THE RELATIONSHIP BETWEEN FLIGHT HOURS, AGE, AND BODY MASS INDEX AND THE OCCURRENCE OF LOW BACK PAIN AMONG COMMERCIAL FIXED-WING PILOTS IN INDONESIA DURING THE COVID-19 PANDEMIC
Keywords:
low back pain, commercial pilots, flight hours, body mass index, occupational health
Abstract
Low back pain (LBP) is a common musculoskeletal complaint among workers, including commercial airline pilots. The aviation work environment is characterized by prolonged static sitting, whole-body vibration, mild hypoxia, low cabin humidity, and individual factors such as age and body mass index (BMI), all of which may contribute to the development of LBP. This study aimed to determine the prevalence of LBP and to analyze the association between total flight hours, age, and BMI with the occurrence of LBP among commercial fixed-wing pilots in Indonesia. An analytic observational study with a cross-sectional design was conducted at the Indonesian Civil Aviation Medical Center. The study population consisted of commercial fixed-wing pilots flying pressurized aircraft who underwent routine medical examinations (MEDEX). A total of 410 pilots met the inclusion criteria and were analyzed. Data were collected using structured questionnaires and medical records, including demographic characteristics, total flight hours, BMI, and LBP assessed using the Oswestry Disability Index (ODI). Data analysis included univariate, bivariate (Chi-square test), and multivariate logistic regression analyses. The prevalence of LBP among commercial fixed-wing pilots in Indonesia was 5.85%. No significant association was found between total flight hours, age, or BMI and the occurrence of LBP (p > 0.05). However, female pilots showed a significantly higher risk of LBP compared to male pilots (OR = 6.85; 95% CI: 1.47–31.81; p = 0.01). The prevalence of LBP among commercial fixed-wing pilots in Indonesia was relatively low. Total flight hours, age, and BMI were not significantly associated with LBP, whereas sex was the most influential factor. These findings highlight the importance of gender-sensitive ergonomic and occupational health strategies in the prevention of LBP among commercial pilots.
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Rodriguez, H. A. F. & Mayorga, V. A. O. Characterization of Low Back Pain in Pilots and Maintenance Technicians on a Commercial Airline. Aerosp. Med.Hum. Perform. 87, 795– 799
(2016).
Steffens D, Maher CG, Pereira LS, Stevens ML, Oliveira VC, Chapple M, Teixeira-Salmela LF, Hancock MJ. Prevention of Low Back Pain: A Systematic Review and Meta-analysis. JAMA Intern Med. 2016 Feb;176(2):199-208.
Rik, L., De Beeck, O. & Hermans, V. Research on work-related low back disorders. (2000). Gaydos, S. J. Low back pain: Considerations for rotary-wing aircrew. Aviat. Sp. Environ. Med.
83, 879–889 (2012).
Çinar-Medeni, Ö., Güzel, N. A. & Erdogan, M. The predictors of low back painin helicopter pilots. Gazi Med. J. 26, 15–18 (2015).
Baron, R. et al. Neuropathic low back pain in clinical practice. Eur. J. Pain (United Kingdom) 20, 861–873 (2016).
Allegri, M. et al. Mechanisms of low back pain: A guide for diagnosis and therapy [version 1; referees: 3 approved]. F1000Research 5, 1–11 (2016).
Khrisnapandit, I., Tapan, H., Firdos, M. & Basuki, B. Flight time, number of sectors and risk of low back pain among short and medium haul commercial female flight attendants in
Indonesia. Heal. Sci. J. Indones. 7, 64–68 (2016).
Peraturan Direktur Jenderal Perhubungan Udara Nomor KP 238 Tahun 2018 Tentang Petunjuk Teknis Peraturan Keselamatan Penerbangan Sipil Bagian 67-02 Tentang Pedoman Penilaian Kesehatan Penerbangan. (2018). Manual of Civil Aviation Medicine. (International Civil Aviation Organization, 2012).
