Medical risk factors in fatal military aviation crashes: a case-control study

Periodic medical examinations are the daily work of the flight surgeon. Their immediate impact on flight safety, however, has not been evaluated. This case-control study was done to ascertain whether, among German military pilots, differences exist in the results of periodic medical examinations that were associated with a higher odds of being involved in a fatal aircraft mishap.

Participants were 146 German military pilots who died in air crashes and 292 controls. Cases and controls were matched 1:2 by aeronautical confounders (age, type of aircraft aeronautical experience, and membership in the air force, army, or navy). Data source was the central register of the German Air Force Institute of Aviation Medicine; data were obtained from periodic medical examinations and included physical examination and laboratory data. Odds ratios were calculated by conditional logistic regression analysis.

Descriptive statistics showed no distinct difference between cases and controls in most of the parameters considered except for total serum bilirubin, but multiple conditional logistic regression showed no remarkably different odds for any of the parameters tested.

In aircrew who pass all the criteria for fitness to fly there are no important medical risk factors for fatal air crashes that can be detected by periodic medical examinations.