, et al. 1998 p 56). In addition, G forces associated with flight may cause problem with acuity generated by spectacles and contact lenses, as well as reduction in the efficiency of head movement for object tracking. G forces may also lead to major deterioration in visual orientation and unconsciousness, as noted below. Acuity may also be reduced by the corneal effects of dry cockpit air, and air at altitude ( Green,R. et al 1996 p.72). Contrast is important for object discrimination, which has led to modern Hawk training aircraft in the RAF being painted black to aid rapid visual location. Severe loss of contrast may occur at night, as well with flight into a sun low on the horizon, and in other situation of solar glare. Another major loss of focal contrast cues occurs in flight over water, snow or dust. Absent focal contrast cues also reduce flat surface perception, and have been reported in 33-56% of military pilots ( Rainford ,2006 p.435). Focal contrast cues are also important for ambient vision. Depth perception at distance is largely a monocular process, with semiconscious integration of parallax, perspective, relative size, contour overlap, distance related object colour and clarity cues to estimate depth. One or several of these cues, such as loss of visibility related aerial image cues for distance, can vary in the flight environment, and cause false percepts. Timing issues with accommodation when transferring attention from within to outside the cockpit create delay of several seconds in distance vision focus. Poor instrument layouts can place tasks requiring focal attention in the ambient field of the pilot, leading to further delays and risks in visual processes. 3.1.2 Ambient cue alteration and disorientation. 8 Empty field myopia in an open, low visibility or night sky, occurs quite naturally in subjects left unchallenged by significant external objects of focus.The resulting focal point of 1-2 metres is not adequate for aviation safety. Autokinesis is the perception of false movement of an external object such as a light when fixation occurs for a prolonged period. The flight environment can at times lack terrestrial variety, and this phenomenon occurs more frequently in low variety visual fields (Reinhart, 2008 p.146). Loss of Horizon used for habitual ambient orientation may also occur due to sand, snow, or atmospheric conditions. This has been reported in 69-82 % of military pilots (Rainford, 2006 p 435). False horizons and surface planes (such as linear cloud formations) may give erroneous horizontal visual references. The lean on the sun illusion may, however, be a more primitive reflex, with terrestrial instincts relating to the overhead position of the sun in body attitude, leading a false command of the aircraft to a sunoverhead attitude. This has been reported by 66-75% of military pilots (Rainford, 2006). Vection illusions such as strobe lights in clouds can produce angular illusions, giving misperceptions of linear motion originating from ocular stimuli. Strobes are also not used in circuit flight and on taxiing, due to the distracting effect on the ambient vision of the pilot and surrounding aircraft. Flares and lasers also pose a risk to the ambient environment of the pilots, as well as a direct retinal blinding effect in some circumstances, and are of recent topical interest around Australian airports. 3.1.3 Colour alteration Disorientation may occur if red/green blind pilots require the assistance of PAPI or VASIS on final approach, and when orienting using coloured Electronic Flight Instrument Systems (EFIS) 3.1.4 Vibration and visual fixation Vibration in the aviation environment can be tolerated (as far as object fixing is concerned) up to a frequency of about 8 HZ by function of vestibulo-ocular reflexes. Vibratory movement of an object cannot be 9 stabilized by the pilots’ vision above 1HZ. Higher frequencies of vibration such as 60-90 Hz and 17-25 Hz cause resonance of the eyeball and the head respectively, further compromising visual acuity. 3.1.5 Gravitational effects unique to aviation. As indicated above, vision deteriorates from 3.5-4.5 Gz (decay in peripheral vision), to 4-5Gz (total loss of vision), and ultimately to loss of consciousness ( G-LOC) at 4-6Gz . This cause of impaired visual orientation is most relevant to military flight, and aerobatics, particular in older pilots. 