Morbidity among airline pilots: The AMAS experience

Background: Various cohort studies, military databases, and Federal Aviatio n Administration databases have characterized morbidity and disability in p ilots. However, an overriding limitation of these studies is acquiring comp lete and accurate medical information from pilots with a profession, hobby, or aircraft investment to protect (6). The unique role of Aviation Medicin e Advisory Service (AMAS) as pure pilot advocate with guaranteed patient co nfidentiality eliminates the aviator's need to conceal medical problems. Th erefore, analyses of cases reported to AMAS might provide additional insigh t regarding the true prevalence of morbidity in airline pilots. Methods: Al l AMAS cases of airline pilots and flight engineers from January 1996 throu gh November 1999 were reviewed (n = 20,522). During that time, AMAS provide d consultation to approximately 51 U.S. and Canadian airlines. Diagnoses we re stratified by decades ranging from 20 to 69 yr of age. Results: Notably, the five conditions most frequently inquired about at AMAS were similar to the major causes of long term disability found in a cohort of Air Canada p ilots (5). Cardiovascular conditions accounted for almost 25% of the inquir ies. However, the relative percentage especially in the older population wa s less than that reported previously. Interestingly, orthopedic and musculo skeletal cases (10-11 %) rated second only to cardiovascular cases. Conclus ions: These findings are limited by the inability to draw an exact referenc e Population at risk, the use of proportional measures for description and the inherent difficulty in attempting to utilize an administrative index as an epidemiological tool. Further study addressing the impact of aviator no ndisclosure of medical problems on the reported prevalence of disease among U.S. airline pilots may help target preventive efforts in the future.