大腸激躁症之航空醫學考量及缺點免計探討

大腸激躁症為功能性胃腸疾病，其症狀如腹痛、腹脹、持續或急切的便意、排便習慣改變，在飛行途中都極易影響飛行員執行任務的能力，進而影響飛航安全。大腸激躁症具有症狀變異性高、病程難以預測、壓力為誘發因素、無法根治之特性，使得罹病飛行員的缺點免計裁量成為一大挑戰。本文就我國空軍及美國空軍、海軍航醫教範、美國民航局（FAA）、英國民航局（CAA）體檢指引做比較。根據我國航空醫務教範，罹患大腸激躁症即為空勤體位不合格；然透過飲食及行為治療達到疾病可控範圍之人員，能否申請缺點免計，於我國教範中尚無相關討論與規定。國外教範及文獻中，除美國空軍I／IA類空勤人員罹患大腸激躁症將判定為體位不合格之外，其他則多半認為，症狀輕微可用飲食或非藥物控制者，可予以缺點免計。

關鍵字

大腸激躁症；飛行失能；缺點免計；航空醫學考量

並列摘要

Irritable bowel syndrome (IBS) is a functional disorder of gastrointestinal system. It may cause symptoms like abdominal pain, bloating, persistency, urgency in evacuation and altered bowel habits. All these discomforts can affect pilots' capability during flight and thus put aviation safety in danger. Moreover, IBS features highly variable symptoms, unpredictable courses, and may be precipitated by stress. Therefore, aeromedical concerns and waiver requests IBS pilots becomes a big challenge. We reviewed waiver guides on bowel-related diseases in military (R.O.C. and U.S.) and civilian sectors (FAA and CAA). According to R.O.C Air Force aeromedical guideline, pilots will be disqualified after being diagnosed with IBS, whether the disease is controllable or not after diet modification and behavior therapy. US Air Force wavier guide suggests disqualifying IBS pilots in class I/IA air crew, while for II/III class there is still some room for wavier in flyers with minor symptoms and controllable with diet.

並列關鍵字

irritable bowel syndrome ； in-flight incapacitation ； waiver ； aeromedical consideration

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