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KORENG
  • 원저2001-03-01

    대한민국 공군 조종사의 건강관련 체력검사의 규준지향 기준설정

    Chan Kim,M.D., Ph.D., Dong-Won Kim,M.D., Ph.D.,Soo-Jin Lee,M.D., Ph.D., Jae-Hwan Pyo, Chul-Hyun Kim,Jun-WonJi, and Seung-Cheol Ahn, M.D., Ph.D.
    Korean J Aerosp Environ Med 2001; 11(1): 13-19

    Abstract : Background : The present study is undertaken to acquire normative data of health-related physical fitness (HRPF) of Republic of Korea Air Force (ROKAF) aircrews and to provide norm-referenced standard of HRPF. Methods: From 15 May 1998 through 14 December 1999, 1284 KAF pilots are checked muscular strength, muscular endurance, flexibility, and body fat percentage. Result : The grip strength was relatively maintained, but flexibility, back strength, and muscular endurance were declined according to promotion and aging. And the incidence of obesity determined by bioelectrical impedence analysis was higher than that assessed on the basis of height and weight. Conclusion : It is suggested that many pilots who were normal in BMI have abdominal or visceral obesity. Further studies must be made on the health promotion program for the pilots, on the changes in physical fitness, and on the criterion-referenced standard of HRPF of the pilots.

  • Review2011-12-01

    Malignant Melanoma in Pilots and Aircrew

    Jeongku Lim
    Korean J Aerosp Environ Med 2011; 21(3): 51-55

    Abstract : Malignant melanoma is a malignant tumor of melanocyte, its incidence has been steadily increasing in the past several decades. It accounts for 160,000 new cases annually, with slightly more occuring in women than in men. Since it is common in circrew compared to general population, many studies have been done to figure out the development mechanism. Although its incidece in Korea is not high, it is important that we should understand and prevent it. The pilot with malignant melanoma was grounded in the past. But, recently they can fly according to their clinical stage.

  • 원저2013-04-01

    공사 생도의 신체검사 및 진료실태분석을 통한 건강관리향상방안 연구

    Jung-Suk Jang, M.D., Jung-Hwa Son, B.S., Hyun-Ju Cho, B.S.
    Korean J Aerosp Environ Med 2013; 23(1): 5-11

    Abstract : In this paper the authors analyzed ROKAF airforce academy cadets health problems through data of physical examination, outpatients and hospitalized patients from 2009 to 2011 in Aerospace medical center. As results, data on status of pass or fail in flight registration was analyzed. Among 29 disqualified cadets, 17 cases of failure were due to ametropia (41.3%) and 5 cases were pneumothorax (17.5%). During the previous 3 years, there have been 1,275 medical treatments for outpatients; 242 cases of treatments for colds (18.5%), 173 for ankle sprain (13.56%), 82 for habitual ligament injury (6.43%) and 67 for Lumbar sprain (5.25%). We found that musculoskeletal disease is one of frequently occurred disease and it occupies a high portion, 35.4%. For the 3 years, 146 patients were hospitalized; 30 cases of pharyngitis (20.5%), 27 cases of influenza (18.4%). URI and colds take 38.9% with 57 cases in a sum. In conclusion, we suggest that customized healthcare education and health consults for cadets are practically required. And for prevention of frequent occurred musculoskeletal diseases from ankle, knee and lumbar spine, an enough stretching before action is to be preceded and proper helath educationis to be delivered in regular life. Lastly, for the health improvement of cadets an increasing effort of tailored health care education for each cadet is needed.

