Survey study on the neck pain in fighter pilots and its influences to operational flying

Objective To investigate the prevalence of daily neck pain (DNP) and fly-related neck pain(FNP) in fighter pilots and to estimate how neck symptoms influenced operational flying in fighter pilots, so as to provide elementary data for further investigation of risk factors and preventive measure. Methods Two hundred and thirty-three fighter pilots, including 94 high-performance fighter pilots and 139 conventional fighter pilots, were surveyed on self-reported prevalence of DNP and FNP in past 1-yr. The pilots were grouped into with DNP and healthy groups by prevalence of DNP, and the FNP prevalence was compared between these two groups. The prevalences of DNP and FNP were compared between high-performance fighter pilots and conventional fighter pilots. Pilots also described how FNP influenced operational flying. Results Among all pilots, 32.6% had experienced DNP, 59.7% had experienced FNP and 17.2% had experienced frequent FNP. DNP pilots had statistically higher FNP and frequent FNP prevalence than healthy pilots (χ2=41.665, 54.669, P<0.01). Comparing with conventional fighter pilots, high performance fighter pilots had no statistically different DNP and FNP prevalence, but had statistically different frequent FNP prevalence(χ2=7.753, P<0.01). Among the pilots with FNP, 18.7% reported neck pain impacted flying endurance, 20.1% reported impacted ability of concentration or stamina, 37.4% reported impacted ability of observation or target searching, 59.7% reported impacted agile operation or high G maneuvers. Among high performance fighter pilots with FNP, 67.8% reported restricted air combat maneuvers resulted from FNP. Conclusions Prevalence of daily neck pain and fly-related neck pain are considerably high in fighter pilots. Pilots with daily neck pain are more easily to experience fly-related neck pain, indicating that their neck functions are steadily weakened and require prompt and effective intervention. High performance fighter pilots are more easily to experience frequent fly-related neck pain. The fly-related neck pain affects operational flying in many ways. Those findings highlight the stricter demand of neck function for high performance fighter pilots and the necessary support to air service. Key words: Neck pain; Prevalence; Epidemiologic studies; Aviation; Pilots