Abstract PURPOSE: Federal Aviation regulations prohibit any individual ages 60 years or older from serving as a pilot on an airplane under Part 121 regulations. The assumption underlying the “Age-60 Rule” is that pilots' safety performance declines with advancing age due to adverse effects of aging on health and cognitive functions. Epidemiological evidence for this premise, however, has been lacking. This study evaluates the risk of crash involvement during the process of aging in a cohort of professional pilots. METHODS: Pilots who were 45–54 years old in 1987 with Class I medical certificates and who flew Part 135 operations (n = 3,306) were followed up for 11 years. Information on demographics, medical conditions, flight experience, crash involvement, and exposure to flight were collected through biannual medical certification data and aviation crash surveillance systems. Proportional hazards modeling was used in the statistical analysis. RESULTS: During the 11-year period, a total of 12,926,214 pilot-flight-hours and 66 crashes were recorded, yielding a crash rate of 0.51 per 100,000 pilot-flight-hours. The crash rates were 0.56, 0.43, 0.55, 1.10 per 100,000 pilot-flight-hours at age 45–49 years, 50–54 years, 55–59 years, 60–64 years, respectively. In the oldest group, the number of crashes was small (n = 3) and some were the result of aircraft malfunction. Pilots with more than 5,000 hours of total flight time at the baseline had significantly lower crash rates than their less experienced counterparts. Multivariate regression revealed that crash risk appeared to increase with age in a quadratic manner; yet the age effect did not reach statistical significance (p = 0.10). CONCLUSION: Safety performance as measured by crash risk in part 135 pilots does not seem to change significantly during the process of aging, possibly due to the “Healthy Worker Effect” resulting from periodic medical certification and voluntary retirement.
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