2687-1491 Журнал медико-биологических исследований Journal of Medical and Biological Research Северный (Арктический) федеральный университет 10.37482/2687-1491-Z298 https://journals.narfu.ru/index.php/med/article/view/2485 НАУЧНЫЕ ОБЗОРЫ REVIEW ARTICLES Современные научные представления о профессиональном здоровье авиационных специалистов (обзор) Contemporary Scientific Perspectives on the Professional Health of Aviation Specialists (Review) Аденинская Елена Евгеньевна Аденинская Елена Евгеньевна Adeninskaya Elena E. mail@ckbga.ru 0000-0001-7483-3855 Забродина Наталья Борисовна Забродина Наталья Борисовна Zabrodina Natalia B. mail@ckbga.ru 0000-0002-8509-5103 Потиевский Борис Григорьевич Потиевский Борис Григорьевич Potievsky Boris G. mail@ckbga.ru 0009-0007-1855-9362 Центральная клиническая больница гражданской авиации; Государственный научный центр Российской Федерации – Федеральный медицинский биофизический центр имени А.И. Бурназяна (Москва, Россия) State Scientific Center of the Russian Federation – A.I. Burnazyan Federal Medical Biophysical Center (Moscow, Russia) Центральная клиническая больница гражданской авиации; Российская медицинская академия непрерывного профессионального образования (Москва, Россия) Central Clinical Hospital of Civil Aviation; Russian Medical Academy of Continuous Professional Education (Moscow, Russia) 07 10 2026 2026 14 3 89 103 13 02 2026 17 04 2026 14 04 2026 © Аденинская Е.Е., Забродина Н.Б., Потиевский Б.Г., 2026 2026 Аденинская Е.Е., Забродина Н.Б., Потиевский Б.Г. Adeninskaya E.E., Zabrodina N.B., Potievsky B.G. CC BY 4.0 https://journals.narfu.ru/index.php/med/article/view/2485

Обеспечение профессионального долголетия пилотов и диспетчеров управления воздушным движением является одной из приоритетных стратегических задач гражданской авиации. Традиционные подходы медицины труда, основанные на выявлении нозологических форм профессиональных заболеваний, демонстрируют ограниченную эффективность в условиях глубокой трансформации характера деятельности. Цель исследования – системный анализ концепций профессионального здоровья авиационных специалистов и выявление факторов его формирования на основе данных современной литературы. Проведен аналитический обзор отечественных и зарубежных публикаций, размещенных в базах данных PubMed, Scopus, Web of Science и eLIBRARY.RU, за последние 10 лет с привлечением более ранних фундаментальных источников. Установлено, что в авиационной медицине происходит концептуальный переход от юридической категории «профессиональное заболевание» к медико-биологическому понятию «профессиональное здоровье» как состоянию функциональных резервов организма. Выявлен глобальный сдвиг профиля рисков от доминирования физических факторов среды (шум, вибрация) к организационным и психофизиологическим детерминантам: сменному графику, хроническому десинхронозу и воздействию обесогенной среды. Показано, что пилоты и диспетчеры образуют единый контур риска, где лимитирующим фактором профессионального долголетия выступает истощение адаптационных ресурсов, ведущее к кардиометаболическим нарушениям и преждевременному старению на фоне накопленного «биологического долга». Обнаружено, что высокая когнитивная сложность труда при условии адекватного восстановления выполняет функцию нейротренинга, способствуя формированию когнитивного резерва и долгосрочной нейропротекции. Обоснована необходимость смены парадигмы медицинского обеспечения полетов – перехода от стратегии «экспертного отсева» к проактивному управлению модифицируемыми факторами риска (гигиена сна, нутритивный статус, физическая активность) и динамическому мониторингу функциональных резервов организма работников. Реализация данного подхода является ключевым условием сохранения кадрового потенциала гражданской авиации и безопасности полетов.

