Coronary Artery Disease in Aircrew Fatalities: Morphology, Risk Factors, and Possible Predictors

Dumser, Thomas; Borsch, Mathias; Wonhas, Christoph

doi:10.3357/asem.3352.2013

Cited by 8 publications

(4 citation statements)

References 7 publications

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“…The daytime jet lag complaints seem to be ascribed in part to sleep deprivation and in part to the parallel nighttime physiology of circadian outputs (e.g., core body temperature, alertness, and metabolism are at their minimum, while melatonin, the circadian hormone promoting sleep onset, reaches its secretion peak) (Arendt, 2009). Even if jet lag symptoms are transient (until the realignment of the internal clock), different studies suggest that chronic jet lag experienced by aircrew members might have long term effects on health, such as cognitive deficits, increased risk of heart diseases and cancer (Cho, 2001; Dumser, Borsch, & Wonhas, 2013; Kojo, Pukkala, & Auvinen, 2005).…”

Section: Misalignment Of the Circadian Clock System In Modern Lifesty...mentioning

confidence: 99%

Rhythm and mood: Relationships between the circadian clock and mood-related behavior.

Schnell

Albrecht

Sandrelli

2014

Behavioral Neuroscience

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Mood disorders are multifactorial and heterogeneous diseases caused by the interplay of several genetic and environmental factors. In humans, mood disorders are often accompanied by abnormalities in the organization of the circadian system, which normally synchronizes activities and functions of cells and tissues. Studies on animal models suggest that the basic circadian clock mechanism, which runs in essentially all cells, is implicated in the modulation of biological phenomena regulating affective behaviors. In particular, recent findings highlight the importance of the circadian clock mechanisms in neurological pathways involved in mood, such as monoaminergic neurotransmission, hypothalamus-pituitary-adrenal axis regulation, suprachiasmatic nucleus and olfactory bulb activities, and neurogenesis. Defects at the level of both, the circadian clock mechanism and system, may contribute to the etiology of mood disorders. Modification of the circadian system using chronotherapy appears to be an effective treatment for mood disorders. Additionally, understanding the role of circadian clock mechanisms, which affect the regulation of different mood pathways, will open up the possibility for targeted pharmacological treatments.

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Section: Misalignment Of the Circadian Clock System In Modern Lifesty...mentioning

confidence: 99%

Rhythm and mood: Relationships between the circadian clock and mood-related behavior.

Schnell

Albrecht

Sandrelli

2014

Behavioral Neuroscience

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“…In aircrew, despite a consistent finding of lower risk of CVD mortality compared to the general population, the prevalence of CAD in pilots is the same as age-matched controls in the general population, 18,19 and whilst most experienced astronauts are middle aged, and at risk for developing major adverse cardiovascular events, recent contemporary data has revealed similar rates of developing CVD as the general population despite exposure to spaceflight. [20][21][22][23] In the military, like the general population, the most frequent cause of death is CAD, with an increasing trend seen with increasing age.…”

Section: Healthy Worker Effectmentioning

confidence: 86%

“…[108][109][110] Autopsy studies among military pilots and aircrew reveal that atherosclerotic cardiovascular disease is a common finding, and in some cases, there is evidence of severe disease. 18,111 Furthermore, there is evidence of systemic underreporting of cardiac symptoms among the military pilot and aircrew population 112 likely stemming from aircrew being cognizant that CV disease is the most common reason for flight disqualification. 56,[112][113][114]…”

Section: Military Pilots and Aircrewmentioning

confidence: 99%

The role of cardiovascular CT in occupational health assessment for coronary heart disease: An expert consensus document from the Society of Cardiovascular Computed Tomography (SCCT)

Slim¹,

Fentanes

Cheezum

et al. 2021

Journal of Cardiovascular Computed Tomography

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In response to the increasing application of cardiovascular computed tomography (cardiovascular CT), the Society of Cardiovascular Computed Tomography (SCCT) guidelines committee has produced this document to guide the use of cardiac CT in the risk assessment of coronary artery disease (CAD) in occupational health evaluation. The purpose of this document is to support quality care given to individuals who undergo occupational health evaluation for the diagnosis of CAD. This document reviews evidence regarding the prevalence of coronary artery disease (CAD), the incidence of major adverse cardiac events (MACE), and the recommendations for enhanced cardiovascular screening and investigation for CAD evaluation amongst safety sensitive occupations. This document examines occupation risk categories where cardiac CT may be appropriate to investigate for CAD and evaluates available testing strategies for risk assessment.

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“…It is generally difficult to verify false-negative ECG results; and with the data in our study, it is impossible. However, there have been a number of autopsy studies in which coronary artery disease was detected in pilots post mortem, which was previously undetected [ 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

Electrocardiographic abnormalities in medically screened German military aircrew

Guettler

Sammito

2021

J Occup Med Toxicol

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Background A resting electrocardiogram (ECG) is a well-tolerated, non-invasive, and inexpensive test for overt electrical signs of cardiac pathology and is widely used in the screening of aircrew and other high-hazard occupations. Given the low number of pathological results leading to disqualification or restriction however, there is an ongoing debate as to how often screening ECGs should be performed in different age groups. Methods We restrospectively analyzed 8275 resting 12-lead ECGs registered between 2007 and 2020 in the German Air Force Centre of Aerospace Medicine. Findings were categorized according to consensus recommendations published by the NATO Working Group on Occupational Cardiology in Military Aircrew, based on ECG screening criteria published for athletes which were used at the time of registration. Age, sex, height, weight, and body mass index of the probands were also captured. Additionally, 4839 pilot and non-pilot aircrew members were analyzed longitudinally over a maximum period of 13.4 years. Results Out of all the ECGs only 18 revealed findings requiring further investigation, and only one individual was temporarily disqualified because of a ventricular pre-excitation (delta wave) as a sign of an antegrade conducting accessory pathway. The longitudinal analysis of 25,829 ECGs revealed 28 abnormalities requiring further investigation, and only two ECG findings (in probands aged 48.8 and 59.1 years) led to temporary, or permanent disqualification. In a third case, the ECG showed signs of a myocardial infarction, which was already known from the proband’s history. Conclusions Initial ECG screening for asymptomatic aircrew revealed extremely low numbers of individuals requiring further investigation in our cohort. This would appear to justify an initial screening ECG and follow-up ECGs at certain intervals starting at a certain age, but routine ECG screening of applicants in professions with a higher risk tolerance or frequent, e.g. annual, follow-up ECGs in younger aircrew is not supported by our data because of the minimal yield of ECG findings requiring further investigation.

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Coronary Artery Disease in Aircrew Fatalities: Morphology, Risk Factors, and Possible Predictors

Cited by 8 publications

References 7 publications

Rhythm and mood: Relationships between the circadian clock and mood-related behavior.

Rhythm and mood: Relationships between the circadian clock and mood-related behavior.

The role of cardiovascular CT in occupational health assessment for coronary heart disease: An expert consensus document from the Society of Cardiovascular Computed Tomography (SCCT)

Electrocardiographic abnormalities in medically screened German military aircrew

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