#59 Women on the flight deck: Disease prevalence among female airline pilots in four us airlines

PURPOSE: The purpose of this study was to calculate disease prevalence among female commercial airline pilots using data from self-report. Because the majority of aviators historically have been men, little is known about the health impact of commercial flying on the increasing number of women entering this profession.METHODS: Through collaboration with the Air Line Pilots Association International (ALPA), health and lifestyle surveys were mailed to all women flying for each of four selected US airlines. Self-reported data were used to calculate duration prevalence for the study period.RESULTS: Of the 400 surveys mailed to women, 188 were returned (47% response rate). Respondent age ranged from 25 to 60 years, with an average age of 40 years, and racial distribution as follows: 172 white, 5 black, 3 Asian, 1 Hispanic, 7 unspecified. The only non-cancer diseases with more than 1 reported case were hypertension (5 cases) and high cholesterol (20 cases). A total of 14 cancers were reported: 4 breast, 3 cervix, 5 non-melanoma skin, 1 melanoma, and 1 thyroid. All four breast cancers occurred since 1997 among 91 white women in the age group 40–54 (4.4% of this age, gender group). The 5-year SEER limited duration prevalence for the same age, gender group is 2.3%. Available data did not permit adjustment for parity, age at first pregnancy, or other potential confounders of breast cancer rates.CONCLUSION: The suggested increase in breast cancer is consistent with findings from studies of flight attendants. However, a much larger study, with improved response rate and more confounder information, is needed to assure valid statistical analysis. To this end, a detailed survey on women's health has been mailed to all female commercial airline pilots across all ALPA airlines (2112 women across 42 airlines). The survey includes questions on disease, fertility, pregnancy outcomes, and hormone use.     

Age,flight experience,and risk of crash involvement in a cohort of professional pilots

Federal aviation regulations prohibit airline pilots from flying beyond the age of 60 years. However, the relation between pilot age and flight safety has not been rigorously assessed using empirical data. From 1987 to 1997, the authors followed a cohort of 3,306 commuter air carrier and air taxi pilots who were aged 45-54 years in 1987. During the follow-up period, the pilots accumulated a total of 12.9 million flight hours and 66 aviation crashes, yielding a rate of 5.1 crashes per million pilot flight hours. Crash risk remained fairly stable as the pilots aged from their late forties to their late fifties. Flight experience, as measured by total flight time at baseline, showed a significant protective effect against the risk of crash involvement. With adjustment for age, pilots who had 5,000-9,999 hours of total flight time at baseline had a 57% lower risk of a crash than their less experienced counterparts (relative risk = 0.43, 95% confidence interval: 0.21, 0.87). The protective effect of flight experience leveled off after total flight time reached 10,000 hours. The lack of an association between pilot age and crash risk may reflect a strong "healthy worker effect" stemming from the rigorous medical standards and periodic physical examinations required for professional pilots.     

航线飞行特质人格和航线飞行工作情境人格对飞行员心理健康的影响

目的 考察航线飞行特质人格和航线飞行工作情境人格对航线飞行员心理健康的影响. 方法 采用自编量表“航线飞行员人格量表”和临床症状自评量表(SCL-90)对南方航空公司及其分公司的286名男性飞行员进行心理测量研究. 结果 心理健康的各个因子均值在1.36～1.64之间,心理健康总评分也在2分以下.另外,阳性项目数平均值为25.57,远远小于40的异常标准,并且无明显峰值出现.总体健康水平和航线飞行特质人格的相关系数(-0.75)显著高于和航线飞行工作情境人格的相关系数(-0.17);航线飞行特质人格和航线飞行工作情境人格均单独对心理健康有直接影响作用;另外,航线飞行特质人格还可通过影响航线飞行工作情境人格进而影响心理健康. 结论 航线飞行员整体心理健康状况良好;两种人格对心理健康均有预测作用,其中航线飞行特质人格显示了较强的预测作用,航线飞行工作情境人格在航线飞行特质人格对心理健康的影响中发挥着部分中介作用.     

