Stuck A E, van Gorp W G, Josephson K R, Morgenstern H, Beck J C
Department of Medicine, Multicampus Division of Geriatric Medicine and Gerontology, Los Angeles, CA 90024-1687.
J Am Geriatr Soc. 1992 May;40(5):526-32. doi: 10.1111/j.1532-5415.1992.tb02024.x.
To determine whether airline pilots over the age of 60 pose a hazard to aviation safety and whether risk assessment could replace age-based retirement.
A computer-assisted literature search (MEDLINE), expert consultation, and government reports.
Original studies on flight performance and pilot age; sudden incapacitation, neuropsychological testing, and/or medication use in pilots; and/or non-invasive testing for predicting sudden death or stroke in asymptomatic subjects.
Pertinent results and methods data were abstracted from the 49 included studies.
No study on aircraft accidents or pilot performance has shown an increased accident risk for over-60-year-old pilots. Normal age-related cognitive changes probably have minimal impact on aviation safety up to age 70, given above average health, education, and experience in airline pilots. Cognitive tests have not been validated for predicting flight performance safety, but they can detect early stages of cognitive disease. Cardiovascular incapacitation risk increases with age, but risk factor profiles and non-invasive tests could identify pilots with non-acceptable risk.
An improved medical certification test could identify those pathologic conditions that might occur more frequently in older subjects. If pilots also underwent adequate performance testing, a gradual increase of the retirement age to approximately age 70 would seem justified. In the future, a longitudinal database should be established to validate medical tests for their ability to predict a pilot's accident risk. Using individual pilots as their own controls might be more sensitive than using population-based norm values. Progress in this field would advance medical assessment for other groups such as air traffic controllers or automobile drivers.
确定60岁以上的航空公司飞行员是否对航空安全构成危害，以及风险评估是否可以取代基于年龄的退休规定。
计算机辅助文献检索（MEDLINE）、专家咨询和政府报告。
关于飞行性能与飞行员年龄的原始研究；飞行员的突然失能、神经心理学测试和/或药物使用；和/或对无症状受试者猝死或中风的非侵入性检测。
从49项纳入研究中提取相关结果和方法数据。
没有关于飞机事故或飞行员性能的研究表明60岁以上飞行员的事故风险增加。考虑到航空公司飞行员的健康、教育和经验高于平均水平，正常的与年龄相关的认知变化在70岁之前可能对航空安全影响极小。认知测试尚未经过验证以预测飞行性能安全，但它们可以检测认知疾病的早期阶段。心血管失能风险随年龄增加，但风险因素特征和非侵入性测试可以识别风险不可接受的飞行员。
改进的医学认证测试可以识别那些可能在老年受试者中更频繁出现的病理状况。如果飞行员也接受充分的性能测试，将退休年龄逐步提高到约70岁似乎是合理的。未来，应建立一个纵向数据库，以验证医学测试预测飞行员事故风险的能力。以个体飞行员作为自身对照可能比使用基于人群的标准值更敏感。该领域的进展将推动对空中交通管制员或汽车驾驶员等其他群体的医学评估。