Maintaining the professional longevity of pilots and air traffic controllers is a priority strategic objective for civil aviation. Traditional occupational medicine approaches, based on identifying nosological forms of occupational diseases, have demonstrated limited effectiveness in the context of the profound transformation of work patterns. The aim of this study is to conduct a systematic analysis of the concepts of professional health of aviation specialists and identify the factors influencing it based on contemporary research works. An analytical review of domestic and international publications in the PubMed, Scopus, Web of Science, and eLIBRARY databases over the last 10 years was conducted, including earlier fundamental sources. The study shows that aviation medicine is undergoing a conceptual transition from the legal category of “occupational disease” to the medico-biological concept of “professional health” as a state of the body’s functional reserves. A global shift in the risk profile is revealed, from the dominance of physical environmental factors (noise, vibration) to organizational and psychophysiological determinants such as shift work, chronic desynchronosis, and exposure to an obesogenic environment. Pilots and air traffic controllers belong to the same risk profile, where the limiting factor for professional longevity is the depletion of adaptive reserves, leading to cardiometabolic disorders and premature aging against the background of accumulated “biological debt”. High cognitive complexity of work provides neurotraining, contributing to the development of cognitive reserve and long-term neuroprotection, if adequate recovery is ensured. The need for a paradigm shift in medical flight support is substantiated: a shift from the “expert deselection” strategy to the proactive management of modifiable risk factors (sleep hygiene, nutritional status, physical activity) and dynamic monitoring of employees’ functional reserves. Implementation of this approach is key for maintaining the human resources potential of civil aviation and ensuring flight safety.

 Ключевые слова авиационная медицина медицина труда функциональные резервы организма пилот диспетчер управления воздушным движением профессиональное здоровье профессиональное долголетие Keywords aviation medicine occupational medicine functional reserves pilot air traffic controller occupational health professional longevity Зибарев Е.В., Кравченко О.К., Климов А.А., Ивашов С.Н. Оптимизация режимов труда и отдыха членов летных экипажей с целью повышения безопасности полетов в гражданской авиации // Медицина труда и пром. экология. 2022. Т. 62, № 3. С. 193–200. https://doi.org/10.31089/1026-9428-2022-62-3-193-200 Simons R., Maire R., Van Drongelen A., Valk P. Grounding of Pilots: Medical Reasons and Recommendations for Prevention // Aerosp. Med. Hum. Perform. 2021. Vol. 92, № 12. P. 950–955. https://doi.org/10.3357/AMHP.5985.2021 Wang L., Gao S., Hong R., Jiang Y. Effects of Age and Flight Exposure on Flight Safety Performance: Evidence from a Large Cross-Sectional Pilot Sample // Safety Sci. 2023. Vol. 165, № 9. Art. № 106199. https://doi.org/10.1016/j.ssci.2023.106199 Minoretti P., Emanuele E. Health in the Skies: A Narrative Review of the Issues Faced by Commercial Airline Pilots // Cureus. 2023. Vol. 15, № 4. Art. № e38000. https://doi.org/10.7759/cureus.38000 Matthews M.J., Stretanski M.F. Pilot Medical Certification. Treasure Island, 2026. URL: https://www.ncbi.nlm.nih.gov/books/NBK567745/ (дата обращения: 11.02.2026). Праскурничий Е.А., Куличенко В.П., Полубенцева Е.И., Иванов И.