Cataracts in Airline Pilots: Prevalence and Aeromedical Considerations in Japan
ABSTRACT Despite modern aviation being increasingly less dependent on human factors, the pilot is still part of the aircraft systems and vision is critical for flight safety. The incidence of cataract increases with age, but as most epidemiological studies focus on senior age groups, there is no data relevant to working age groups.
The aim of our study was to elucidate the prevalence of lens opacity in Japanese airline pilots.
A retrospective cohort study was conducted at the Japan Aeromedical Research Center. Medical records for all ophthalmological assessments performed in the 12-mo period prior to March 2008 were reviewed. Data collected included whether there was documented lens opacity or a history of previous cataract surgery.
Over 12 mo, 3780 pilots underwent slit-lamp examination with an ophthalmologist as part of their scheduled medical and 105 pilots were identified with cataract. Out of these, 59/105 were bilateral, 29/105 were congenital types (of which 19 were bilateral), and 12/105 pilots gave a history of previous cataract surgery. In all 105 pilots, the visual acuity was sufficient to continue the privileges of their licenses.
This study offers insight into the clinical iceberg of early cataracts in persons of working age. Mild and early lens opacities can cause significant glare and haze, and changes in color vision, which might compromise pilot performance even in the absence of decreased visual acuity. Cataracts in otherwise fit pilots have important aeromedical significance which requires further consideration.
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ABSTRACT: Population and animal studies indicate that long-term exposure to short-wavelength visible light and ultraviolet (UV) radiation causes increased risk of certain ocular pathologies such as cataracts and maculopathy. The potential risk to flight crew is unknown. The UK Civil Aviation Authority (CAA) has issued guidance to pilots regarding sunglass selection; however, it is not known if this guidance is appropriate given pilots' unique occupational environment. A search and appraisal of the relevant literature was conducted which showed that within the airline pilot population, there is limited evidence of a higher prevalence of cataracts. There are no data of other known UV-related ocular pathology. There is some evidence of higher prevalence of skin melanomas. Studies measuring cockpit UV radiation levels are limited and leave unanswered questions regarding airline pilot exposure. Data from optical transmission of cockpit windshields demonstrates the UV blocking properties at sea level. No studies have addressed the occupational use of sunglasses in airline pilots. Although it is likely that an aircraft windshield effectively blocks UV-B, the intensity of UV-A and short wavelength blue light present within the cockpit at altitude is unknown. Pilots may be exposed to solar radiation for periods of many hours during flight where UV radiation is known to be significantly greater. Aircraft windshields should have a standard for optical transmission, particularly of short-wavelength radiation. Clear, untinted prescription glasses will offer some degree of UV protection; however, sunglasses will offer superior protection. Any sunglasses used should conform to a national standard.Aviation Space and Environmental Medicine 09/2011; 82(9):895-900. DOI:10.3357/ASEM.3034.2011 · 0.78 Impact Factor
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ABSTRACT: The special working environment of helicopter pilots, such as high altitudes and high temperatures, may give them a special health status. There has been little research on helicopter pilot health issues in China. The aim of this study was to gain a clear understanding of the disease spectrum in helicopter pilots and to provide a scientific basis for disease control and prevention in this population. The annual aeromedical examination records and inpatient records of 516 helicopter pilots were collected by random sampling. The prevalence and sick leave time associated with each disease were computed. Spearman rank correlation analysis was employed to explore the relationship between prevalence and sick leave duration. The organ systems with the highest prevalence of disease were the digestive system (32.36%), cardiovascular system (18.60%), and musculoskeletal system (12.40%), while those with the longest associated sick leave periods were the digestive system (574 d), musculoskeletal system (532 d), and nervous system (323 d). There were no significant correlations between prevalence and sick leave times of diseases in any system (r = 0.64). The diseases with the highest prevalence were fatty liver (9.88%), hyperlipidemia (6.98%), and polypoid lesion of the gallbladder (3.49%), while those with the longest sick leave times were ground syncope (157 d), chronic gastritis (145 d), and lumbar disc herniation (91 d). Pilot health and performance were most affected by diseases of the digestive and musculoskeletal systems. Although not highly common, aero-related diseases (i.e., ground syncope) were also noteworthy for their long sick-leave times.Aviation Space and Environmental Medicine 03/2013; 84(3):234-6. DOI:10.3357/ASEM.3397.2013 · 0.78 Impact Factor
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ABSTRACT: The aim of this study was to determine the prevalence of color vision defects in the middle-age population of Shahroud, Iran. We selected 6,311 people from the 40- to 64-year-old population through random cluster sampling. Color vision testing was performed with the Farnsworth D-15. Cases with similar and symmetric results in both eyes were classified as hereditary, and those with asymmetric results were considered acquired. Cases that did not conform to standard patterns were classified as unknown category. Of 5,190 respondents (response rate 82.2 %), 5,102 participants underwent the color vision test. Of these, 14.7 % (95 % confidence interval 13.7-15.6) had some type of color vision deficiency. Of the 2,157 male participants, 6.2 % were hereditary and 10.2 % were acquired and of the 2,945 female participants, 3.1 % were hereditary and 10 % were acquired. Hereditary color deficiencies were mostly of the deutan form (63.8 %), and acquired deficiencies were mostly tritan (66.1 %). The prevalence of hereditary and acquired color vision deficiency, as well as different types of red-green and blue-yellow color vision defects significantly increased with age (p < 0.001). In conclusion, the pattern of color vision defects among the middle-aged population of Shahroud was significantly different from that seen in the younger population. This could be due to changes associated with age, gender, medical and ocular conditions, and differences in race and environment. Thus, results of previous examinations and the overall health status should be considered before making any judgment about the status of color vision in middle-aged people.International Ophthalmology 02/2014; 34(5). DOI:10.1007/s10792-014-9911-2 · 0.55 Impact Factor