Medical fitness trajectories and associated factors among licensed aviation personnel in Korea: a retrospective cohort study
4 affiliations
- 1The Catholic University of Korea Seoul St Mary’s Hospital, Seocho-gu, Seoul, Korea (the Republic of)
- 2Eulji University, Gyeonggi-do, Korea (the Republic of)
- 3Aviation Health & Medical Center, Korean Air Lines Co, Seoul, Korea (the Republic of)
- 4The Catholic University of Korea, Seocho-gu, Seoul, Korea (the Republic of)
Abstract
Objectives: To identify longitudinal trajectories of medical fitness among licensed aviation personnel and examine factors associated with trajectory membership.
Design: Retrospective cohort study.
Setting: Aviation medical examination records maintained by the Korean Society of Aerospace and Environmental Medicine, Republic of Korea, 2015–2022.
Participants: 7740 licensed aviation personnel with at least five examinations, drawn from 14 237 licensed individuals.
Primary 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.
Results: 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.
Conclusions: 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.
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BibTeX
@article{choi2026medical,
title = {{Medical fitness trajectories and associated factors among licensed aviation personnel in Korea: a retrospective cohort study}},
author = {Ju-Hyun Choi and Eun-Hi Choi and Yun Young Choi and Hye-Sun Jung},
journal = {BMJ Open},
year = {2026},
month = oct,
doi = {10.1136/bmjopen-2026-122473},
url = {https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-122473},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Medical fitness trajectories and associated factors among licensed aviation personnel in Korea: a retrospective cohort study
AU - Ju-Hyun Choi
AU - Eun-Hi Choi
AU - Yun Young Choi
AU - Hye-Sun Jung
PY - 2026
DA - 2026/10/28
JO - BMJ Open
DO - 10.1136/bmjopen-2026-122473
UR - https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-122473
AB - Objectives: To identify longitudinal trajectories of medical fitness among licensed aviation personnel and examine factors associated with trajectory membership. Design: Retrospective cohort study. Setting: Aviation medical examination records maintained by the Korean Society of Aerospace and Environmental Medicine, Republic of Korea, 2015–2022. Participants: 7740 licensed aviation personnel with at least five examinations, drawn from 14 237 licensed individuals. Primary 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. Results: 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. Conclusions: 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.
SN - 2044-6055
SN - 2044-6055
ER -