3.1.6 Night flight – specific problems Physiologic dark adaptation photochemical replacement is a slow, non linear process, with an initial 1 minute increase in dark adaption of 10 fold becoming a 40 minute dark adaption of 25,000 fold. Pupillary adaption is more rapid increasing night acuity 30 fold quite quickly. Most pilots would agree that the human eye, when flying at night, is not the useful organ it has evolved to be in the daytime. The night blind spot created by absence of night vision rods in the macular area requires adaptive off centre tracking techniques at night for pilots. Relative hypoxia above 5,000 feet (or lower altitudes in the elderly and smokers) leads to as much as 30% deterioration in night time vision relative to lower altitudes. Autokinetic illusions are mentioned above, along with reduced night contrast, increasing disorientation risk at night. Night myopia occurs, particularly in corrected myopes, as a result of enlarged pupils and slight involuntary accommodation altering the shape of the eye, lens and cornea. Loss of almost all ambient visual cues during a “Black Hole “ night approach to land, substantially increases risk of SD and loss of aircraft control. When training, the pilot is required to rely on remaining instrument cues (attitude, altitude, airspeed and rate of descent) and external runway light cues, right down to the limited additional orientation of landing lights during flare just above the runway. 3.1.7 Approach to landing - visual illusions 10 Shapes not usually viewed in terrestrial context can lead to depth and height misperceptions in aviation. Runway width that is narrower than usual may lead the pilot to infer a high approach, and thus fly lower than necessary on finals. Conversely, a wide runway may falsely infer a low approach, leading to a pilot flying an inaccurately high approach. This latter event will lead to delayed touchdown, and at times missing the appropriate taxiway at major city airports! Upsloping terrain on approach may falsely infer greater altitude above the runway than is the case, leading to an excessively low approach (the converse also applies). Lack of ground features of appropriate scale may falsely infer greater altitude than is the case leading to a low approach .This is particularly true of water approaches (Reinhart, 2008 p.147-149). 3.18 Helicopter flight - specific visual problems in orientation Another vection illusion is the “waterfall effect” in which helicopter hovering or slow flight over water can produce the illusion from water particles in downward motion that the aircraft is climbing relative to the outside. The wave drift effect is also a vection illusion produced by hovering in poor visibility, as water or tall grasses is seen to move away from the aircraft falsely inferring motion in the opposite direction. Lack of sufficient external visual cues to indicate motion produces the lack of motion illusion, which may lead the pilot to attempt an unnecessary increase in airspeed. Significant loss of visual cues also occurs in the brown-out or white-out effects of rotor wash near landing sites. Night visual operations using infrared vision with a narrow field of view leads to the peripheral field of vision inferring a descending trajectory of objects moving near the aircraft (the crater illusion) when in fact they are in straight and flight. This produces some added risk for night vision device (NVD) operations , which are the source of more than 40% of all SD-related accidents in a USAARL study of military helicopter accidents (Davis,2008). 3.2 Vestibular disorientation Terrestrial vestibular orientational cues are regarded as inherently unreliable in non visual conditions. Pilots are trained to avoid rapid head movements, and to give active continous priority to visual instrument cues at night, in instrument conditions, and during transitions to and 11 from VFC to IMC conditions (Kern,998 p267). In flight, vestibular disorientation risk is worsened by stress, hypoxia, distraction, boredom, single pilot operations, and advancing pilot age. In general these disorientations are classified as false perceptions relating to linear motion or attitude, or false perceptions relating to angular motion and vertigo (Rainford, 2006 Ch. 28). Vestibular orientation in the flight environment deals with the added effects of rapid or sustained motion, at gravities higher than terrestrially experienced, and with the addition of 3 dimensional motion and vibration not normally experienced in the evolutionary environment. Its worth noting at the outset that subtle, sub threshold variations in subject motion, while of lesser importance terrestrially, if remaining undetected in the flight environment, may have significant implications for safety due to the multiplication effects of the velocities and energy inherent in an aircraft in flight. 