В. Безопасность полетов – новые понятийные и концептуальные авиамедицинские аспекты // Авиакосм. и экол. медицина. 2021. Т. 55, № 5. С. 31–39. https://doi.org/10.21687/0233-528X-2021-55-5-31-39 Sonati J., De Martino M., Vilarta R., Maciel É., Moreira E., Sanchez F., De Martino G., Sonati R. Quality of Life, Health, and Sleep of Air Traffic Controllers with Different Shift Systems // Aerosp. Med. Hum. Perform. 2015. Vol. 86, № 10. P. 895–900. https://doi.org/10.3357/AMHP.4325.2015 Rosenstock L., Cullen M., Fingerhut M. Chapter 60. Occupational Health // Disease Control Priorities in Developing Countries / ed. by D.T. Jamison et al. 2nd ed. Washington, 2006. URL: https://www.ncbi.nlm.nih.gov/books/NBK11750/ (дата обращения: 11.02.2026). Kirsten W. The Evolution from Occupational Health to Healthy Workplaces // Am. J. Lifestyle Med. 2022. Vol. 18, № 1. P. 64–74. https://doi.org/10.1177/15598276221113509 Панкова В.Б., Вильк М.Ф., Зибарев Е.В., Федина И.Н. К вопросу учета новых факторов в патогенезе профессиональной потери слуха (на примере работников транспорта) // Медицина труда и пром. экология. 2022. Т. 62, № 8. С. 488–500. https://doi.org/10.31089/1026-9428-2022-62-8-488-500 Богданова В.Е., Сериков В.В., Закревская А.А., Дмитриева Е.В. Организационная культура авиакомпаний как фактор рисков для профессионального здоровья пилотов и безопасности полетов в современной российской гражданской авиации // Медицина труда и пром. экология. 2021. Т. 61, № 10. С. 667–673. https://doi.org/10.31089/1026-9428-2021-61-10-667-673 Wagstaff A.S., Arva P. Hearing Loss in Civilian Airline and Helicopter Pilots Compared to Air Traffic Control Personnel // Aviat. Space Environ. Med. 2009. Vol. 80, № 10. P. 857–861. https://doi.org/10.3357/asem.1991.2009 Choi J.H., Jung H.S., Choi E.H. Association of Control Service Types with Aviation Medical Examination Results and Sick Leave in Air Traffic Controllers in Korea // Healthcare (Basel). 2025. Vol. 13, № 2. Art. № 132. https://doi.org/10.3390/healthcare13020132 Piňosová M., Andrejiova M., Badida M., Moravec M. Occupational Disease as the Bane of Workers’ Lives: A Chronological Review of the Literature and Study of Its Development in Slovakia. Part 1 // Int. J. Environ. Res. Public Health. 2021. Vol. 18, № 11. Art. № 5910. https://doi.org/10.3390/ijerph18115910 Franco G. Bernardino Ramazzini’s De Morbis Artificum Diatriba on Workers’ Health – the Birth of a New Discipline // J. UOEH. 2021. Vol. 43, № 3. P. 341–348. https://doi.org/10.7888/juoeh.43.341 Omran F. The Prevalence of Occupational Health Problems In-Flight Crews (Pilots and Flight Attendants): A Systematic Review and Meta-Analysis. Cape Town, 2023. URL: http://hdl.handle.net/11427/39816 (дата обращения: 11.02.2026). Shin I., Oh J.B., Yi H.K. Workers’ Compensation Insurance and Occupational Injuries // Saf. Health Work. 2011. Vol. 2, № 2. P. 148–157. https://doi.org/10.5491/SHAW.2011.2.2.148 Pega F., Hamzaoui H., Náfrádi B., Momen N.C. Global, Regional and National Burden of Disease Attributable to 19 Selected Occupational Risk Factors for 183 Countries, 2000–2016: A Systematic Analysis from the WHO/ILO Joint Estimates of the Work-Related Burden of Disease and Injury // Scand. J. Work Environ. Health. 2022. Vol. 48, № 2. P. 158–168. https://doi.org/10.5271/sjweh.4001 Stern Y., Albert M., Barnes C.A., Cabeza R., Pascual-Leone A., Rapp P.R. A Framework for Concepts of Reserve and Resilience in Aging // Neurobiol. Aging. 2023. Vol. 124. P. 100–103. https://doi.org/10.1016/j.neurobiolaging.2022.10.015 Wilson D., Driller M., Johnston B., Gill N. The Prevalence of Cardiometabolic Health Risk Factors among Airline Pilots: A Systematic Review // Int. J. Environ. Res. Public Health. 