The periodic medical examination in the Republic of Singapore Air Force--a review.
Aeromedical Examinations (AMEs) have been done in the Republic of Singapore Air Force (RSAF) since its beginning for licensing and monitoring health status of essential personnel. The rapid progress in scientific advances and medical costs of recent years prompted a re-evaluation of the AME as a preventive tool, both in accident prevention and health promotion. A retrospective cohort study of 233 males spanning the time they joined the Air Force until 1990 was done and a descriptive analysis of the cohort with the incidence rate of cases picked up during this period was used as an indicator of usefulness of the AME. In the follow-up period of 2997 person-years, a small number of cases were picked up which resulted in two pilots being grounded permanently. Most procedures were found to be useful to varying extent except the routine chest X-rays which was found to be ineffective. Trends of biodata resulting from serial examinations are useful in planning and evaluation of intervention and health education programme, but only if the baseline measurements are accurate, hence quality control at all stages is important. The AME can be an effective tool for prevention if designed appropriately. Screening tests included must be scientific and the logic for selecting tests must be convincing. Most importantly, it is suggested that a clear and detailed medical history is the most useful component for early detection of problems. This is facilitated by a strong bond and rapport between doctors and subjects to ensure that the information is forthcoming and honest.