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Medical risks in older pilots: a systematic review on incapacitation and age

  • Review Article
  • Published:
International Archives of Occupational and Environmental Health Aims and scope Submit manuscript

Abstract

Purpose

Our ageing society faces an ageing work force. The target of this systematic review was to analyse whether pilots have a measurable age-dependent increased risk of incapacitation due to medical reasons.

Methods

Publications listed in PubMed, NCBI and EMBASE were identified using defined terms. Two independent raters analysed 2,342 retrieved publications by predefined criteria. Ten publications met the inclusion criteria.

Results

Four publications use a similar numerator (in-flight incapacitation) and identical denominator (flight hours) and show in-flight incapacitation of pilots happening 0.19–0.45 times/106 flight hours. Two of these studies did not analyse the possible correlation of incapacitation and age, and two did not use the denominator flight hours here. Age dependency of incapacitation is analysed in seven publications: Three analyse in-flight incapacitation and four analyse general incapacitation to fly. All but one—the only one including professional pilots older than 60 years—show an age-depending increase in incapacitation. The increase in in-flight incapacitation is far less than the increase in general flight incapacitation.

Conclusions

Medical in-flight incapacitation is a very rare event. Whether the increase in in-flight incapacitation results in an increase in accidents or can be compensated for by error reduction through experience cannot be answered. A register of all pilots with a clear identification system to follow their career and health, their accidents and impairments, might help to reconsider the grounding of pilots over 60 and to define better criteria than mere age.

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Acknowledgements

Contract grant sponsor: The study was supported by ADAC Air Rescue (ADAC Luftrettung GmbH, Gemeinnützige Gesellschaft), DRF Air Rescue (DRF Stiftung Luftrettung gemeinnützige AG), and ÖAMTC Air Rescue (Christophorus Flugrettungsverein). These are non-profit organizations. Objectivity and unbiased research was contractually ensured.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Institut und Poliklinik für Arbeits-Sozial- und Umweltmedizin, Klinikum der Universität München, Munich, Bavaria, Germany

    Katharina M. Huster, Maria J. Prohn, Dennis Nowak & Britta Herbig

  2. Institute of Occupational and Social Medicine, Heinrich Heine University Düsseldorf, Universitätsstr. 1, 40225, Düsseldorf, Germany

    Andreas Müller

Authors
  1. Katharina M. Huster
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  2. Andreas Müller
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  3. Maria J. Prohn
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  4. Dennis Nowak
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  5. Britta Herbig
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Correspondence to Katharina M. Huster.

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Huster, K.M., Müller, A., Prohn, M.J. et al. Medical risks in older pilots: a systematic review on incapacitation and age. Int Arch Occup Environ Health 87, 567–578 (2014). https://doi.org/10.1007/s00420-013-0901-x

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  • DOI: https://doi.org/10.1007/s00420-013-0901-x

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