2022. Vol. 19, № 8. Art. № 4848. https://doi.org/10.3390/ijerph19084848 Li G., Baker S.P., Grabowski J.G., Qiang Y., McCarthy M.L., Rebok G.W. Age, Flight Experience, and Risk of Crash Involvement in a Cohort of Professional Pilots // Am. J. Epidemiol. 2003. Vol. 157, № 10. P. 874–880. https://doi.org/10.1093/aje/kwg071 Huster K.M., Müller A., Prohn M.J., Nowak D., Herbig B. Medical Risks in Older Pilots: A Systematic Review on Incapacitation and Age // Int. Arch. Occup. Environ. Health. 2014. Vol. 87, № 6. P. 567–578. https://doi.org/10.1007/s00420-013-0901-x Wilkening R. The Age 60 Rule: Age Discrimination in Commercial Aviation // Aviat. Space Environ. Med. 2002. Vol. 73, № 3. P. 194–202. Simons R., van Drongelen A., Roelen A., Maire R., Brouwer O., van Dijk H., Valk P. Age Limitations Commercial Air Transport Pilots: Final Report EASA_REP¬_RESEA_2017_1 / European Union Aviation Safety Agency. URL: https://www.easa.europa.eu/sites/default/files/dfu/EASA_REP_RESEA_2017_1.pdf (дата обращения: 11.02.2026). Трубецков А.Д., Каменева А.Д. Использование индекса трудоспособности (Work Ability Index) в медицине труда (обзор литературы) // Гигиена и санитария. 2022. Т. 101, № 6. С. 645–648. https://doi.org/10.47470/0016-9900-2022-101-6-645-648 Sallinen M., Onninen J., Ketola K., Puttonen S., Tuori A., Virkkala J., Åkerstedt T. Self-Reported Reasons for On-Duty Sleepiness among Commercial Airline Pilots // Chronobiol. Int. 2021. Vol. 38, № 9. P. 1308–1318. https://doi.org/10.1080/07420528.2021.1927071 Котеров А.Н., Ушенкова Л.Н. «Эффект здорового работника» у пилотов и радиация: систематический обзор и мета-анализ. Сравнение с показателями для работников ядерной индустрии // Радиац. биология. Радиоэкология. 2025. Т. 65, № 2. С. 131–155. https://doi.org/10.31857/S0869803125020027 AlMuammar S., Alkhaldi R., Aldealij R., Allbdi D., Ismail N., Alasmari B., Alsharif R., Alkhaldi A., Alasmari M. In the Captain’s Chair: A Cross-Sectional Study on Back Pain among Commercial Airline Pilots in Saudi Arabia // BMC Musculoskelet. Disord. 2025. Vol. 26, № 1. Art. № 143. https://doi.org/10.1186/s12891-025-08405-5 Зибарев Е.В., Бухтияров И.В., Кравченко О.К., Астанин П.А. Разработка новой концепции оценки напряженности труда пилотов гражданской авиации // Анализ риска здоровью. 2022. № 2. С. 73–87. https://doi.org/10.21668/health.risk/2022.2.07 Hilburn B. Cognitive Complexity in Air Traffic Control: A Literature Review. Brétigny-sur-Orge, 2004. 56 p. Terenzi M., Ricciardi O., Di Nocera F. Rostering in Air Traffic Control: A Narrative Review // Int. J. Environ. Res. Public Health. 2022. Vol. 19, № 8. Art. № 4625. https://doi.org/10.3390/ijerph19084625 Masi G., Amprimo G., Ferraris C., Priano L. Stress and Workload Assessment in Aviation – a Narrative Review // Sensors (Basel). 2023. Vol. 23, № 7. Art. № 3556. https://doi.org/10.3390/s23073556 Causse M., Mouratille D., Rouillard Y., El Yagoubi R., Matton N., Hidalgo-Muñoz A. How a Pilot’s Brain Copes with Stress and Mental Load? Insights from the Executive Control Network // Behav. Brain Res. 2024. Vol. 456. Art. № 114698. https://doi.org/10.1016/j.bbr.2023.114698 Minoretti P., Fortuna G., Lavdas K., D’Acquino D. Functional and Blood-Based Biomarkers of Brain Aging in Senior Airline Pilots Approaching Mandatory Retirement: A Case-Control Comparison with Age-Matched Office Workers // Cureus. 2025. Vol. 17, № 8. Art. № e90822. https://doi.org/10.7759/cureus.90822 Wilson D., Driller M., Johnston B., Gill N. Healthy Nutrition, Physical Activity, and Sleep Hygiene to Promote Cardiometabolic Health of Airline Pilots: A Narrative Review // J. Lifestyle Med. 2023. Vol. 13, № 1. P. 1–15. https://doi.org/10.15280/jlm.2023.13.1.1 Gupta C.C., Coates A.M., Dorrian J., Banks S. The Factors Influencing the Eating Behaviour of Shiftworkers: What, When, Where and Why // Ind. Health. 2019. Vol. 57, № 4. P. 419–453. https://doi.org/10.2486/indhealth.2018-0147 Minoretti P., Santiago Sáez A., García Martín Á., Liaño Riera M., Gómez Serrano M., Emanuele E. Prevalence of Hepatic Steatosis and Fibrosis in Apparently Healthy Airline Pilots: A Transient Elastography Study // Hepatol. Forum. 2024. Vol. 5, № 1. P. 7–10. https://doi.org/10.14744/hf.2023.2023.0050 Nunes A., Kramer A.F. Experience-Based Mitigation of Age-Related Performance Declines: Evidence from Air Traffic Control // J. Exp. Psychol. Appl. 2009. Vol. 15, № 1. P. 12–24. https://doi.org/10.1037/a0014947 Li W.C., Kearney P., Zhang J., Hsu Y.L., Braithwaite G. The Analysis of Occurrences Associated with Air Traffic Volume and Air Traffic Controllers’ Alertness for Fatigue Risk Management // Risk Analysis. 2021. Vol. 41, № 6. P. 1004–1018. https://doi.org/10.1111/risa.13594 Inoue S., Furuta K., Nakata K., Kanno T., Aoyama H., Brown M. Cognitive Process Modelling of Controllers in Еn Route Air Traffic Control // Ergonomics. 2012. Vol. 55, № 4. P. 450–464. https://doi.org/10.1080/00140139.2011.647093 Minoretti P., Santiago Sáez A., García Martín Á., Liaño Riera M., Gómez Serrano M. Carotid Intima-Media Thickness, Overweight, and Poor Sleep Quality in Commercial Airline Pilots: A Cross-Sectional Study // Cureus. 2024. Vol. 16, № 7. Art. № e63552. https://doi.org/10.7759/cureus.63552 Yong L.C., Pinkerton L.E., Yiin J.H., Anderson J.L., Deddens J.A. Mortality among a Cohort of U.S. Commercial Airline Cockpit Crew // Am. J. Ind. Med. 2014. Vol. 57, № 8. P. 906–914. https://doi.org/10.1002/ajim.22318 Linnersjö A., Brodin L.Å., Andersson C., Alfredsson L., Hammar N. Low Mortality and Myocardial Infarction Incidence among Flying Personnel During Working Career and Beyond // Scand. J. Work Environ. Health. 2011. Vol. 37, № 3. P. 219–226. https://doi.org/10.5271/sjweh.3134 Kim J.S., Han B.S., Kwon Y.H., Lim J.U. A 5-Year Analysis of Aviation Medical Examinations in South Korea // Aerosp. Med. Hum. Perform. 2022. Vol. 93, № 6. P. 499–506. https://doi.org/10.3357/AMHP.5973.2022 Gunduz S.H., Metin S. Medical Reasons for Permanent and Temporary Disqualification of Turkish Civil Aviation Pilots // Arch. Environ. Occup. Health. 2024. Vol. 79, № 3–4. P. 113–120. https://doi.org/10.1080/19338244.2024.2359416 Evans S., Radcliffe S.A. The Annual Incapacitation Rate of Commercial Pilots // Aviat. Space Environ. Med. 2012. Vol. 83, № 1. P. 42–49. https://doi.org/10.3357/asem.3134.2012 Li X., Huang Z., Peng X., Zhang J., Liu Y., Luo Y., Guo L. Job Satisfaction, Burnout, and Safety Behavior in Air Traffic Controllers: A Mediation Analysis and Decision Tree Insights // Front. Public Health. 2025. Vol. 13. Art. № 1626328. https://doi.org/10.3389/fpubh.2025.1626328 Sanlorenzo M., Wehner M.R., Linos E., Kornak J., Kainz W., Posch C., Vujic I., Johnston K., Gho D., Monico G. et al. The Risk of Melanoma in Airline Pilots and Cabin Crew: A Meta-Analysis // JAMA Dermatol. 2015. Vol. 151, № 1. P. 51–58. https://doi.org/10.1001/jamadermatol.2014.1077 Zibarev E.V., Kravchenko O.K., Klimov A.A., Ivashov S.N. Optimization of Work and Rest Modes of Flight Crew Members in Order to Improve Flight Safety in Civil Aviation. Meditsina truda i promyshlennaya ekologiya, 2022, vol. 62, no. 3, pp. 193–200 (in Russ.). https://doi.org/10.31089/1026-9428-2022-62-3-193-200 Simons R., Maire R., Van Drongelen A., Valk P. Grounding of Pilots: Medical Reasons and Recommendations for Prevention. Aerosp. Med. Hum. Perform., 2021, vol. 92, no. 12, pp. 950–955. https://doi.org/10.3357/AMHP.5985.2021 Wang L., Gao S., Hong R., Jiang Y. Effects of Age and Flight Exposure on Flight Safety Performance: Evidence from a Large Cross-Sectional Pilot Sample. Safety Sci., 2023, vol. 165. Art. no. 106199. https://doi.org/10.1016/j.ssci.2023.106199 Minoretti P., Emanuele E. Health in the Skies: A Narrative Review of the Issues Faced by Commercial Airline Pilots. Cureus, 2023, vol. 15, no. 4. Art. no. e38000. https://doi.org/10.7759/cureus.38000 Matthews M.J., Stretanski M.F. Pilot Medical Certification. Treasure Island (FL), 2026. Available at: https://www.ncbi.nlm.nih.gov/books/NBK567745/ (accessed: 11 February 2026). Praskurnichiy E.A., Kulichenko V.P., Polubentseva E.I., Ivanov I.V. Flight Safety – New Conceptual Aeromedical Aspects. Aviakosmicheskaya i ekologicheskaya meditsina, 2021, vol. 55, no. 5, pp. 31–39 (in Russ.). https://doi.org/10.21687/0233-528X-2021-55-5-31-39 Sonati J., De Martino M., Vilarta R., Maciel É., Moreira E., Sanchez F., De Martino G., Sonati R. Quality of Life, Health, and Sleep of Air Traffic Controllers with Different Shift Systems. Aerosp. Med. Hum. Perform., 2015, vol. 86, no. 10, pp. 895–900. https://doi.org/10.3357/AMHP.4325.2015 Rosenstock L., Cullen M., Fingerhut M. Chapter 60. Occupational Health. Jamison D.T. et al. (eds.). Disease Control Priorities in Developing Countries. 2nd ed. Washington (DC), 2006. Available at: https://www.ncbi.nlm.nih.gov/books/NBK11750/ (accessed: 11 February 2026). Kirsten W. The Evolution from Occupational Health to Healthy Workplaces. Am. J. Lifestyle Med., 2022, vol. 18, no. 1, pp. 64–74. https://doi.org/10.1177/15598276221113509 Pankova V.B., Vilk M.F., Zibarev E.V., Fedina I.N. On the Issue of Taking into Account New Factors in the Pathogenesis of Occupational Hearing Loss (on the Example of Transport Workers). Russ. J. Occup. Health Ind. Ecol., 2022, vol. 62, no. 8, pp. 488–500. https://doi.org/10.31089/1026-9428-2022-62-8-488-500 Bogdanova V.E., Serikov V.V., Zakrevskaya A.A., Dmitrieva E.V. Airline Organizational Culture as a Risk Factor for Pilots’ Professional Health and Flight Safety in Modern Russian Civil Aviation. Russ. J. Occup. Health Ind. Ecol., 2021, vol. 61, no. 10, pp. 667–673 (in Russ.). https://doi.org/10.31089/1026-9428-2021-61-10-667-673. Wagstaff A.S., Arva P. Hearing Loss in Civilian Airline and Helicopter Pilots Compared to Air Traffic Control Personnel. Aviat. Space Environ. Med., 2009, vol. 80, no. 10, pp. 857–861. https://doi.org/10.3357/asem.1991.2009 Choi J.H., Jung H.S., Choi E.H. Association of Control Service Types with Aviation Medical Examination Results and Sick Leave in Air Traffic Controllers in Korea. Healthcare (Basel), 2025, vol. 13, no. 2. Art. no. 132. https://doi.org/10.3390/healthcare13020132 Piňosová M., Andrejiova M., Badida M., Moravec M. Occupational Disease as the Bane of Workers’ Lives: A Chronological Review of the Literature and Study of Its Development in Slovakia. Part 1. Int. J. Environ. Res. Public Health, 2021, vol. 18, no. 11. Art. no. 5910. https://doi.org/10.3390/ijerph18115910 Franco G. Bernardino Ramazzini’s De Morbis Artificum Diatriba on Workers’ Health – the Birth of a New Discipline. J. UOEH, 2021, vol. 43, no. 3, pp. 341–348. https://doi.org/10.7888/juoeh.43.341 Omran F. The Prevalence of Occupational Health Problems In-Flight Crews (Pilots andFlight Attendants): A Systematic Review and Meta-Analysis. Cape Town, 2023. Available at: http://hdl.handle.net/11427/39816 (accessed: 11 February 2026). Shin I., Oh J.B., Yi H.K. Workers’ Compensation Insurance and Occupational Injuries. Saf. Health Work, 2011, vol. 2, no. 2, pp. 148–157. https://doi.org/10.5491/SHAW.2011.2.2.148 Pega F., Hamzaoui H., Náfrádi B., Momen N.C. Global, Regional and National Burden