3.2.1 The “Leans” – false perception of attitude and linear motion This is regarded as the most common illusion experienced in flight (Reinhart, 2008 p.139), usually in instrument conditions. Prevalence rates of 92% (RAF) and 76 % (USAF) are reported (Rainford, 2006 p.435)). A slow undetected turn in these conditions can register as straight and level (S &L) flight, with subsequent attempts to resume S & L being erroneously perceived as banking in the opposite direction. The affected pilot leans in the direction of the original undetected turn, and tends to re bank the aircraft in that direction. The cause of this phenomenon is poorly described, and is thought to be due to inaccurate baseline signals from otolith structures, which can only be oriented (“reset”) by visual means where visual input from instrument orientation is often inadequate (Rainford,2006 p.448).The problem is usually easily addressed by the presence of unambiguous external visual cues, but can be a problem in prolonged IMC flight (not typical of terrestrial conditions!). 3.2.2 Somatogravic Illusions – false perception of attitude and linear motion Errors in attitude perception occur due to confusion of acceleration force with gravitational force in the flight environment, particularly in IMC 12 conditions, although subtle effects occur in VMC flight. Classic lethal accidents occur, typically post take-off with a 20-30 degree pitch down attitude, in IMC or night VMC, or IMC after overshoot on landing ( Kern,1999 p.268 and Rainford ,2006 p.445)). These illusions confuse acceleration as pitch up. Pilots can also confuse deceleration as pitch down,( leading to a pitch up command risking stall at low level) , or confuse a coordinated turn as a wings level attitude. Similarly, an aircraft in a subtle accelerating undetected descent may give an illusory perception of being more nose high than it is, and pilots may command a nose down altitudes in response – a response of increased risk for low level flight, and also glider pilots with low maximum airspeed limits ( Rainford, 2006 p. 445). Occulogravic illusions also originate in the otolith and are related to somatogravic illusions. These illusions lead to externally perceived displacement of visual cues as a result of gravity or linear motion of the body.The somatogravic illusion of pitch up on acceleration may be associated, for example, with a perceived upward movement of objects (termed the “elevator” illusion) within the visual field (Rainford, 2006 p.446). 3.2.3 G- excess illusions - false perceptions of attitude and linear motion G excess illusions are a sub group of erroneous sensations produced by prolonged or atypical sensation of otoliths by large radius turns, generating illusionary sensations of climbing or diving when moving the head in pitch axis. 3.2.4 Somatogyral illusions – false perception of angular motion Constant angular motions at a constant speed will also lead to a gradual cessation of SCC stimulation, usually over 10-15 seconds. This can lead to a false sensation of the spin being less intense than it really is. Of particular danger however is the period of cessation of spinning movements, when the subject may feel a false perception of spinning in the opposite direction due to the inertial energy of the cupula continuing the stimulus in the direction of the original spin. This may led to overcorrection of the spin recovery in the opposite direction. 13 The orientational dangers of spin correction therefore increase with the length of time of the aircraft’s spin. At the time of spin cessation, the only reliable sensory inputs are visual (Rainford, 2006 p.449) at a time when nystagmus may be impairing visual acuity. Spin recovery is no longer a mandated requirement of non commercial aviation training in Australia. 3.2.5 Oculogyral illusions – false perceptions of angular motion due to image stabilization failure Inappropriate signals from the SCC’s also have disorienting effects on visual perception. External objects fixed at the beginning of a turn or a roll can create the impression that internal objects moving in unison with the aircraft (such as the instrument panel) to be moving in the same plane. Also, on recovery from a turn, objects may be perceived as moving in the same direction as the erroneous perceptions of the turn. External objects can be subject to this illusion, with false perceptions of non turning leading to external lights being perceived as having motions when in fact they do not. There are reports of aircraft attempting to join formation with nonmoving lights due to this Illusion! 