Permanent grounding and flying restrictions in Canadian Forces pilots: a 10-year review.

The medical files were reviewed of all Canadian Forces pilots in whom a permanent change in flying category was recommended during the period 1 January 1978 through 31 December 1987. In an average pilot population of 2,697 pilots, 60 permanent groundings (2.2 per thousand) and 209 permanent operational flying restrictions (7.7 per thousand) were assigned among 258 pilots. Coronary heart disease was the most common cause for permanent grounding (25% of total), followed by neurologic disorders including migraine (22% of total), other cardiovascular disorders, including mitral valve prolapse and arrhythmias (17%), and psychiatric problems (12%). Refractive errors were the most common basis for an operational flying restriction (25%), followed by orthopedic disorders (17%), mainly low back pain. The relevance of these observations is discussed in terms of medical selection and surveillance procedures.