Aerospace Assessment Of Fitness For Duty

Book
In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan.
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Excerpt

Medical standards are put in place to prevent hazards during a flight that could be caused by the physical, medical, and psychological conditions held by the pilot or the crew. The International Civil Aviation Organization (ICAO) agreed at the Chicago Convention in 1944 to standardize practices where uniformity would improve air navigation. In subsequent annexes to the original convention, the regulations that standardize personnel licensing and rules of the air were established that guide the medical requirements for pilots and aircrew today. After evaluation of available data and the potential risks at different times during a flight, ICAO set a goal of less than 1% risk of pilot incapacitation per year to guide the standards for medical examinations. Gastrointestinal issues, earaches, faintness, headache, and vertigo are the most common causes of incapacitation. Less common but more dangerous debilitations such as alcohol intoxication and sudden cardiac death have been implicated in mishaps, so screening for these risks carries high importance. Mental health is also extremely important given mishaps like Germanwings Flight 9525 and other cases of suicide by aircraft. While some research has been done in the field of pilot incapacitation, there is not a significant evidence base for many recommendations, but rather it is a consensus of professional opinion. Member states, therefore, often have different interpretations of the guidelines and therefore different regulations.

The Federal Aviation Administration (FAA) governs the standards in the United States for civilians, and the military has a separate set of directives for active-duty aviators, with military rules generally being more stringent. In general, military aviators have to be physically fit for duty as military officers as well as passing requirements for aviation. This article will discuss the major medical statutes as laid out by the FAA and any differences in requirements in the Navy, Army, and Air Force. The FAA lays out slightly different regulations for airline transport pilots and commercial pilots versus private pilots, with private pilots having less rigorous requirements. The military also distinguishes medical requirements for aviators versus aircrew or other individuals within the aviation community. All organizations have disqualifying conditions that are not conducive to aviation due to an adverse impact on safety and health, but many conditions may be considered for waiver. All initial physical exams for licensing and fitness for duty must be conducted by an Aviation Medical Examiner (AME) or its military equivalent. If the AME finds the candidate is medically disqualified, the candidate may be referred to a Federal Air Surgeon for evaluation for a Special Issuance of Medical Certificate. Air Transport Pilots require a first-class medical certificate valid for 12 months for those aged less than 40 and 6 months for those over 40. Commercial pilots and aircrew need a second-class certificate valid for 12 months for all ages. Private pilots require a third-class certificate valid for 24 months for those over 40 and 60 months for those under 30.

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