Lucertini M, Lugli V, Casagrande M, Trivelloni P. Effects of airsickness in male and female student pilots: adaptation rates and 4-year outcomes. Aviat Space Environ Med 2008; 79:677–84. Introduction: Airsickness (AS) often affects aircrew members, especially at the beginning of their flight careers. In this study the AS incidence in 376 Italian Air Force student pilots (336 men and 40 women) was investigated during their initial flight activity. Methods: The study was separated into two parts. In part 1, the AS incidence was analyzed in the whole sample to determine the overall characteristics of AS and the hypothetical differences between men and women during the first flight certification (Basic). Part 2 analyzed a subpopulation of 102 individuals (86 men, 16 women) over 4 subsequent years throughout the first 4 flight certifications (for a total of about 60 flight hours). In all cases, AS was evaluated according to the number of flight missions affected by vomiting episodes. Results: The overall AS incidence during Basic was 34.8%, without significant gender differences. However, within AS individuals, a significantly higher percentage of women were slow adaptors (12.5% of the whole female sample vs. 3.3% in men). AS overall affected the likelihood of reaching Basic certification, but this was not significantly related to the number of AS episodes. The 1-yr interval between two subsequent flight certifications caused a loss of adaptation to the flight environment in most cases. Discussion: The absolute incidence of AS in our study resulted within the expected range, without significant differences between men and women. In a minor number of individuals (11 out of 336 men and 5 out of 40 women) a slow capability of adaptation to AS was observed. Such a finding was statistically more prevalent in women. In contrast to previous literature data, when prolonged interruptions from flight activity are planned, the retention of adaptation in our study did not play a significant role in avoiding future episodes of AS.