Abstract Background Peer support programmes are mandated for commercial pilots in parts of Europe and increasingly promoted internationally, but case-level evidence of effectiveness remains limited. Aims To describe presenting problems in a large pilot peer support cohort, examine associations with occupational factors, and assess severity change over an episode of support. Methods We conducted a retrospective audit of 830 de-identified peer support cases from a programme serving pilots across 25 airlines in 12 European countries between 2019 and 2025. Presenting concerns were grouped into nine categories for analysis. Associations with sex, job role, and work status were examined, and severity improvement was modelled using logistic regression. Results Most cases involved male pilots, and the most common concerns were training and checks, relationships, and health-related issues. Severity decreased significantly between entry and closure, with 86% of cases improving and fewer than 1% worsening. Pilots who were unfit for work at programme entry had higher odds of improvement than those in work. Personal relationship cases had lower odds of improvement than training-related cases. Conclusions Pilots used peer support mainly for occupational, interpersonal, and health-related stressors rather than acute crisis. Peer support may act as tertiary preventive support within aviation safety systems, although some interpersonal difficulties may be less amenable to short-term peer support alone and may require additional support pathways.
Abstract Background Firefighting involves repeated exposure to traumatic and occupational stressors, increasing vulnerability to post-traumatic stress disorder (PTSD). Clarifying psychosocial factors underlying these outcomes is crucial for targeted prevention. Aims To examine associations between perceived stressors, social support, coping strategies, and PTSD symptoms among professional and volunteer firefighters in Croatia, within the Job Demands–Resources model. Methods A cross-sectional survey was conducted with 266 firefighters (44% professional). Participants completed measures of perceived occupational stressors, social support, coping, and PTSD symptoms. Non-parametric tests and regression models with robust (HC3) standard errors were applied. Results Greater perceived stressors were positively associated with PTSD, whereas social support showed a negative association. Avoidance coping was the strongest predictor (β = 0.56, 95% confidence interval [CI] [0.39, 0.74], P < 0.001; odds ratio [OR] = 6.75, 95% CI [2.79, 16.34]). Stressors were also significant (β = 0.30, 95% CI [0.19, 0.42], P < 0.001; OR = 4.64, 95% CI [1.95, 11.08]). Social support was protective (β = –0.11, 95% CI [–0.21, –0.01], P = 0.025; OR = 0.43, 95% CI [0.21, 0.87]). The stressors × support interaction was significant (β = –1.81, 95% CI [–3.55, –0.07], P = 0.042), indicating a buffering effect. Eleven percent met the clinical PTSD threshold. Perceived stressors, support, and coping jointly explained 50% of the variance (R² = 0.503). Conclusions Avoidance coping, occupational stressors, and social support jointly account for substantial variance in PTSD symptoms among firefighters. Targeting maladaptive coping and strengthening social support may foster resilience across professional and volunteer units.
Abstract Background Welding fumes contain toxic metals, such as chromium (Cr) and nickel (Ni), which pose long-term health risks, including chronic respiratory diseases and cancer. Tungsten inert gas (TIG) welding of stainless steel generates ultrafine particles of these metals. Evidence on urinary concentrations in welders is limited. Aims To assess urinary Cr and Ni concentrations in male metalworkers, according to job role and smoking habits and evaluate associations with exceeding ACGIH biological limit values (Cr: 0.7 μg/l; Ni: 5 μg/l). Methods In this cross-sectional study, 245 male metalworkers from Friuli Venezia Giulia were recruited, including 179 welders and 66 non-welders. Demographics and smoking history (pack-years) were collected during annual health surveillance. End-of-week urine samples were analysed for Cr and Ni using inductively coupled plasma mass spectrometry. Group differences were tested with non-parametric methods. Logistic regression estimated adjusted odds of exceeding biological limits. Results Welders had higher median urinary Cr and Ni than non-welders (0.75 versus 0.56 μg/l; P = 0.020 and 1.70 versus 1.10 μg/l; P = 0.0001, respectively. Half of the subjects (50.0%) exceeded the Cr limit. Welding was associated with a borderline higher odds of exceeding the Cr limit (OR = 1.71; 95% CI 0.96–3.06; P = 0.070). Age and smoking were not related to exceeding limits. Conclusions Welders are exposed to higher urinary Cr and Ni levels than non-welders, with stronger associations for Cr. Findings support the need for preventive intervention and targeted biomonitoring, particularly in TIG stainless steel welding.
Abstract Background Fast-jet pilots frequently experience high +Gz forces, leading to cervical musculoskeletal adaptations and performance impairments. The biomechanical mechanisms underlying these effects remain unclear. Understanding these biomechanical adaptations is critical to developing preventive measures and ergonomic guidelines aimed at reducing the risk of injury, maintaining pilot health and ensuring long-term operational readiness, and ultimately improving flight safety. Aims This study compared cervical muscle properties, kinematics and movement-related pain perception between fast-jet pilots and matched non-pilot controls. Methods Twenty Eurofighter pilots and 20 near-matched non-pilots participated in a cross-sectional comparative study. Muscle tone, stiffness and elasticity were measured using MyotonPRO. Cervical movements were analysed via 3D motion capture. Pain was measured by the Visual Analogue Scale. Statistical group comparisons were performed. Results No significant differences in cervical range of motion between groups were found (P > 0.05). Pilots exhibited reduced elasticity in the sternocleidomastoid and trapezius muscles (P < 0.05), suggesting neuromuscular adaptation. Increased muscle tone was observed in non-pilots (P < 0.05). Pain perception did not differ significantly (P > 0.05). Conclusions Pilots maintain normal cervical mobility, compared to non-pilots, despite high-G exposure, but altered muscle properties suggest long-term adaptations. Occupational medicine approaches, including ergonomic cockpit adjustments, targeted physiotherapy, and preventive exercise protocols, are recommended to address cervical muscle adaptations identified in this study. Such strategies could mitigate musculoskeletal strain, enhance pilot wellbeing, and sustain operational safety throughout pilots’ careers.
Abstract Background A proportion of the working population sustained COVID-19 infections due to exposures at work, but the association between persistent post-COVID symptoms and work status is unknown. Aims To describe symptoms associated with work-related COVID-19 infections, 18 months post-infection, and examine the relationship between symptoms and working status. Methods Survey data was collected from 605 respondents with accepted workers’ compensation claims in Ontario, Canada, for COVID-19 infections, 18 months after their infection. Information collected included COVID-19 symptoms in the last 4 weeks, current work status and several potential confounders. Symptom clusters were created using latent class analysis, and multinomial logistic regression examined the relationship between symptom clusters and work status. Results Four symptom clusters were identified: no symptoms (n = 349, 59%); high burden of constitutional symptoms with moderate burden of neuropsychiatric and respiratory symptoms (n = 97, 16%); low burden of constitutional symptoms with moderate burden of neuropsychiatric and respiratory symptoms (n = 100, 17%); and high burden across all symptom domains (n = 51, 9%). Compared to respondents with no symptoms, those in the high burden group across all symptoms were more likely to be not working at 18 months post-infection (OR = 4.27, 95% CI 1.77–10.29). Conclusions For a proportion of workers, COVID-19 symptoms persist following a work-related infection. Managing work disability among those with high constitutional symptoms represents an important strategy to support return-to-work.