  • Original Article2017-12-31

    민간 항공사 운항승무원 비행휴 현황(2016)

    Yeo Jeong Yun, R.N.
    Korean J Aerosp Environ Med 2017; 27(3): 72-75

    Abstract : Good health is an essential element for pilots responsible for the flight safety. Airline issue sick leave to pilots who are not medically qualified to perform his/her professional aviation duty because of diseases. The goal of this study was to review sick leave rate and understand the main diseases of sick leave among airline pilots in 2016. This study analyzed the sick leave data registered electronic medical record system in the aeromedical center of an airline from January 1, 2016 to December 31, 2016. The total cases of sick leave in 2016 were 2,204. The statistics showed the average rate of sick leave per 1,000 pilots in 2016 were 16. The frequency rate and severity rate of sick leave were 0.6 and 4.9. The organ systems with the highest prevalence of disease were the respiratory system (45.6%), digestive system (26.4%), and musculoskeletal system (14.1%), while those with the longest associated sick leave periods were the musculoskeletal system (28.0%), respiratory system (22.5%), and digestive system (18.4%).

  • Original Article2020-04-30

    민간 항공기 운항승무원의 건강문제 분석(2016~2018)

    Ji Seon Kim , R.N., Yun Young Choi , R.N., M.P.H.
    Korean J Aerosp Environ Med 2020; 30(1): 34-39 https://doi.org/10.46246/KJAsEM.30.1.34

    Abstract : The medical fitness of pilots is part of the civil aviation safety scenery. This study aimed to analyze the health problems occurring among Korean commercial pilots. Three data sources were used to identify the health problems: 7,574 aviation medical examination data, 5,400 sick leaves and 39 cases of a decrease in medical fitness during flight duty period and layover of Korean commercial pilots who have been working for K airline from Jan. 1, 2016 to Dec. 31, 2018. This study was retrospectively analyzed using SPSS 22 statistical program. Waiver of medical certificates was an average 11.9% of total issuance for 3 years, with a denial of 0.1%. The leading cause of denial of medical certificates was predominantly of cardiovascular cause (55.6%). Mild respiratory and digestive disease accounted for 82% of total sick prevalence and 68% of total sick days. The psychiatric and cardiovascular disease were ranked high according to the number of days lost per case. The most common cause of decrease in medical fitness during flight duty period was acute abdominal pain (36.4%) and musculoskeletal disorder (40%) when staying abroad. Aeromedical emphasis on minimizing cardiovascular risk remains appropriate. Major pilot health problems identified in this study should be considered in establishing pilot health promotion programs for aviation safety.

Journal Info

The Korean Journal of Aerospace and Environmental Medicine
March 2023
Vol.33 No.1

pISSN 1738-2548
eISSN 2713-9972

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Editorial Office

Most Articles

KORENG
  • Original Article2021-08-31

    Fatigue and Associated Factors among Airline Pilots

    Abstract : Purpose: This study aimed to identify the prevalence of fatigue and its associated factors leading to the fatigue among Korean commercial airline pilots. Methods: An anonymous, web-based questionnaire collecting data on sleep related characteristics was completed by airline pilots. The final 1,029 samples of completed questionnaires were analyzed. The association of the risk factors with fatigue was determined using logistic regression analysis. Results: The prevalence of fatigue was 60% (Fatigue Severity Scale index≥3.2), disturbed sleep 28% (Pittsburgh Sleep Quality Index≥9), daytime sleepiness 17% (Epworth Sleepiness Scale≥10), and sleep apnea (Berlin Questionnaire≥2) 11%. The fully adjusted logistic regression showed that quality of life (odds ratio [OR]=0.16, confidence interval [CI]=0.11–0.24), daytime sleepiness (OR=1.26, CI=1.18–1.34), sleep quality (OR=1.44, CI=1.29–1.61), mental workload (OR=1.10, CI=1.05–1.14), vigorous physical activity (OR=0.82, CI=0.72–0.92), late starts (OR=1.25, CI=1.06– 1.46) and average weekly flying hours (OR=1.02, CI=1.00–1.03) were associated with higher levels of fatigue. Conclusion: Lower quality of life, disturbed sleep, more subjective sleepiness, shorter sleep duration, higher mental workload, less vigorous physical activity, frequent late starts, and longer flying hour were shown to be risk factors for fatigue in airline pilots. These findings should be taken into account in the development of sleep and fatigue countermeasures for airline pilots.

