AsMA 2008 MEETING ABSTRACTS
with short peak exposures, and have perceived tinnitus related to age, high
impulse noise levels, and hearing impairment.
Learning Objectives: 1. The relationship between personal factors, hearing
impairment and tinnitus will be presented.
Monday, May 12 10:30AM
SLIDE: Aeromedical Standards I
[22]MUSCULOSKELETAL DIAGNOSES AMONG COMMERCIAL
AIRLINE FLIGHT ATTENDANTS
W. W. DALITSCH1, J. L. FISHBACK2, A. J. PARMET3,
G. L. BONO2 and M. S. MAYO2
1
U.S. Navy, FPO, AE (Europe); 2University of Kansas Medical
Center, Kansas City, KS; 3University of Kansas Medical Center,
Kansas City, MO
Background: Flight attendants in the U.S. are not required by
regulation to undergo physical examinations. Earlier abstracts by this group
revealed that the prevalence rate for potentially disqualifying conditions
among flight attendants is 38.35% (0.3595, 0.4075), significantly higher
than that of applicants for a Federal Aviation Administration Third Class
medical certification (8.23%, p<0.00001). Categorizing conditions by
organ system showed that the fifth leading cause of disqualifying diagnoses
is musculoskeletal (35 of 606, 5.78%). Methods: A total of 1580 (39.5%
of total) flight attendant medical records at a major airline were randomly
selected and screened for potentially disqualifying conditions based on FAA
Third Class medical certification standards. Individual flight attendants were
categorized as not physically qualified due to a musculoskeletal diagnosis
if the local Aviation Medical Examiner would be unable to issue a medical
certificate without deferral. Those conditions were then broken down by
diagnosis. Results: The disqualifying diagnoses in the musculoskeletal
category included degenerative joint disease (16 of 35, 45.7%), debilitating
knee disorder without surgical correction (8 of 35, 22.9%), degenerative
disc disease (6 of 35, 17.1%), arthritis (4 of 35, 11.4%) and chronic
myofascial pain (1 of 35, 2.9%). For those with multiple diagnoses, only
the most recent active diagnosis was categorized. Conclusion: Significant
numbers of flight attendants are working with potentially debilitating
diagnoses. These diagnoses are distributed throughout all organ systems,
with 5.78% being musculoskeletal. Flight attendants with conditions that
can limit basic functions such as arthritis, degenerative joint disease and
knee disorders may have the potential to interfere with passenger safety,
particularly in an emergency situation. A thorough medical history and
physical examination can elucidate who might not be physically qualified.
Learning Objectives: 1. The audience will learn the leading potentially
debilitating musculoskeletal diagnoses among commercial airline flight
attendants.
[23] A RETROSPECTIVE ANALYSIS OF MUSCULOSKELETAL
DISABILITIES IN MILITARY AND CIVIL AIRCREW IN INDIA
(1999-2006)
N. TANEJA
Institute of Aerospace Medicine, Indian Air Force, Bangalore,
Karnataka, India
Background: Musculoskeletal disabilities are a cause for concern
in aircrew as they can critically affect return to flying duties, besides
entailing a prolonged course of recovery. Analysis of nature and cause
of musculoskeletal disabilities can provide insights that could assist in
developing preventive and therapeutic intervention programs. Purpose:
The purpose of this study was to analyze musculoskeletal disabilities
among military and civil aircrew in India. Method: The Institute of
Aerospace Medicine (IAM) is responsible for centralized evaluation
of military and civil aircrew with any musculoskeletal disability. We
analyzed musculoskeletal disabilities among aircrew who were evaluated
at this Institute from 1999-2006. Results: A total of 626 aircrew (civil=39,
military=587) were evaluated during the above period. Most of the military
pilots (38%) were from the fighter stream. While a large number of military
pilots were less than 30 years of age, all the civil pilots were more than 30
years of age. Musculoskeletal injuries affecting the spine constituted 39%
(n=297) of the disabilities followed by upper (29.1%, n=220) and lower
limbs (23.0%, n=174) respectively. Of the spinal disabilities, compression
fractures and degenerative disease of the disc were the leading disabilities
212
(39.7%, n=118) followed by fracture of the spine in 30% (n=88). Eighteen
aircrew needed surgical intervention for disc disease. Spinal disabilities
were the maximum among fighter pilots. Road traffic accidents accounted
for almost a quarter of the injuries (23.7%, n=132); ejection and aircraft
accidents accounted for 22% of the disabilities. Discussion: The findings
provide insight into the nature of musculoskeletal disabilities among
military aircrew. Implications for preventive and therapeutic strategies are
elaborated. Disc disease in military aircrew appears to be a cause for
concern. A follow up study attempting to correlate imaging and return to
flying duties has been initiated to develop a better understanding of the
significance of these radiological findings
Learning Objectives: 1. An awareness of the spectrum of musculoskeletal
disabilities in military and civil aircrew. 2. Understanding of the nature of
the spinal disabilities in military aircrew.
