title: Modern Air Combat Developments and Their Influence on Neck and Back Pain in F-16 Pilots.
abstract: BACKGROUND
  Neck and back pain in fighter pilots remains a serious occupational problem. We hypothesized that recent advances such as the joint helmet mounted cueing system (JHMCS) in modern air combat might contribute to the development of spinal complaints in F-16 pilots.
  
  
  METHODS
  Surveyed were 59 F-16 pilots of the Royal Netherlands Air Force who were compared to 49 F-16 pilots who filled in a similar questionnaire in 2007. The prevalence of neck and back pain, work situations, and capacity of the pilot were analyzed.
  
  
  RESULTS
  The self-reported 1-yr prevalence of regular or continuous neck and lower back pain in 2014 were 22% and 31%, respectively, compared to both being 12% in 2007. Age, military flying experience, total number of flying hours, flying hours on the F-16, and total number of hours flown with night vision goggles (NVG) were significantly higher in 2014. In 2014, 95% flew with JHMCS, compared to 0% in 2007. Flying with JHMCS (88%), NVG (88%), type of flight (63%), and sitting posture (50%) were the most reported causes of flight-related neck pain. Sitting posture (89%), duration of flight (56%), and seat (44%) were among the reported causes of back pain.
  
  
  CONCLUSIONS
  The increasing trend of neck and lower back pain might be caused by multiple changes in both the work situation and capacity of the pilots since 2007. Future innovations will increase the load on the pilot's spine. To successfully address their spinal problems in the future, fighter pilots must be monitored continuously.
authors.affiliation: Center for Man in Aviation, The Royal Netherlands Air Force, Soesterberg, The Netherlands.
authors.forename: Stijn J J
authors.initials: SJ
authors.lastname: Thoolen
authors.forename: Marieke H A H
authors.initials: MH
authors.lastname: van den Oord
mesh_terms: D000328:Adult; D000337:Aerospace Medicine; D000401:Aircraft; D001416:Back Pain / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005135:Eye Protective Devices; D006260:Head Protective Devices; D006801:Humans; D008297:Male; D008887:Military Medicine; D019547:Neck Pain / Q000453:epidemiology*; D009784:Occupational Diseases / Q000453:epidemiology*; D015995:Prevalence