Occupational health, risk factors, and protection among unmanned aerial vehicle operator in the high-altitude region of China: an observational study

Objectives: Unmanned Combat aerial vehicles (UAVs) have evolved into assets of tactical-critical importance, thus safeguarding the occupational health of their operators is imperative. As UAV units of the Chinese are predominantly stationed in high-altitude regions, this study aimed to systematically assess the occupational health status and risk factors faced by these operators during their service, and to propose targeted protective measures. Methods: A cohort of 62 active-duty UAV operators stationed in high-altitude regions was recruited to complete a self-administered questionnaire. The investigation was conducted utilizing a comprehensive framework encompassing occupational health assessment, risk factor evaluation, and protective measures analysis. Statistical methodologies employed included descriptive statistical analysis, symptom co-occurrence network analysis, and clustering pattern analysis. Results: UAV operators in high-altitude regions exhibited significantly higher prevalence of neurological (67.74%), musculoskeletal (64.52%), and psychological symptoms (46.77%) compared to their counterparts in plain areas, with additional manifestations of otorhinolaryngological (67.74%) and respiratory symptoms (64.52%). Symptom co-occurrence network analysis identified "musculoskeletal pain" and "memory impairment "as central hubs. Clustering analysis revealed distinct risk stratification, with high-, medium-, and low-risk subgroups constituting 20.97, 40.32, and 38.71% of the cohort, respectively. Among risk factors, "unreasonable work schedules" and "high-altitude hypoxia" received the two highest risk scores. Regarding protective measures, "health education," (0.66) "scientific training protocols," (0.62) and "rational shift scheduling" (0.60) demonstrated the highest comprehensive effectiveness scores. Conclusion: The UAV operator cohort in high-altitude regions demonstrated a notably poor occupational health status. "musculoskeletal pain" and "memory impairment "were identified as critical intervention targets. Given the prominent roles of "high-altitude hypoxia" and "unreasonable work-rest schedules" as dominant risk factors, occupational health strategies should be strategically redirected from over-reliance on personal protective equipment toward prioritized investment in efficient management systems. These include implementing "scientific training protocols," enhancing "health education," and establishing structured "work-rest rotation systems." Simultaneously, essential oxygen supply and noise reduction equipment should be deployed at high-altitude workplaces.