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Purpose: The Korean Journal of Aerospace and Environmental Medicine (KJASEM) is a primary outlet for aerospace medicine research in Korea, with a mission to advance the health and safety of aviation personnel and passengers. Methods: We analyzed 120 KJASEM articles (2020–2025) using natural language processing and bibliometric techniques. Latent Dirichlet Allocation (LDA) with 6 topics was applied to article abstracts to identify prevalent themes. Each article was also tagged into one of 10 aerospace medicine domains (e.g., human factors, space medicine). Yearly trends in topic and domain frequencies were evaluated using the Mann–Kendall test, a non-parametric trend test, with false discovery rate (FDR) correction for multiple tests. Results: The analysis revealed a marked decline in COVID-19-related research in KJASEM over time, accompanied by stable or increasing representation of traditional topics such as pilot health and flight safety. One LDA topic associated with the COVID-19 pandemic showed a significant downward trend (P<0.05, FDR-adjusted), dropping from approximately 20% of articles in 2020–2021 to virtually 0% by 2024. Domain-level analysis echoed these findings: only the public health/pandemic domain exhibited a significant trend (decline), whereas domains like flight safety and aerospace physiology showed no significant change. Descriptive data indicated that all articles provided English abstracts, whereas none had Korean-language abstracts in the open-access records. Conclusion: KJASEM’s content has shifted since 2020, with COVID-19 papers surging and then receding, while core aerospace medicine themes persisted.

This issue of the Korean Journal of Aerospace and Environmental Medicine (KJASEM) (Vol. 35, No. 3) presents five studies that expand our understanding of aviation safety, space health, and human factors. An original bibliometric analysis of 120 articles tracks thematic shifts in KJASEM, showing the rise and fall of COVID-19 research alongside sustained focus on pilot health and safety. A review on crew resource management (CRM) synthesizes ten years of evidence that CRM fosters safety culture and effective cockpit–cabin collaboration. A review on long-duration spaceflight medicine outlines physiological and psychological risks—bone loss, neuro-ocular syndrome, radiationinjury—and evaluates countermeasures critical for Mars missions. A review of stress factors in aviation human factors integrates evidence on fatigue, emotional labor, and role ambiguity, linking them to both safety outcomes and service quality. Finally, a case report on Alzheimer’s disease in a senior airline captain highlights the aeromedical importance of detecting mild cognitive impairment for flight safety.

In aviation, pilots and cabin crew are continually exposed to stressors such as fatigue, shift work, emotional labor, and role ambiguity, which undermine both safety and service performance. Yet, integrative reviews on their simultaneous effects remain limited. This study conducted a narrative review of empirical and review literature published between 2000 and 2025, searching KCI, DBpia, ScienceON, PubMed, and Scopus. Stressors examined included fatigue, sleep disturbance, emotional labor, role ambiguity, and shift work, with outcomes covering safety (safety behaviors, situation awareness, emergency response) and service (service quality, emotional consistency, customer satisfaction). Regulatory guidelines from the International Civil Aviation Organization, the United States Federal Aviation Administration, the European Union Aviation Safety Agency, and the International Air Transport Association were also reviewed to ensure international relevance. Findings revealed that fatigue, sleep disturbance, and shift work consistently reduced safety behaviors, impaired situation awareness, and hindered emergency response. Emotional labor and role ambiguity degraded service quality, emotional consistency, and customer satisfaction. Conversely, sleep quality and organizational support emerged as protective factors. These results suggest that stressors in aviation should be regarded not only as welfare concerns but as strategic determinants of organizational performance, calling for longitudinal research, integrated models, and practical interventions.

Alzheimer’s disease (AD) poses a significant threat to aviation safety due to its insidious cognitive decline. The early stage, mild cognitive impairment (MCI), is challenging to detect in high-functioning individuals like pilots, yet any impairment requires strict aeromedical evaluation. This case involved a 60-year-old commercial pilot with over 20,000 flight hours who presented with a one-year history of gradual cognitive decline. Initially dismissed as stress, these symptoms were eventually noted by colleagues. A comprehensive evaluation, including neuropsychological testing and a brain magnetic resonance imaging revealing hippocampal atrophy, led to a diagnosis of MCI due to AD. He began treatment with a cholinesterase inhibitor. However, given AD’s progressive nature on functions vital for flight and potential medication side effects, he was disqualified from duty permanently. This case underscores the critical need for effective cognitive screening protocols and robust aeromedical guidelines for pilots with neurodegenerative conditions to ensure aviation safety.