海军飞行人员疲劳状况与心理健康的关系

目的 探讨海军飞行人员疲劳状况及其与心理健康的相关性,为疗养期间开展综合心理干预及制订训练方案提供依据.方法 采用疲劳评定量表(FAI)和症状自评量表(SCL-90)对540名海军飞行人员进行量表测评,数据采用SPSS 15.0软件包进行统计分析.结果 飞行人员在疲劳的严重程度上与健康组无明显差异,而明显低于慢性疲劳综合征(CFS)病人组(P＜0.01);不同机种飞行人员在疲劳的严重程度和情境特异性方面存在显著性差异(P＜0.05,P＜0.01),其中轰炸机飞行人员的疲劳程度显著高于歼击机飞行人员,情境特异性显著高于运输机飞行人员;不同专业飞行人员在疲劳的情境特异性方面存在显著性差异(P＜0.01),其中机械师在疲劳的情境特异性方面明显偏低;飞行人员疲劳状况与心理健康呈显著相关,多元逐步回归分析显示,SCL-90的躯体化和强迫症状是导致疲劳的重要因素.结论 不同机种飞行人员、不同专业飞行人员疲劳程度明显不同,飞行人员疲劳状况与心理健康密切相关.     

Incidence of occupational skin conditions in a food manufacturing company: results of a health surveillance programme

BACKGROUND: The food industry has been associated with a high risk of work-related skin problems. Aim To examine the incidence of work-related skin conditions and the likely causative agents in a single large food company. METHOD: Analysis of a health surveillance programme, conducted over a 7 year period, in a food company with 21 000 employees working in diverse manufacturing processes. RESULTS: The mean incidence of skin conditions, taking all of the different food manufacturing operations together, was 1310 per million employees per annum. The mean incidence was greatest in the manufacturing sector whose operations involved chilled or frozen product (3180 per million employees per annum). Most of the cases reported (184/192 = 96%) were due to primary irritant dermatitis. The two commonest suspected causes of the dermatitis were contact with ingredients and hand washing. Taken together, these factors accounted for 58% of all cases. Although the wearing of gloves is often considered necessary to prevent dermatitis from exposure to ingredients and to lessen the need for hand washing, this factor itself was responsible for 9% of all cases. CONCLUSION: Analysis of a company health surveillance scheme showed the average incidence of work-related skin problems to be lower than previously reported in the food industry.     

Risk factors for fatigue among airline pilots

Purpose

The objective of this study is to determine risk factors for fatigue among airline pilots, taking into account person-, work-, health-, sleep-, and lifestyle-related characteristics.

Methods

The study population consisted of 502 pilots who participated in the MORE Energy study. Included risk factors were either measured through an online questionnaire or provided by the company. The outcome of this study, fatigue, was assessed using the Checklist Individual Strength (CIS), and was defined as scoring more than 76 points on this questionnaire. The association of the risk factors with fatigue was determined using univariate and multivariate logistic regression analyses.

Results

Of the participating pilots, 29.5 % scored more than 76 points on the CIS and were classified as being fatigued. The fully adjusted regression model showed that person-, work-, health-, and lifestyle-related characteristics were associated with fatigue. Pilots who were aged 31 to 40 (OR 3.36, 95 % CI 1.32–8.53) or 41 to 50 (OR 4.19, 95 % CI 1.40–12.47), an evening type (OR 2.40, 95 % CI 1.38–4.16), scored higher on work-life balance disturbance (OR 1.22, 95 % CI 1.10–1.36), scored higher on need for recovery (OR 1.02, 95 % CI 1.01–1.04), scored lower on general health perception (OR 0.31, 95 % CI 0.20–0.47), were less physically active (OR 0.77, 95 % CI 0.66–0.89), and had a moderate alcohol consumption (OR 3.88, 95 % CI 1.21–12.43), were at higher risk for fatigue.

Conclusions

Higher age, being an evening type, disturbance of the work-life balance, more need for recovery, a lower perceived health, less physical activity, and moderate alcohol consumption were shown to be risk factors for fatigue. Further longitudinal research is needed to elucidate the direction of the associations found and to evaluate the effects of possible countermeasures in airline pilots.