  • Original Article2022-04-30

    Epidemiological Aspects of Hepatitis E Virus Infections between South Korea and Japan

    Abstract : Purpose: Hepatitis E outbreaks are a serious public health concern in the world. The pilots or air traffic controllers can be incapacitated by severe hepatitis symptoms. If the symptoms of acute hepatitis do not improve, it is not suitable for aviation duties. In this study, we compare of incidence status of hepatitis E virus (HEV) infections, and epidemic aspects between South Korea (from here on, ‘Korea’) and Japan. Methods: The raw data on confirmed of HEV infection cases were obtained from the National Notified Disease Surveillance System of Korea Diseases Control and Prevention Agency, the Ministry of Health and Welfare in Korea, and the National Epidemiological surveillance of Infectious Diseases surveillance system, administered by the National Institute of Infectious Diseases in Japan. Statistically significant differences between the epidemiological aspects and risk factors were determined using the Pearson’s chi-squared test or paired t-test. All data analyses were performed in Microsoft Excel 2010 (Microsoft, Redmond, WA, USA). Results: There were 191 cases of HEV infected cases with a prevalence rate (PR) of 0.37 per 100,000 populations of Korea in 2020. During the same year in Japan, there were 454 cases with a PR of 0.36. When compared, there is statistically none significantly differences. Moreover, both PR per 100,000 populations of HEV infections in habitat of two countries were compared, in the provinces (0.39) of Korea were much higher than that in capital city of Seoul (0.27; P

  • Original Article2021-08-31

    Comparative Observation of Body Mass Index among Adults in Korea and Japan

    Abstract : Background: Obesity is a major public health problem that is causally related to serious medical conditions. In this study, the public health implications of obesity based on body mass index (BMI) with anthropometric measures among adults in the Republic of Korea and Japan in 2019 were compared. Methods: A simple cross-section, nationally representative of the raw data from the National Health and Nutrition Examination Survey in 2019 between Korea and Japan were used. We analyzed the data of those categorized as obese with a BMI of ≥25 kg/ m2 according to the World Health Organization Expert Consultation. Results: The average values of BMI based on body height and body weight among males and females in Korea were 24.6±0.08 and 23.3±0.09, respectively; those in Japan were 23.9±0.08 and 22.6±0.08, respectively. The measured anthropometric values were obviously higher in Korean than in Japan (P

  • Case Report2021-08-31

    아토피성 피부염을 가진 조종사의 판정 증례보고

    Abstract : Atopic dermatitis is a condition that makes skin red and itchy. It is common in children but can occur at any age. Atopic dermatitis is chronic and tends to flare periodically. The pathogenesis of the disease has not yet been clearly elucidated but genetic predisposition, immunological dysfunction, and environmental factors are presumed to be involved in the pathogenesis. In general, it is difficult to cure, but as time passes, most of them heal naturally and the symptoms disappear, but the symptoms continue to recur. So, the basic treatment is to relieve the pruritus and prevent it from reoccurring. Treatment involves avoiding things that make the condition worse, daily bathing with application of moisturizing cream afterwards, applying steroid creams when flares occur, and medications to relieve itching sensation. Steroid pills or creams based on calcineurin inhibitors may occasionally be used if other measures are not effective. When examining a pilot with atopic dermatitis, the dermatitis condition, the treatment being used, and the side effects of the medications should be considered. This case involves an otherwise healthy applicant for the 1st class medical certification who has had atopic dermatitis.

