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Activity title

Expert panel for state of the art cardiovascular risk assessment in aircrew and other high risk occupations.

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Human Factors and Medicine

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Aircrew, Aviation, Cardiology, Cardiothoracic surgery, Occupational Assessment


Specific features of military aviation (such as +Gz, positive pressure breathing, air combat sorties) place high levels of stress on the cardiovascular system. Determining the acceptability of cardiovascular disease in military aviation is challenging given the paucity of evidence and limited number of military aviation cardiologists (most nations may have one or two individuals only). In HFM-251, the group produced a series of consensus recommendations for the assessment and disposition of aircrew with suspected or proven cardiovascular disease. These recommendations were based on the evidence available in the different cardiac conditions, but which is almost exclusively drawn from the non-aircrew population. Evidence drawn specifically from aircrew will permit more focussed and relevant risk assessment and disposition decisions to be made.


1. To undertake retrospective research on pooled multi-national datasets, combining data already available within individual member countries. This will provide evidence to move from consensus recommendations to clearer guidelines. 2. To maximise the impact and awareness of the recently published consensus documents on occupational aviation cardiology, including publicising and sharing work of the HFM-251 Occupational Cardiology Aviation RTG, for instance by participating in relevant symposia/conferences, and possibly developing an app available to all NATO nations (and the wider aviation medicine community), to allow wider access to the Heart BMJ publications produced by HFM-251 and any further research outputs developed by the proposed new RTG. 3. To explore key areas that may be appropriate targets for larger scale prospective studies in our aircrew populations.


This working group will undertake investigations into all areas of cardiovascular medicine (screening, coronary artery disease, valvular heart disease, arrhythmias, and heart muscle disease). It will also explore the potential value of novel advanced imaging tools such as computational flow dynamics, machine learning, and artificial intelligence tools in the assessment of cardiovascular disease in aircrew.

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