The Republic of Korea is rapidly entering an aging society. With the aging of society, the overseas travel of the elderly is increasing rapidly. According to the Korea Tourism Organization, the number of overseas tourists aged 61 or older last year exceeded 2.5 million, of which over 80 were over 200,000. Age is no longer a limiting factor for traveling abroad, but traveling to unfamiliar places is certainly a challenge. Old people may experience a variety of problems, so special care should be taken. In particular, the aircraft cabin environment is different from the ground, so elderly travelers with respiratory or heart disease require special attention. In this paper, we want to know the precautions and how to prepare for the safe air travel for the elderly.

This study aimed to quantify the causes of Korean airline pilots' medical disqualification during 2015~2019. The airline pilot disqualification data is important for grasping what health problems are common to pilots and establishing preventive health care programs. We were able to obtain data from official sources at the Korean Civil Aviation Authority during 2015~2019. The total number of pilots was 29,095, and the number of disqualified professional pilots in Korea was 36. Looking at airline pilots'status by age group, the 40s were the highest with 38%. However, the disqualification rate per 1,000 pilots was the highest in the 60s, at 4.6. When the different diagnostic categories classified the disqualification results, cardiovascular disease was the highest with 12 cases (33.3%), followed by eye disease, malignancy, neurology,psychiatry, otorhinolaryngology, and respiratory disease. The total number of pilots during 2015~2019 was 29,095, and the overall disqualification rate of 1.6/1,000 pilots.

Obstructive sleep apnea (OSA) is a breathing disorder characterized by a secondary intermittent decrease in blood oxygen saturation concentration, increased respiratory ability, and frequent awakening due to obstruction of airflow through repetitive upper airway during sleep. In adults, it is known to occur in 2 to 4% of the total population. In the case of obstructive sleep apnea without treatment for a long period of time, there is a decrease in working productivity due to daytime sleepiness and concentration problems.In addition, there are several types of serious complications, such as anorexia nervosa, related diseases, metabolic syndrome, etc. The National Transportation Safety Board (NTSB) reported a six-fold increase in the risk of aviation crashes for pilots with OSA. Based on this, the Federal Aviation Administration (FAA) is required to evaluate OSA on an aviation medical examination. OSA is an important issue directly linked to aviation safety. The purpose of this study is to evaluate the importance of the evaluation of obstructive sleep apnea in aviation medical examination and the evaluation method of OSA in foreign and domestic aviation medical examination.

“Incapacitation” means any reduction in medical fitness to a degree or of a nature that is likely to jeopardize flight safety. Incapacitation of flight crew during flight is a serious threat to aviation safety. The focus of the periodic medical examination has been to detect medical conditions, and almost exclusively the emphasis has been on detecting physical medical conditions that may pose a threat to flight safety during the ensuing period of validity of the Medical Assessment. Therefore, the aviation medical examiner should be able to understand the incapacitation to utilize it for flight crew health evaluation and promotion.

Coronavirus disease 2019 (COVID-19) has had a significant impact on our society as a whole. The COVID-19 pandemic is not only a health crisis, it is also an economic, social and humanitarian crisis. Considering the dramatic global economic and social impact that the crisis has engendered, the aviation system is standing on the doorstep of rapid transformation. In particular, the impact on the aviation and travel industries is enormous. Air travel to most countries has been suspended and blocked. Looking at Korea’s current situation, COVID-19 has wholly changed the aviation industry. As COVID-19 spreads around the world, countries have come up with aviation safety measures. Infectious disease safety measures were established to protect passengers and crew members, and countries with collapsed medical systems extended the validity period for aviation medical examinations. In Korea, on August 11, the Ministry of Land, Infrastructure and Transport provided guidance on medical measures related to COVID-19 through an official letter of “Notification of cautions for pilots and air traffic control officers (ATCO) when COVID-19 is confirmed”. Overseas countries such as the United States and the United Kingdom have announced regulations for aviation medical examination regulations in relation to COVID-19, and have set standards for returning to aviation after COVID-19 is confirmed. In this paper, we would like to investigate the regulations for aviation medical examination related to COVID-19.

