{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T02:38:06Z","timestamp":1777343886021,"version":"3.51.4"},"reference-count":24,"publisher":"Aerospace Medical Association","issue":"5","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:p>\n                    <jats:bold>INTRODUCTION:<\/jats:bold>\n                    Spatial disorientation poses a significant hazard to aviators, particularly during low-visibility conditions, such as nocturnal operations or adverse weather scenarios. Visual illusions, exacerbated by the absence of external references, can mislead pilots into incorrect judgments of aircraft orientation, potentially resulting in catastrophic consequences. Perrone\u2019s black hole approach theory describes how lateral reference loss distorts perceived approach angles during landing.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>METHODS:<\/jats:bold>\n                    This study systematically assessed black hole approach risk at 119 Italian civil and military airports using Perrone\u2019s visual slant misperception formula to calculate apparent glide path angles. Airports were categorized into four risk levels: low (2\u20134\u00b0), moderate (4\u20136\u00b0), medium (6\u20138\u00b0), and high (&gt;8\u00b0).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>RESULTS:<\/jats:bold>\n                    Analysis revealed that nine airports (7.6% of total) presented medium to high risk (descent angles \u22656\u00b0) yet lacked Precision Approach Path Indicator (PAPI) systems as of February 2025. Further investigation demonstrated that none of these airports are authorized for nighttime operations; thus, primary black hole approach conditions are avoided.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>DISCUSSION:<\/jats:bold>\n                    These findings raise questions about whether airports lack PAPI systems because night operations are not authorized or whether the absence of visual aids drives operational limitations. Results underscore the critical importance of comprehensive pilot training in recognizing and recovering from spatial disorientation, relying on onboard instruments, and implementing advanced guidance systems. The analysis highlights the role of visual aids, such as PAPI and the Instrument Landing System, in ensuring flight safety and demonstrates the need for standardized risk assessment protocols that integrate airport physical characteristics with operational context and available safety infrastructure.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>\n                      Cacciapuoti L, Piccardi L, Paolillo M, Grieco M, Vittorini M, Verde P.\n                      <jats:italic>The black hole approach and the Italian experience<\/jats:italic>\n                      . Aerosp Med Hum Perform. 2026; 97(5):375\u2013378.\n                    <\/jats:bold>\n                  <\/jats:p>","DOI":"10.3357\/amhp.6740.2026","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T01:59:02Z","timestamp":1777341542000},"page":"375-378","source":"Crossref","is-referenced-by-count":0,"title":["The Black Hole Approach and The Italian Experience"],"prefix":"10.3357","volume":"97","author":[{"given":"Luigi","family":"Cacciapuoti","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Piccardi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcello","family":"Paolillo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matilde","family":"Grieco","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariagrazia","family":"Vittorini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paola","family":"Verde","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1911","reference":[{"key":"B1","series-title":"Spatial disorientation in aviation.","year":"2004","unstructured":"Previc FH, Ercoline WR, editors. Spatial disorientation in aviation. Reston (VA): American Institute of Aeronautics and Astronautics; 2004."},{"issue":"11","key":"B2","series-title":"Aviat Space Environ Med.","first-page":"1020","article-title":"Visual slant misperception and the \u201cblack-hole\u201d landing situation","volume":"55","author":"Perrone JA.","year":"1984","unstructured":"Perrone JA. Visual slant misperception and the \u201cblack-hole\u201d landing situation. Aviat Space Environ Med. 1984 Nov; 55(11):1020\u20135."},{"key":"B3","author":"Perrone JA.","year":"1982","unstructured":"Perrone JA. Visual slant underestimation [dissertation]. Christchurch (New Zealand): University of Canterbury; 1982."},{"key":"B4","series-title":"The ecological approach to visual perception.","author":"Gibson JJ.","year":"1986","unstructured":"Gibson JJ. The ecological approach to visual perception. Hillsdale (NJ): Lawrence Erlbaum Associates; 1986."},{"key":"B5","series-title":"Cognitive styles: essence and origins.","author":"Witkin HA","year":"1981","unstructured":"Witkin HA, Goodenough DR. Cognitive styles: essence and origins. New York (NY): International Universities Press; 1981."},{"key":"B6","series-title":"Psychology: from research to practice.","first-page":"363","article-title":"A psychophysical contribution to air safety: simulator studies of visual illusions in night visual approaches","author":"Kraft CL Jr","year":"1978","unstructured":"Kraft CL Jr. A psychophysical contribution to air safety: simulator studies of visual illusions in night visual approaches. In: Pick HL Leibowitz HW, Singer JE, Steinschneider A, Stevenson HW, editors. Psychology: from research to practice. 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Annapolis (MD): Naval Institute Press; 1985."},{"issue":"9","key":"B9","series-title":"Neuropsychologia.","first-page":"2025","article-title":"Changes of visual vertical perception: a long-term sign of unilateral and bilateral vestibular loss","volume":"45","author":"Lopez C","year":"2007","unstructured":"Lopez C, Lacour M, Ahmadi AE, Magnan J, Borel L. Changes of visual vertical perception: a long-term sign of unilateral and bilateral vestibular loss. Neuropsychologia. 2007 May 15; 45(9):2025\u201337."},{"key":"B10","author":"Newman DG.","year":"2007","unstructured":"Newman DG. An overview of spatial disorientation as a factor in aviation accidents and incidents. Canberra (Australia): Australian Transport Safety Bureau; 2007. Report No.: AR-2007-055."},{"key":"B11","year":"2008","unstructured":"Ente Nazionale per l\u2019Aviazione Civile. APS 01: Certificazione dei prestatori di servizi della navigazione aerea [APS 01: Certification of air navigation service providers]. Rome (Italy): ENAC; 2008 [Italian]."},{"key":"B12","article-title":"Le luci PAPI: cosa sono e come funzionano [PAPI lights: what they are and how they work]","year":"2023","unstructured":"FlyAldo. Le luci PAPI: cosa sono e come funzionano [PAPI lights: what they are and how they work]. Flybros; 2023 Feb 17 [Italian]. [Accessed 2025 June 15]. Available from  https:\/\/flybros.org\/cultura-aeronautica\/le-luci-papi-cosa-sono-e-come-funzionano\/."},{"key":"B1","series-title":"Spatial disorientation in aviation.","year":"2004","unstructured":"Previc FH, Ercoline WR, editors. Spatial disorientation in aviation. Reston (VA): American Institute of Aeronautics and Astronautics; 2004."},{"issue":"11","key":"B2","series-title":"Aviat Space Environ Med.","first-page":"1020","article-title":"Visual slant misperception and the \u201cblack-hole\u201d landing situation","volume":"55","author":"Perrone JA.","year":"1984","unstructured":"Perrone JA. 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An overview of spatial disorientation as a factor in aviation accidents and incidents. Canberra (Australia): Australian Transport Safety Bureau; 2007. Report No.: AR-2007-055."},{"key":"B11","year":"2008","unstructured":"Ente Nazionale per l\u2019Aviazione Civile. APS 01: Certificazione dei prestatori di servizi della navigazione aerea [APS 01: Certification of air navigation service providers]. Rome (Italy): ENAC; 2008 [Italian]."},{"key":"B12","article-title":"Le luci PAPI: cosa sono e come funzionano [PAPI lights: what they are and how they work]","year":"2023","unstructured":"FlyAldo. Le luci PAPI: cosa sono e come funzionano [PAPI lights: what they are and how they work]. Flybros; 2023 Feb 17 [Italian]. [Accessed 2025 June 15]. 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