[Use of the prenosology approach for attaining the objectives of pilot medical expertise].

Early diagnostics of senior pilots for diseases and conditions undesirable in terms of flight safety is tightly linked with evaluation of risks of their development. Prenosology diagnostics is focused on borderline states that may pass from health to disease (prenosology and premorbidity) and, vice versa, from disease to recovery (postnosology). Regarding health as a vital adaptation reserve, prenosology diagnostics is concerned with the ability of organism to adapt to an environment rather than probability of disease. Constant drain of adaptation reserves may become a reason for increased risks of disease. Heart rate variability analysis is one of the instruments of prenosology diagnostics. Authors of the paper discuss applicability of the space medicine oriented probabilistic approach to evaluation of adaptation risks by medical expertise boards certifying civil pilots. Results of 2 series of investigations showed increased adaptation risks and reduced functional reserves in pilots found unfit to continue career.