Occupational medicine support for international air carriers

Although aviation medical support to flight deck crews and cabin staff has been the subject of numerous articles, information about occupational medical support to ground crews, maintenance personnel, and other behind-the-lines personnel who help to "keep them flying" has rarely been presented. This report discusses the occupational medical support provided by six major U.S. international air carriers. Each carrier arranges for medical support of employees through a variety of health care systems, ranging from an airline medical department to total use of contract medical services. Approximately 70% of the airline personnel are non-flying and consequently come under the provisions of classical occupational medical services. Further, many of the flying personnel who may have sustained injuries or illnesses as a result of their aviation occupation also are managed in classical occupational medicine terms. Several airline medical directors interviewed estimate that 65% or more of their professional time is concerned with classical occupational medicine activities rather than aviation medicine programs as usually defined. A major challenge to international air carriers is the numerous jurisdictional arenas concerned with workers' compensation regulations and law under which they operate.