ObjectivesOccupational exposure to cosmic and ultraviolet radiation may increase airline pilots’ risk of cutaneous melanoma. Meta-analyses of available data show a higher than average incidence of melanoma in airline pilots, but the most recent systematic review revealed that few contemporary data are available. Moreover, all relevant studies have been conducted in Northern Hemisphere populations. We therefore aimed to examine if Australian commercial pilots have a raised incidence of melanoma compared with the general population.MethodsWe examined all melanoma histologically diagnosed among Australian-licensed commercial pilots in the period 2011–2016 by manually reviewing de-identified data in the medical records system of the Australian Civil Aviation Safety Authority. We estimated age-specific incidence rates and compared these with corresponding population rates using standardised incidence ratios (SIRs) as measures of relative risk. Expected numbers were calculated by multiplying age- and calendar period-specific person-years (PYs) with corresponding rates from the entire Australian population; 95% CI were calculated assuming a Poisson distribution of the observed cases.ResultsIn this cohort of Australian-licensed commercial pilots observed for 91 370 PYs, 114 developed a melanoma (51 invasive, 63 in situ). More than 50% of melanomas occurred on the trunk, and the predominant subtype was superficial spreading melanoma. The SIR for invasive melanoma was 1.20 (95% CI 0.89 to 1.55) and for melanoma in situ, 1.39 (95% CI 1.08 to 1.78).ConclusionAustralian-licensed commercial pilots have a modestly raised risk of in situ melanoma but no elevation of invasive melanoma compared with the general population.

Acute renal colic is an incapacitating condition. Advances in understanding the pathogenesis of calculi and their detection and treatment require a new approach to aeromedical risk assessment. Can this new information support the stratification of aeromedical risk into "High" and "Low" categories, and fulfill the paramount responsibility of the Civil Aviation Safety Authority, Australia's aviation regulator, which isthe maintenance of aviation safety? This article reviews the epidemiology of calculi and finds 2-10% annual risk of a symptomatic event following incidental detection of a calculus. While calculi 4 mm or less in size may not require surgical intervention, this does not equate to a pain-free passage. Similarly, calculus recurrence rates may vary in different anatomical locations, but no location can be considered "safe." The recognition of parenchymal calcification and Randall's plaques as precursors to the development of calculi places such individuals at elevated risk of developing calculi. More recently evidence has supported a link between metabolic syndrome and calculus formation. In an occupational group where there is potential for elevated radiation exposure, appropriate imaging is of particular importance. CT, X-ray, and ultrasound modalities are reviewed with recommendations presented for aeromedical assessment and surveillance based on identification of those at high risk of colic and minimization of investigational radiation exposure.

Pilot training has always been a relatively expensive undertaking. So attempts to control these costs by predicting the likelihood of success or failure is a constant that is almost as old as aviation itself. Incorporation of Psychometric testing was made to pilot selection in the years between the first and second world wars. Despite the many changes that have occurred in this area, psychometric testing continues to feature in modern systems of pilot aptitude testing. This paper reviews some of the history of psychometric testing in pilot selection.

The study confirmed that PD will be of increased relevance over the next decade. Gaps between policy and practice managing past cases were identified. Updated guidelines have been published aiming to address the deficiencies identified in the study. Historically pilots and controllers have been able to maintain certification for an average of 3.75 yr. This information should be of benefit to clinicians, pilots, and controllers when considering occupation and treatment options.