Mortality risk in a birth cohort of commuter air carrier and air taxi pilots.

Commuter and air taxi pilots have higher work-related death rates than most other occupational groups. In this longitudinal study, the authors examined the mortality in a cohort of 3263 commuter and air taxi pilots. With adjustment for age, proportional hazards modeling revealed that termination or downgrading of medical certificates during the 11-year follow-up was associated with a significantly increased risk of overall mortality (relative risk, 2.32; 95% confidence interval [CI] = 1.43-3.77). Relative to the general population with similar demographic characteristics, commuter air carrier and air taxi pilots had significantly lower overall mortality (standard mortality ratio [SMR], 0.36; 95% CI = 0.32-0.41) and mortality from cardiovascular diseases (SMR, 0.18, 95% CI = 0.15-0.22), but considerably higher mortality from aviation crashes (SMR, 128.88; 95% CI = 6.35-2624.36). The results indicate that the current medical certification system is effective in maintaining a healthy pilot workforce.