空军飞行人员颈椎病职业医学调查

目的：研究空军飞行人员颈椎病患病情况,探索发病规律,为开展飞行人员颈椎病防治工作提供依据。方法：对某部747名现役飞行人员颈椎病进行职业医学调查,对致病因素、发病机制和发病规律进行综合分析。结果：不同年龄飞行人员颈椎病的患病率不同,25-30岁组、30-35岁组、35-40岁组、41-47岁组飞行员患病率分别为3.2%、13.7%、9.0%、9.7%;不同机种飞行人员颈椎病的患病率不同,运输机和轰炸机、高教机、歼击机飞行人员患病率分别为3.3%、10.1%、21.3%。结论：行人员颈椎病患病率较高,发病年龄比普通人提前,飞行人员颈椎病致病原因主要为年龄增长导致颈椎退行性病变,飞行中高载荷、飞行头盔面罩等负重增加了颈部损伤几率,飞行固定工作姿势导致颈部劳损。飞行人员颈椎病防治要从日常健康维护、设计合适头盔、提高抗荷能力、专项体能训练、及早进行防治等方面入手。     

空军飞行人员颈椎病发病情况调查

颈椎病缩短了飞行人员的飞行寿命,是一种严重影响飞行人员身体健康和正常训练的疾病.近年来,飞行人员颈椎病的发病率明显上升,已成为影响飞行人员健康的重要疾病[1].为了更好地了解飞行人员颈椎病的病因并做好预防工作,我们对来我科疗养的1786名飞行人员的颈椎病发病情况进行了调查分析. 一、对象与方法 1.对象与分组:整群抽取来我院疗养的1786名飞行人员,均为男性,年龄22～57岁,平均年龄34.96岁;飞行时间1～1 3800 h,平均飞行时间2143 h.按飞行机种分为歼击机和运输机2组;按发病年龄分为≤30岁、31～40岁、≥41岁3组;按飞行时间分为＜500 h、500～2000 h、＞2000 h 3组.     

歼击机飞行员颈椎病的年龄分布特点

目的:研究歼击机飞行员颈椎病与年龄的相关性。方法:统计某部歼击机177名歼击机飞行员不同年龄段的颈椎病发病率。结果:各年龄段歼击机飞行员颈椎病发病率不同,26～30岁组为8.93%;31～35岁组为42.86%;36～40岁组为25.00%;41～48岁组为17.5%。结论:歼击机飞行员颈椎病患病率分布具有明显的年龄特征。与普通人群相比,飞行员颈椎病高发年龄提前。提示航空卫生保障人员要加强歼击机飞行员颈椎病的预防,针对不同年龄采取不同的防治措施。     

疗养飞行人员高脂血症调查分析及干预措施

目的调查分析2010—03～2012—08疗养的飞行人员高脂血症患病率及相关特点和规律。方法依据疗养飞行人员入院72h内完成大体检的检验结果：血清总胆固醇（TC）≥5．17mmol／L,血清甘油三酯（TG）≥1．71mmol／L为诊断标准。检验仪器为日本产,东芝120型全智能生化分析仪。结果3772例飞行人员中,单纯高胆固醇血症482例,患病率为12．78％;单纯高甘油三酯血症404例,患病率为10．71％;两者均高者425例,患病率为11．27％。各年龄组间比较,以上三种检验结果发病率均为30—39岁年龄组〉21—29岁年龄组〉40岁以上年龄组。各机种间比较,歼击机组〉教练机组一运输机组〉直升机组〉轰炸机组〉预警机组。危险因素与高脂血症伴随情况如下：每周体能训练3次以下者71．53％,体质指数（BMI）大于标准者68．24％,每日吸烟10支以上者65．65％,每周饮酒3次以上、每次饮酒150ml以上者52．76％,伴高血压46．12％,伴糖尿病2．12％。结论健康疗养飞行人员的高脂血症应引起高度重视,加强飞行人员的营养干预、运动干预等生活方式干预和营养知识教育刻不容缓。     