  • Review Article2021-08-31

    4차 산업혁명 시대의 CRM: 인간과 자율 시스템의 협업 관점에서

    Abstract : In the era of the 4th industrial revolution, the aviation industry is also growing remarkably with the development of artificial intelligence and networks, so it is necessary to study a new concept of crew resource management (CRM), which is required in the process of operating state-of-the-art equipment. The automation system, which has been treated only as a tool, is changing its role as a decision-making agent with the development of artificial intelligence, and it is necessary to set clear standards for the role and responsibility in the safety-critical field. We present a new perspective on the automation system in the CRM program through the understanding of the autonomous system. In the future, autonomous system will develop as an agent for human pilots to cooperate, and accordingly, changes in role division and reorganization of regulations are required.

  • Case Report2021-08-31

    말초성 어지럼 및 이명: 증례보고 및 항공의학적 고찰

    Abstract : Aviation medical examiners should always keep two principles in mind when evaluating patients with vertigo: Does this disease render him or her incapacitated? And does this disease recur? Meniere's disease accompanies vertigo and hearing symptoms such as hearing loss and tinnitus and is particularly important because it can render the patient incapacitated and has recurrent consequences. In this case, we intended to investigate the course of a patient who was evaluated with symptoms of dizziness and tinnitus and to review the patient's judgment result according to the principles of aeromedical evaluation.

  • Review Article2021-12-31

    기내 심폐소생술과 COVID-19

    Abstract : As the number of passengers using aircraft increases around the world, there may be more medical measures needed within the aircraft. These medical measures may also include measures against serious situations such as cardiopulmonary resuscitation (CPR). However, since the environment is different from the hospital in the aircraft, it may be difficult to cope with such a situation. Moreover, such in-flight CPR may become more difficult at a time when the proportion of out-of-hospital CPR is decreasing due to the recent COVID-19 pandemic. In this paper, I would like to summarize how in-flight CPR is performed and review the main discussions on CPR in the COVID-19 pandemic, and finally suggest how to perform a safe CPR in the COVID-19 situation.

Most Articles
KORENG
  • Review Article2020-04-30

    한국형 기내 의학적 상황 대처 방안 안내서

    Abstract : As the number of passengers using aircraft increases around the world, there may be more medical measures needed within the aircraft. These medical measures may also include measures against serious situations such as cardiopulmonary resuscitation (CPR). However, since the environment is different from the hospital in the aircraft, it may be difficult to cope with such a situation. Moreover, such in-flight CPR may become more difficult at a time when the proportion of out-of-hospital CPR is decreasing due to the recent COVID-19 pandemic. In this paper, I would like to summarize how in-flight CPR is performed and review the main discussions on CPR in the COVID-19 pandemic, and finally suggest how to perform a safe CPR in the COVID-19 situation.

  • Original Article2022-04-30

    Epidemiological Aspects of Hepatitis E Virus Infections between South Korea and Japan

    Abstract : As the number of passengers using aircraft increases around the world, there may be more medical measures needed within the aircraft. These medical measures may also include measures against serious situations such as cardiopulmonary resuscitation (CPR). However, since the environment is different from the hospital in the aircraft, it may be difficult to cope with such a situation. Moreover, such in-flight CPR may become more difficult at a time when the proportion of out-of-hospital CPR is decreasing due to the recent COVID-19 pandemic. In this paper, I would like to summarize how in-flight CPR is performed and review the main discussions on CPR in the COVID-19 pandemic, and finally suggest how to perform a safe CPR in the COVID-19 situation.

  • Review Article2021-04-30

    항공종사자와 코로나바이러스감염증-19 백신 예방 접종

    Abstract : As the number of passengers using aircraft increases around the world, there may be more medical measures needed within the aircraft. These medical measures may also include measures against serious situations such as cardiopulmonary resuscitation (CPR). However, since the environment is different from the hospital in the aircraft, it may be difficult to cope with such a situation. Moreover, such in-flight CPR may become more difficult at a time when the proportion of out-of-hospital CPR is decreasing due to the recent COVID-19 pandemic. In this paper, I would like to summarize how in-flight CPR is performed and review the main discussions on CPR in the COVID-19 pandemic, and finally suggest how to perform a safe CPR in the COVID-19 situation.

