Alternative Medicine ― Impacts to Flying Safety

摘要

Complementary and Alternative Medicine (CAM) therapies have been functionally defined as interventions neither taught widely in medical schools nor generally available in US hospitals. The use of CAM treatments has been increasing due to greater adoption of these strategies by the public with health care professions and industries following public demand. Most patients use CAM along with conventional strategies, and it has been estimated that only about 5% of patients use only alternative treatments. Finally, an estimated 15 million adults in 1997 took prescription medications concurrently with herbal remedies and/or high dose vitamins (18.4% of all prescription users). CAM treatments are often assumed to be safer than conventional strategies, i.e. "natural". Some illustrative examples of CAM include herbal therapy, including St. John's Wort for depression, acupuncture, spinal adjustments for low back pain, therapeutic touch, and chelation therapy. Given the scope of this paper, we will cover primarily herbal therapy and the top ten (10) herbs in clinical practice. These herbs may be used by pilots to enhance health and performance and their uses, side effects and safety should be available to anyone concerned with the health and safety of pilots. An excellent reference for this topic is the monograph by Micozzi. (1) CAM use is increasing. It has been estimated that the proportion of patients trying CAM therapies has increased from 34% (427 million visits) in 1990 to 42% (629 million visits) in 1997. Overall expenditures have increased from $14 billion to $27 billion and most of these expenditures are not reimbursed by insurance. The therapies increasing the most included herbal medicine, massage, megavitamins, self-help groups, folk remedies, energy healing, and homeopathy. Of interest to the aviation medicine practitioner, the highest rates of use (50.1%) were reported for the 35-9 age group that may include many active pilots today. Higher usages were also noted for those with college education (50.6%) and with annual incomes above $50,000. Again, the professional pilots fit these categories;