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Paratz ED, Sprott T, Preitner C, Anbalagan G, Manderson K, Hochberg T. Navigating Coronary Artery Disease in Aviation Cardiology in Australia and New Zealand. Heart Lung Circ 2024:S1443-9506(24)00618-8. [PMID: 38871530 DOI: 10.1016/j.hlc.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 05/09/2024] [Accepted: 05/14/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND Cardiologists will commonly assess patients who hold an aviation medical certificate and require unique assessments and communications with national civil aviation authorities (in Australia, the Civil Aviation Safety Authority [CASA] and in New Zealand, the Civil Aviation Authority of New Zealand [CAA NZ]). Cardiac conditions are the most common reason for disqualification from holding an aviation licence, and coronary artery disease is considered a high-risk condition for pilot incapacitation. AIM To provide a contemporary update on the aeromedical approach to the evaluation, detection, and management of coronary artery disease in an Australasian context. METHODS A narrative view of current and historical practice in the area of aeromedical evaluation of coronary disease was undertaken. RESULTS This review highlights the aeromedical approach to risk stratification and specific challenges of the aviation environment for patients with coronary artery disease. Scenarios of coronary artery disease screening, common and rare acute coronary syndromes, and the assessment of established coronary artery disease are examined in detail. Suggestions to facilitate communications between specialists and CASA or CAA NZ to facilitate patient re-certification are also provided. CONCLUSION Patients who are pilots have unique requirements in terms of their coronary assessment, management, and follow-up to maintain eligibility to fly. It is important for cardiologists to be aware of relevant occupational requirements to provide optimal care to their patients.
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Affiliation(s)
- Elizabeth D Paratz
- St Vincent's Institute of Medical Research, Fitzroy, Vic, Australia; Department of Cardiology, St Vincent's Hospital, Melbourne, Vic, Australia; Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Parkville, Vic, Australia; Victor Chang Cardiac Research Institute, Darlinghurst, NSW, Australia.
| | - Timothy Sprott
- Civil Aviation Authority of New Zealand, Wellington, New Zealand
| | - Claude Preitner
- Civil Aviation Authority of New Zealand, Wellington, New Zealand
| | - Ganesh Anbalagan
- Civil Aviation Safety Authority, Aviation House, Phillip, ACT, Australia
| | - Kate Manderson
- Civil Aviation Safety Authority, Aviation House, Phillip, ACT, Australia
| | - Tony Hochberg
- Civil Aviation Safety Authority, Aviation House, Phillip, ACT, Australia
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Xu W, Bao Y, Zhang L, Li Y, Zhang E, Li H, Jin Q, Chen Y, Duan Q, Shi F, Wang L, Lu Z, Chen X, Gao Q, Han H, Ren B, Su Y, Xiang M. Challenges and support needs in psychological and physical health among pilots: a qualitative study. Front Public Health 2024; 12:1351568. [PMID: 38689767 PMCID: PMC11058901 DOI: 10.3389/fpubh.2024.1351568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 04/05/2024] [Indexed: 05/02/2024] Open
Abstract
Introduction Physical and mental health problems among pilots affect their working state and impact flight safety. Although pilots' physical and mental health problems have become increasingly prominent, their health has not been taken seriously. This study aimed to clarify challenges and support needs related to psychological and physical health among pilots to inform development of a more scientific and comprehensive physical and mental health system for civil aviation pilots. Methods This qualitative study recruited pilots from nine civil aviation companies. Focus group interviews via an online conference platform were conducted in August 2022. Colaizzi analysis was used to derive themes from the data and explore pilots' experiences, challenges, and support needs. Results The main sub-themes capturing pilots' psychological and physical health challenges were: (1) imbalance between family life and work; (2) pressure from assessment and physical examination eligibility requirements; (3) pressure from worries about being infected with COVID-19; (4) nutrition deficiency during working hours; (5) changes in eating habits because of the COVID-19 pandemic; (6) sleep deprivation; (7) occupational diseases; (8) lack of support from the company in coping with stress; (9) pilots' yearly examination standards; (10) support with sports equipment; (11) respecting planned rest time; and (12) isolation periods. Discussion The interviewed pilots experienced major psychological pressure from various sources, and their physical health condition was concerning. We offer several suggestions that could be addressed to improve pilots' physical and mental health. However, more research is needed to compare standard health measures for pilots around the world in order to improve their physical and mental health and contribute to overall aviation safety.