  • Original Article2020-04-30

    항공종사자 건강증진활동계획에 반영되어야 할 근거자료: 3년간의 항공신체검사 결과 분석

    Abstract : As the number of passengers using aircraft increases around the world, there may be more medical measures needed within the aircraft. These medical measures may also include measures against serious situations such as cardiopulmonary resuscitation (CPR). However, since the environment is different from the hospital in the aircraft, it may be difficult to cope with such a situation. Moreover, such in-flight CPR may become more difficult at a time when the proportion of out-of-hospital CPR is decreasing due to the recent COVID-19 pandemic. In this paper, I would like to summarize how in-flight CPR is performed and review the main discussions on CPR in the COVID-19 pandemic, and finally suggest how to perform a safe CPR in the COVID-19 situation.

  • Original Article2020-08-31

    최근 5년간 국적항공사 조종사의 항공신체검사 부적합 판정결과

    Abstract : As the number of passengers using aircraft increases around the world, there may be more medical measures needed within the aircraft. These medical measures may also include measures against serious situations such as cardiopulmonary resuscitation (CPR). However, since the environment is different from the hospital in the aircraft, it may be difficult to cope with such a situation. Moreover, such in-flight CPR may become more difficult at a time when the proportion of out-of-hospital CPR is decreasing due to the recent COVID-19 pandemic. In this paper, I would like to summarize how in-flight CPR is performed and review the main discussions on CPR in the COVID-19 pandemic, and finally suggest how to perform a safe CPR in the COVID-19 situation.

  • Review Article2021-04-30

    말초성 어지럼의 이해 및 항공업무 적합성 평가

    Abstract : As the number of passengers using aircraft increases around the world, there may be more medical measures needed within the aircraft. These medical measures may also include measures against serious situations such as cardiopulmonary resuscitation (CPR). However, since the environment is different from the hospital in the aircraft, it may be difficult to cope with such a situation. Moreover, such in-flight CPR may become more difficult at a time when the proportion of out-of-hospital CPR is decreasing due to the recent COVID-19 pandemic. In this paper, I would like to summarize how in-flight CPR is performed and review the main discussions on CPR in the COVID-19 pandemic, and finally suggest how to perform a safe CPR in the COVID-19 situation.

  • Review Article2021-04-30

    COVID-19 감염증이 호흡기 알레르기 질환에 미치는 영향

    Abstract : As the number of passengers using aircraft increases around the world, there may be more medical measures needed within the aircraft. These medical measures may also include measures against serious situations such as cardiopulmonary resuscitation (CPR). However, since the environment is different from the hospital in the aircraft, it may be difficult to cope with such a situation. Moreover, such in-flight CPR may become more difficult at a time when the proportion of out-of-hospital CPR is decreasing due to the recent COVID-19 pandemic. In this paper, I would like to summarize how in-flight CPR is performed and review the main discussions on CPR in the COVID-19 pandemic, and finally suggest how to perform a safe CPR in the COVID-19 situation.

