title: +Gz-induced spinal symptoms in fighter pilots: operational and individual associated factors.
abstract: BACKGROUND
  Neck pain in fighter pilots has been studied by several air forces and found to be relatively common. The aim of this project was to study the incidence, characteristics, possible associated causative factors, and operational impact of neck pain in Royal Norwegian Air Force (RNoAF) fighter pilots.
  
  
  METHODS
  The study was designed as a retrospective anonymous questionnaire survey, collecting data on age, aircraft type, flying hours, and physical activity. Any experience of spinal symptoms related to flying was included, as well as detailed questions on operational factors. Estimates regarding how neck symptoms influenced flying performance were established using visual analogue scales (VAS). Pilots also described their own in-flight techniques to avoid neck symptoms.
  
  
  RESULTS
  Of respondents, 72% had experienced neck pain in relation to flying, while 35% had experienced back pain. Of these episodes, 93% were related to neck rotation. Mean G level for acute incidents of in-flight pain was 6.7 G. Total training time is on average higher in pilots who have no neck pain compared to those who have had neck pain events in the last 12 mo; the mean training time being 3.9 h in the "no pain-group" vs. 2.7 h in the "pain group". "Checking six" was the most affected in-flight function.
  
  
  CONCLUSIONS
  New technologies such as night-vision goggles and helmet-mounted displays increase helmet weight, thereby adding a higher strain to the neck even in moderate G environments. More research on specific prevention strategies is warranted in order to improve the in-flight working environment of fighter pilots.
authors.affiliation: Institute of Aviation Medicine, Norwegian Armed Forces Medical Services, P.O. Box 14 Blindern, 0313 Oslo, Norway. anthony.wagstaff@flymed.uio.no
authors.forename: Anthony S
authors.initials: AS
authors.lastname: Wagstaff
authors.forename: Karl Ivar
authors.initials: KI
authors.lastname: Jahr
authors.forename: Suzanne
authors.initials: S
authors.lastname: Rodskier
mesh_terms: D000328:Adult; D000337:Aerospace Medicine; D001416:Back Pain / Q000453:epidemiology / Q000209:etiology*; D005135:Eye Protective Devices / Q000009:adverse effects; D006112:Gravitation; D006260:Head Protective Devices / Q000009:adverse effects; D006801:Humans; D008875:Middle Aged; D008889:Military Personnel; D019547:Neck Pain / Q000453:epidemiology / Q000209:etiology*; D009664:Norway / Q000453:epidemiology; D010147:Pain Measurement; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires