Pulmonary bullae detected during physical examinations of military pilots and aeromedical assessments

LIU Yiling; BAI Yu; SONG Wenhui; YUAN Weimin; PAN Xiangrong

doi:10.3969/j.issn.2097-1753.2025.03.005

Abstract：Objective To analyze the incidence of pulmonary bullae detected by chance in pilots who underwent annual physical examinations at our center over the past three years in order to offer recommendations about related aeromedical assessments.Methods The results of chest CT examination of 5069 military pilots who received treatment at our center between July 2020 and November 2022 were retrospectively analyzed.The rates of detection,locations and sizes of pulmonary bullae were summarized.The detection rates of pulmonary bullae were compared between aircrews of different armed forces,aircraft types,flight times and jobs.The current number of confirmed cases of pulmonary bullae and the incidence of this disease accidentally found during aircrew physical examinations were analyzed.Considerations for aeromedical assessments were determined.Results The medical examination of aircrew found that the incidence of pulmonary bullae was about 4.46％(226/5 069).The annual large-scale medical examination concluded that 6 cases were temporarily disqualified for flight,accounting for approximately 2.65％(6/226)of the total number of patients.Pulmonary bullae that ranged from over 1 to 2 cm in diameter accounted for 67.26％(152/226).The detection rate of pulmonary bullae varied depending on the types of armed forces,with the army aircrews having a rate of 6.79％(55/810),which was higher than that of aircrews from Air Force or Navy.The detection rate also varied according to types of aircraft(P=0.006,=0.001),with the transport aircraft crews having a rate of 7.22％(76/1 052),which was higher than among other crews(P=0.005,＜0.001,＜0.001).The detection rate of pulmonary bullae in the group with flight time that ranged from over 3 000 to less than 5 000 hours was 8.70％(105/1213),which was higher than in the group with flight time of ≤1 000 h and over 1 000 to 3 000 h(both P＜0.001).All these differences were statistically significant.However,no statistically significant difference was found in the detection rate of pulmonary bullae between aircrews doing different jobs(P=0.615).Conclusion Aeromedical assessments should take into account such factors as the location and size of pulmonary bullae as well as the aircraft types and jobs of aircrews.