ENVIRONMENTAL IMPACT IN OFFICERS AND NCO, INVOLVED IN THE EXERCISE "RED FLAG" 2012 AT NELLIS AIR FORCE BASE, NEVADA, UNITED STATES

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1 ENVIRONMENTAL IMPACT IN OFFICERS AND NCO, INVOLVED IN THE EXERCISE "RED FLAG" 2012 AT NELLIS AIR FORCE BASE, NEVADA, UNITED STATES Lieutenant Colonel Daniel Fernando Aparicio Gómez Sports Medicine Specialist Centro de Medicina Aeroespacial Fuerza Aérea Colombiana

2 DISCLOSURE INFORMATION 84th Annual AsMA Scientific Meeting Lieutenant Colonel Daniel Fernando Aparicio Gómez I have the following financial relationships to disclose: Employee of Colombian Air Force I will not discuss off-label use and/or investigational use in my presentation

3 OPERATIONAL ASPECTS What is RED FAG? Realistic combat training exercise involving the Air Forces of the United States and its allies. The exercise was organized at Nellis Air Force Base, Nevada, from 16 to 27 July Is the most important Air Force Base in military training with more than 12,000 square miles of asigned airspace and kilometers land.

4 OPERATIONAL ASPECTS With 1,900 possible targets, realistic threat systems and an enemy force that can not be replicated in the rest of the world. This "peacetime battlefield" provides combat air forces with the ability to train and fight together, survive together and win together.

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7 OPERATIONAL ASPECTS The Combat Training Squadron 414A is responsible for the execution of "Red Flag" and the exercise is just one of a series of advanced training programs ruled by Nellis AFB. More than 70 aircraft are scheduled to depart from Nellis AFB twice a day, one at noon and other at night.

8 OPERATIONAL ASPECTS The airplanes can remain airborne for up to eight hours. Flights are scheduled to accommodate the other flying missions at Nellis AFB. and provide Red Flag participants with valuable training in planning and executing a wide variety of combat missions.

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11 TEAM MOVILIZATION Was conducted in 3 stages: (8 Kfir ) 1. Departure from Colombia (Barranquilla) - to San Antonio, Texas

12 TEAM MOVILIZATION 2. San Antonio Texas Tucson Arizona Davis Monthan AFB, 15 days, training

13 TEAM MOVILIZATION 3. Tucson Arizona (Davis Monthan AFB), to Las Vegas Nevada (Nellis AFB)

14 1 Stage (1000kms) Nellis AFB, Las Vegas Davis Monthan AFB, Tucson 2 Stage (4360kms) 3 Stage (670 Kms) Barranquilla (COL) Bogotá (COL)

15 Along with this great amount of responsibilities and external stress factors, these crews and technicians had to face the unfrendly environmental added in the areas where operations are carried out. The temperatures of 40 º C to 45 º C were the average during the 15 days of operations, with a very low relative humidity (not exceeding 15%).

16 Those enviromental factors can generate health issues due to lost fluids during the training performed by the pilots and thecnicians.

17 OBJETIVE To observe and describe the trend of hydration behavior of Colombian Air Force personnel exposed to extreme temperatures during Red Flag 2012 exercise, performed at Nellis Air Force Base in Nevada, United States.

18 OBSERVATIONS Temperature average behavior at Nellis AFB over the last five years Month Temperatur e max average ( C) Temperatur e min average media ( C) Precipitatio n (mm) Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dic , ,

19 METHODOLOGICAL ASPECTS Type of Study Transversal descriptive Population Staff officers and NCOs of Colombian Air Force, pilots and flight engineers who attended the Red Flag exercise at Nellis AFB. Sample: 60 subjects, 16 pilots (Kfir, B-767 and 707), 44 flight engineers. B-

20 METHODOLOGICAL ASPECTS Location: Nellis AFB, Nevada, United States of America. Method: The chosen sample was taken within pilot officers and NCOs maintenance personnel involved in flight duties during the day shift.

21 METHODOLOGICAL ASPECTS Inclusion criteria: Working day shift, average 8 hours, Were part of the personnel exposed to outdoors environment (heat and low humidity) Exclusion criteria: Personnel who worked in controlled environments throughout the day (temperature).

22 MATERIALS AND METHODS The staff who attended Red Flag 2012 was previously selected from fit to fly crews.

23 MATERIALS AND METHODS 1. Public awareness of this study among the crews. 2. Selection of officers and NCO s according selection criteria. 3. Systematic data recording.

24 MATERIALS AND METHODS 4. Assessment of hydration percentage, with reference bio impedance and weight. 5. Fluid intake survey. 6. Excel data processing. 7. Submit findings.

25 RESULTS Patients (60) Age (years) Weight total (kg) Weigth lost NCO (ramp) (gr) Weigth lost Kfir pilots (gr) Lost Weight percentage Min Max Average % ,8% ,1%

26 RESULTS Fluids loss: NCO s ramp: cc of fluids ± cc (after about 8-12 hours of work) Kfir pilots: 1450 cc of liquid ± cc (planning + after 2 hours of exposure in ramp + sorties). Boeing 767 filler tanker: there were no significant losses due to low exposure.

27 DISCUTION Although the information received previously, this personnel exposed to this harsh environment didn t realize the risk involved in the exercise. They showed dehydration of more than 3% (2nd grade). Average dehydration 3.5 kgr in NCO s and 1,5 kgr in Kfir pilots. This grade of dehydration can impair their performance. Need to stress the importance of hydration within our crews. Safety involved issue.

28 QUESTIONS!!! COLOMBIAN AIR FORCE AEROSPACE MEDICINE CENTRE