Prenosological approach to attaining the objectives of aviation medical expert assessment

Early diagnosis of diseases and conditions undesirable in terms of flight safety in senior pilots is tightly linked with the evaluation of disease risks. Prenosological diagnostics is focused on borderline states that may pass from health to disease (prenosology and premorbidity) and, vice versa, from disease to recovery (post-nosology). Regarding health as a vital adaptation reserve, prenosology diagnostics is concerned with the ability of the body to adapt to the environment rather than develop a disease. A constant drain of adaptation reserves may become the reason for increased risks of disease. Heart rate variability analysis is one of the instruments of prenosological diagnostics. The paper discusses the applicability of the space-medicine oriented probabilistic approach to the evaluation of adaptation risks by medical expert assessment boards certifying civil pilots. The results of two series of investigations showed increased adaptation risks and reduced functional reserves in pilots found unfit to continue their careers.