Clinical Characteristics of Abnormal Pulmonary Function and Correlation with Chest Computed Tomography Findings in Army Rotary-Wing Pilots

Purpose: Our study's goal was to evaluate the prevalence of abnormal pulmonary function among Republic of Korea Army rotary-wing pilots and to identify independent clinical risk factors and the utility of supplementary chest computed tomography (CT).Methods: A cross-sectional study was carried out using medical records from 244 pilots collected between 2021 and 2022.Forced expiratory volume at 1 second/forced vital capacity (FEV1/FVC) <70% or FVC <80% predicted was classified as abnormal pulmonary function.Clinical variables, including age, metabolic profiles, smoking status, and history of tuberculosis, were analyzed.Logistic regression analyses, both univariable and multivariable were conducted to determine independent factors associated with abnormal results.Low-dose chest CT (LDCT) findings were reviewed for participants with abnormal pulmonary function.Results: The prevalence of abnormal pulmonary function was 4.1% (n=10).Univariable analysis showed that age, total cholesterol, and high-density lipoprotein (HDL) cholesterol were significantly associated with abnormal results.In the multivariable model, HDL cholesterol was identified as the only independent protective factor (adjusted odds ratio 0.902, 95% confidence interval 0.826-0.985;P-value=0.022).Among the abnormal group, 70% (n=7) displayed structural lung abnormalities on LDCT, most commonly pulmonary nodules (60%), followed by emphysema and airway changes.Conclusion: Compared with the general populace, pilots' prevalence of pulmonary dysfunction appeared lower, and HDL cholesterol might serve as an independent predictor of pulmonary function in this group.Together with supplementary LDCT, regular pulmonary function testing could contribute to early detection of underlying structural lung diseases.