Authors' objectives: To determine whether there is evidence to support a (causal) association between the development or acceleration of degenerative disc disease (DDD) and work as a helicopter pilot.

Authors' results and conclusions: In May 2016, the Evidence Based Practice Group (EBPG), conducted a systematic review investigating the causal association between the development or acceleration of DDD and work as a helicopter pilot. At that time, we found that there is no data to support the causal association between working as a helicopter pilot and the development or acceleration of cervical DDD. We updated this systematic review in November 2024. In this update, we did not find any new published, peer-reviewed, primary study that may be relevant to assess such a causal association. However, in this update we found two5,8, non-peer-reviewed, documents that were relevant to our objective. One5 of these documents provided guidelines on the entitlement eligibility of cervical disease condition, including cervical degenerative disc disease, among helicopter or high-performance aircraft pilots. However, this guideline did not provide any evidence of such potential (causal) associations between being a helicopter or higher performance aircraft pilot and developing cervical DDD. The other non-peer-reviewed document, in the form of a relatively good retrospective cohort study (level of evidence 2. Appendix 1), provided some data demonstrating that there was no difference with regard to the incidence of displacement of a lumbar disc, degenerative lumbar disc, cervical disc displacement, displacement lumbar intervertebral disc without myelopathy and degeneration of lumbar or lumbosacral intervertebral disc in helicopter/tiltrotor pilot compared to non-pilot officers or fixed-wing pilots.

Authors' methods: A comprehensive systematic literature search was conducted on May 24 and 25, 2016. The literature search was done on commercial medical literature databases by employing combination of key words. No limitations, such as on date or language of publication, were employed in this review. The websites of Veteran Affairs Canada (http://www.veterans.gc.ca/eng) and the United States Department of Veterans Affairs (http://www.va.gov/) were also searched on May 24, 2016, for any relevant policy/policies pertaining to the acceptance of claims associated with the development or acceleration of degenerative disc disease among helicopter pilots. Manual searches were also conducted on the references of the five articles that were retrieved in full. Five more studies were identified and fully retrieved for further appraisal. By following the same methodology, we updated the literature search of this systematic review on November 18, 2024.

Project Status: Completed

URL for project: https://www.worksafebc.com/en/about-us/research-services/evidence-based-medicine-and-systematic-reviews

Year Published: 2024

URL for published report: https://www.worksafebc.com/en/resources/health-care-providers/guides/risk-factors-degenerative-disc-disease-helicopter-pilots-first-update?lang=en

English language abstract: An English language summary is available

Publication Type: Mini HTA

Country: Canada

Organisation Name: WorkSafeBC

Contact Address: 6591 Westminster Highway, Richmond, BC, V7C 1C6 Canada. Tel: 604-231-8417; Fax: 604-279-7698

Contact Name: ebpg@worksafebc.com

Contact Email: ebpg@worksafebc.com

Copyright: WorkSafe BC