Naval Medical Research Unit – Dayton, 711th Human Performance Wing partner to combat physiological episodes during flight

WRIGHT-PATTERSON AIR FORCE BASE, Ohio – The Naval Medical Research Unit – Dayton and the Air Force Research Laboratory’s 711th Human Performance Wing have joined forces to respond to a number of instances where military pilots have experienced physiologic episodes such as “hypoxia-like” symptoms during flight.

Together, the two organizations are leveraging their joint research expertise to answer the most complex aeromedical, environmental health, and human performance challenges facing the military today.

NAMRU-D has been based at Wright-Patterson Air Force Base since 2010 when the Naval Aerospace Medical Research Laboratory, or NAMRL, moved from Naval Air Station Pensacola, Florida, and joined with the Navy’s Environmental Health Effects Laboratory already at Wright-Patterson to form NAMRU-D. NAMRL’s move was based on a 2005 Base Realignment and Closure decision that has helped NAMRU-D partner with the Air Force Research Laboratory’s 711th Human Performance Wing here in conducting research into a number of human performance areas.

“A physiologic episode is where a pilot or an aircrew member experiences physiologic symptom’s that are not normal for the environment he or she is in,” said Dr. Richard D. Arnold, Naval Aerospace Medical Research Laboratory director.

According to Arnold, aircrew members undergo altitude training which was previously done mostly in a low-pressure chamber, but the Services are now doing it more using gas mixing, or low-oxygen mixture using a device called a Reduced Oxygen Breathing Device which replaces oxygen with nitrogen.

“The trainee will wear an oxygen mask and will breathe this reduced oxygen air and they will get hypoxic. The purpose of that is so they can learn to recognize the symptoms so that if they occur in flight they’ll know what’s going on,” Arnold said.

“There have been a number of incidences where pilots have gotten hypoxic, recognized their symptoms, pulled the emergency oxygen ring, and safely recovered and returned to base.”

“There are other physiologic conditions that can produce similar symptoms,” Arnold said.

“For example, hyperventilation. Now you have too much oxygen and you wash out carbon dioxide and you can get symptoms that are very similar to the symptoms of hypoxia, but the remedy is very different. You don’t want to go on emergency oxygen. In that case you would want to slow your rate and depth of breathing to recover.”

Arnold said it is very important to diagnose for these different physiologic episodes exactly what is happening so that for any given circumstance the correct remedy can be applied.

“There are any number of different things that can produce a physiologic episode. It’s a bit elusive for that reason alone so we’re attempting to address it systematically, identify everything that could go wrong, and then develop tools to detect when those particular things are going wrong so that pilots can have the tools they need to respond effectively.”

NAMRL was originally located just about a block away from the Navy’s Environmental Health Effects Lab on the base. Not long after, the Navy decided to combine the two labs into a single command – the Naval Medical Research Unit – Dayton. Today, the command has a staff of about 85 people.

Arnold cited the enhancing effect of the proximity of the labs.

“USAFSAM moved up from San Antonio at the same time and within the first year of moving to Wright-Patt, the Air Force F-22 situation reared its head. We’d been talking with the Air Force and touring each other’s labs and learning what each other did. We were invited to join their response team and participate in the F-22 response, so we had a small group of researchers from our lab who were involved in the F-22 response from the outset and contributed quite significantly.”

“After that situation began to calm down, NAMRU-D continued working with the 711th on human physiology at altitude research and six months ago, the Navy physiologic episode situation came up with the T-45 Goshawks, causing them to be grounded,” Arnold said.

“Shortly thereafter, the F-18 Hornets had some concerns. We were able to reach across the road to our Air Force partners and they’ve been helping us with the Navy response – it’s perfect symmetry and a great BRAC success story.”

One of the research tools that was developed by the Air Force during the F-22 Raptor oxygen investigation is the Real-Time Air Quality Sensor, which NAMRU-D consulted on along with the 711th.

“It’s now being installed on the T-45 and F-18 Hornets in order to sample the breathing air that’s being produced by those jets,” Arnold said.

NAMRU-D’s Environment Health Effects Lab has been located at Wright-Patterson since the 1975-76 timeframe and prior to that, was located in Bethesda, Maryland.

“The Environment Health Effects Lab looks at potential health effects associated with all types of environmental exposures,” said Dr. Karen L. Mumy, Environmental Health Effects Lab director.

This lab has previously studied health effects related to particulate matter exposure, focusing on pulmonary effects, in addition to the breathing atmospheres onboard submarines, and many other exposures relevant to military men and women.

“We recently performed a study that looked at the combinatory effects of both particulate matter [sand] true to deployed locations such as Iraq and Afghanistan as well as burn pit emissions,” Mumy said.

She added that there are a number of stressors, or hazards that no matter what Service you’re in, service members could be exposed to including jet fuels, coolants and hydraulic fluids. Another major hazard, according to Mumy, is noise.

“Hearing loss is the number one most costly health effect for the VA,” Mumy said.

Another area that NAMRU-D is partnering with AFRL is a project to develop new selection tests for RPA operators.

“All the Services have very well established and validated selection tests to screen pilots for manned aviation. Those tests are very effective in identifying people who have the ‘right stuff’ if you will. But there’s not anything available that was designed to measure the ‘right stuff’ for RPA operators,” said Arnold.

“We’re working with AFRL on a Navy funded project out of the Office of Naval Research and ONR has agreed that the tests generated by the project will be available for the Air Force to use as well,” Arnold said.

NAMRU-D is also working with AFRL on pilot spatial disorientation – the single leading cause of Class A flight mishaps across all the Services, according to Arnold. Jointly, they’re working on some novel helmet-mounted display symbology to try to reduce incidents of spatial disorientation, targeting F-35 helmet symbology.

The Disorientation Research Device at NAMRU-D, known as the Kraken, was accepted by the government in October 2016 and has its first research project scheduled to begin data collection using volunteer participants in October.

Both NAMRU-D and the 711th join officials from the Army, NASA, and Federal Aviation Administration once a year to discuss past and current aerospace medicine research, programmatic research objectives, future research, and potential collaborations across the U.S. government as part of the Aeromedical Research Alignment and Collaboration Working Group.

“We compare notes and make sure that all the big problems are covered from a research perspective and that we’re not unnecessarily duplicating efforts and to see if there are opportunities to align research,” said Arnold. The Air Force will host the next meeting, Jan. 18, 2018 at Wright-Patterson to coincide with the 100th anniversary of the establishment of the United States Air Force School of Aerospace Medicine.

The Environmental Health Effects Laboratory also participates in a Tri-Service Toxicology Consortium for much the same purpose and their next meeting will be Aug. 16-17 at Tec^Edge, Wright Brothers Institute, Dayton, Ohio

“Funding dollars are slim so we all have to work together to ensure we’re really leveraging each other’s expertise and capabilities,” said Mumy.

Naval Medical Research Unit Dayton’s mission is to maximize warfighter performance and survivability through premier aerospace medical and environmental health research by delivering solutions to the Field, the Fleet and for the Future.