Retrospective cohort study of duodenal ulcer disease in U.S. Air Force pilots

Current waiver policy for duodenal ulcer (DU) disease in pilots is based on data from civilian populations since little information is available on the course and prognosis of this disease in pilots. The United States Air Force (USAF) waiver file and the Office of Medical Support database were used to identify 100 pilots with onset of DU between 1981 and 1987. A written questionnaire was returned by 86 (86%) of these pilots. The incidence of DU in USAF active-duty pilots was estimated to be 5.0 per 10,000 pilot-years. DU was significantly associated with cigarette smoking. Bleeding ulcers were significantly associated with aspirin use. After 587 person-years of follow-up there were no fatalities; serious sequelae were reported in only 6 pilots, and moderate sequelae in only 12 others. The risk of recurrence of DU in this population was not appreciably higher among those initially presenting with hemorrhage.