Decompression Sickness Risk Assessment and Awareness in General Aviation

Michael F. Harrison, William P. Butler, M. Hassan Murad, Gary N. Toups

Research output: Contribution to journalArticlepeer-review


INTRODUCTION: Decompression sickness (DCS) can occur during unpressurized fight to altitudes. 18,000 ft (FL180; 5486 m). To our knowledge, this has not been studied in general aviation (GA). This knowledge gap may have public health and safety implications because the most popular models of GA aircraft by sales volume are capable of fying.FL180. METHODS: Data from a 1-yr period in a commercial flight tracking database were analyzed to identify fights.FL180 in unpressurized, piston aircraft in the United States. Peak altitude and duration at that altitude were used to calculate DCS risk employing the U.S. Air Force (USAF) Altitude Decompression Sickness Risk Assessment Computer (ADRAC). Registration numbers were cross referenced in publicly available federal databases to identify any events that might be attributable to impairment due to DCS. A web-based survey of practices and associated symptoms was also made available to GA pilots through an online discussion forum. RESULTS: During the data collection period, 1696 flights occurred. The DCS risk was calculated to be 1.9 ± 4.2%. There were 42 responses to the survey. Of these, 25 (59.5%) pilots reported having flown at altitudes.FL180 and 21 (84%) of them reported symptoms possibly attributable to DCS. None sought medical attention. No safety events were identifed for any of the aircraft during the study period. CONCLUSION: The risk of DCS in the GA community is not zero. As GA aircraft performance profiles advance and sales increase, this may have signifcant implications from a public health and safety perspective. Further study is warranted.

Original languageEnglish (US)
Pages (from-to)138-148
Number of pages11
JournalAerospace Medicine and Human Performance
Issue number3
StatePublished - 2021


  • decompression sickness
  • hypobaria
  • private pilot
  • public health

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Public Health, Environmental and Occupational Health


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