Most Articles
KORENG
  • Original Article2021-08-31

    Fatigue and Associated Factors among Airline Pilots

    Abstract : Purpose: This study aimed to identify the prevalence of fatigue and its associated factors leading to the fatigue among Korean commercial airline pilots. Methods: An anonymous, web-based questionnaire collecting data on sleep related characteristics was completed by airline pilots. The final 1,029 samples of completed questionnaires were analyzed. The association of the risk factors with fatigue was determined using logistic regression analysis. Results: The prevalence of fatigue was 60% (Fatigue Severity Scale index≥3.2), disturbed sleep 28% (Pittsburgh Sleep Quality Index≥9), daytime sleepiness 17% (Epworth Sleepiness Scale≥10), and sleep apnea (Berlin Questionnaire≥2) 11%. The fully adjusted logistic regression showed that quality of life (odds ratio [OR]=0.16, confidence interval [CI]=0.11–0.24), daytime sleepiness (OR=1.26, CI=1.18–1.34), sleep quality (OR=1.44, CI=1.29–1.61), mental workload (OR=1.10, CI=1.05–1.14), vigorous physical activity (OR=0.82, CI=0.72–0.92), late starts (OR=1.25, CI=1.06– 1.46) and average weekly flying hours (OR=1.02, CI=1.00–1.03) were associated with higher levels of fatigue. Conclusion: Lower quality of life, disturbed sleep, more subjective sleepiness, shorter sleep duration, higher mental workload, less vigorous physical activity, frequent late starts, and longer flying hour were shown to be risk factors for fatigue in airline pilots. These findings should be taken into account in the development of sleep and fatigue countermeasures for airline pilots.

  • Original Article2021-12-31

    5년간의 미국 이민 비자 신체검사 결과 분석

    Abstract : Purpose: The United States of America have pre-migration screening program are mandated through legislation. The one of purpose of this program is to prevent the importation of certain communicable diseases. Examinations of migration applicants are performed by panel physicians who are licensed physicians in the countries of origin that have agreements with the government departments of the country of destination to undertake this activity. In recent decades, the number of US migrants has increased, however COVID-19 impacted this trend of international migrants. The Aim of this study is to examine trends of US applicants and outcomes of tuberculosis and sexual transmitted infections (STIs) screening in South Korean applicants for US visa. Methods: A total of 4,442 applicants participated in US visa health check-up in 2016 to 2020. Results: The numbers of applicant for US visa in males and females was 1,814 and 2,628. The positive results in tuberculosis and STIs screening was noted with 0.66% in nontuberculous mycobacteria (NTM), 0.03% in tuberculosis, 0.03% in gonorrhea, 0.08% in syphilis, and 0.74% in chlamydia. The age groups of 2 to 14 years showed higher positive rate (13.89%) in tuberculin skin test (TST) tests compared to the rate of interferon gamma release assay (IGRA) tests (0.44%, P

  • Case Report2021-08-31

    아토피성 피부염을 가진 조종사의 판정 증례보고

    Abstract : Atopic dermatitis is a condition that makes skin red and itchy. It is common in children but can occur at any age. Atopic dermatitis is chronic and tends to flare periodically. The pathogenesis of the disease has not yet been clearly elucidated but genetic predisposition, immunological dysfunction, and environmental factors are presumed to be involved in the pathogenesis. In general, it is difficult to cure, but as time passes, most of them heal naturally and the symptoms disappear, but the symptoms continue to recur. So, the basic treatment is to relieve the pruritus and prevent it from reoccurring. Treatment involves avoiding things that make the condition worse, daily bathing with application of moisturizing cream afterwards, applying steroid creams when flares occur, and medications to relieve itching sensation. Steroid pills or creams based on calcineurin inhibitors may occasionally be used if other measures are not effective. When examining a pilot with atopic dermatitis, the dermatitis condition, the treatment being used, and the side effects of the medications should be considered. This case involves an otherwise healthy applicant for the 1st class medical certification who has had atopic dermatitis.

  • Review Article2022-04-30

    항공 피로위험관리를 위한 생체수리적 모델 접근 방안

    Abstract : In the aviation sector, it is recommended to adopt an aviation safety management system (SMS) from international organizations (International Civil Aviation Organization, Federal Aviation Administration, etc.) and to apply a related system in each organization. Among them, fatigue management recommends fatigue risk management system (FRMS) operating as part of SMS proactive risk management. Advanced aviation organizations are developing and applying various related risk assessment techniques that consider characteristics in order to apply scientific and systematic FRMS. Among which the biomathematical fatigue model (BFM) are representative. The Bio-mathematical Model is designed to represent the level by converting it into a simple numerical score, taking into account various related factors for the measurement object. The BFM is tool to predict the level of fatigue of the crew based on scientific understanding of the factors that contribute to fatigue. The Biomathematical Model is used as a scientific approach that promotes the transition to a performance-based safety management. In this study, the recent trends and implications for the BFM developed and applied in the aviation field are to be reviewed. First, FRMS was considered within the SMS framework, then the characteristics and application methods of the BFM were examined, and finally, the direction of the development of the BFM was suggested.

