Ann Rehabil Med.  2013 Oct;37(5):706-712. 10.5535/arm.2013.37.5.706.

Degenerative Changes of Spine in Helicopter Pilots

• Byeon JH
• Kim JW
• Jeong HJ
• Sim YJ
• Kim DK
• Choi JK
• Im HJ
• Kim GC

• KMID: 2266589
• DOI: http://doi.org/10.5535/arm.2013.37.5.706

Abstract

OBJECTIVE
To determine the relationship between whole body vibration (WBV) induced helicopter flights and degenerative changes of the cervical and lumbar spine.
METHODS
We examined 186 helicopter pilots who were exposed to WBV and 94 military clerical workers at a military hospital. Questionnaires and interviews were completed for 164 of the 186 pilots (response rate, 88.2%) and 88 of the 94 clerical workers (response rate, 93.6%). Radiographic examinations of the cervical and the lumbar spines were performed after obtaining informed consent in both groups. Degenerative changes of the cervical and lumbar spines were determined using four radiographs per subject, and diagnosed by two independent, blinded radiologists.
RESULTS
There was no significant difference in general and work-related characteristics except for flight hours and frequency between helicopter pilots and clerical workers. Degenerative changes in the cervical spine were significantly more prevalent in the helicopter pilots compared with control group. In the cervical spine multivariate model, accumulated flight hours (per 100 hours) was associated with degenerative changes. And in the lumbar spine multivariate model, accumulated flight hours (per 100 hours) and age were associated with degenerative changes.
CONCLUSION
Accumulated flight hours were associated with degenerative changes of the cervical and lumbar spines in helicopter pilots.

Keyword

Vibration; Spine; Degenerative changes; Aircraft

MeSH Terms

Aircraft*
Hospitals, Military
Humans
Informed Consent
Military Personnel
Spine*
Vibration
Surveys and Questionnaires

Reference

1. Griffin MJ. Handbook of human vibration. 1st ed. London: Academic Press;1990.

2. Seidel H. Selected health risks caused by long-term, whole-body vibration. Am J Ind Med. 1993; 23:589–604. PMID: 8480768.

3. Ishitake T, Miyazaki Y, Ando H, Matoba T. Suppressive mechanism of gastric motility by whole-body vibration. Int Arch Occup Environ Health. 1999; 72:469–474. PMID: 10541912.

4. Staines WR, McIlroy WE, Brooke JD. Cortical representation of whole-body movement is modulated by proprioceptive discharge in humans. Exp Brain Res. 2001; 138:235–242. PMID: 11417464.

5. Cohen R. Injuries caused by physical hazards. In : LaDou J, editor. Current occupational and environmental medicine. 3rd ed. New York: McGraw-Hill;2004. p. 122–151.

6. Alund M, Larsson SE, Lewin T. Work-related persistent neck impairment: a study on former steelworks grinders. Ergonomics. 1994; 37:1253–1260. PMID: 8050409.

7. Langauer-Lewowicka H, Harazin B, Brzozowska I, Szlapa P. Evaluation of health risk in machine operators exposed to whole body vibration. Med Pr. 1996; 47:97–106. PMID: 8657008.

8. Walker-Bone K, Palmer KT. Musculoskeletal disorders in farmers and farm workers. Occup Med (Lond). 2002; 52:441–450. PMID: 12488514.

9. Hart SG. Helicopter human factors. In : Wiener EL, Nagel DC, editors. Human factors in aviation. San Diego: Academic Press;1988. p. 591–638.

10. Hansen OB, Wagstaff AS. Low back pain in Norwegian helicopter aircrew. Aviat Space Environ Med. 2001; 72:161–164. PMID: 11277279.

11. Lopez-Lopez JA, Vallejo P, Rios-Tejada F, Jimenez R, Sierra I, Garcia-Mora L. Determination of lumbar muscular activity in helicopter pilots: a new approach. Aviat Space Environ Med. 2001; 72:38–43. PMID: 11194992.

12. De Oliveira CG, Nadal J. Transmissibility of helicopter vibration in the spines of pilots in flight. Aviat Space Environ Med. 2005; 76:576–580. PMID: 15945403.

13. Pelham TW, White H, Holt LE, Lee SW. The etiology of low back pain in military helicopter aviators: prevention and treatment. Work. 2005; 24:101–110. PMID: 15860899.

14. Ang B, Harms-Ringdahl K. Neck pain and related disability in helicopter pilots: a survey of prevalence and risk factors. Aviat Space Environ Med. 2006; 77:713–719. PMID: 16856356.

15. Schall DG. Non-ejection cervical spine injuries due to +Gz in high performance aircraft. Aviat Space Environ Med. 1989; 60:445–456. PMID: 2730489.

16. Hamalainen O, Vanharanta H, Kuusela T. Degeneration of cervical intervertebral disks in fighter pilots frequently exposed to high +Gz forces. Aviat Space Environ Med. 1993; 64:692–696. PMID: 8368981.