     

#58 Age,flight experience and the risk of crash involvement in a cohort of professional pilots

PURPOSE: Federal Aviation regulations prohibit any individual ages 60 years or older from serving as a pilot on an airplane under Part 121 regulations. The assumption underlying the “Age-60 Rule” is that pilots' safety performance declines with advancing age due to adverse effects of aging on health and cognitive functions. Epidemiological evidence for this premise, however, has been lacking. This study evaluates the risk of crash involvement during the process of aging in a cohort of professional pilots.METHODS: Pilots who were 45–54 years old in 1987 with Class I medical certificates and who flew Part 135 operations (n = 3,306) were followed up for 11 years. Information on demographics, medical conditions, flight experience, crash involvement, and exposure to flight were collected through biannual medical certification data and aviation crash surveillance systems. Proportional hazards modeling was used in the statistical analysis.RESULTS: During the 11-year period, a total of 12,926,214 pilot-flight-hours and 66 crashes were recorded, yielding a crash rate of 0.51 per 100,000 pilot-flight-hours. The crash rates were 0.56, 0.43, 0.55, 1.10 per 100,000 pilot-flight-hours at age 45–49 years, 50–54 years, 55–59 years, 60–64 years, respectively. In the oldest group, the number of crashes was small (n = 3) and some were the result of aircraft malfunction. Pilots with more than 5,000 hours of total flight time at the baseline had significantly lower crash rates than their less experienced counterparts. Multivariate regression revealed that crash risk appeared to increase with age in a quadratic manner; yet the age effect did not reach statistical significance (p = 0.10).CONCLUSION: Safety performance as measured by crash risk in part 135 pilots does not seem to change significantly during the process of aging, possibly due to the “Healthy Worker Effect” resulting from periodic medical certification and voluntary retirement.     

Self-reported work-related health problems from the Oslo Health Study

BACKGROUND: Lack of knowledge about the occurrence of work-related health problems in the general population makes it difficult to estimate the potential for their prevention in the workplace. AIMS: To examine the prevalence of self-reported work-related health problems among adult citizens of Oslo, Norway. METHODS: The study was part of the Oslo Health Study 2000-2001, in which all individuals in certain age cohorts were invited to a comprehensive health screening. All 30-, 40- and 45-year old subjects who attended the screening were asked if they had experienced any of 11 common health problems in the past month, and whether they considered these to be work-related. Of the 26,074 invitees in these age cohorts, 8,594 (33%) answered the questionnaire. RESULTS: Nearly 60% of subjects reported one or more work-related health problems, most commonly reported were pain in the neck/shoulders (38%) and low back pain (23%). Neck/shoulder pain was most frequently attributed to working conditions, by 74% of subjects with this problem; followed by arm pain (72%), fatigue (51%) and low back pain (50%). Work-related fractions for eczema and asthma symptoms were 23 and 18%, respectively. There were marked gender differences, but small age differences. CONCLUSIONS: A substantial proportion of common health problems in the Oslo population were attributed to working conditions. This implies a large preventive potential and call for increased preventive efforts targeted at known risk factors in the workplace.     

Ozone toxicity symptoms among flight attendants

Because of persistent complaints of ozone-toxicity type symptoms among crew members of commercial airlines, we undertook a survey to determine the extent of the problem and the associated flight factors. Self-reported questionnaires and flight diaries were completed by 1,330 flight attendants, (FAs) working for three different airlines. Ozone-toxicity type symptoms were reported three or four times more frequently by FAs with airlines flying at high altitudes than by those with low-flying airlines. When examined by characteristics of flights, the ozone-toxicity type symptoms were significantly associated with flight altitude, duration and type of aircraft, but not with years worked, sex, medical history, or home residence. Other symptoms indicative of fatigue or stress were mainly associated with flight duration. While these indirect data cannot implicate ozone specifically, they offer evidence that ozone-related health problems do exist among a large proportion of FAs.     

Health physics concerns in commercial aviation

Airline pilots and flight attendants are occupationally exposed to cosmic radiation. There has been uncertainty about how to handle the radiation protection requirements of their unique situation. Calculated dose equivalents associated with typical flight routes and crewmember work patterns have recently been published. The results show that flight attendants and pilots on ordinary subsonic aircraft can receive annual doses approaching 10 mSv y-1. I argue that flight crewmembers should receive specific education regarding the risks to their health from radiation exposure. I also argue that a suitable dosimeter system should be employed to provide crewmembers with information on their total doses. This is of particular importance for pregnant crewmembers who risk exceeding recommended fetal dose limits by working some routes during their pregnancy. In addition to airline crewmembers, business "frequent flyers" may receive significant occupational exposures while traveling. They too need appropriate education in order to assist them in assessing their risks from such exposures. Finally, flying during a large solar proton event would significantly increase the dose that would be received. During such an event, the total dose to the fetus of a pregnant crewmember or passenger might exceed the 0.5 mSv recommended monthly maximum. Warnings and action plans for these special circumstances should be improved.     