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Affiliation(s)
- Wen Xu
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
- Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuyan Bao
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
- Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lin Zhang
- CAAC East China Aviation Personnel Medical Appraisal Center, Civil Aviation Shanghai Hospital, Shanghai, China
| | - Yunfei Li
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Shinjuku, Japan
| | - Erliang Zhang
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Huilun Li
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Qingqing Jin
- CAAC East China Aviation Personnel Medical Appraisal Center, Civil Aviation Shanghai Hospital, Shanghai, China
| | - Yan Chen
- CAAC East China Aviation Personnel Medical Appraisal Center, Civil Aviation Shanghai Hospital, Shanghai, China
| | - Qingqing Duan
- CAAC East China Aviation Personnel Medical Appraisal Center, Civil Aviation Shanghai Hospital, Shanghai, China
| | - Feng Shi
- CAAC East China Aviation Personnel Medical Appraisal Center, Civil Aviation Shanghai Hospital, Shanghai, China
| | - Linlin Wang
- CAAC East China Aviation Personnel Medical Appraisal Center, Civil Aviation Shanghai Hospital, Shanghai, China
| | - Ziyang Lu
- Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xuhua Chen
- Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qijing Gao
- Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hangyu Han
- Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bin Ren
- CAAC East China Aviation Personnel Medical Appraisal Center, Civil Aviation Shanghai Hospital, Shanghai, China
| | - Ya Su
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Mi Xiang
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
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Minoretti P, Sáez ASS, Martín ÁFG, Riera ML, Serrano MG, Emanuele E. Prevalence of hepatic steatosis and fibrosis in apparently healthy airline pilots: A transient elastography study. HEPATOLOGY FORUM 2024; 5:7-10. [PMID: 38283276 PMCID: PMC10809345 DOI: 10.14744/hf.2023.2023.0050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 09/15/2023] [Accepted: 09/20/2023] [Indexed: 01/30/2024]
Abstract
Background and Aim Airline pilots (APs) are often characterized by a sedentary lifestyle, predisposing them to adverse cardiometabolic consequences. In this cross-sectional study, we used transient elastography (TE) to investigate the prevalence of hepatic steatosis and fibrosis among apparently healthy APs. Materials and Methods The study cohort consisted of 137 male APs of Caucasian descent who voluntarily underwent TE. To evaluate the extent and severity of hepatic steatosis and fibrosis, we employed established cutoff values for the controlled attenuation parameter (CAP) and liver stiffness measurement (LSM). Results Of the APs, 34 (24.8%) were diagnosed with TE-defined steatosis. Specifically, 25 APs (18.2%) exhibited mild steatosis, 6 (4.4%) moderate steatosis, and 3 (2.2%) severe steatosis. The majority of participants (80 APs or 58.4%) showed no signs of liver fibrosis based on LSM values. However, 49 APs (35.8%) were diagnosed with mild fibrosis (F1), 7 (5.1%) with significant fibrosis (F2), and one (0.7%) with advanced fibrosis (F3). None of the pilots had F4 (cirrhosis). In multivariable linear regression analysis, BMI was the sole independent predictor of both CAP (β=0.34, p<0.001) and LSM (β=0.41, p<0.001) values in our sample of male APs. Conclusion TE is a straightforward and convenient non-invasive method for detecting hepatic steatosis and fibrosis in high-risk occupational groups such as APs.
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Affiliation(s)
- Piercarlo Minoretti
- Studio Minoretti, Oggiono (LC), Italy
- Department of Legal Medicine, Psychiatry and Pathology, Complutense University of Madrid School of Medicine, Madrid, Spain
| | - Andrés S. Santiago Sáez
- Department of Legal Medicine, Psychiatry and Pathology, Complutense University of Madrid School of Medicine, Madrid, Spain
| | - Ángel F. García Martín
- Department of Legal Medicine, Psychiatry and Pathology, Complutense University of Madrid School of Medicine, Madrid, Spain
| | - Miryam Liaño Riera
- Department of Legal Medicine, Psychiatry and Pathology, Complutense University of Madrid School of Medicine, Madrid, Spain
| | - Manuel Gómez Serrano
- Department of Legal Medicine, Psychiatry and Pathology, Complutense University of Madrid School of Medicine, Madrid, Spain
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