Cardiovascular Risk Factor Modification in Asymptomatic Adults and Implications for Pilots.

This study aims to examine the available evidence that supports a more aggressive approach to managing asymptomatic people with low to intermediate cardiovascular risks; to evaluate the appropriate threshold for initiating pharmacologic interventions to treat hyperglycaemia, hyperlipidaemia, and hypertension; and to describe the implications for airline pilots. A systematic search was performed employing an OvidSP interface, including all EBM Reviews, EMBASE, and Ovid MEDLINE databases. Data, including sixteen randomised controlled trials, on the appropriate threshold for initiating pharmacologic interventions were extracted.

Cardiovascular Tests for Risk Assessment in Asymptomatic Adults and Implications for Pilots.

Background: This study aims to examine which marker or testing protocols have been suggested for cardiovascular disease (CVD) risk assessment in asymptomatic populations, at which CVD risk level, and how this can be implemented for CVD risk assessment in pilot populations.

Methods: A systematic search was performed using Systematic Reviews Subset on PubMed; the OvidSP interface, including all EBM reviews and EMBASE databases; and the G-I-N International Guideline Library. From each recommendation, we extracted data on consideration of the use of a marker or test for cardiovascular risk assessment in asymptomatic populations.

Fatigue in Air Medical Clinicians Undertaking High-acuity Patient Transports.

Abstract Background. Fatigue is likely to be a significant issue for air medical transport clinicians due to the challenging nature of their work, but there is little published evidence for this. Objective.

Cardiovascular investigations of airline pilots with excessive cardiovascular risk.

Background: This study examined the prevalence of airline pilots who have an excessive cardiovascular disease (CVD) risk score according to the New Zealand Guideline Group (NZGG) Framingham-based Risk Chart and describes their cardiovascular risk assessment and investigations.

Methods: A cross-sectional study was performed among 856 pilots employed in an Oceania based airline. Pilots with elevated CVD risk that had been previously evaluated at various times over the previous 19 yr were reviewed retrospectively from the airline's medical records, and the subsequent cardiovascular investigations were then described.

A study of airline pilot morbidity.

Introduction: It has long been believed that airline pilots are healthier than the general population. There are a number of reasons why this should be the case. However, there is very little evidence to support this belief as fact.

The occupational health and safety of flight attendants.

In order to perform safety-critical roles in emergency situations, flight attendants should meet minimum health standards and not be impaired by factors such as fatigue. In addition, the unique occupational and environmental characteristics of flight attendant employment may have consequential occupational health and safety implications, including radiation exposure, cancer, mental ill-health, musculoskeletal injury, reproductive disorders, and symptoms from cabin air contamination. The respective roles of governments and employers in managing these are controversial.

Cardiovascular risk score and cardiovascular events among airline pilots: a case-control study.

Background: A cardiovascular risk prediction score is routinely applied by aviation authorities worldwide. We examined the accuracy of the Framingham-based risk chart used by the New Zealand Civil Aviation Authority in predicting cardiovascular events among airline pilots.

Methods: A matched case-control design was applied to assess the association of 5-yr cardiovascular risk score and cardiovascular events in Oceania-based airline pilots.

Symptom-based categorization of in-flight passenger medical incidents.

Introduction: The majority of in-flight passenger medical events are managed by cabin crew. Our study aimed to evaluate the reliability of cabin crew reports of in-flight medical events and to develop a symptom-based categorization system.

Methods: All cabin crew in-flight passenger medical incident reports for an airline over a 9-yr period were examined retrospectively.

Retention of knowledge and skills in first aid and resuscitation by airline cabin crew.

The study was conducted to investigate the retention of CPR and AED skills, first aid knowledge and perceived levels of confidence for a sample of 35 cabin crew 12 months after recurrent training. The 35 cabin crew undertook a mock resuscitation scenario using the AED and bag-valve-mask carried in the medical kit. Of the 35 subjects, 33 subjects failed to use the bag-mask correctly, 18 performed chest compressions at the incorrect site, only 13 achieved the correct compression depth, only 20 placed the AED pads correctly, and the average time to first shock was 110 s after commencement of the resuscitation.

Visual conversion disorder in a harbor pilot leading to sudden loss of control of a large vessel.

We describe an accident caused by the rapid onset of visual impairment in a ship's pilot, who was subsequently diagnosed as having visual conversion disorder (hysterical blindness). This case is documented to draw attention to the unusual cause of sudden incapacitation in transport crew and the consequential threat to transportation safety. Because sudden visual impairment incidents caused by conversion disorder are isolated and rare, they may be under-reported in the scientific literature.