Back pain and its consequences among Polish Air Force pilots flying high performance aircraft

Objectives

Back pain in Air Force fast jet pilots has been studied by several air forces and found to be relatively common. The objective of the study was to determine the prevalence and degree of the pain intensity in the cervical, thoracic and lumbar spine, subjective risk factors and their effect on the pilots’ performance while flying high maneuver aircrafts and the consequences for cognitive deficiencies.

Material and Methods

The study was designed as a retrospective, anonymous questionnaire survey, collecting data on the age, aircraft type, flying hours, pain characteristics, physical activity, etc. The study was participated by 94 pilots aged 28–45 years (mean age: 35.9±3.3 years), actively flying fast jet aircrafts Su-22, Mig-29 and F-16. The estimates regarding the level of the subjective back pain were established using visual analogue scales (VAS).

Results

The values of the Cochran and Cox T-test for heterogeneous variances are as follows: for the total number of flying hours: F = 2.53, p = 0.0145, for the pilot’s age: F = 3.15, p = 0.003, and for the BMI factor F = 2.73, p = 0.008.

Conclusions

Our questionnaire survey showed a significant problem regarding spinal conditions in high performance aircraft pilots. The determination of the risk factors may lead to solving this problem and help eliminate the effect of the unfavorable environment on piloting jet aircrafts. Experiencing back pain during the flight might influence the mission performance and flight safety. The costs of pilots education are enormous and inability to fly, or even disability, leads to considerable economic loss. More research on specific prevention strategies is warranted in order to improve the in-flight working environment of fighter pilots.     

Magnetic field exposure of commercial airline pilots

PURPOSE: Airline pilots are exposed to magnetic fields generated by the aircraft's electrical and electronic systems. The purpose of this study was to directly measure the flight deck magnetic fields to which commercial airline pilots are exposed when flying on different aircraft types over a 75-hour flight-duty month.METHODS: Magentic field measurements were taken using personal dosimeters capable of measuring magnetic fields in the 40-800 Hz frequency range. Dosimeters were carried by either the Captain or the First Officer on Boeing 737/200, Boeing 747/400, Boeing 767/300ER, and Airbus 320 aircraft. The data were analyzed by aircraft type, with statistics based on block hours. Block hours begin when the aircraft departs the gate prior to take off and end when the aircraft returns to the gate after landing.RESULTS: Approximately 1008 block hours were recorded at a sampling rate of 3 seconds. Total block time exposure to the pilots ranged from a harmonic geometric mean of 6.7 milliGauss (mG) for the Boeing 767/300ER to 12.7 mG for the Boeing 737/200.CONCLUSIONS: Measured flight deck magnetic field levels were substantially above the 0.8 to 1 mG level typically found in the home or office and suggest the need for further study to evaluate potential health effects of long-term exposure.     

Identifying workers at risk of sickness absence by questionnaire

BACKGROUND: Sickness absence is an important economic problem, because of high costs and lost productivity. Determining factors associated with increased risk of sickness absence may lead to the development of preventive measures. AIMS: To determine whether self-report questionnaires can identify those employees at risk of sickness absence METHODS: Prospective study of 238 healthy administrative workers. Participants completed a questionnaire proven to be valid and consistent. The questionnaire consisted of 116 items about health, work and working conditions. Sickness absence was followed-up for a period of 1 year. RESULTS: The questionnaires of 191 workers (80%) were suitable for analysis. The number of reported health complaints was significantly (P < 0.01) associated with sickness absence (OR 2.18; 95% CI 1.32-3.61). Concentration problems were correlated with more frequent absences, and both nervous complaints and coping problems with longer duration. Age (OR 0.96; 95% CI 0.93-0.99; P = 0.02) and job insecurity (OR 0.68; 95% CI 0.47-0.98; P = 0.04) were negatively associated with sickness absence. Psychosocial and physical work factors were not associated with sickness absence. CONCLUSIONS: Questionnaires on health and work can identify employees at future risk of sickness absence. Workers who report multiple health complaints, especially concentration problems, nervous complaints or coping problems, may be at increased risk of sickness absence.     

