The Soviet Union has developed one of the world's most sophisticated civil aviation medicine programs. The program gives specific attention to aerial application operations and includes special preflight pilot medical examinations, aircraft with specialized protective airflow systems for the pilots, minimum flight altitude spraying limit of 5 m, and the use of a "chemical log book" by each pilot in addition to the flight log book. These and additional steps--i.e. limiting a pilot's daily agricultural flights to 4-6 h--have led to a reported USSR agricultural aviation annual accident rate near zero. The Soviet workhorse aircraft, the Antonov AN-2, can serve multipurpose roles since, when not used for application flights, it can be rapidly converted to executive, courier, cargo, or air taxi, or air ambulance use. A new, single-engine turbojet biplane, the Polish M-15, is undergoing evaluation in the Soviet Union as a replacement for the AN-2. Countries with very high agricultural aircraft accident rates may wish to study the Soviet approach, especially the use by the pilot of a chemical log book.