3.2.6 Coriolis Phenomena (cross-coupling) - false perceptions of angular movement due to stimulation of semicircular canals. Coriolis illusions are bizarre vestibular sensations produced by combined stimulation of multiple axes of the SCC’s . The phenomena occurs when the relative axes of yaw, pitch and roll are falsely interpreted as alternate axes due to complexity of head movement – ie a head movement in roll plus pitch whilst experiencing simultaneous yaw. The author has experienced this in dark night aviation and it is a frightening event, risk being resolved only by immediate attention to the artificial horizon, and by straight and level flight. In Coriolis stimulation, a “head referenced” action, can be powerfully and falsely attributed as being “Earth referenced”. The event is usually a major conflict between SCC and otolith inputs, not normally experienced terrestrially unless one has labyrinthitis or is rolling down a hill in a barrel! The experience of motion sickness may also be type of coriolis event, and it is interesting to note that ballet dancers tend to focus on one object whilst spinning, presumably in an attempt to achieve a stable head reference whilst avoiding complex head movements. 14 3.2.6 Flicker vertigo and pressure vertigo These are less common as aviation dangers, however vertigo and nausea can arise from non biological flickering stimuli often in the 8-10 Hz frequency and usually from instrument clusters, or even from helicopter rotors. Dysfunction of vestibular systems from pressure inequalities not usually experienced in terrestrial conditions may trigger false signals of movement, vertigo, nausea, as well as significant nystagmus affected visual tracking. 3.3 Postural Disorientations (Reinhart, 2008 p.128) Unbalanced turns in flight, especially in the climb, with significant skidding or slipping, can generate tissue and proprioceptive signals that give the impression of tilting (false earth references). 3.4 Technology and Spatial Disorientation One final observation is that many accidents occur due to the pilots forming a false cognitive belief in the accuracy of automated flight orientation, a form of orientation non existent in our evolutionary history! Pilots forming an unchallenged belief in the total accuracy of automated orientation will eventually be found short. Unchecked navigational computer inputs, false pitot information, false beliefs that an autopilot is engaged when it is not, or not engaged when it is, lead to dangerous command decisions overriding even simple visual observation of the flight attitude indicator. In situations of high stall risk, and when close to the ground, a false cognitive “ hierarchy” may override practical visual instrument cues and recovery techniques, leading significant loss of life (Job, 2011 pp. 60-61). 4.0 Conclusion Major loss of life still results from spatially disoriented command inputs in commercial flight, such as the loss of 114 lives of Air Kenya flight KQ 507 in Cameroon in 2007, and 148 lives in the Flash Airlines flight 604 accident at Sharma El-Sheikh, Egypt in 2004 (Job, 2011). 15 It is clear to aviation physiologists that due to our terrestrial evolutionary environment, humans are not physiologically well adapted to flight. Since December 17th, 1903 however, pilots unaware of the limitations of terrestrially originated spatial references, sadly do not escape that same process of Darwinian natural selection. 16 References Davis,J., Johnson,R., Stepanek,J., Fogarty,J.(Eds.) Fundamentals of Aerospace Medicine 4th ed.(2006). Phildelphia. Lippincot Williams and Wilkins. Flight Safety Australia. (2011). That was the year that was; 78:44-45 (no author). Goff,L.S., Price,J.M. (2006). General aviation accidents in degraded visibility: a case control study of 72 accidents. Aviation Space and Environmental Medicine,77(10):1062-7. Green,R.G.,Muir,H.,James,M.,Gradwell,D.,Green,R.L.(1996) Human Factors for Pilots. Surrey, U.K. Ashgate Publishing. Harding,R.,Mills,F.(1993).Aviation Medicine. London. BMJ Publishing. Job,M. (2011). A dark and stormy night - and 90 seconds to disaster. Flight Safety Australia, May-June,80:58-61. Kern,T. (1998). Flight Discipline. New York. McGraw Hill. Li,G., and Baker, S. (2007). Crash Risk in General Aviation. Journal of the American Medical Association; 297(14): 1596-1598. Maurino,D.,Reason.J.,Johnston,J.,Lee,R. (1995). Beyond Aviation Human Factors. Surrey, U.K. Ashgate Publishing. Rainford,D.J.,Grdwell,D.P.(eds.)(2006). Ernsting’s Aviation Medicine (4th Ed.) London. Edwin Arnold. Reinhart,R.O. (2008).Basic Flight Physiology. New York. McGraw Hill 17 University of Washington,Tacoma. Central visual Pathways Ch. 15, pp.97-106. Retrieved from http://courses.washington.edu/psych333/handouts/coursepack/c h15-Central_vision_pathways.pdf 18