飞行人员头痛状况调查（摘要）

目的调查飞行人员头痛患病情况。方法采用调查问卷方法,针对住院飞行人员、基层部队飞行人员及来院参加改装体检飞行人员进行调查。结果住院病人组、改装体检组与基层部队组比较,两两之间头痛患病率均具有显著差异,三者头痛患病率由高到低依次为：住院病人组、基层部队组、改装体检组。基层部队组经常头痛者患病率约为11％,其中紧张型头痛占90．5％,偏头痛占9．5％。直升机飞行人员头痛患病率18．8％,     

某部直升机飞行员腰部疾患的调查

目的　调查某部直升机飞行人员腰部疾病的种类、患病率 ,为防护提供资料。　方法　采用自行设计的问卷 ,集体讲解 ,独立回答。对有症状者进行身体检查 ,按通常的诊断标准诊断。将腰部疾患有明确诊断者按年龄、飞行总时间、职务和肥胖程度分组比较。　结果　该部队飞行人员中 71.4%的人有颈背痛症状 ;30 .6 %的人诊断为腰肌劳损 ;不同年龄组的患病率为 :2 0～ 2 9岁 11.1% ,30～ 39岁 36 .4% ,40岁以上72 .7%。不同飞行时间的患病率为 :5 0 0 h以下 17.7% ,5 0 0～ 10 0 0 h为 5 .9% ,10 0 0 h以上 73.3%。肥胖者患病率5 1.4% ,正力体型者为 …     

不同机种飞行人员颈腰部疾病现状调查

目的 探究不同机种军事飞行人员颈腰部疾病患病特点,为制定军事飞行人员颈腰部疾病防治策略提供科学参考.方法 采用整群抽样的方法,以1165名空军飞行人员为研究对象,对其颈腰部疾病现状进行问卷调查,对不同机种、不同年龄和不同飞行时间飞行人员颈腰部疾病的患病率进行比较.结果 24.12％的飞行人员患有颈腰部疾病,其中腰部疾病患病率高于颈部和颈腰部(P<0.05).不同机种的飞行人员中,初教机飞行人员的腰部疾病患病率最高(P<0.05);不同职务的飞行人员中,飞行教员的腰部疾病患病率最高(P<0.01);不同年龄的飞行人员中,31～35岁初教机飞行人员的颈腰部疾病患病率显著高于二代机和运输机飞行人员(P<0.05);不同飞行时间的飞行人员中,飞行时间为1001～2000 h的三代机、初教机、高教机飞行人员颈腰部疾病患病率显著高于运输机飞行人员(P<0.05),飞行时间为3001～4000 h的三代机、初教机飞行人员颈腰部疾病患病率显著高于运输机飞行人员(P<0.05),飞行时间>6001 h的初教机飞行人员颈腰部疾病患病率显著高于运输机飞行人员(P<0.05).结论 不同机种军事飞行人员颈腰部疾病患病率不同,初教机飞行人员患病率较高;随年龄的增长和飞行时间的延长,飞行人员颈腰疾病患病率呈现上升趋势.     

飞行人员代谢综合征危险因素调查分析

目的探讨代谢综合征（metabolic syndrome,MS）发病危险因素对现役飞行人员的影响,提供防治策略。方法测量682例飞行人员体质指数（BMI）、血压、血甘油三酯（TG）、空腹血糖（FPG）等指标,以BMI≥25kg／m^2、血压≥140／90mmHg、TG≥1．7mmol／I。FPG≥6．1mmol／L为异常,上述指标≥3项异常者诊断为MS;比较七述指标在小州年龄组之间的差异;查阅受检者过去健康档案,观察上述指标的动态变化。结果682例飞行人员中共检出MS44例,发病率为6．45％。30岁以下飞行人员未榆出MS患者;31～40岁组发病率为4．73％,41～50岁组发病率为18．99％,51岁以上发病率为25．00％。奉组飞行人员中高BMI、高TG血症、高血压、高FPG异常率分别为39．44％、22．29％、8．21％、1．61％;其中l项代驸指标异常者205例（30．06％）,2项指标异常者72例（10．56％）,3项指标异常者43例（6．30％）,4项指标异常者1例（0．15％）,共累及321人,总检出率47．07％。结论MS已成为影响飞行人员身体健康的重要疾病。超重、高脂血症、年龄增长是MS发病的主要危险因素,应引起足够重视。     

