Height and In-Flight Low Back Pain Association Among Military Helicopter Pilots

ORSELLO CA, PHILLIPS AS, RICE GM. Height and in-flight low back pain association among military helicopter pilots. Aviat Space Environ Med 2013; 84:32-7. Introduction: Low back pain (LBP) among helicopter pilots is a well-recognized problem, with prevalence ranging from 61 to over 80%. Studies indicate association with total flight hour (TFH) exposure and lack of association with height or body mass index (BMI); however, those that have excluded pilots with back injuries unrelated to flying are limited. Methods: Surveyed regarding LBP were 1028 U.S. Navy helicopter pilots. Of the 648 (63%) respondents, 83 pilots, or 12.9%, who reported nonflying related back injuries and those without necessary data were excluded, yielding N = 554. Case-control analysis was performed with logistic regression for height, BMI, and TFH on significant LBP (defined as >30% of each flight) presence versus absence with Chi-square on the median split of each and ANOVA to include airframes. Results: Height was a positive predictor for significant LBP among all subjects (OR: 1.7), with the strongest association among male pilots (OR: 2.1). BMI, THF, and airframe (H-60, TH-57, H-53, and H-46) were not associated. Discussion: These results imply that ergonomic stressors that adversely impact lumbar symmetry may be a predominant factor in LBP during flight. Significant prevalence rates may persist in the absence of design enhancements that mitigate these stressors. Height was a significant predictor for in-flight LBP among U.S. Navy helicopter pilots studied and BMI, TFHs, and airframe were not. For every 1 '' increase among male pilot height values, the odds of experiencing significant LBP in flight increased by 9.3%, with those equal/taller than median (71 in.) having over twice the odds compared with those shorter. Keywords: lumbar spine, low back pain, helicopter, predictors, military.