The coronavirus disease-19 (COVID-19) vaccine is expected to play an important role in stopping the pandemic. Studies show that COVID-19 vaccines are effective at keeping you from getting COVID-19. Getting a COVID-19 vaccine will also help keep you from getting seriously ill even if you do get COVID-19. Efforts to find an effective vaccine against severe acute respiratory syndrome coronavirus 2 have progressed unprecedentedly through active support from public research grants and private-public partnership programs. Clinical studies have been actively conducted, and some vaccines are being vaccinated with approval for urgent use.The WHO has approved and supplied the Pfizer-BioNTech COVID-19 vaccine and the Oxford-AstraZeneca COVID-19 vaccine. In Korea, the Oxford-AstraZeneca vaccine was approved for urgent use, and vaccination began on February 26, 2021. In this paper, the efficacy and side effects of each vaccines and the effect on pilots and air traffic controllers related to COVID-19 vaccination were investigated in terms of aviation medicine.

Atopic dermatitis is a condition that makes skin red and itchy. It is common in children but can occur at any age. Atopic dermatitis is chronic and tends to flare periodically. The pathogenesis of the disease has not yet been clearly elucidated but genetic predisposition, immunological dysfunction, and environmental factors are presumed to be involved in the pathogenesis. In general, it is difficult to cure, but as time passes, most of them heal naturally and the symptoms disappear, but the symptoms continue to recur. So, the basic treatment is to relieve the pruritus and prevent it from reoccurring. Treatment involves avoiding things that make the condition worse, daily bathing with application of moisturizing cream afterwards, applying steroid creams when flares occur, and medications to relieve itching sensation. Steroid pills or creams based on calcineurin inhibitors may occasionally be used if other measures are not effective. When examining a pilot with atopic dermatitis, the dermatitis condition, the treatment being used, and the side effects of the medications should be considered. This case involves an otherwise healthy applicant for the 1st class medical certification who has had atopic dermatitis.

When the COVID-19 crisis hit air transport, the whole aviation industry was affected. The change in the behavior of passengers following the COVID-19 crisis, travel restrictions and the ensuing economic crisis have resulted in a dramatic drop in demand for airline services. The COVID-19 pandemic, with all its associated consequences, has had a significant impact on the mental health and well-being of pilots, which could impact operational safety. As the number of international flights has decreased, pilots are exposed to high levels of psychological stress such as job instability, reduced income and increased risk of infection during flight work. Psychological stress lowers work performance and threatens aviation safety. The pilot needs mental health management during the COVID-19 pandemic, but psychological support is weak. For pilot mental health management, it is important to raise awareness about mental health and to continuously respond. To this end, it is necessary to foster a safe and trustworthy culture in which mental health issues are discussed freely and solved together without hiding them. They should also support the establishment of a peer support program that is easily accessible and that allows pilots to discuss their issues with confidence.

Pericardial effusion and subsequent cardiac tamponade are recognized as infrequent complications of a ST-elevation myocardial infarction (STEMI) causing hemodynamic instability. The cause of pericarditis is mostly idiopathic which makes up around 90% of cases. Other causes are infections caused by viruses, bacteria or tuberculosis. Other causes could include neoplasms, a connective tissue disorder, renal failure, post-myocardial infarction (also known as Dressler syndrome), open heart surgery (also known as the postpericardiotomy syndrome) and drugs. Acute myocardial infarction is a significant cause of the pilot incapacitation. Pericardial effusion after treatment for acute myocardial infarction is a factor that worsens the prognosis. I present the case of a pilot with a STEMI which was treated with primary percutaneous coronary intervention (PCI) to proximal left circumflex artery. After PCI, the pilot went on to develop pericardial effusion with tamponade.

Since its emergence in Wuhan, China, COVID-19 has spread and had a profound effect on the lives and health of people around the globe. Most people who develop COVID-19 fully recover, but current evidence suggests approximately 10% to 20% of people experience a variety of mid- and long-term effects after they recover from their initial illness. These mid- and long-term effects are collectively known as post covid-19 condition or “long COVID”. Studies have shown that a significant number of patients complain of multiple symptoms over a period of several months or longer. The symptoms of long covid include fatigue or muscle weakness, dyspnea, cognitive impairment, and depression or anxiety. These chronic symptoms can also negatively affect aviation safety. Therefore, this review summarizes studies of the long-term effects of COVID-19, and aeromedical implications of long COVID.