  • Review Article2021-12-31

    기내 심폐소생술과 COVID-19

    Abstract : As the number of passengers using aircraft increases around the world, there may be more medical measures needed within the aircraft. These medical measures may also include measures against serious situations such as cardiopulmonary resuscitation (CPR). However, since the environment is different from the hospital in the aircraft, it may be difficult to cope with such a situation. Moreover, such in-flight CPR may become more difficult at a time when the proportion of out-of-hospital CPR is decreasing due to the recent COVID-19 pandemic. In this paper, I would like to summarize how in-flight CPR is performed and review the main discussions on CPR in the COVID-19 pandemic, and finally suggest how to perform a safe CPR in the COVID-19 situation.

  • Review Article2021-12-31

    코로나19 팬데믹과 조종사 정신건강 관리

    Abstract : When the COVID-19 crisis hit air transport, the whole aviation industry was affected. The change in the behavior of passengers following the COVID-19 crisis, travel restrictions and the ensuing economic crisis have resulted in a dramatic drop in demand for airline services. The COVID-19 pandemic, with all its associated consequences, has had a significant impact on the mental health and well-being of pilots, which could impact operational safety. As the number of international flights has decreased, pilots are exposed to high levels of psychological stress such as job instability, reduced income and increased risk of infection during flight work. Psychological stress lowers work performance and threatens aviation safety. The pilot needs mental health management during the COVID-19 pandemic, but psychological support is weak. For pilot mental health management, it is important to raise awareness about mental health and to continuously respond. To this end, it is necessary to foster a safe and trustworthy culture in which mental health issues are discussed freely and solved together without hiding them. They should also support the establishment of a peer support program that is easily accessible and that allows pilots to discuss their issues with confidence.

  • Case Report2021-08-31

    폐암 수술 후 흉막 내 미세잔류병변 판정사례

    Abstract : For nonsmall cell lung cancer (NSCLC), surgery is indicated only for stage 3 as a curative measure. Even so, there is a high risk of recurrence following stage 3 lung cancer surgery, a third (33.9%) of patients experienced a cancer recurrence mostly within 2 years after surgery. The median survival time for all stages reaches only 21.9 months. For people undergoing surgery for stage 3A NSCLC, a pre-operative course of (neoadjuvant chemotherapy) can improve survival times, by improving the resectability and lowering the risk of recurrence. Pleural metastases are frequently associated with tumors of the lung and breast. Chest radiographs and computed tomography scans of pleural metastases can present as an effusion or smooth or nodular pleural thickening. In the absence of irregular or nodular pleural thickening, it is difficult to distinguish a benign from a malignant pleural effusion. To treat lung cancer, tyrosine kinase inhibitors (TKIs) recently have been used to cope with genetic mutations, apart from cytotoxic anticancer drugs. Compared to cytotoxic drugs, they are effective, have fewer side effects, and are easy to administer. Airman must have no cancer disease to apply for Class-I medical certification. Specifically, if previously operated on cancer, the cancer should not remain in the body at present, and the disease free state should persist at least one year after all kinds of anti-cancer treatments including adjuvant chemotherapy are completed. Here, this case deals with a 41-year-old pilot who has ATP license who had stage 3A NSCLC. The pilot underwent curative lung cancer surgery (lobectomy) a year ago and showed suspicious pleural metastasis at the time of his application for certification and was still using an unauthorized TKI agent alectinib (Alecensa; Roche, Basel, Switzerland).

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