INTRODUCTION: Hypoxia continues to be a significant threat in military aviation. In an attempt to counter the hypoxia threat, military jet aviators receive periodic training using a reduced oxygen breathing device (ROBD). This study explored the characteristics of in-flight hypoxia events among tactical jet aviators and compared reported symptoms to those experienced during ROBD training. METHODS: An anonymous survey was administered to naval aviators prior to aviation physiology training. The survey queried them about previous in-flight hypoxia encounters and the symptoms they experienced. These data were then compared to symptom data from a previous ROBD training survey using Chi-square analyses. RESULTS: Of the 566 aviators who completed the survey, 112 (20%) reported experiencing hypoxia symptoms in a tactical jet aircraft and 64 aviators (57%) indicated they were not wearing the required oxygen mask when the incident first occurred. The results also revealed only 21% of hypoxia events were reported in aviation hazard reports and the three most commonly recorded in-flight hypoxia symptoms were tingling (54%), difficulty concentrating (32%), and dizziness (30%). Chi-square analyses revealed statistically significant differences in frequency of reporting between 5 of 16 symptoms encountered in flight compared to ROBD training. DISCUSSION: The present investigation is the first survey-based study of hypoxia events in U.S. naval aviation. The study reveals in-flight, mask-on hypoxia has a similar overall reported symptom profile to ROBD training. Further, results suggest increased oxygen-mask compliance among these aviators may be necessary to effectively combat in-flight hypoxia.
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