Perspectives of those impacted: airline pilot's perspective

The airline pilot operates within an environment that consists of circadian dysrhythmia, reduced atmospheric pressure, mild hypoxia, low humidity, and exposure to sound, vibration, cosmic-radiation, and magnetic-field exposure. These occupational exposures present physiological challenges to the long term health of the airline pilot. In particular, exposure to cosmic radiation and its carcinogenic potential have recently received considerable attention. Given the complexity of the environment and possible synergistic exposures, there is an immediate requirement for comprehensive research into both cosmic-radiation and magnetic-field exposures in airline pilots. In response, the Airline Pilots Association International in conjunction with the Medical University of South Carolina (Department of Biometry and Epidemiology) has initiated an extensive research program into these occupational exposures. These investigations include ground based calculations, flight-dose estimates, epidemiological survey and exposure assessment, and biological marker analysis.     

Lifestyle and work predictors of fatigue in Japanese manufacturing workers

BACKGROUND: Fatigue is one of the most common symptoms encountered in medical practice. However, little is known about the causal relationship between change in lifestyle and fatigue. AIM: To help prevent fatigue-related disorders, we investigated the association between changes in lifestyle and fatigue among employees. METHODS: We studied data sets from the High-risk and Population Strategy for Occupational Health Promotion study for employees at 10 workplaces in Japan. The baseline survey was done in 1999 and the follow-up survey in 2003 via a questionnaire which examined lifestyle and fatigue variables using the vitality domain scale of the SF-36 Health Survey. The lifestyle factors focused on were diet, smoking and alcohol habits and working conditions. Four-year changes in lifestyle that predicted the vitality domain score in the follow-up survey were examined by analysis of covariance RESULTS: Of the 6284 participants in the baseline survey, 4507 replied to the follow-up survey, of whom 3498, with a mean age of 37 (SD 18) years, returned valid responses. A low vitality score at follow-up was predicted by a change in lifestyle factors such as an increase in overtime work, change to non-sedentary work and increased frequency of eating between meals (P < 0.01, P < 0.01 and P = 0.02, respectively). CONCLUSION: Fatigue in salaried workers as measured by the vitality domain of the SF-36 is predicted by an increase in overtime work, change to non-sedentary work and an increase in the frequency of eating between meals.     

Occupational health in the Andalusian Fisheries Sector

BACKGROUND: The conditions of work in the fisheries sector are arduous with high rates of occupational accidents. Numerous factors are known that can directly influence the health of the sailor or fisherman both in fishing and merchant fleets. AIM: To evaluate the health status, safety and working conditions in the Andalusian fishing sector. METHODS: Cross-sectional questionnaire study with proportional sampling of the health and lifestyles of fishery workers in 19 of the 23 Andalusian ports. RESULTS: A total of 247 workers employed on 202 craft fishing boats responded. In all 87% of workers reported a current medical condition. The main problems reported were musculoskeletal disorders, respiratory diseases, diseases of the digestive system, eye problems and skin problems. A total of 72% reported taking some self-prescribed medication, and 60% of fishery workers smoked. Nine per cent of fishery workers admitted taking illicit drugs and 3% reported using illicit drugs on board. Diets on board were poorly balanced. While on board, 62% of crews reported a subjective significant worsening of previous health. The lifetime prevalence of accidents was 76%. CONCLUSIONS: Fishery workers had a high prevalence of self-reported medical problems, a high prevalence of self-medication, poor diets and frequently smoked. Self-medication and some medical conditions (diabetes, angina and depression) may reflect a potential failing of health checks and pre-employment checks. National health services and insurance companies dealing with occupational health should focus more on appropriate health checks, illness prevention and health promotion activities for this population.     

