Medical Events During Centrifuge Training in the Republic of Singapore Air Force: A 10-Year Analysis

INTRODUCTION: The Republic of Singapore Air Force uses the Human Training Centrifuge (HTC) to train aircrew in effective anti-G straining maneuvers and improve G tolerance. Training comprises computer-controlled (open-loop) profiles for trainees and dynamic flight simulation (closed-loop) profiles for trained aircrew, where simulated aerial combat maneuvers allow for pilot-controlled G onset rates. This study investigated medical incidents related to HTC usage in aviation physiology training. METHODS: A retrospective audit was conducted of 8013 HTC runs over 10 yr (2014-2023), during which 103 medical incident reports were documented. Data was collected through incident report forms and analyzed using descriptive statistics and statistical tests to compare training profile outcomes. RESULTS: Musculoskeletal injuries were the most prevalent (76.70%), with back pain being the predominant condition within this category (41.77%). Other conditions included cardiovascular (13.59%) and ophthalmological (3.88%) events. There were 3 medical incidents out of 955 (0.314%) closed-loop profiles, compared to 100 in 7058 (1.42%) open-loop profiles. Among reported incidents, 35 aircrew (33.98%) had significantly related past medical history. Post-incident, 73 aircrew (70.87%) completed centrifuge training eventually and returned to flying. DISCUSSION: HTC training demonstrates a favorable safety profile with low complication rates, and most affected aircrew completed their training requirements successfully. The yearly reported incidents of medical events post-HTC have shown a general downward trend. Compared with open-loop training profiles, closed-loop training provides dual benefits of providing realistic scenarios while allowing aircrew to control G exposure parameters, resulting in significantly lower medical complications while achieving training objectives. To YH, Woo JHA, Low JW, See B, Kwong J. Medical events during centrifuge training in the Republic of Singapore Air Force: a 10-year analysis. Aerosp Med Hum Perform. 2026; 97(5):308-315.