Froom P, Benbassat J, Gross M, Ribak J, Lewis B S
Israel Air Force Aeromedical Center, Tel Hashomer.
Aviat Space Environ Med. 1988 Mar;59(3):278-81.
The epidemiology of sudden death, the etiology of inflight sudden incapacitation, and the influence of pilot age and experience on air accident rates are reviewed in order to determine the aeromedical emphasis needed to minimize accidents. Sudden deaths in men over age 35 are nearly all due to coronary artery disease, whereas in those under 35 years they are mostly due to hypertrophic cardiomyopathy. The incidence of fatal accidents from human error is, however, far greater than that from physical illness. Since inexperienced pilots have a 2-3 times increased incidence of mishaps due to pilot error, the estimated risk of disease related in-flight sudden incapacitation should be balanced by consideration of pilot experience. Therefore, it may be preferable to grant waivers to experienced pilots with an increased incidence of disease-related inflight sudden incapacitation than to replace them with novices. We conclude that overly strict medical criteria may paradoxically increase accident rates.
回顾了猝死的流行病学、飞行中突发失能的病因以及飞行员年龄和经验对空难发生率的影响，以确定将事故降至最低所需的航空医学重点。35岁以上男性的猝死几乎都归因于冠状动脉疾病，而35岁以下的则主要归因于肥厚型心肌病。然而，人为失误导致的致命事故发生率远高于身体疾病导致的。由于缺乏经验的飞行员因操作失误导致事故的发生率增加2至3倍，所以在考虑飞行员经验的情况下，应平衡与疾病相关的飞行中突发失能的估计风险。因此，对于与疾病相关的飞行中突发失能发生率增加的经验丰富的飞行员，给予豁免可能比用新手取代他们更可取。我们得出结论，过于严格的医学标准可能会自相矛盾地增加事故发生率。