Musculoskeletal disorders and visual strain in intensive data processing workers

BACKGROUND: This study was conducted for a UK Trade Union in response to increasing numbers of health complaints among intensive computer workers in a data processing environment. AIM: To estimate prevalence of musculoskeletal pain/discomfort and visual strain symptoms among data processing workers and to explore associations with work factors. METHODS: A self-report questionnaire was distributed to data processors (n = 175) and a control group (n = 129) in the same organization. RESULTS: Eighty-six per cent of data processors reported musculoskeletal pain/discomfort in the previous year, with the highest prevalence rate found for the neck (58%). The 12 month reported prevalence for visual strain symptoms was 47%, tired eyes (41%) was the most commonly reported symptom. In the last week, 56% reported pain/discomfort and 25% visual strain symptoms. Data processors reporting pain in the previous year were more likely to be dissatisfied with their jobs (P < 0.01), to report a lack of choice in deciding what they did at work (P < 0.02), to have insufficient time to complete work (P < 0.05) or to receive help from others when time was limited (P < 0.03). CONCLUSION: The prevalence of self-reported musculoskeletal pain/discomfort and visual strain symptoms was high among data processors. A systematic approach to risk reduction addressing organizational, psychosocial and physical work factors is required. This study has implications for reorganization of this and other intensive computer work, given the increasing requirement for intensive computing work in many industrial sectors. More research is needed to investigate interactions between job demands and support systems for these workers.     

基于睡眠的飞行员疲劳测量方法对比研究

飞行员的工作性质使得其睡眠严重紊乱,在昼夜节律的作用下,飞行员因睡眠不足产生疲劳,从而影响其工作效率,增加事故风险,研究与睡眠有关的飞行员疲劳对于降低飞行事故／事件,保障飞行员的健康与安全具有重要意义。作为飞行员疲劳研究的基础,作者从飞行员疲劳测量方法的性质、分类、特征等方面对飞行员疲劳测量工具进行了系统的对比分析与探讨,认为对于诸多的疲劳测量工具,应从中选取适用于飞行员工作特点和实际运行环境的方法来综合测量飞行员的疲劳状态。以超长航程为例,说明测量方法的使用原则和方法,从而为疲劳的实时测量提供依据。     

飞行员医学临时停飞标准

《飞行员医学临时停飞标准》是指在临飞阶段因飞行员身体出现异常而作出暂时不放飞的医学准则。本《标准》适用于军事飞行人员。共３２个条款，含总则３条，临时停飞２９条。本《标准》已在陆、海、空三军航空兵中广泛使用。两年多来不断收到部队的反映：称本《标准》推进了飞行卫生保障工作的科学化和规范化进程，提高了航空医师工作的权威性。在临飞体检中，对照《标准》已查出数以百计的病例数，杜绝了因身体原因引起的飞行事故，     

某部航空兵官兵疲劳状况调查

目的：调查分析航空部队官兵疲劳状况及影响因素。方法采用多维疲劳量表（MFI-20）中文版和一般调查问卷对某部航空部队995例官兵进行测评。结果官兵总体疲劳检出率为14．8％。战斗机组体力疲劳、脑力疲劳及疲劳总均分分值高于直升机组（P＜0．01）;不同年龄段各组间体力疲劳、活动减少、疲劳总均分分值存有差异,其中31～35岁年龄组得分最高（P＜0．05）;士兵组动力下降分值高于军官组（P＜0．01）,士官组活动减少分值高于士兵组（P＜0．05）;飞行勤务组体力疲劳、活动减少及疲劳总均分分值均高于飞行员组（P＜0．01）;飞行时数≥1000h组体力疲劳、疲劳总均分分值高于飞行时数＜500h组（P＜0．01）;受教育水平大学以上组体力疲劳、脑力疲劳、活动减少及疲劳总均分分值高于中专组及高中组（P＜0．01）;家庭经济较差组体力疲劳和疲劳总均分分值高于经济很好及中上组（P＜0．05）;相关分析显示年龄与活动减少呈显著正相关（P＜0．05）,军衔与动力下降呈显著负相关（P＜0．01）,与活动减少呈显著正相关（P＜0．05）,飞行时数与体力疲劳呈显著正相关（P＜0．01）,教育程度与动力下降呈显著负相关（P＜0．01）,家庭经济状况与疲劳总均分、体力疲劳、脑力疲劳和活动减少呈显著正相关（P＜0．05）。结论年龄、岗位、职务、飞行时数、受教育水平及家庭经济状况是航空部队官兵疲劳的影响因素。