Airline pilot disability: the continued experience of a major US airline

This study details our continued experience with preemployment screening and medical disability in a large group of pilots from one airline from 1975 through 1982. During this period, 368 pilot applicants underwent preemployment screening and 73 of these were rejected for employment because of medical reasons. The majority (45) of these were unsuitable for psychological reasons. Medical disability accounted for approximately 20% of the pilots separated from the company during the period of study. Age-specific disability rates increased rapidly after age 45 years, with cardiovascular disease responsible for more than 50% of these medical losses. Disability rates of older pilots have decreased considerably compared with previous rates: the age-adjusted rate for pilots age 45 years or older has decreased from 27.50/1,000 person-years to 8.97/1,000 person-years (p less than 0.0001). The reasons for this reduction remain unclear, but changes in the interpretation of the Federal Aviation Administration regulations and changes in company policies may have contributed. The role of preventive medicine in the form of regular medical surveillance is uncertain, with no direct evidence of a beneficial effect.