1. Human Factors  Col William W. Pond, MD, SFS, INANG  Indiana State Air Surgeon  AANGFS Readiness Skills Verification (RSV) Program  25 July 2015 at Andrews AFB, MD

2. RSV Requirement for 48G & 48R  HUMAN FACTORS BRIEFINGS:  IRC, Quarterly Wing Flying Safety  Must be accomplished every 24 months  May be satisfied by AMP, RSV course, briefing, NVG course, or HUD tape, or suitable substitute.  May also be satisfied by reading relevant portion of Flight Surgeon’s Guide, or SGP Tactics Guide.  More specific requirements are under development  Must perform at least 2.

3. RSV Requirement  This lecture will fulfill the 2 in 24 month requirement  Human Factors review by Col William Pond  Night Vision Goggle Review  Heads Up Display Review  Human Factors/Tobacco Interaction by Col John Sotos  Human Factors/Decompression Sickness by Col Lisa Snyder

4. Objectives Lecture  1. Define Human Factors  2. Give brief history of Human Factors Integration  3. Night Vision Technology  Review Night Vision Goggle Technology  Flight Surgeon items to review  4 Heads Up Display  Review Head Up Display Technology  Flight Surgeon items to review

5. Disclosure of Relevant Financial Relationships  Col Sotos, Col Snyder Col Pond (or spouse or significant partner) do not have any conflict of interest or relevant financial relationship with any commercial interest.  (Additional information or questions may be addressed to the, Col William Pond, (260)602-5167 or wwpond@aol.com) wwpond@aol.com 25 July 2015 CME providers are required by ISMA/ACCME accreditation standards to identify and resolve conflicts of interest prior to the educational activity. (Information projected at beginning of lecture and placed adjacent to sign-in roster.)

6. Human Factors  Definition  “Fit the system to the operator to improve performance.”  History  WWII origins with the flying community  1960s highly incorporated in the NASA Apollo  1982 USAF Systems Integration  Present USAF Flight Surgeon RSV Training  Present in many varied disciplines

7. Human Factors Human Systems Integration includes: Human Elements Personnel Training Environment Safety Occupational Health Survivability Habitability

8. Human Factors Training Generate an understanding of how humans interact with the environment, each other and their equipment. 1. Must first share a common vision and understanding 2. This improves effectiveness of the individuals and their system. 3. Decreases cost 4. Decreases mishap rate

9. Night Vision Technology: How to “nogs” work?

10. Night Vision Googles

12. Principles of operation

13. The Human Factors Trade Off  Higher sensitivity and resolution:  Higher weight, more strain on neck  Trade off between resolution & sensitivity  Bright light “Halo Effect”  Increased power requirements, decreased battery life

14. Common Human Factors  Weight/balance of device on head/neck  Hyperstereopsis  Visual acuity  Blurred/tired vision  Hypoxic effects at altitude on vision

15. Head and Neck  Clear association between NVD use and both in-flight and post-flight neck discomforts  Headaches are common in both NVD and non-NVD sorties  Headache duration normally < 1 hour  Incidence and duration linked to the length of the sortie and the amount of concentration required; thus, may be an issue with visual strain

16. Hyperstereopsis  Over-demand for convergence  Stresses oculomotor system; increased visual fatigue  Creates slightly magnified images, creating illusion of being lower than actual altitude

17. Visual Acuity  Best attainable acuity ~20/40 with NVDs  USAF trials show that maximal acuity is attained by making adjustments in controlled, preflight lighting conditions  20/35-20/40 for controlled preflight conditions  20/50-20/55 for in-flight adjustments

18. Visual Acuity Adjustment Principles

19. Visual Acuity Adjustment Procedure 1. Align vertical 2. Adjust tilt (tilt adjustment level) 3. Check interpupillary distance (eye span knob; controls stereopsis) 4. Adjust eye relief (fore/aft adjustment nob) 5. Objective lens focus 6. Diopter lens focus 7. Focus check at 3 meters, using Snellen card 8. Note settings 9. Refocus to infinity, using standard aircraft lettering at least 30 meters away in the dark area of the airfield

20. Blurred Vision Tip  Two factors appear to be at play here:  Increased incidence after using NVD for > 1 hour  Increased incidence after cumulative NVD experience (> 100 hours)  Often necessitates in-flight visual acuity adjustments  Leads to reduced visual acuity (20/50) from baseline preflight acuity (20/40)

21. Hypoxic Visual Acuity Effects  Mild hypoxia is capable of affecting visual acuity  At 12,500’ altitude, visual acuity drops an additional 25%  With NVDs, this is even more significant as visual acuity is already reduced from baseline

22. For More Information  1.5 day full NVG instructor course  Steven.hadley.1@us.af.mil Steven.hadley.1@us.af.mil

23. Heads Up Display  Also known as “HUD”  Transparent display that presents data without having to look away from viewpoint  Advantage: refocus not required between instruments and outside view

