[Reasons for medical disqualification of Norwegian commercial pilots].
BACKGROUND: The aim of this study is to present the reasons for medical disqualification (grounding) of Norwegian commercial pilots over a twenty-year period. We have also examined the issues of whether a change has taken place in the disease spectrum and to which extent new regulations have influenced aeromedical decision making. MATERIAL AND METHODS: The material is collected from the aeromedical section's archive. Files on all grounded pilots have been reviewed and classified by age group and diagnosis and grounding rates have been calculated. RESULTS: From the study population comprising 48,229 pilot-years, 275 pilots were permanently grounded, i.e. an average grounding rate of 5.7 per 1000 pilot-years. INTERPRETATION: Over this twenty-year period, the grounding rate based on cardiovascular disease fell; this may be explained by better treatment or more lenient requirements. In the diagnostic categories neurologic, musculoskeletal and psychiatric diseases the grounding rates went up. This cannot be attributed to more stringent health requirements, but possibly to the attitudes of pilots, who have become more critical of their working environment.