Age, aging and physiological dysregulation in safety-critical work: a retrospective longitudinal study of helicopter emergency medical services pilots

Bauer, Hans; Nowak, Dennis und Herbig, Britta (2019): Age, aging and physiological dysregulation in safety-critical work: a retrospective longitudinal study of helicopter emergency medical services pilots. In: International Archives of Occupational and Environmental Health, Bd. 93, Nr. 3: S. 301-314

Abstract

Purpose Concurrent progressive physiological dysregulation in different organ systems may be a driver of phenotypical frailty and is associated with morbidity and performance declines. In aging societies, health and performance of older workers are given increased scrutiny. However, there are few studies researching the effect of age on physiological dysregulation specifically in the working population and none for high-risk occupations with close medical supervision. Here, we aim to investigate this association cross-sectionally and longitudinally in a healthy sample of European helicopter emergency medical services pilots. Methods Using a retrospective cohort design, we constructed indices of (a) physiological dysregulation state (N = 52 participants) and (b) pace of change (N = 41 participants, average follow-up 7.9 years) based on measurements of 18 health risk-associated biomarkers, as documented in the participating pilots' aeromedical examination records. The relationship of these two indices with average age (range 27.9-60.6 years) and average baseline age (29.3-57.2 years), respectively, was modeled by weighted least squares regression, adjusting for region of origin, smoking, and medication. Results Longitudinally, dysregulation significantly increased over the follow-up period, but the pace of change did not increase with baseline age. Cross-sectionally, we observed a significant negative quadratic effect of age on physiological dysregulation state, with maximum estimated physiological dysregulation at ages 45-50. Conclusions As hypothesized, progression of dysregulation over approximately 8 years is observable in a healthy occupational sample but it does not accelerate (i.e., does not increase with baseline age). Increases in dysregulation are counteracted by what appears to be a strong healthy worker survivor effect. The study shows that the development of physiological dysregulation in high-risk occupations differs from that in the general population and that physiological dysregulation indices may be helpful in reconciling safety concerns and fair treatment of aging workers in safety-critical jobs.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin > Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0340-0131
• Sprache: Englisch