Embouchure Dysfunction in Air Force Band Brass Musicians.

UNLABELLED: Occupational injuries and medical problems in musicians are well described, but relatively less attention has been paid to orofacial and embouchure-related problems in professional brass players. This study addressed embouchure-related problems in Air Force Band members, a population of musicians with an intense practice and performance schedule. METHODS: A survey was developed and distributed via the Air Force Survey Office to 599 active-duty Air Force Band members and 201 Air National Guard members. The survey assessed practice patterns, practice and performance venues, and presence of symptoms suggesting embouchure dysfunction. RESULTS: Responses were obtained from 167 Air Force Band brass players. Of the 157 responding to the question about embouchure dysfunction, 42% reported having experienced an embouchure problem at some point in the past, and 53% of those respondents reported that they were currently experiencing an embouchure problem. Forty-one percent of those with embouchure problems cited practice venues that were not conducive to effective and efficient practice at the time their embouchure problems began, and 48% of those with embouchure problems reported having to overblow in rehearsal at the time their problems began. DISCUSSION: Embouchure disorders were reported in a large proportion of Air Force Band brass survey respondents, and specific concerns related to practice venues and the need to overblow in practice settings suggest factors suitable to remediation and preventive strategies.

Primary cerebral lymphoma: clinical and aeromedical considerations.

Cancer, and the complications of cancer therapy, can present significant obstacles to the airman wishing to return to flying status. If found to be free of recurrent lymphoma and to be neurologically intact after completion of therapy, applicants can be considered for a time-limited medical certificate, provided that they are otherwise qualified. Long-term follow up of patients must include not only disease-free survival time, but also serial neuropsychometric evaluation and quality-of-life assessments. This case illustrates the aeromedical considerations and certification issues for a patient presenting with performance issues progressing to discreet neurological findings, culminating in the diagnosis and treatment of primary central nervous system (CNS) lymphoma.

Gastrointestinal Disease in Pilots, 2001-2013.

INTRODUCTION: The frequency and distribution of gastrointestinal (GI) disease in the population of active duty Air Force pilots is poorly understood, even though GI illness can temporarily or permanently lead to disqualification from flying duties. Better understanding of GI disease within this population could yield considerable operational risk and human performance insight and provide data to use in assessing the effectiveness of current medical standards related to flight training and flying duties. METHODS: A dataset reflecting inpatient and outpatient healthcare visits from 2001 through 2013 was developed and reviewed. Gastrointestinal illness was grouped into 18 subcategories of disease, and the frequency and distribution of visits for these categories were tallied. The total burden of GI illness over the target dates was compared between pilots, nonpilot aircrew/special operational duty personnel, and nonaircrew/nonspecial duty personnel. RESULTS: Esophageal disease and dyspeptic conditions were the two most frequently encountered diagnoses among all three population groups, comprising almost 50% of the gastrointestinal diagnoses in age and gender-matched samples of all three populations. The overall burden of disease over the total timeframe of the study was not statistically different in the three populations, with a median of four encounters per person for GI disease. Of interest, the total burden of disease increased over the course of the study period in all populations, driven in large measure by increases in esophageal disease and dyspeptic conditions. DISCUSSION: The general distribution and overall burden of GI disease in populations of Air Force pilots, nonpilot aircrew/special operational duty personnel, and nonaircrew/nonspecial duty personnel were similar. The increase in esophageal and dyspeptic conditions over time warrants further attention.

Medical waiver experience at U.S. Air Force Special Operations Command, 1992-2003.

INTRODUCTION: Strict physical standards are applied to military applicants and service members, but these standards can be waived on a case-by-case basis when a member is felt to be capable of continued service in spite of their infirmity. Knowledge of the waiver experience at the unit or major command (MAJCOM) level could yield important operational risk management insight. The present study examined the waiver experience at Air Force Special Operations Command (AFSOC) from 1992 through 2003. METHODS: A dataset reflecting the accumulated waiver experience at AFSOC from 1992 to 2003 was reviewed. Diagnostic groups and occupations were tallied, and waiver rates determined for each. RESULTS: There were 1042 individuals considered for waivers of 1270 medical conditions. Combat controllers made up the largest occupational group, and were statistically more likely to seek waiver consideration than would be expected in the general AFSOC population. The five most commonly encountered diagnostic groups were: otorhinolaryngologic, 26.9%; musculoskeletal, 17.6%; ophthalmologic, 10.9%; cardiovascular, 7.2%; and gastrointestinal, 7.9%. Waivers were granted to 83.9% of the group. Pilots and navigators were more likely to receive a waiver, and aerial gunners were less likely to receive a waiver. DISCUSSION: The five most commonly encountered diagnostic groups accounted for 69% of waiver requests, and the overall waiver rate of 83.9% exceeded that reported in other studies. This MAJCOM-specific data could serve as a valuable resource for comparison to waiver data obtained from other MAJCOMs, and could aid in the development of targeted operational risk management activities.