Lee, H., Wilbur, J. & Conrad, K. M. Work-Related Musculoskeletal Symptoms Reported by Female Flight Attendants on Long-Haul Flights. 77, 1283–1287 (2006). Taneja, N. Spinal disabilities in military and civil aviators. Spine (Phila. Pa. 1976). 33, 2749–
2753 (2008).
Haugli L, Skogstad A, Hellesoy OH . Health, sleep, and mood perceptions reported by airline rews fl ying short and long hauls . Aviat Space Environ Med 1994 ; 65 : 27 – 34 .Peter A. Simpson & J. Mark Porter (2003) Flight-Related Musculoskeletal Pain and Discomfort in General Aviation Pilots From the United Kingdom and Ireland, The International Journal of Aviation Psychology, 13:3, 301-318
Prombumroong, J., Janwantanakul, P., & Pensri, P. (2011). Prevalence of and Biopsychosocial Factors Associated with Low Back Pain in Commercial Airline Pilots. Aviation, Space, and
Environmental Medicine, 82(9), 879–884.
Fajardo Rodriguez, H. A., & Ortiz Mayorga, V. A. (2016). Characterization of Low Back Pain in Pilots and Maintenance Technicians on a Commercial Airline. Aerospace Medicine and
Human Performance, 87(9), 795–799
Albermann M, Lehmann M, Eiche C, Schmidt J, Prottengeier J. Low Back Pain in Commercial Airline Pilots. Aerosp Med Hum Perform. 2020 Dec 1;91(12):940-947 Peraturan Menteri Perhubungan nomor 28 Tahun 2013 Tentang Peraturan Keselamatan
Penerbangan Sipil Bagian 121 (mengacu pada Civil Aviation Safety Regulation Part 121) Tentang Persyaratan-Persyaratan Sertifikasi Dan Operasi Bagi Perusahaan Angkutan Udara Yang Melakukan Penerbangan Dalam Negeri, Internasional Dan Angkutan Udara Niaga Tidak
Berjadwal (2013)
Snell, Richard S. ; Sugiharto, Liliana ; Ardy Suwahjo ; Yohanes Antoni Liestyawan.Anatomi Klinis Berdasarkan Sistem / Richard S. Snell; Alih Bahasa, Liliana Sugiharto; Editor, Ardy Suwahjo; Yohanes Antoni Liestyawan. .2012
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Vismara L., Menegoni F., Fabio Zaina F., Galli M., Negrini S., Capodaglio P., 2010. Effect of obesity and low back pain on spinal mobility: a cross sectional study in women. http://www.jneuroengrehab.com/content/7/1/3
Purnamasari H., 2010. Overweight Sebagai Faktor Risiko Low Back Pain Pada Pasien PoliSaraf Prof. Dr. Margono Soekarjo Purwokerto, Mandala of Health 4: 26-32. Rathjen,
T. et al. Fundamentals of Aerospace Medicine 4th Edition. Fundamentals of Aerospace Medicine (2008).
Gradwell, D. Ernsting’s Aviation and Space Medicine 5E. Ernsting’s Aviation and Space Medicine 5E (2016).
Nesthus, T. E., Rush, L. L. & Wreggit, S. S. Effects of mild hypoxia on pilot performances at general aviation altitudes. (1997).
Ma, K. et al. Mechanisms of endogenous repair failure during intervertebral disc degeneration.
Osteoarthr. Cartil. 27, 41–48 (2019).
Hiyama, A. et al. Hypoxia activates the notch signaling pathway in cells of the intervertebral disc: Implications in degenerative disc disease. Arthritis Rheum.63, 1355–1364 (2011).
Samartzis, D., Cheung, K. M. C. & Orth, F. Ionizing radiation exposure and the development of intervertebral disc degeneration in humans : myth or reality. Spine J. 11, 979–982 (2011).