24. HUD Principles  Projection unit is usually optical collimator  Convex lens or concave mirror with Cathode Ray Tube/LED at focus  Focal point perceived to be infinity  “Combiner” is flat angled glass beam splitter  Located directly in front of viewer  Special coating reflects monochromatic light  Other wavelengths pass

25. What is displayed?  Boresight—where nose is pointing  Acceleration Indicator—to left of the FPV (above is acceleration)  Angle of Attack—wing angle relative to airflow  Navigational Data  Airspeed  Altitude Flight Path Vector (FPV)—where the aircraft is going Landing, keep the FPV on the glide desired descent angle Aim the FPV, not the Boresight at the touchdown point

26. Helmet Mounted Display  Helmet Mounted Displays (HMD) is a type of HUD  Moves with the pilot  Is the only type on the F35  Information projected on helmet’s visor  Distributed Aperture System streams real-time imagery from 6 infrared cameras.  Allows pilot to “look through” the airframe.

27. Design Factors  Field of View  Better to have wide FOV for cross wind landings  Collimation: makes light rays parallel and focus at infinity  Eyebox: where the image can be viewed, e.g.  5” lateral  3” vertical  6” horizontal  Luminance/contrast: adjust for ambient lighting

28. Militarily significant HUD  Boresight: Aircraft HUD components aligned with 3 axes  Accuracy to 7.0 milliradians  Projected and actual object must line up  Military aircraft display targeting information in addition to the navigation information displayed on commercial HUDS.  Target Designation (TD)  Vc—closing velocity to target  Range—to target or waypoint  Weapon seeker—where seeker is pointing  Weapons status

29. Spatial Disorientation Start at 1:07

30. Back Seat G intolerance

31. 11-2F16V3 governs G Awareness 3.14.5.1. (PACAF) The G-awareness maneuver will consist of at least two 90 degree turns. (The second turn of the g-awareness exercise for air-to-air sorties will be a minimum of 180 degrees of turn). The first turn will be a smooth onset rate to approximately 4 Gs. Pilots will use this turn to ensure proper g-suit operation and to practice their anti-g straining maneuver. Regain airspeed and perform another 90 degree turn at up to 6-7 Gs. If aircraft limits preclude either of the above, turns should be performed so as not to exceed aircraft limits. Do not perform systems checks or other items that detract from the intended purpose of the G-awareness maneuver.  3.14.5.3. G-awareness exercises will be filmed in HUD and in Hot Mic. In addition, the tactical portion of all basic missions (BFM, SA, ACM, etc) will be flown in Hot Mic to enable assessment of the AGSM. For high task sorties (DACT, Composite Force, Opposed SAT, etc), it is highly desired for pilots to fly in Hot Mic.

32. G-awareness maneuver  3.14.5.2. A G-awareness maneuver will be accomplished prior to any tactical maneuvering, including range missions. Accomplish this maneuver in day or night VMC only.  3.14.5.3. G-awareness exercises will be filmed in HUD and in Hot Mic. In addition, the tactical portion of all basic missions (BFM, SA, ACM, etc) will be flown in Hot Mic to enable assessment of the AGSM. For high task sorties (DACT, Composite Force, Opposed SAT, etc), it is highly desired for pilots to fly in Hot Mic.

33. Flying After Diving by Col Lisa Snyder  Current recommendations by DAN & PADI:  12 hours if single dive with no compression limits  18 hours if repetitive dives in a day.  18++ hours if decompression dives  Source  Flying after Diving: Should recommendations be reviewed? In flight echocardiographic study in bubble- prone and bubble resistant divers. Diving Hyperb Med. 2015; 45(1):10-15

34. The Study  Studied postdive gas bubbles in venous blood ( venous gas emboli, VGE) in 56 recreational diver volunteers, healthy with no history of DCS over 6 day period. Each diver did roughly 13 dives.  Method  Monitored VGE after each dive at 30,60&90 minutes after surfacing. Average maximum depth was around 99 feet of sea water, average dive duration was about 49 minutes, and ascent rates ranged from 30 to 60 feet per minute.

35. Results  Immediately before takeoff, 24 hours after the last dive, VGE were not detected.  After take off however bubbles were detected in eight subjects from the RB group and none from the other two groups, at 90 minutes all subjects were bubble free  23 almost never develop detectable bubbles (NB), 17 divers bubble occasionally (OB), and 16 divers produce bubbles every day after almost every dive (RB)

36. Conclusion  Some divers have a predilection to have bubbles.  Flying commercially, even after a 24 hour surface interval can produce bubbles.

37. Thanks and credits to the following:  Air Force Human Systems Integration Handbook: Planning and Execution of Human Systems Integration  Hugh Griffits: The_Review_Issue_18_White_Maple_Consulting_oct_11.pdf