Evaluation of aircrew candidate blood testing

The medical assessment of Royal Air Force (RAF) aircrew candidates includes the measurement of 39 individual blood parameters, grouped into 9 blood test panels, to detect disqualifying medical condition(s) (DMC). Although this program has run for over 20 yr, its contribution to the assessment of fitness to fly remains unquantified.

To determine whether blood testing independently identified DMC, the medical records of 589 male and female aircrew candidates, assessed at the RAF Officer and Aircrew Selection Centre during 2009 and 2010, were scrutinized for DMC while blinded to blood results. DMC identified through blood testing were then recorded and the sensitivity, specificity, and predictive values were calculated. The costs for the financial year 2009-2010 were estimated.

For all candidates ages < or = 32 yr, specificity and positive predictive value for all blood test panels combined were 79% and < 1%, respectively. There were 8 DMC identified by blood testing while 994 (21%) of all panels contained an abnormality. For older candidates, three DMC were detected through blood testing that were not recorded elsewhere. The direct cost of the program, based on monetary charges levied for blood testing, was over pound 10,900 (c. US$16,350) but the total costs, including indirect costs to the RAF and individuals, were considerably higher.

Blood testing at the initial medical assessment identified few DMC, but the organizational and individual burden associated with the program was substantial. Consideration should be given to the curtailment of blood testing in RAF aircrew candidates.