"If it's nighttime and you have a problem, the pilot doesn't have as many opportunities to make corrections," Susan P. Baker, the study's lead author, told SpaceDaily.com. "The crash forces and impact angles tend to be greater at night."

Baker, a professor at The Johns Hopkins School of Public Health in Baltimore, Md., and colleagues examined U.S. National Transportation Safety Board records of EMS helicopter crashes between Jan. 1, 1983, and April 30, 2005. During that period, 184 occupants died in 182 crashes, of which 77 percent occurred when conditions required instrumentation. In darkness, 56 percent of the crashes were fatal, compared with 24 percent in daylight.

Their study, published online in the Annals of Emergency Medicine, found that one in four EMS helicopters is likely to crash during its expected 15 years of service, and the death rate for EMS flight crew members is 20 times higher than for U.S. workers.

"A new helicopter costs about $4 million," Baker said. "With one chance in four of a crash during its lifetime, it makes good sense both to prevent crashes and to make sure the occupants aren't going to be killed."

The team found that in more than one-third of the crashes, at least one of the EMS helicopter occupants survived, Baker said. "That means there might be an opportunity here for better design, in terms of fuel containment and occupant restraints," she added.

In the published study, Baker's team recommended more research to determine which preventive measures � including equipping pilots with night-vision goggles; reducing night flights, or using better restraints, energy-absorbing landing gear and seats and crash-resistant fuel systems � could reduce EMS copter crashes and fatalities most effectively and efficiently.

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