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April/May 2014 (vol. 10/6)
European Union Regulation 1178/2011 prohibits pilots over the age of 60 from flying commercial aeroplanes unless they are part of a multi-pilot crew, and sets an upper limit of 65. This systematic review (10 papers met inclusion criteria) concludes that medical in-flight incapacitation is very rare, and while the risk rises with age ‘the slope of the increase in in-flight incapacitation is a lot flatter than for medical incapacitation in general’. There is limited evidence on increasing incapacitation with age, with some estimates derived by extrapolating risks in the general population without adjusting for the better health of pilots. Comparable data (in-flight incapacitation versus flight hours) were available from four papers, giving an all-age rate of 0.19–0.46 incapacitations per million flight hours for professional pilots. Most incapacitations are neither deadly nor lead to an accident, and the majority are not age-related, being caused, for example, by gastroenteritis and viral infection. A register of all pilots’ career and health information would provide more objective information on deciding upper age limits.
Occupational Health at Work April/May 2014 (vol. 10/6) pp18