17. Bridger RS, Groom MR, Jones H, Pethybridge RJ, Pullinger N. Task and postural factors are related to back pain in helicopter pilots. Aviat Space Environ Med. 2002; 73:805–811. PMID: 12182222.

18. Petren-Mallmin M, Linder J. Cervical spine degeneration in fighter pilots and controls: a 5-yr follow-up study. Aviat Space Environ Med. 2001; 72:443–446. PMID: 11346010.

19. Aydog ST, Turbedar E, Demirel AH, Tetik O, Akin A, Doral MN. Cervical and lumbar spinal changes diagnosed in four-view radiographs of 732 military pilots. Aviat Space Environ Med. 2004; 75:154–157. PMID: 14960051.

20. Thomae MK, Porteous JE, Brock JR, Allen GD, Heller RF. Back pain in Australian military helicopter pilots: a preliminary study. Aviat space Environ Med. 1998; 69:468–473. PMID: 9591616.

21. De Oliveira CG, Simpson DM, Nadal J. Lumbar back muscle activity of helicopter pilots and whole-body vibration. J Biomech. 2001; 34:1309–1315. PMID: 11522310.

22. Bovenzi M, Hulshof CT. An updated review of epidemiologic studies on the relationship between exposure to whole-body vibration and low back pain (1986-1997). Int Arch Occup Environ Health. 1999; 72:351–365. PMID: 10473835.

23. Lings S, Leboeuf-Yde C. Whole-body vibration and low back pain: a systematic, critical review of the epidemiological literature 1992-1999. Int Arch Occup Environ Health. 2000; 73:290–297. PMID: 10963411.

24. Cheung WS, Byeon JH. Measurements of whole-body vibration exposed from and their UH60-helicopter analysis results. Trans Korean Soc Noise Vibr Eng. 2005; 15:1327–1331.

25. Internatinal Diabetes Institute. World Health Organization. The Asia-Pacific perspective: redefining obesity and its treatment. Balmain: Health Communications Australia;2000.

26. Mimura M, Panjabi MM, Oxland TR, Crisco JJ, Yamamoto I, Vasavada A. Disc degeneration affects the multidirectional flexibility of the lumbar spine. Spine (Phila Pa 1976). 1994; 19:1371–1380. PMID: 8066518.

27. Silberstein CE. The evolution of degenerative changes in the cervical spine and an investigation into the "Joints of Luschka". Clin Orthop Relat Res. 1965; 40:184–204. PMID: 14304709.

28. Cote P, van der Velde G, Cassidy JD, Carroll LJ, Hogg-Johnson S, Holm LW, et al. The burden and determinants of neck pain in workers: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Spine (Phila Pa 1976). 2008; 33(4 Suppl):S60–S74. PMID: 18204402.

29. Bongers PM, Hulshof CT, Dijkstra L, Boshuizen HC, Groenhout HJ, Valken E. Back pain and exposure to whole body vibration in helicopter pilots. Ergonomics. 1990; 33:1007–1026. PMID: 2147003.

30. Froom P, Froom J, Van Dyk D, Caine Y, Ribak J, Margaliot S, et al. Lytic spondylolisthesis in helicopter pilots. Aviat Space Environ Med. 1984; 55:556–557. PMID: 6466252.

31. Landau DA, Chapnick L, Yoffe N, Azaria B, Goldstein L, Atar E. Cervical and lumbar MRI findings in aviators as a function of aircraft type. Aviat Space Environ Med. 2006; 77:1158–1161. PMID: 17086770.

32. Viikari-Juntura E, Riihimaki H, Tola S, Videman T, Mutanen P. Neck trouble in machine operating, dynamic physical work and sedentary work: a prospective study on occupational and individual risk factors. J Clin Epidemiol. 1996; 47:1411–1422. PMID: 7730850.

33. Ariens GA, van Mechelen W, Bongers PM, Bouter LM, van der Wal G. Physical risk factors for neck pain. Scand J Work Environ Health. 2000; 26:7–19. PMID: 10744172.

34. Ashrafiuon H, Alem NM, McEntire BJ. Effects of weight and center of gravity location of head-supported devices on neck loading. Aviat Space Environ Med. 1997; 68:915–922. PMID: 9327117.

35. Thuresson M, Ang B, Linder J, Harms-Ringdahl K. Neck muscle activity in helicopter pilots: effect of position and helmet-mounted equipment. Aviat Space Environ Med. 2003; 74:527–532. PMID: 12751581.

36. Hagberg M. Occupational musculoskeletal stress and disorders of the neck and shoulder: a review of possible pathophysiology. Int Arch Occup Environ Health. 1984; 53:269–278. PMID: 6368402.

37. Ariens GA, Bongers PM, Douwes M, Miedema MC, Hoogendoorn WE, van der Wal G, et al. Are neck flexion, neck rotation, and sitting at work risk factors for neck pain? Results of a prospective cohort study. Occup Environ Med. 2001; 58:200–207. PMID: 11171934.

38. Seidel H. On the relationship between whole-body vibration exposure and spinal health risk. Ind Health. 2005; 43:361–377. PMID: 16100914.