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Paul S. Rostykus, MD, MPH; Peter Cummings, MD, MPH; Beth A. Mueller, DrPH

JAMA. 1998;280:997-999.

Context.— Most pilots survive airplane crash landings in small airplanes. Factors associated with pilot death have not been well studied.

Objective.— To identify factors associated with fatalities in general aviation airplane crash landings.

Design.— Case-control study.

Setting.— The United States.

Subjects.— All pilots in general aviation crash landings of airplanes with 10 seats or fewer, from 1983 through 1992.

Main Outcome Measure.— Pilot death.

Results.— Pilots died in 437 (5.2%) of 8411 crash landings. A fire or explosion on the ground was strongly associated with pilot death (relative risk [RR], 20.4; 95% confidence interval [CI], 15.5-26.9), adjusted for pilot age, pilot flight hours, type of landing gear, and the filing of an instrument flight plan. Pilots who failed to use both lap belt and shoulder harness were more likely to die (adjusted RR, 6.8; 95% CI, 1.8-25.5), as were those who used only the lap belt (adjusted RR, 1.7; 95% CI, 1.3-2.2), compared with pilots who used both restraints.

Conclusion.— Pilots may be able to reduce their risk of death in a crash landing by using lap and shoulder restraints.

From the Department of Epidemiology, University of Washington School of Public Health and Community Medicine (Drs Rostykus, Cummings, and Mueller); and the Harborview Injury Prevention and Research Center, University of Washington (Drs Cummings and Mueller), Seattle. Dr Rostykus is now with the Emergency Department, Ashland Community Hospital, Ashland, Ore.

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