of Disease Attributable to Selected Occupational Risk Factors. Scand. J. Work Environ. Health, 2022, vol. 48, no. 2, pp. 158–168. https://doi.org/10.5271/sjweh.4001 Stern Y., Albert M., Barnes C.A., Cabeza R., Pascual-Leone A., Rapp P.R. A Framework for Concepts of Reserve and Resilience in Aging. Neurobiol. Aging, 2023, vol. 124, pp. 100–103. https://doi.org/10.1016/j.neurobiolaging.2022.10.015 Wilson D., Driller M., Johnston B., Gill N. The Prevalence of Cardiometabolic Health Risk Factors among Airline Pilots: A Systematic Review. Int. J. Environ. Res. Public Health, 2022, vol. 19, no. 8. Art. no. 4848. https://doi.org/10.3390/ijerph19084848 Li G., Baker S.P., Grabowski J.G., Qiang Y., McCarthy M.L., Rebok G.W. Age, Flight Experience, and Risk of Crash Involvement in a Cohort of Professional Pilots. Am. J. Epidemiol., 2003, vol. 157, no. 10, pp. 874–880. https://doi.org/10.1093/aje/kwg071 Huster K.M., Müller A., Prohn M.J., Nowak D., Herbig B. Medical Risks in Older Pilots: A Systematic Review on Incapacitation and Age. Int. Arch. Occup. Environ. Health, 2014, vol. 87, no. 6, pp. 567–578. https://doi.org/10.1007/s00420-013-0901-x Wilkening R. The Age 60 Rule: Age Discrimination in Commercial Aviation. Aviat. Space Environ. Med., 2002, vol. 73, no. 3, pp. 194–202. Simons R., van Drongelen A., Roelen A., Maire R., Brouwer O., van Dijk H., Valk P. Age Limitations Commercial Air Transport Pilots: Final Report EASA_REP_RESEA_2017_1. Available at: https://www.easa.europa.eu/sites/default/files/dfu/EASA_REP_RESEA_2017_1.pdf (accessed: 11 February 2026). Trubetskov A.D., Kameneva A.D. The Use of the Work Ability Index in Occupational Health (Literature Review). Hyg. Sanit., 2022, vol. 101, no. 6, pp. 645–648 (in Russ.). https://doi.org/10.47470/0016-9900-2022-101-6-645-648 Sallinen M., Onninen J., Ketola K., Puttonen S., Tuori A., Virkkala J., Åkerstedt T. Self-Reported Reasons for On-Duty Sleepiness among Commercial Airline Pilots. Chronobiol. Int., 2021, vol. 38, no. 9, pp. 1308–1318. https://doi.org/10.1080/07420528.2021.1927071 Koterov A.N., Ushenkova L.N. The “Healthy Worker Effect” in Pilots and Radiation: A Systematic Review and Meta-Analysis. Comparison with Indicators for Nuclear Industry Workers. Radiatsionnaya biologiya. Radioekologiya, 2025, vol. 65, no. 2, pp. 131–155 (in Russ.). https://doi.org/10.31857/S0869803125020027 AlMuammar S., Alkhaldi R., Aldealij R., Allbdi D., Ismail N., Alasmari B., Alsharif R., Alkhaldi A., Alasmari M. In the Captain’s Chair: A Cross-Sectional Study on Back Pain among Commercial Airline Pilots in Saudi Arabia. BMC Musculoskelet. Disord., 2025, vol. 26, no. 1. Art. no. 143. https://doi.org/10.1186/s12891-025-08405-5 Zibarev E.V., Bukhtiyarov I.V., Kravchenko O.K., Astanin P.A. Development of a New Concept for Assessing Work Intensity of Civil Aviation Pilots. Health Risk Analysis, 2022, no. 2, pp. 73–87 (in Russ.). https://doi.org/10.21668/health.risk/2022.2.07 Hilburn B. Cognitive Complexity in Air Traffic Control: A Literature Review. Brétigny-sur-Orge, 2004. 69 p. Terenzi M., Ricciardi O., Di Nocera F. Rostering in Air Traffic Control: A Narrative Review. Int. J. Environ. Res. Public Health, 2022, vol. 19, no. 8. Art. no. 4625. https://doi.org/10.3390/ijerph19084625 Masi G., Amprimo G., Ferraris C., Priano L. Stress and Workload Assessment in Aviation: A Narrative Review. Sensors (Basel), 2023, vol. 23, no. 7. Art. no. 3556. https://doi.org/10.3390/s23073556 Causse M., Mouratille D., Rouillard Y., El Yagoubi R., Matton N., Hidalgo-Muñoz A. How a Pilot’s Brain Copes with Stress and Mental Load? Insights from the Executive Control Network. Behav. Brain Res., 2024, vol. 456. Art. no. 114698. https://doi.org/10.1016/j.bbr.2023.114698 