飞行员冠状动脉造影39例临床研究

目的 探讨飞行人员冠心病的临床特点和冠状动脉造影在医学鉴定中的意义。方法 对39例飞行员冠状动脉造影病例进行回顾性分析，对象均为男性，年龄25～59岁，通过无创检查方法均不能捧除冠心病。结果 ①通过冠状动脉造影，发现8人出现明显的冠状动脉硬化，其中7人有不同程度冠状动脉狭窄(称该8人为冠脉病变组)，其余有18人诊断为其他心血管疾病(其他疾病组)，13人未做疾病诊断(健康组)。②冠脉病变组年龄较大(48～55岁)，临床症状(87．5％)和平板运动试验(100％)阳性率最高；其他疾病组临床症状也较突出(83．3％)，但平板运动试验阳性率较低(35．3％)；健康组年龄大多较轻，较少有临床症状(30．8％)。③经过冠状动脉造影，使人20／39名飞行员重返飞行岗位，包括健康组全部、其他疾病组5人、冠脉病变组2人。结论 本研究不支持以往调查认为中国飞行人员冠心病发病比普通人群早10～15年的论点。冠状动脉造影对飞行人员冠心病诊断和医学鉴定有重要意义。     

在飞行人员大体检中增设颈椎X线检查的必要性

飞行人员颈椎病患病率较高,发病年龄较普通职业人群早,因患颈椎病而停飞的人数居外科疾病停飞的第3位,是前10种停飞疾病之一,占总停飞人数的4.1％～3.7％。为解决此问题,我院于2002年开始在飞行人员年度大体检中试行颈椎检查,现报告体检结果,并对有关问题讲行分析探讨。     

Air accidents, pilot experience, and disease-related inflight sudden incapacitation

The epidemiology of sudden death, the etiology of inflight sudden incapacitation, and the influence of pilot age and experience on air accident rates are reviewed in order to determine the aeromedical emphasis needed to minimize accidents. Sudden deaths in men over age 35 are nearly all due to coronary artery disease, whereas in those under 35 years they are mostly due to hypertrophic cardiomyopathy. The incidence of fatal accidents from human error is, however, far greater than that from physical illness. Since inexperienced pilots have a 2-3 times increased incidence of mishaps due to pilot error, the estimated risk of disease related in-flight sudden incapacitation should be balanced by consideration of pilot experience. Therefore, it may be preferable to grant waivers to experienced pilots with an increased incidence of disease-related inflight sudden incapacitation than to replace them with novices. We conclude that overly strict medical criteria may paradoxically increase accident rates.     

各机种飞行员颈椎X线对比分析（摘要）

目的探讨飞行环境对各机种飞行员颈椎及周围软组织产生的影响。方法对83名歼击机、强击机和80名运输机、轰炸机飞行员颈椎X线表现进行对比分析。结果歼击机、强击机飞行员与运输机、轰炸机飞行员颈椎分类X线表现中,椎体不稳有非常显著差异,项韧带钙化有明显差异,生理曲度异常35岁（含35岁）以下有明显差异。结论持续性过载作用对颈椎及周围软组织产生急性损伤。     

益生菌酸奶调节飞行员肠道菌群的考察

目的观察富含益生菌酸奶对飞行员肠道菌群以及飞行员腹泻率的影响。方法采集食用益生菌酸奶前后不同时间点飞行员便标本,细菌培养法测定肠道常见菌群含量,计算肠道定值抗力（CR）值,分析肠道菌群的变化。调查表调查飞行员腹泻率,比较食用不同时间益生菌酸奶飞行员腹泻率的差异。结果益生菌酸奶明显增加肠道菌群中双歧杆菌、消化球菌含量,降低肠球菌含量,增加CR值,对肠杆菌和拟杆菌无显著影响。停止食用益生菌酸奶后飞行员肠道菌群中5种细菌及CR值与对照组比无明显差异。长期食用益生菌酸奶可使飞行员腹泻率明显降低。结论益生菌酸奶具有调节飞行员肠道菌群,降低腹泻率的作用。     

