title: Medical risks in older pilots: a systematic review on incapacitation and age.
abstract: OBJECTIVE
  Our ageing society faces an ageing work force. The target of this systematic review was to analyse whether pilots have a measurable age-dependent increased risk of incapacitation due to medical reasons.
  
  
  METHODS
  Publications listed in PubMed, NCBI and EMBASE were identified using defined terms. Two independent raters analysed 2,342 retrieved publications by predefined criteria. Ten publications met the inclusion criteria.
  
  
  RESULTS
  Four publications use a similar numerator (in-flight incapacitation) and identical denominator (flight hours) and show in-flight incapacitation of pilots happening 0.19-0.45 times/10(6) flight hours. Two of these studies did not analyse the possible correlation of incapacitation and age, and two did not use the denominator flight hours here. Age dependency of incapacitation is analysed in seven publications: Three analyse in-flight incapacitation and four analyse general incapacitation to fly. All but one--the only one including professional pilots older than 60 years--show an age-depending increase in incapacitation. The increase in in-flight incapacitation is far less than the increase in general flight incapacitation.
  
  
  CONCLUSIONS
  Medical in-flight incapacitation is a very rare event. Whether the increase in in-flight incapacitation results in an increase in accidents or can be compensated for by error reduction through experience cannot be answered. A register of all pilots with a clear identification system to follow their career and health, their accidents and impairments, might help to reconsider the grounding of pilots over 60 and to define better criteria than mere age.
authors: Institut und Poliklinik für Arbeits-Sozial- und Umweltmedizin, Klinikum der Universität München, Munich, Bavaria, Germany, Katharina.Huster@med.uni-muenchen.de.
authors: Katharina M
authors: KM
authors: Huster
authors: Andreas
authors: A
authors: Müller
authors: Maria J
authors: MJ
authors: Prohn
authors: Dennis
authors: D
authors: Nowak
authors: Britta
authors: B
authors: Herbig
mesh_terms: D000060:Accidents, Aviation; D000328:Adult; D000337:Aerospace Medicine; D000367:Age Factors; D001359:Aviation; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D018570:Risk Assessment; D014938:Work Capacity Evaluation
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