Minoretti P., Fortuna G., Lavdas K., D’Acquino D. Functional and Blood-Based Biomarkers of Brain Aging in Senior Airline Pilots Approaching Mandatory Retirement: A Case-Control Comparison with Age-Matched Office Workers. Cureus, 2025, vol. 17, no. 8. Art. no. e90822. https://doi.org/10.7759/cureus.90822 Wilson D., Driller M., Johnston B., Gill N. Healthy Nutrition, Physical Activity, and Sleep Hygiene to Promote Cardiometabolic Health of Airline Pilots: A Narrative Review. J. Lifestyle Med., 2023, vol. 13, no. 1, pp. 1–15. https://doi.org/10.15280/jlm.2023.13.1.1 Gupta C.C., Coates A.M., Dorrian J., Banks S. The Factors Influencing the Eating Behaviour of Shiftworkers: What, When, Where and Why. Ind. Health, 2019, vol. 57, no. 4, pp. 419–453. https://doi.org/10.2486/indhealth.2018-0147 Minoretti P., Santiago Sáez A., García Martín Á., Liaño Riera M., Gómez Serrano M., Emanuele E. Prevalence of Hepatic Steatosis and Fibrosis in Apparently Healthy Airline Pilots: A Transient Elastography Study. Hepatol. Forum, 2024, vol. 5, no. 1, pp. 7–10. https://doi.org/10.14744/hf.2023.2023.0050 Nunes A., Kramer A. F. Experience-Based Mitigation of Age-Related Performance Declines: Evidence from Air Traffic Control. J. Exp. Psychol. Appl., 2009, vol. 15, no. 1, pp. 12–24. https://doi.org/10.1037/a0014947 Li W.C., Kearney P., Zhang J., Hsu Y.L., Braithwaite G.R. The Analysis of Occurrences Associated with Air Traffic Volume and Air Traffic Controllers’ Alertness for Fatigue Risk Management. Risk Analysis, 2021, vol. 41, no. 6, pp. 1004–1018. https://doi.org/10.1111/risa.13594 Inoue S., Furuta K., Nakata K., Kanno T., Aoyama H., Brown M. Cognitive Process Modelling of Controllers in En Route Air Traffic Control. Ergonomics, 2012, vol. 55, no. 4, pp. 450–464. https://doi.org/10.1080/00140139.2011.647093 Minoretti P., Santiago Sáez A., García Martín Á., Liaño Riera M., Gómez Serrano M. Carotid Intima-Media Thickness, Overweight, and Poor Sleep Quality in Commercial Airline Pilots. Cureus, 2024, vol. 16, no. 7. Art. no. e63552. https://doi.org/10.7759/cureus.63552 Yong L.C., Pinkerton L.E., Yiin J.H., Anderson J.L., Deddens J.A. Mortality among a Cohort of U.S. Commercial Airline Cockpit Crew. Am. J. Ind. Med., 2014, vol. 57, no. 8, pp. 906–914. https://doi.org/10.1002/ajim.22318 Linnersjö A., Brodin L.Å., Andersson C., Alfredsson L., Hammar N. Low Mortality and Myocardial Infarction Incidence among Flying Personnel during Working Career and beyond. Scand. J. Work Environ. Health, 2011, vol. 37, no. 3, pp. 219–226. https://doi.org/10.5271/sjweh.3134 Kim J.S., Han B.S., Kwon Y.H., Lim J. A 5-Year Analysis of Aviation Medical Examinations in South Korea. Aerosp. Med. Hum. Perform., 2022, vol. 93, no. 6, pp. 499–506. https://doi.org/10.3357/AMHP.5973.2022 Gunduz S.H., Metin S. Medical Reasons for Permanent and Temporary Disqualification of Turkish Civil Aviation Pilots. Arch. Environ. Occup. Health, 2024, vol. 79, no. 3–4, pp. 113–120. https://doi.org/10.1080/19338244.2024.2359416 Evans S., Radcliffe S.A. The Annual Incapacitation Rate of Commercial Pilots. Aviat. Space Environ. Med., 2012, vol. 83, no. 1, pp. 42–49. https://doi.org/10.3357/asem.3134.2012 Li X., Huang Z., Peng X., Zhang J., Liu Y., Luo Y., Guo L. Job Satisfaction, Burnout, and Safety Behavior in Air Traffic Controllers. Front. Public Health, 2025, vol. 13. Art. no. 1626328. https://doi.org/10.3389/fpubh.2025.1626328 Sanlorenzo M., Wehner M.R., Linos E., Kornak J., Kainz W., Posch C., Vujic I., Johnston K., Gho D., Monico G. et al. The Risk of Melanoma in Airline Pilots and Cabin Crew: A Meta-Analysis. JAMA Dermatol., 2015, vol. 151, no. 1, pp. 51–58. https://doi.org/10.1001/jamadermatol.2014.1077