飞行员年度体检结果分析及医学鉴定

目的 了解高性能战斗机飞行员的患病及医学鉴定情况,探讨常见疾病的发病规律.方法 对250名高性能战斗机飞行员年度体检检出的疾病进行统计分析.按年龄分为5组：≤30岁（Ⅰ组,n=104）,31～35岁（Ⅱ组,n=63）,36～40岁（Ⅲ组,n=55）,41～45岁（Ⅳ组,n=21）,＞45岁（Ⅴ组,n=7）,比较不同年龄组疾病检出情况及医学鉴定情况. 结果 ①检出疾病者占61.20％,检出2种以上疾病者占检出疾病人数的79.74％.医学鉴定结论：飞行合格243名,暂时飞行不合格7名.②不同年龄组疾病检出率差异有统计学意义（χ^2=50.777,P＜0.01）,Ⅰ组明显低于其他年龄组（P＜0.05）.③检出位列前10位的疾病为高脂血症、脂肪肝、高尿酸血症、胆囊息肉、椎间盘突出症、肝血管瘤、肾囊肿、腰椎峡部裂、肝囊肿和肝功能异常.④不同年龄组间,高脂血症、脂肪肝、高尿酸血症、椎间盘突出症、肾囊肿、肝囊肿及肝功能异常检出率差异有统计学意义（χ^2=9.797～56.140,P＜0.01或＜0.05）. 结论 高性能战斗机飞行员罹患病症以与生活方式相关的代谢性疾病为主,椎间盘突出症检出率也较高.应加强对飞行员健康生活方式的引导,加强颈腰背肌专项锻炼,促进飞行员健康.     

Hand sanitizer and rates of acute illness in military aviation personnel

INTRODUCTION: Alcohol-based hand sanitizer (HS) kills most organisms that cause acute illness, an important cause of lost duty time among aviation personnel. This preliminary study observed the impact on the acute illness rate when HS was made readily accessible to pilots. METHODS: Wall-mounted HS dispensers were placed in two fighter squadron operations buildings during November 2005 and various media were used to alert all base personnel to the importance of hand hygiene and cough hygiene. Data were obtained for two groups of personnel on the same base: 1) pilots who worked in the two HS-equipped buildings (Squadron) (n = 56); and 2) pilots and air traffic controllers who worked at other locations (Non-Squadron) (n = 61). The incidence of acute illness and the cumulative number of duty days lost was determined in each group for the winters of 2004-05 (no HS) and 2005-06 (HS available). RESULTS: For the Squadron group, the acute illness rates were 2.4% in 2004-5 (210 duty days lost) (no HS) compared with 0.9% in 2005-6 (78 duty days lost) when HS was provided. No year-to-year difference was apparent for the Non-Squadron group, where the illness rates were 2.4% in 2004-5 (229 duty days lost) and 2.3% in 2005-6 (221 duty days lost). DISCUSSION: Making HS readily available at locations frequented by pilots together with educating them regarding hand hygiene may reduce the occurrence of acute illness and number of duty days lost.     

空军飞行员3年间高尿酸血症发展趋势研究

目的调查空军飞行员尿酸（UA）水平及变化趋势,为飞行员心血管系统健康水平的评价及心血管疾病的预防提供参考依据。方法回顾性分析2008-01至2010-01来我院体检飞行员的尿酸水平,计算高尿酸血症患病率及尿酸水平与血压、血糖、血脂等指标的关系。结果 3年间高尿酸血症发生率分别为8.2%、14.2%、14.6%。与正常尿酸组比较,高尿酸血症飞行员胆固醇（CHO）、三酰甘油（TG）显著偏高（P〈0.01）;舒张压（DBP）、收缩压（SBP）、血糖（BG）均高于正常尿酸组（P〈0.05）。结论本组飞行员高尿酸血症有逐年增加的趋势,而且与心血管疾病其他危险因素有关。应采取措施加强高尿酸血症的控制,预防心血管系统疾病的发生。     

