title: The annual incapacitation rate of commercial pilots.
abstract: BACKGROUND
  Scant data are available on the annual incapacitation rate of aircrew. This study analyzes all incapacitations occurring among UK commercial pilots, in flight and off duty, in 2004 to derive a baseline minimum annual incapacitation rate for the UK commercial pilot population.
  
  
  METHODS
  The study cohort was all professional pilots holding a valid UK/JAR (Joint Aviation Requirements) Class 1 medical certificate and license in 2004. Three data sources were used to identify episodes of incapacitation: the statutory notification of prolonged illness, personal injury, or pregnancy to the UK Civil Aviation Authority; Mandatory Occurrence Reports (MORs) for in-flight medical incidents; and death certificates. The total number of incapacitations was expressed as a proportion of the number of professional pilots to give an incapacitation rate.
  
  
  RESULTS
  In 2004 there were 16,145 UK/JAR professional pilot license holders. Of the notified medical events, 36 presented as incapacitations; half were cardiac or cerebrovascular. In-flight incapacitations were predominantly of psychiatric cause. There were four sudden deaths. The type of incapacitation varied with age. A male pilot in his 60s had 5 times the risk of incapacitation of a male pilot in his 40s. The annual incapacitation rate was 40/16,145 = 0.25%.
  
  
  CONCLUSIONS
  Aeromedical emphasis on minimizing cardiovascular risk and monitoring the mental health of pilots remains appropriate. Age should influence the content and periodicity of regulatory aeromedical assessments. The demonstrated annual incapacitation rate of 0.25% may provide a basis for quantifying the acceptable risk for a pilot undertaking single pilot commercial air transport operations.
authors.affiliation: Medical Department, UK Civil Aviation Authority, Aviation House, Gatwick Airport South, West Sussex RH6 0YR, UK. sally.evans@caa.co.uk
authors.forename: Sally
authors.initials: S
authors.lastname: Evans
authors.forename: Sally-Ann
authors.initials: SA
authors.lastname: Radcliffe
mesh_terms: D000059:Accidents / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000337:Aerospace Medicine; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000453:epidemiology*; D009203:Myocardial Infarction / Q000453:epidemiology; D016272:Occupational Health; D011247:Pregnancy; D011363:Professional Impairment / Q000706:statistics & numerical data*; D020521:Stroke / Q000453:epidemiology; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult