united states air force school of aerospace medicine united states air force school of aerospace medicine the united states air force school of aerospace medicine (usafsam) is the united states air force (usaf) organization focused on education, research, and operational consultation in aerospace and operational medicine. usafsam was founded in 1918 to conduct research into the medical and physiologic domains related to human flight, and as a school for medical officers trained to support military aviation operations, later coined as flight surgeons. the school supported early military aviation from world war i through the evolution of aviation and into the modern era. usafsam conducted medical research and provided medical support for the initial us space operations beginning in 1947 through the establishment of nasa in 1958. after the creation of nasa, usafsam continued to actively support civilian and military manned space missions through clinical and physiologic research. usafsam is one of the oldest continually operating school for flight surgeons and other operational medical personnel of its kind in the world. usafsam is located in dayton, ohio at wright-patterson air force base, and is part of the 711th human performance wing (711 hpw) and the air force research laboratory (afrl). shield of usafsam – created 21 march 1925 mission education usafsam provides in-residence and distance learning courses graduating approximately 4000 students annually. initial skills training is provided for enlisted and officers in the disciplines of public health and preventive medicine, bioenvironmental engineering, aerospace physiology, aeromedical evacuation for nurses and enlisted medical technicians, flight and operational medicine, and critical care air transport team (ccatt) treatment. advanced and refresher courses are provided in these same disciplines as well as pre-deployment critical care refresher training for surgeons, critical care nurses, respiratory therapists, emergency department physicians, anesthesiologists, and other primary care providers. a two-year accreditation council for graduate medical education (acgme) accredited clinical residency in aerospace medicine is provided for physicians. and a six-month fellowship in aerospace medicine for international officers is conducted each year. usafsam is host to the largest aeromedical library in the us – the franzello aeromedical library. in 2010, 65 students from 46 countries attended courses at usafsam. classrooms over 500,000 square feet of classroom and laboratory space centrifuge usafsam provides initial and refresher acceleration training for all usaf fast-jet aviators in a man-rated centrifuge. the centrifuge exposes subject to up to 9gs (g-forces), or 9 times the normal force of gravity, to teach the effects of g-forces on human physiology and to measure the subject's ability to counteract the effects and prevent g-induced loss of consciousness (g-loc). when usafsam relocated to wright-patterson afb in 2011 the new centrifuge construction at wright-patterson afb was not complete. usafsam has continued using the centrifuge located at brooks city base in san antonio, texas while awaiting completion of construction of the new centrifuge on wright patterson afb. when complete, the usafsam centrifuge at wright-patterson afb will be the only man-rated centrifuge in the department of defense and will provide acceleration training for all usaf fast-jet aviators. training altitude chambers the usafsam operates two training altitude chambers to provide initial hypoxia training to all flight surgeons, flight nurses, aerospace physiologists, aeromedical evacuation technicians, and aerospace physiology technicians. refresher training to is also provided to trained aircrew in the region. reduced oxygen breathing device (robd) the robd is a device that mixes breathing air with nitrogen to produce sea-level equivalent atmospheric oxygen content for higher altitudes. the usafsam robd provides hypoxia training to aircrew, similar to that provided in the altitude chamber, without the decreased pressure and risk of altitude exposure. fuselage simulators usafsam utilizes a c-17, t-767, and four c-130 aircraft fuselage trainers to provide current and realistic learning environments. aeromedical aviation laboratory the department of aerospace medicine operates an aeromedical aviation laboratory in support of the aerospace medicine primary course and the residency in aerospace medicine (ram). the aviation laboratory is located at greene county airport with civilian flight instructors who are all prior usaf pilots. students receive training in cirrus sr-22 and pitts s2b aircraft. students complete aeromedical and flying ground training and then receive seven flights following didactic curriculum. approximately 500-600 students are trained in the aerospace aviation laboratory each year. air force center for expeditionary team training basic expeditionary medical readiness training is provided for medical personnel prior to military deployment through the center for sustainment of trauma and readiness skills (c-stars) provided on site at partner medical facilities in baltimore, maryland; cincinnati, ohio; and st. louis, missouri. consultation usafsam provides consultative support to all usaf bases in the disciplines listed above fielding approximately 5000 requests and over 2.3m laboratory tests annually. the aeromedical consultation service the aeromedical consult service (acs) provides medical opinion to usaf and major command (majcom) leaders regarding medical selection of aviators and individual waivers of aeromedical standards, and informs policy decisions regarding risks of medical conditions and therapies in military aviation and special operational duty environments. among the acs staff are specialists in the aeromedical facets of such fields as cardiology, pulmonology, neurology, ophthalmology, psychiatry, and neuropsychology. the epidemiology consultation service the epidemiology consult service provides global consultation services to the usaf and department of defense in public health surveillance, epidemiology, and preventive medicine, with capabilities for rapid on-site epidemiologic assistance for outbreak response. specific areas of consultation expertise include entomology, food safety/defense, clinical reference laboratory and diagnostic testing services, usaf active duty and retiree mortality surveillance, influenza and respiratory disease surveillance, tuberculosis and other disease risk assessments, as well as reportable disease and medical event collection. the epidemiology laboratory the epidemiology laboratory is the usaf's only clinical reference laboratory offering clinical diagnostic, public health and force health screening testing for sustainment of the usaf beneficiary population. the laboratory provides immunodiagnostic, virology, microbiology, and molecular testing capabilities to enable autoimmune, infectious disease, and chronic disease diagnoses, as well as health surveillance. additionally, it provides human immunodeficiency virus (hiv) and vaccination status testing to maintain dod force readiness. the laboratory is the central facility for the dod's global emerging surveillance and response systems' influenza surveillance program and provides influenzastrain data annually to support national vaccine decisions. the laboratory is also a reference-level member of the