The association of aviator's health conditions, age, gender, and flight hours with aircraft accidents and incidents

The aim of this study was to explore the association of a large number of health conditions in medically certified aviators to aviation accidents and incidents. Associations for most of the conditions have not been previously explored using modern techniques.;This was accomplished using case-control studies for commercial and noncommercial pilots separately. The commercial group consisted of 4964 cases and 114624 controls and the noncommercial group had 6460 cases and 300752 controls. Associations were obtained using multivariate logistic regression modeling to adjust for age, gender, recent and total flight times. The association with adverse outcomes for most of the conditions after adjustment was not statistically significant. This is not surprising since this is the residual risk in aviators who have successfully obtained a medical certificate.;A history of alcohol related driving offenses was found to be significantly associated with adverse outcomes with odds ratios of 1.50 (95% CI 1.31--1.72) for commercial airmen and 1.16 (1.02--1.32) for the private pilot group. This is the only health condition previously explored using modern techniques and the results are comparable. The association of drug related offenses has not been previously reported but is even stronger with OR = 5.13 (3.28--8.03) in the commercial aviators.;Other conditions with statistically significant positive associations included several visual conditions and hearing deficits. Multiple sclerosis, myocardial infarction, coronary artery disease, and neurosis were associated with adverse events in the private pilot group. Migraine headaches, low back conditions, stomach ulcers, and diabetes were risk factors in the commercial group. The majority of these conditions had odds ratios less than 2.0 and due to the exploratory nature of this study must be considered as hypothesis generating. The aeromedical significance of these conditions does warrant further study to confirm these findings and elucidate the mechanisms of risk.