{
  "abstract": "Objectives: To identify longitudinal trajectories of medical fitness among licensed aviation personnel and examine factors associated with trajectory membership.\n\nDesign: Retrospective cohort study.\n\nSetting: Aviation medical examination records maintained by the Korean Society of Aerospace and Environmental Medicine, Republic of Korea, 2015–2022.\n\nParticipants: 7740 licensed aviation personnel with at least five examinations, drawn from 14 237 licensed individuals.\n\nPrimary and secondary outcome measures: Latent classes of final fitness classifications across the first five examinations were identified using latent class analysis. Associated factors were examined using multinomial logistic regression. Model 2 additionally included body mass index change, fifth-examination smoking status and licence change.\n\nResults: Three trajectories were identified: sustained fit (86.3%), persistent conditional fit (10.2%) and progressive deterioration (3.6%). Older age was associated with both persistent conditional fit (OR per year 1.10, 95% CI 1.09 to 1.12) and progressive deterioration (OR per year 1.06, 95% CI 1.04 to 1.08), as was first-examination obesity (OR 1.58, 95% CI 1.29 to 1.93 and OR 1.78, 95% CI 1.30 to 2.44, respectively). Compared with current smoking, former smoking was associated with higher odds of persistent conditional fit (OR 1.62, 95% CI 1.27 to 2.06) but lower odds of progressive deterioration (OR 0.71, 95% CI 0.52 to 0.98). Commercial pilot licence holders had lower odds of persistent conditional fit than airline transport pilot licence holders (OR 0.69, 95% CI 0.52 to 0.91). Additional variables showed no clear associations and did not significantly improve model fit; Nagelkerke pseudo R² values were 0.181 and 0.182.\n\nConclusions: Repeated examination records identified distinct fitness trajectories. Older age and first-examination obesity were associated with both adverse trajectories. Potential selection bias, overlapping measurement periods and limited model explanatory performance restrict causal interpretation and generalisability.",
  "abstract_shown": true,
  "affiliations": [
    "The Catholic University of Korea Seoul St Mary’s Hospital, Seocho-gu, Seoul, Korea (the Republic of)",
    "Eulji University, Gyeonggi-do, Korea (the Republic of)",
    "Aviation Health & Medical Center, Korean Air Lines Co, Seoul, Korea (the Republic of)",
    "The Catholic University of Korea, Seocho-gu, Seoul, Korea (the Republic of)"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Ju-Hyun Choi"
    },
    {
      "affs": [
        1
      ],
      "name": "Eun-Hi Choi",
      "orcid": "0000-0002-5175-0210"
    },
    {
      "affs": [
        2
      ],
      "name": "Yun Young Choi"
    },
    {
      "affs": [
        3
      ],
      "name": "Hye-Sun Jung"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/adjvats19pgar.bib",
  "cited_by": 0,
  "doi": "10.1136/bmjopen-2026-122473",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13725912/",
  "id": "adjvats19pgar",
  "issns": [
    "2044-6055",
    "2044-6055"
  ],
  "landing_url": "https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-122473",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "1506"
    ],
    [
      "heading",
      "1716"
    ],
    [
      "heading",
      "Occupational and Environmental Medicine"
    ],
    [
      "openalex",
      "3609|Occupational Health and Performance"
    ]
  ],
  "openalex": "W7224082958",
  "pdf_url": null,
  "pmcid": "PMC13725912",
  "pmid": "42951301",
  "published": "2026-10-28",
  "publisher": "BMJ",
  "ris": "https://research.draconitic.com/paper/adjvats19pgar.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:44Z",
      "native_id": "10.1136/bmjopen-2026-122473",
      "source": "crossref",
      "url": "https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-122473"
    },
    {
      "first_seen": "2026-11-05T12:22:21Z",
      "native_id": "PMC13725912",
      "source": "pmc",
      "url": "https://doi.org/10.1136/bmjopen-2026-122473"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:F27",
      "subfield": "general"
    }
  ],
  "title": "Medical fitness trajectories and associated factors among licensed aviation personnel in Korea: a retrospective cohort study",
  "title_text": "Medical fitness trajectories and associated factors among licensed aviation personnel in Korea: a retrospective cohort study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-05T12:22:21Z",
  "url": "https://research.draconitic.com/paper/adjvats19pgar",
  "venue": "BMJ Open",
  "versions": []
}