centers for disease control and prevention's laboratory response network and dod's defense laboratory network, providing biothreat agent identification capabilities in a biodefense response. and they operate a biosafety level 3 (bsl) facility for safety in handling clinical specimens. the food defense laboratory the food defense laboratory capabilities include analysis of epidemiologically linked suspect food samples submitted by base-level usaf public health personnel in response to clusters or outbreaks of foodborne illnesses. the laboratory collaborates with the aeromedical research department to evaluate commercial off the shelf (cots) technology that could be used by public health personnel to enhance pathogen detection and identification capabilities from food and the environment. the entomology laboratory the epidemiology consult service supports all usaf activities and bases worldwide with rapid identification of arthropod pests and disease vectors. the laboratory tests for the pathogens that cause malaria, west nile, and zika fever as well as other arboviruses and parasites. additionally, the laboratory collaborates with the aerospace medicine research laboratory to conduct research on arthropods and arthropod-borne diseases, such as lyme disease, to include arthropod testing in support of usaf public health consultations. the occupational and environmental consultation service the occupational and environmental consult service provides total exposure health risk consultation in environmental and occupational health. environmental consultation includes population and community health. occupational health consultation includes stressors, such as ionizing radiation, lasers, electromagnetic field radiation, hazardous materials, noise, and ergonomic challenges found in the work and deployed environments. these services are provided at a multitude of venues, such as onsite consulting, development of technical guidance, telephonic consultation, collaborating with dod and usaf on the development of policies/standards, formal collaborations with universities, and representing the usaf with national and international professional and standard setting organizations. the radioanalytical laboratory the radioanalytical laboratory processes and analyzes environmental samples for ionizing radiation to meet nuclear regulatory commission and other regulatory requirements. this includes air, soil, vegetation, water, bioassays, and swipe samples. the laboratory analyzes approximately 10,000 samples annually. the radiation dosimetry laboratory the radiation dosimetry laboratory calibrates, distributes, and manages over 70,000 thermolumenscent dosimeters and 12,000 electronic personal dosimeters for radiation workers and first responders worldwide. data gathered from this equipment is entered into the master radiation exposure registry, providing a comprehensive dosimetry record for all personnel who use usaf dosimetry services, totaling over 3.9 million records. the industrial hygiene laboratory the industrial hygiene laboratory provides oversight and guidance to enable usaf bioenvironmental engineering to perform occupational and environmental health risk assessments through analysis, consultation, and execution support. the industrial hygiene laboratory oversees testing and data analysis for 15,000 samples annually. the proficiency analytical testing laboratory the proficiency analytical testing laboratory enhances the ability of bioenvironmental engineering personnel worldwide to remain competent in utilizing field-portable analytical equipment to detect and identify unknown chemical and biological samples. the laboratory prepares and distributes 12,000 samples each year and evaluates and certifies results for 1,400 bioenvironmental personnel. the operational consult service the operational consult service is a multidisciplinary professional team which performs rapid research, studies, and analysis to answer emerging human factors questions from across the operational usaf. research usafsam aeromedical research department conducts research in four key areas: en route care the en route care research team leads 711 hpw's research and consultation in the areas of aeromedical evacuation and expeditionary medicine, to include stabilizing battlefield trauma patients for transport and en route critical and routine care of the injured during strategic evacuation. the en route care research team oversees research at three c-stars sites. research conducted in this area addresses requirements including all elements of patient care and support functions during patient staging and transportation, beginning with receipt of initial request for patient/casualty movement until patient/casualty movement is no longer required. this includes research relevant to: en route patient staging system (erpss), aeromedical evacuation (ae), ccatt, and tactical critical care evacuation teams (tccet). force health protection usafsam's force health protection research addresses the need for timely, accurate, and actionable health risk characterization for health hazards related to flight and for injuries due to physical, chemical, biological, radiological, directed energy and other environmental threats. this research also identifies the cause of and adequate treatments for newly identified and rapidly evolving diseases, as well as the development of enhanced genetics/genomics capabilities to predict human and microbial susceptibility. human performance the usafsam human performance research team leads the 711 hpw's aeromedical research and consultation in optimizing and maintaining physical and mental health and performance of airmen. this team conducts research in the areas of altitude and acceleration, operational psychology, vision standards, and aircrew/operator performance. human performance research personnel oversee research activities on the only dod centrifuge and in the unique research altitude chambers facility, as well as the operational based vision assessment (obva) laboratory. expeditionary medicine the usafsam expeditionary medicine research team leads the 711 hpw's research and consultation in supporting the health and performance of patients and providers across the spectrum of austere environments. history the new york chapter the united states air force school of aerospace medicine began operations on january 19, 1918 at hazelhurst field, mineola, long island as the air service medical research laboratory under the leadership of col. william h. wilmer. the hazelhurst laboratory had a small decompression chamber and research was begun on human tolerance to lowered oxygen tension. the impetus for the creation of the lab was the entry of the united states into world war i on april 6, 1917 and the resulting increase in use of aircraft by military forces. as a result, on april 28, 1917, an air service medical, signal corps, us army was organized with general theodore c. lyster, medical corps, us army, appointed to the newly created position of chief surgeon, aviation section, signal corps on september 6, 1917. one of the first observations made by general lyster was the alarming mortality rate from aircraft accidents among flying cadets at training centers in the u.s. and with the allies in france. in the first year of flying in world war i the english and french found that 2% of aircraft accidents were due to combat, 8% were caused by mechanical problems, and 90%