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Multidimensional Risk Assessment versus Age as Criterion for Retirement of Airline Pilots
Author(s) -
Stuck Andreas E.,
Gorp Wilfred G.,
Josephson Karen R.,
Morgenstern Hal,
Beck John C.
Publication year - 1992
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1992.tb02024.x
Subject(s) - medicine , risk assessment , occupational safety and health , population , poison control , montreal cognitive assessment , aviation , aviation safety , injury prevention , cognition , medical emergency , environmental health , cognitive impairment , psychiatry , computer security , engineering , pathology , computer science , aerospace engineering
Objective To determine whether airline pilots over the age of 60 pose a hazard to aviation safety and whether risk assessment could replace age‐based retirement. Data Sources A computer‐assisted literature search (MEDLINE), expert consultation, and government reports. Study Selection Original studies on flight performance and pilot age; sudden incapacitation, neuropsychological testing, and/or medication use in pilots; and/or non‐invasive testing for predicting sudden death or stroke in asymptomatic subjects. Data Extraction Pertinent results and methods data were abstracted from the 49 included studies. Data Synthesis No study on aircraft accidents or pilot performance has shown an increased accident risk for over‐60‐year‐old pilots. Normal age‐related cognitive changes probably have minimal impact on aviation safety up to age 70, given above average health, education, and experience in airline pilots. Cognitive tests have not been validated for predicting flight performance safety, but they can detect early stages of cognitive disease. Cardiovascular incapacitation risk increases with age, but risk factor profiles and non‐invasive tests could identify pilots with non‐acceptable risk. Conclusions An improved medical certification test could identify those pathologic conditions that might occur more frequently in older subjects. If pilots also underwent adequate performance testing, a gradual increase of the retirement age to approximately age 70 would seem justified. In the future, a longitudinal database should be established to validate medical tests for their ability to predict a pilot's accident risk. Using individual pilots as their own controls might be more sensitive than using population‐based norm values. Progress in this field would advance medical assessment for other groups such as air traffic controllers or automobile drivers.