Under-Reporting of Self-Reported Medical Conditions in Aviation: A Cross-Sectional Survey
BACKGROUND: The applicants’ self-declaration of medical history is crucial for safety. Some evidence indicates that under-reporting of medical conditions exists. However, the magnitude in a population of aviation personnel has not been reported earlier.
METHODS: A total of 9941 applicants for medical certificate/attestation for aviation-related safety functions during the last 5 yr up to December 2019 were registered at the Civil Aviation Authority Norway. E-mail addresses were known for 9027 of these applicants, who were invited to participate in a web-based survey.
RESULTS: Among the 1616 respondents, 726 (45%) were commercial pilots, 457 (28%) private pilots, 272 (17%) air traffic controllers, and the remaining were cabin crew or crew in aerodrome/helicopter flight information service (AFIS or HFIS, respectively). A total of 108 were initial applicants. The age group 50+ constituted the largest proportion of respondents (53%). Aeromedical certification in general was believed to improve flight safety “to a high” or “very high extent” by 64% of the respondents. A total of 188 individuals (12%) admitted having under-reported information related to one or more categories, including mental (3%) or physical health (4%), medications (2%), and drug use, including alcohol use (5%). Among these, 21 participants believed their own under-reporting “to some” or “to a high extent” affected flight safety. In total 50% of noninitial applicants reported that they knew colleagues who had under-reported information. Analyses revealed that being a commercial pilot showed a higher risk for under-reporting compared with other classes and the perception of aeromedical examiners in a supportive or authoritative role reduced the risk.
CONCLUSIONS: Under-reporting of medical conditions could be significant in aviation. Further studies should be conducted to investigate the true extent of under-reporting and its impact on flight safety and what mitigating measures might be recommended.
Strand T-E, Lystrup N, Martinussen M. Under-reporting of self-reported medical conditions in aviation: a cross-sectional survey. Aerosp Med Hum Perform. 2022; 93(4):376–383.
METHODS: A total of 9941 applicants for medical certificate/attestation for aviation-related safety functions during the last 5 yr up to December 2019 were registered at the Civil Aviation Authority Norway. E-mail addresses were known for 9027 of these applicants, who were invited to participate in a web-based survey.
RESULTS: Among the 1616 respondents, 726 (45%) were commercial pilots, 457 (28%) private pilots, 272 (17%) air traffic controllers, and the remaining were cabin crew or crew in aerodrome/helicopter flight information service (AFIS or HFIS, respectively). A total of 108 were initial applicants. The age group 50+ constituted the largest proportion of respondents (53%). Aeromedical certification in general was believed to improve flight safety “to a high” or “very high extent” by 64% of the respondents. A total of 188 individuals (12%) admitted having under-reported information related to one or more categories, including mental (3%) or physical health (4%), medications (2%), and drug use, including alcohol use (5%). Among these, 21 participants believed their own under-reporting “to some” or “to a high extent” affected flight safety. In total 50% of noninitial applicants reported that they knew colleagues who had under-reported information. Analyses revealed that being a commercial pilot showed a higher risk for under-reporting compared with other classes and the perception of aeromedical examiners in a supportive or authoritative role reduced the risk.
CONCLUSIONS: Under-reporting of medical conditions could be significant in aviation. Further studies should be conducted to investigate the true extent of under-reporting and its impact on flight safety and what mitigating measures might be recommended.
Strand T-E, Lystrup N, Martinussen M. Under-reporting of self-reported medical conditions in aviation: a cross-sectional survey. Aerosp Med Hum Perform. 2022; 93(4):376–383.
Keywords: aeromedical selection; under-reporting
Document Type: Research Article
Publication date: 01 April 2022
- This journal (formerly Aviation, Space, and Environmental Medicine), representing the members of the Aerospace Medical Association, is published monthly for those interested in aerospace medicine and human performance. It is devoted to serving and supporting all who explore, travel, work, or live in hazardous environments ranging from beneath the sea to the outermost reaches of space. The original scientific articles in this journal provide the latest available information on investigations into such areas as changes in ambient pressure, motion sickness, increased or decreased gravitational forces, thermal stresses, vision, fatigue, circadian rhythms, psychological stress, artificial environments, predictors of success, health maintenance, human factors engineering, clinical care, and others. This journal also publishes notes on scientific news and technical items of interest to the general reader, and provides teaching material and reviews for health care professionals.
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