空军飞行员皮肤病住院情况的调查分析

目的了解空军飞行员中皮肤病的患病特点,使其防治工作科学化。方法对288名患皮肤病的空军飞行员进行了调查分析。结果心身性及免疫性皮肤病住院人数、人次居首位,分别为57．99％和61．39％;而且其住院时间较长,平均28．9天,明显高于另两类皮肤病。随着飞行技术和强度的增高,飞行时间的延长,飞行员的心身性及免疫性皮肤病患病率和复发率也随之增加。结论在各类皮肤病中,心身性及免疫性皮肤病应作为防治的重点,在药物治疗的同时,应注意健康教育和心理疏导,以提高防治效果。     

Age-related vision problems in commuter and air taxi pilots: a study of 3019 pilots, 1987-1997

INTRODUCTION: Vision problems have become an increasingly important health and safety concern for pilots due to the aging of the pilot population. This paper examines the incidence of age-related vision problems in a birth cohort of commuter air carrier and air taxi pilots. METHODS: A cohort of 3019 male pilots ages 45-54 yr at baseline and holding Class I medical certificates in 1987 were retrospectively studied from 1987 to 1997 through the medical certification system of the Federal Aviation Administration. Poisson regression modeling based on generalized estimation equations was used to assess the associations of pilot characteristics with risk of developing vision problems. RESULTS: The study period accumulated 419 incident cases of vision problems, yielding an incidence of 20.3 per 1000 person-years. For pilots ages 45-49, 50-54, 55-59, and 60-64, the incidence of vision problems was 17, 20, 24, and 39 per 1000 person-years, respectively. A baseline history of eye problems and older age were each significantly associated with an increased incidence of vision problems. The adjusted relative risks of vision problems for pilot age were 1.0 (45-49 yr), 1.2 (50-54 yr), 1.4 (55-59 yr), and 3.0 (60-64 yr). The three most prevalent types of visual problems were corneal problems (16%), glaucoma (15%), and cataracts (7%). CONCLUSION: Identifying and preventing pathological changes that alter visual performance among pilots is an important component of aviation safety. With the increasing maturity of the pilot population, it is essential that appropriate visual screening and correction be emphasized for specific age-related ophthalmic conditions.     

Pilot error in air carrier accidents: does age matter?

INTRODUCTION: The relationship between pilot age and safety performance has been the subject of research and controversy since the "Age 60 Rule" became effective in 1960. This study aimed to examine age-related differences in the prevalence and patterns of pilot error in air carrier accidents. METHODS: Investigation reports from the National Transportation Safety Board for accidents involving Part 121 operations in the United States between 1983 and 2002 were reviewed to identify pilot error and other contributing factors. Accident circumstances and the presence and type of pilot error were analyzed in relation to pilot age using Chi-square tests. RESULTS: Of the 558 air carrier accidents studied, 25% resulted from turbulence, 21% from mechanical failure, 16% from taxiing events, 13% from loss of control at landing or takeoff, and 25% from other causes. Accidents involving older pilots were more likely to be caused by turbulence, whereas accidents involving younger pilots were more likely to be taxiing events. Pilot error was a contributing factor in 34%, 38%, 35%, and 34% of the accidents involving pilots ages 25-34 yr, 35-44 yr, 45-54 yr, and 55-59 yr, respectively (p = 0.87). The patterns of pilot error were similar across age groups. Overall, 26% of the pilot errors identified were inattentiveness, 22% flawed decisions, 22% mishandled aircraft kinetics, and 11% poor crew interactions. CONCLUSION: The prevalence and patterns of pilot error in air carrier accidents do not seem to change with pilot age. The lack of association between pilot age and error may be due to the "safe worker effect" resulting from the rigorous selection processes and certification standards for professional pilots.     

飞行人员眼外伤的心理护理（摘要）

目的探讨飞行人员眼外伤患者的临床心理干预对提高治疗率和降低并发症的作用。方法回顾性分析1965年5B～2007年5月在我院收治的61例（62眼）飞行人员眼外伤患者通过及时心理护理后的临床愈后状况与护理资料。结果视力1．0以上51眼,占82．2％,治疗前视力0．1以下11例,治疗后视力无明显恢复4例,其中视力0．05有1例,无光感2例,眼前手动1例。结论加强心理护理在眼外伤治疗恢复中有重要作用。