Risk Assessment in the U.S. Pilot Population From 1983-2005: Diabetes Prevalence and Flight Safety

Rogers PB, Véronneau SJH, Forster EM

FAA Office of Aerospace Medicine - Civil Aerospace Medical Institute

关键词: Diabetes;    U.S. Civil Pilot Population;    Data Analysis;    Aviation Safety;    Epidemiology;    Gender;    Medical Class;    Age;    Obesity;    BMI;    Flight Time;    Risk;    Poisson;    Negative Binomial;    Regression;    Scientific Information System;   

RP-ID  :  DOT/FAA/AM-15/5

美国|英语

来源: Federal Aviation Administration

【 摘 要 】

Introduction. A Scientific Information System developed at the Civil Aerospace Medical Institute (CAMI) has supported several studies of the U.S. civil pilot population. The CAMI Numerical Sciences Research Team used this unique data construct to examine the aeromedical and aviation safety aspects of diabetes. The prevalence of diabetes from 1983 through 2005 and its associated risk factor, obesity, was studied. Issues associated with the medical certification of aviators with diabetes and their relationships with accident risk were examined.Methods. The Scientific Information System is a longitudinal dataset of the entire U.S. civil pilot population spanning the years 1983 through 2005. This paper discusses the parallel trends of Body Mass Index (BMI) and numbers of aviators with diabetes over a 23-year time frame. The information was stratified by gender and age groups. A count-based regression model was used to quantify safety risk posed by diabetic airmen.Results. The number of airmen with diabetes in the U.S. active population of airmen has risen from 2,768 in 1983 to 10,806 in 2005. The increasing proportion of reported diabetes within the U.S. civil pilot population escalated to 1.6% and 0.5% for men and women, respectively, in 2005. Increasing median BMI is found to be on the rise from the early nineties through 2005. There was evidence that aviators with reported diabetes controlled by hypoglycemic medication and diabetes controlled by diet alone were at greater accident risk than aviators without these conditions. Examining the accident reports for airmen with diabetes controlled by insulin (Code No. 936) did not reveal any evidence that the diabetes condition played a role in the accident occurrence.Discussion. It is clear that the epidemic of obesity and diabetes began in the early nineties within the U.S. civil pilot population. Increasing numbers of aviators with diabetes can be observed from 1983 through 2005. Diabetes controlled by hypoglycemic medication (Code No. 937) and diabetes controlled by diet (Code No. 935) were statistically associated with aviation accidents. Although associated with aviation accidents, the role of these two diabetes conditions was not a causal one but rather act as markers for a strata of high-risk airmen with multiple comorbid chronic conditions. Each of these comorbid conditions were not, by themselves, medically disqualifying but acted in combination to produce an airman marginally fit for flight.