A 10-Year Review of Back Injury Amongst Republic of Singapore Air Force Fighter Aircrew

INTRODUCTION: Musculoskeletal back injuries pose a substantial occupational health risk to fighter aircrew, potentially leading to prolonged or permanent flying restrictions. Besides unique operational stressors like high-G forces and life support equipment weight, general population risk factors may also be associated with such injuries in fighter aircrew. METHODS: A retrospective case-control study was conducted using data obtained from Republic of Singapore Air Force F-16 and F-15 fighter aircrew between 2014-2024. Cases were defined as aircrew diagnosed with musculoskeletal back injuries resulting in restriction from high-G or flying duties (N = 26). There was a 1:3 ratio of cases to controls (N = 78) matched by gender, age, total flying hours, and platform type. Data on operational, lifestyle, and clinical variables were extracted from the annual health screening database for both groups. RESULTS: Aircrew with an elevated Body Mass Index of ≥25.0 had significantly increased odds while aircrew who regularly exercised ≥3 times/wk had significantly reduced odds for musculoskeletal back injuries. There were no significant associations between musculoskeletal back injuries and hyperlipidemia, hypertension, smoking, alcohol use, depression, or anxiety in the study. DISCUSSION: Common lifestyle factors are significantly associated with operationally relevant musculoskeletal back injuries in fighter aircrew. Understanding the interplay between general risk factors for such injuries and the unique stressors experienced by fighter aircrew will help flight surgeons develop effective preventative and management strategies for back injuries in fighter aircrew. Pong JJJ, Soh FW, See B, Low JW, Chua AQH. A 10-year review of back injury amongst Republic of Singapore Air Force fighter aircrew. Aerosp Med Hum Perform. 2026; 97(6):429-434.