Cardiovascular Risk Score and Cardiovascular Events Among Airline Pilots: A Case-Control Study

Wirawan, I Made Ady; Larsen, Peter; Aldington, Sarah; Griffiths, R; Ellis, Chris

doi:10.3357/asem.3222.2012

Cited by 14 publications

(12 citation statements)

References 13 publications

(13 reference statements)

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“…This may be compared to the general population where, 43.7% men aged 35-74 yr with 10% 5-yr CVD risk or above experienced a CVD event in the subsequent 5-yr period ( 18 ). The diffi culty of accurately detecting cardiovascular risk in this population is further demonstrated by our previous observation that 47% of those with cardiovascular events never achieve a 10% 5 yr risk level using the current risk model ( 25 ).…”

Section: Discussionmentioning

confidence: 86%

Cardiovascular Investigations of Airline Pilots with Excessive Cardiovascular Risk

Wirawan

Aldington²,

Griffiths³

et al. 2013

Aviation, Space, and Environmental Medicine

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Section: Discussionmentioning

confidence: 86%

Cardiovascular Investigations of Airline Pilots with Excessive Cardiovascular Risk

Wirawan

Aldington²,

Griffiths³

et al. 2013

Aviation, Space, and Environmental Medicine

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“…Within the scope of the present work, longitudinally assessing surrogate outcomes in the form of risk markers was therefore the only feasible option. Cardiovascular risk factors and scores were shown to be related to five‐year event incidence in professional pilots . In the long run, the establishment of a cross‐country harmonized database of aeromedical findings appears to be the only way to enable systematic investigations of incapacitating events in the small but healthy group of professional pilots.…”

Section: Discussionmentioning

confidence: 99%

“…(40) Cardiovascular event occurrence is strongly related to common risk factors such as smoking and blood pressure in professional pilots (as in the general population). (41) Investigating cardiometabolic risk markers therefore offers a feasible way to study the incapacitation risk in the small and healthy population of active HEMS pilots. In the analysis, we focus on comparing the direction and magnitude of risk marker change rates between pilots approaching the critical age threshold of 60 years and the remaining pilots.…”

Section: Study Objectivementioning

confidence: 99%

“…A prolonged QTc interval is predictive of cardiac arrhythmia and sudden death . Cardiovascular event occurrence is strongly related to common risk factors such as smoking and blood pressure in professional pilots (as in the general population) . Investigating cardiometabolic risk markers therefore offers a feasible way to study the incapacitation risk in the small and healthy population of active HEMS pilots.…”

Section: Introductionmentioning

confidence: 99%

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Aging and Cardiometabolic Risk in European HEMS Pilots: An Assessment of Occupational Old‐Age Limits as a Regulatory Risk Management Strategy

2017

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Old-age limits are imposed in some occupations in an effort to ensure public safety. In aviation, the "Age 60 Rule" limits permissible flight operations conducted by pilots aged 60 and over. Using a retrospective cohort design, we assessed this rule's validity by comparing age-related change rates of cardiometabolic incapacitation risk markers in European helicopter emergency medical service (HEMS) pilots near age 60 with those in younger pilots. Specifically, individual clinical, laboratory, and electrocardiogram (ECG)-based risk markers and an overall cardiovascular event risk score were determined from aeromedical examination records of 66 German, Austrian, Polish, and Czech HEMS pilots (average follow-up 8.52 years). Risk marker change rates were assessed using linear mixed models and generalized additive models. Body mass index increases over time were slower in pilots near age 60 compared to younger pilots, and fasting glucose levels increased only in the latter. Whereas the lipid profile remained unchanged in the latter, it improved in the former. An ECG-based arrhythmia risk marker increased in younger pilots, which persisted in the older pilots. Six-month risk of a fatal cardiovascular event (in or out of cockpit) was estimated between 0% and 0.3%. Between 41% and 95% of risk marker variability was due to unexplained time-stable between-person differences. To conclude, the cardiometabolic risk marker profile of HEMS pilots appears to improve over time in pilots near age 60, compared to younger pilots. Given large stable interindividual differences, we recommend individualized risk assessment of HEMS pilots near age 60 instead of general grounding.

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“…There has been concern about work related diseases among pilots due to their special work condition. Previous epidemiological studies among commercial pilots have studied cancer [ 1 ], cardiovascular disease [ 2 ], sleeping disorders [ 3 ], and medical symptoms on eyes, nose, skin and general symptoms [ 4 – 7 ]. Some studies have investigated respiratory health and allergy among pilots.…”

Section: Introductionmentioning

confidence: 99%

Respiratory Illness and Allergy Related to Work and Home Environment among Commercial Pilots

Lindgren

Wieslander

et al. 2016

PLoS ONE

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The aim was to study associations between work and home environment and prevalence and incidence of respiratory health and a history of atopy in a 3-y cohort of commercial pilots. A questionnaire was mailed in 1997 to all pilots in a Scandinavian airline company (N = 622); 577 (93%) participated. The same questionnaire was sent to the participants 3 years later, 436 participated (76%). There were questions on asthma, respiratory symptoms and infections, allergies, the cabin environment, psychosocial environment and the home environment. Associations were analyzed by multiple logistic regression, calculating odds ratios (OR) with 95% confidence intervals (95%CI). The incidence of doctors’ diagnosed asthma and atopy were 2.4 and 16.6 per 1000 person years, respectively. Pilots changing type of flight during follow-up got more airway infections (OR = 11.27; 95% CI 2.39–53.14). Those reporting decreased work control (OR = 1.85; 95% CI 1.03–3.31 for 1 unit change) and those with environmental tobacco smoke (ETS) at home (OR = 3.73; 95% CI 1.09–12.83) had a higher incidence of atopy during follow up. Dampness or mould at home was associated with a higher prevalence of asthma symptoms (OR = 3.55; 95% CI 1.43–8.82) and airway infections (OR = 3.12 95% CI 1.27–7.68). Window pane condensation in winter at home, reported at baseline, was associated with increased incidence of asthma symptoms (OR = 4.14; 95% CI 1.32–12.97) and pilots living in newer buildings at baseline had a higher incidence of airway infections (OR = 5.23; 95% CI 1.43–19.10). In conclusion, lack of work control and ETS at home can be a risk factors for development of allergic symptoms in pilots. Window pane condensation at home can be a risk factor for incidence of asthma symptoms. Dampness and mould at home can be a risk factor for prevalence of asthma symptoms and airway infections and living in newer buildings can be a risk factor for incidence of airway infections.

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Cardiovascular Risk Score and Cardiovascular Events Among Airline Pilots: A Case-Control Study

Abstract: Despite a valid and appropriate cutoff point, the tool had low sensitivity and was unable to predict almost half of the cardiovascular events.

Cited by 14 publications

References 13 publications

Cardiovascular Investigations of Airline Pilots with Excessive Cardiovascular Risk

Cardiovascular Investigations of Airline Pilots with Excessive Cardiovascular Risk

Aging and Cardiometabolic Risk in European HEMS Pilots: An Assessment of Occupational Old‐Age Limits as a Regulatory Risk Management Strategy

Respiratory Illness and Allergy Related to Work and Home Environment among Commercial Pilots

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