Permanent medical disqualification in airline cabin crew: causes in 136 cases, 1993-2002

Pronouncing cabin crew permanently unfit to fly is a difficult decision involving personal, professional, ethical, and corporate aspects. We analyzed the causes of permanent medical disqualification in cabin crew in a medium-sized European commercial airline for the period 1993-2002.

The minutes of the official Medical Assessment Board of UCS for TAP Air Portugal were systematically reviewed and yielded a total of 136 cases of permanent medical disqualifications.

The medical conditions most frequently responsible for grounding were otorhinolaryngological (30.1%), followed by musculoskeletal (21.3%), and psychiatric (12.5%). The remaining cases resulted from cardiovascular, malignant neoplastic, ophthalmologic, respiratory, neurological, infectious, urinary, digestive, and metabolic conditions. The disqualification rate was 9.2 for every 1000 cabin crewmembers per year. More than half of all cases (53.6%) were in the age range 41-50 yr (median 46 yr) and 66.1% were women. More than 85% had been with the company for 16 yr or more. The early retirement of these patients resulted in the loss of approximately 2364 person-years of work as cabin crew, although many patients were reassigned to ground duties with the airline.

The annual disqualification rates found in this study were higher than those for airline pilots; we could find no comparable studies of rates for cabin crew. The results indicate the relevance of early detection as well as clinical and occupational follow up.