Systematic review demonstrates the impact of radiation on standardized mortality ratios in pilots, indicating health selection effects in comparison to nuclear workers.
Pilots are included in the list of professions with the most serious selection for health reasons, and therefore the standardized mortality ratio (SMR) indexes for them and the corresponding levels of the “Healthy worker effect” (HWE) can be considered as reference, despite the fact that this professional group is exposed to chronic radiation exposure due to cosmic radiation, which includes a significant proportion of protons and neutrons. A systematic review, combined analyzes (by means of samples) and meta-analysis of papers for SMR estimation for all causes and all cancer mortality for pilots were conducted; final samples included 16 and 13 publications. The presence of HWE was judged based on the fact that the upper limit of the 95% confidence interval (CI) for SMR should be
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A.N. Koterov (2025) studied this question.
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