[24] FIVE YEARS RETROSPECTIVE STUDY OF CANCER AMONG
FRENCH CIVIL CREW AND AIR CONTROLLERS
J. DONNE
None Given, Paris, France
Introduction: French civil crew (pilots and flight attendants) medical
fitness follow up is done through 5 CEMAs:”Centre d´Expertise Médicale
Aéronautique” Percy(military), Charles de Gaulle (AF civil), Toulon
(military), Toulouse (civil), and Bordeaux(military). The air controllers
medical follow up is under control of Civil Aviation Authority (D.A.C.);
For crew members and air controllers the fitness norms must be respected;
These rules are defined under control of transport ministry. Some European
rules (JAR FCL)have been transposed in french norms: for example FCLIII
for pilots. Among pathologies which were found in CEMAs are crew
cancer comparable with air controllers cancer? Methods: In order to
compare types and cancer´s occurrence rates , a study among commercial
french civil crew (pilots and flight attendants) was performed over 5 years
from 1st January 2000 to 31 december 2004 in the five French CEMA. The
same study was undertaken with the french metropolitan air controllers
during the same period. Results: Two hundred and sixty four cancers were
found over 5 years in the 5 french CEMAs concerning the metropolitan
civil aviation crew; less than 50 cancers were found among air controllers.
Discussion: Despite gender bias : gynaecologic (particularly breast) cancer
found among women followed up in the CEMAs and DAC, there is no
significative differences between the two studied populations .
Learning Objectives: 1. Comparison of cancer occurence in 3 aeronatical
populations. 2. Civil aviation medical follow up.
[25] CANCER IN FIGHTERS
C. SHURLOW
United States Government, Beavercreek, OH
Introduction: While stationed at Seymour Johnson AFB, assigned to
the 334th Fighter Squadron in 2002-2004, an alarming number
of cancer cases were uncovered. Within this time period, five
F-15E aviators were diagnosed with urogenital cancer and one was
additionally diagnosed the following year (2005). This study evaluates
potential factors that could precipitate or cause cancer. The factors
include; genetic predisposition, environmental (local and operational
related), and other associated disease precursors. Methods: A retrospective
data base search of the USAF Aeromedical Information Management
Waiver Tracking System (AIMWTS) was conducted for prostate, testicular,
renal cell, and malignant melanoma cancers in the active duty Air Force.
These cancers were compared to aircraft type, hours flown, and fighter
aircraft versus other aircraft type and statistical analysis was conducted for
evaluation. Results: The mean age for a fighter aviator was 43 +/- 8 years.
The mean age for other aircraft aviator was 40 +/- 10 years. There was no
statistical difference in age between fighter pilots with urogenital cancer
versus other pilots with urogenital cancer, p=0.18. The mean hours for a
fighter aviator were 2755 +/- 1016 hours. The mean hours for other aircraft
aviator were 3210 +/- 2078. There was no statistical difference in total
flight hours for fighter pilots with urogenital cancer versus other pilots with
urogenital cancer, p=0.30. The odds of a fighter pilot acquiring urogenital
cancer were 2.4 times greater than non-fighter pilots in the United States
Air Force with a 95% confidence interval of 1.4-4.1.
The odds of an F-15 fighter pilot or WSO, when separated out from total
fighter aviators were not statistically different from the odds for other pilots,
with an odds ratio of 1.6 and a 95% confidence interval of 0.8-3.3.
Learning Objectives: 1. The relationship of cancer and flying high
performance aircraft.
Aviation, Space, and Environmental Medicine x Vol. 79, No. 3 x March 2008