Epidemiological review of insect sting allergy in naval aviation: current policy and real-world practices.

Individuals with conditions not addressed in the physical standards section of the Navy's Manual of the Medical Department can be considered for a waiver that would allow them to continue in naval aviation. Insect sting allergy is addressed in the Navy's waiver guide; however, the actual disposition of these individuals does not coincide with published waiver policies. Our objective was to identify discrepancies, to review current clinical guidelines, and to offer recommendations for updating the Navy's waiver policy. Aviation medical records of individuals with insect sting allergies from 1985 to 2002 were reviewed. Disposition, waiver status, and allergy evaluation were investigated. The data suggest that waiver requests have been addressed not under the current waiver guidelines but instead under current clinical guidelines. New guidelines that properly reflect current diagnostic and treatment modalities were voted on by the Aeromedical Advisory Council and submitted to the Navy's Bureau of Medicine. These changes were incorporated into the Navy's aviation waiver policy guidelines.