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Multidimensional risk assessment versus age as criterion for retirement of airline pilots.

Abstract：

OBJECTIVE:To determine whether airline pilots over the age of 60 pose a hazard to aviation safety and whether risk assessment could replace age-based retirement. DATA SOURCES:A computer-assisted literature search (MEDLINE), expert consultation, and government reports. STUDY SELECTION:Original studies on flight performance and pilot age; sudden incapacitation, neuropsychological testing, and/or medication use in pilots; and/or non-invasive testing for predicting sudden death or stroke in asymptomatic subjects. DATA EXTRACTION:Pertinent results and methods data were abstracted from the 49 included studies. DATA SYNTHESIS:No study on aircraft accidents or pilot performance has shown an increased accident risk for over-60-year-old pilots. Normal age-related cognitive changes probably have minimal impact on aviation safety up to age 70, given above average health, education, and experience in airline pilots. Cognitive tests have not been validated for predicting flight performance safety, but they can detect early stages of cognitive disease. Cardiovascular incapacitation risk increases with age, but risk factor profiles and non-invasive tests could identify pilots with non-acceptable risk. CONCLUSIONS:An improved medical certification test could identify those pathologic conditions that might occur more frequently in older subjects. If pilots also underwent adequate performance testing, a gradual increase of the retirement age to approximately age 70 would seem justified. In the future, a longitudinal database should be established to validate medical tests for their ability to predict a pilot's accident risk. Using individual pilots as their own controls might be more sensitive than using population-based norm values. Progress in this field would advance medical assessment for other groups such as air traffic controllers or automobile drivers.

journal_name

J Am Geriatr Soc

journal_title

Journal of the American Geriatrics Society

authors

Stuck AE,van Gorp WG,Josephson KR,Morgenstern H,Beck JC

doi

10.1111/j.1532-5415.1992.tb02024.x

subject

Has Abstract

pub_date

1992-05-01 00:00:00

pages

526-32

issue

eissn

0002-8614

issn

1532-5415

journal_volume

pub_type

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Multidimensional risk assessment versus age as criterion for retirement of airline pilots.