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humans, the designated medical examiner should be familiar with the physical characteristics of the
environment in which the flight crew operates.
ICAO Preliminary Unedited Version — October 2008 II-1-5
Table 1 shows the relationship between altitude, pressure and temperature as shown in a standard
atmosphere.
ALTITUDE PRESSURE TEMPERATURE
metres feet mm HG psia °C °F
sea level 760 14.7 15.0 59.0
400 1 312 725 14.0 12.4 54.4
600 1 968 707 13.7 11.1 52.0
800 2 625 691 13.4 9.8 49.6
1 000 3 281 674 13.0 8.5 47.3
1 500 4 921 634 12.3 5.3 41.5
2 000 6 562 596 11.5 2.0 35.5
2 500 8 202 560 10.8 −1.2 29.7
3 000 9 842 526 10.2 −4.5 23.9
3 500 11 483 493 9.5 −7.7 18.1
4 000 13 123 462 8.9 −11.0 12.2
4 500 14 764 433 8.4 −14.2 6.4
5 000 16 404 405 7.8 −17.5 0.5
5 500 18 044 379 7.3 −20.7 −5.3
6 000 19 685 354 6.8 −24.0 −11.2
6 500 21 325 331 6.4 −27.2 −16.9
7 000 22 966 308 6.0 −30.5 −22.9
7 500 24 606 287 5.6 −33.7 −28.6
8 000 26 246 267 5.2 −36.9 −34.5
10 000 32 808 199 3.8 −49.9 −57.8
12 000 39 370 146 2.8 −56.5 −69.7
14 000 45 931 106 2.0 −56.5 −69.7
16 000 52 493 78 1.5 −56.5 −69.7
18 000 59 054 57 1.1 −56.5 −69.7
20 000 65 616 41 0.80 −56.5 −69.7
25 000 82 020 19 0.37 −51.6 −60.9
30 000 98 424 9 0.17 −46.6 −51.9
Table 1.— The relationship between altitude (in ft),
pressure (in mm Hg and pounds per square inch (absolute)), and temperature (in °C and °F)
The range of environmental conditions encountered in civil aviation operations varies widely, from
those characteristic of unpressurized small aircraft and gliders, to those of subsonic and supersonic jets.
The relationship between barometric pressure and the operational ceiling of aircraft is shown in
Figure 3, demonstrating the decrease in barometric pressure with increasing altitude.
Physiological effects of hypoxia at different altitudes are given in Table 2.
ICAO Preliminary Unedited Version — October 2008 II-1-6
1) 2 450 m (8 000 ft): The atmosphere provides a blood oxygen saturation of approximately 93 per cent
in the resting individual who does not suffer from cardiovascular or pulmonary disease.
2) 3 050 m (10 000 ft): The atmosphere provides a blood oxygen saturation of approximately
89 per cent. After a period of time at this level, the more complex cerebral functions such as making
mathematical computations begin to suffer. Flight crew members must use oxygen when the cabin
pressure altitudes exceed this level.
3) 3 650 m (12 000 ft): The blood oxygen saturation falls to approximately 87 per cent and in addition to
some arithmetical computation difficulties, short-term memory begins to be impaired and errors of
omission increase with extended exposure.
4) 4 250 m (14 000 ft): The blood oxygen saturation is approximately 83 per cent and all persons are
impaired to a greater or lesser extent with respect to mental function including intellectual and
emotional changes.
5) 4 550 m (15 000 ft): This altitude gives a blood oxygen saturation of approximately 80 per cent and
all persons are impaired, some seriously.
6) 6 100 m (20 000 ft): The blood oxygen saturation is 65 per cent and all unacclimatized persons lose
useful consciousness within 10 minutes (TUC, the time of useful consciousness, is determined
generally from the time of onset of hypoxia to the time when purposeful activity, such as the ability to
don an oxygen mask, is lost). At 6 100 m (20 000 ft), the TUC is 10 minutes. (It should be mentioned
that a given volume of gas at sea level doubles in volume when the pressure is dropped to that at
approximately 5 500 m (18 000 ft).)
7) 7 600 m (25 000 ft): This altitude, and all those above it, produce a blood oxygen saturation below
60 per cent and a TUC of 2.5 minutes or less. Above this altitude, the occurrence of bends (nitrogen
embolism) begins to be a threat.
8) 9 150 m (30 000 ft): The TUC is approximately 30 seconds.
9) 10 350 m (34 000 ft): The TUC is approximately 22 seconds. Provision of 100 per cent oxygen will
produce a 95 per cent blood oxygen saturation (at 10 050 m (33 000 ft), a given volume of gas at sea
level will have approximately quadrupled).
10) 11 300 m (37 000 ft): The TUC is approximately 18 seconds. Provision of 100 per cent oxygen will
produce an oxygen saturation of approximately 89 per cent. When this altitude is exceeded, oxygen
begins to leave the blood unless positive-pressure oxygen is supplied. (A given volume of gas
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Manual of Civil Aviation Medicine 1(58)