Thibeault, C. & Evans, A. D. AsMA medical guidelines for air travel: Stresses of flight.
Aerosp. Med. Hum. Perform. 86, 486–487 (2015).
Reinhart, R. O. Basic flight Physiology. Mc Graw Hill (2008).
Inoue, N. & Orias, A. A. E. Biomechanic of Intervertebral Disc Degeneration. Orthop. Clin.
North Am. 42, 487–499 (2012).
Smith, L. J., Nerurkar, N. L., Choi, K. S., Harfe, B. D. & Elliott, D. M. Degeneration and regeneration of the intervertebral disc: Lessons from development. DMM Dis. Model. Mech. 4, 31–41 (2011).
BALLANTYNE, J., FISHMAN, S., & RATHMELL, J. P. Bonica's management of pain. Fifth Edition. Philadelphia : Wolters Kluwer Health, [2019]
Hall A, Maher C, Latimer J, Ferreira M, Costa L. The patient-specific functional scale is more responsive than the Roland Morris disability questionnaire when activity limitation is low.
European Spine Journal. 2010;20(1):79-86.
Nambi, S. G. (2013). Reliability, validity, sensitivity and specificity of Guajarati version of the Roland-Morris Disability Questionnaire. Journal of Back and Musculoskeletal Rehabilitation,
26(2), 149–153.
Monticone, M., Baiardi, P., Vanti, C., Ferrari, S., Pillastrini, P., Mugnai, R., & Foti, C. (2011).
Responsiveness of the Oswestry Disability Index and the Roland Morris Disability Questionnaire in Italian subjects with sub-acute and chronic low back pain. European Spine
Journal, 21(1), 122–129
Childs, J. D., Piva, S. R., & Fritz, J. M. (2005). Responsiveness of the Numeric Pain Rating Scale in Patients with Low Back Pain. Spine, 30(11), 1331–1334.
Krebs, E. E., Carey, T. S., & Weinberger, M. (2007). Accuracy of the Pain Numeric Rating Scale as a Screening Test in Primary Care. Journal of General Internal Medicine, 22(10), 1453–1458.
Chiarotto, A., Vanti, C., Cedraschi, C., Ferrari, S., de Lima e Sà Resende, F., Ostelo, R. W., & Pillastrini, P. (2016). Responsiveness and Minimal Important Change of the Pain Self- Efficacy Questionnaire and Short Forms in Patients With Chronic Low Back Pain. The Journal of Pain, 17(6), 707–718.
Fairbank, J. C. T., & Pynsent, P. B. (2000). The Oswestry Disability Index. Spine, 25(22), 2940–2953. doi:10.1097/00007632-200011150-00017
Chairani, A. Validity and Reliability Test of The Nordic Musculoskeletal Questionnaire with Formal and Informal Sector Workers. The 7th International Conference on Public Health. Solo. 2020
Panduan Praktik Klinis Neurologi. Perhimpunan Dokter Spesialis Saraf Indonesia. 2016 Foster
, Anema J, Cherkin D, Chou R, Cohen S, Gross D et al. Prevention and treatment of low back pain: evidence, challenges, and promising directions. The Lancet. 2018;391(10137):2368-2383.
Kurniawan, G. P. D. Mckenzie Excercise dalam Penurunan Disabilitas Pasien Non-Specific Low Back Pain. Jurnal Kesehatan Vol. 10 No. 1, Mei 2019
Published
2026-02-14
How to Cite
Parmadi Komalajaya. (2026). THE RELATIONSHIP BETWEEN FLIGHT HOURS, AGE, AND BODY MASS INDEX AND THE OCCURRENCE OF LOW BACK PAIN AMONG COMMERCIAL FIXED-WING PILOTS IN INDONESIA DURING THE COVID-19 PANDEMIC. Jurnal Penelitian Progresif, 5(1), 194-201. https://doi.org/10.61992/jpp.v5i1.323
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