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Dr Peter Saundby. Technical Officer (Medical) Europe Air Sports. What are the Medical Causes of accidents. Medical factors are responsible for 3-4% of both non-commercial aviation and road fatal accidents. The causes in aviation are:
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Dr Peter Saundby Technical Officer (Medical) Europe Air Sports
What are the Medical Causes of accidents Medical factors are responsible for 3-4% of both non-commercial aviation and road fatal accidents. The causes in aviation are: • Cardiovascular [Heart attacks, or strokes in the older pilots]. • Neurological [epilepsy in the young]. • Alcohol or drugs. • Acute infections.
Why Pilot Medicals? • To predict success in training. • (Special Senses) • To ensure a return on training investment. (Initial standards) • To avoid incapacity accidents.
What if No Pilot Medicals? • Increase of failures in training, - One cannot teach a blind person to fly. • Some would not last to enjoy their hobby, - Should they be deprived if there is no risk. • Risk of incapacity accidents, - Ground and passenger or pupil risk.
2005 February 2006 situation
Third party risk • The only justification by States to control pilots. • A real risk to passengers and pupils. • What is the ground risk to random third parties?
Ground Riskthe military experience 6972 RAF aircraft losses 1946 – 1996 • 4424 Aircrew deaths. • 121 Third party deaths. • 727 aircraft weighed < two tonnes. Of these • 202 Aircrew deaths, 8 on the ground,( 2 at airfields and 6 in a military observation post). • The smallest RAF aircraft to penetrate a building and kill an unfortunate civilian was a Harvard which has an AUW of 2,500 Kg.
EASA Essential Requirements[medical and for all pilots] • No disqualifying condition, judged by aeromedical practice [incapacity risk]. • Able to perceive the environment. • Mitigation measures permitted. • Medical validation is required. • Qualifications of examiners.
Concept of aeromedical risk Pioneered by JAR-FCL 3. The risk of incapacity from all causes [including normal old age] can be summated into a single figure. This is the risk expressed as a percentage chance of sudden incapacity occurring in the next year. A major advance upon the ICAO concept of disqualifying diseases. No need to change laws with advances in medicine.
Levels of accepted medical risk No person can be immune from the risk of sudden incapacity. Accepted levels are: 1. Astronaut selection 0.1% • JAR-FCL Class 1 1.0% • JAR-FCL Class 2 1.0% • ICAO Class 2 [Est] 2.0% • EU Gp 2 Professional 2.0% • EU Gp 1 Private 20.0%
EASA Essential Requirements[medical and for all pilots] • No disqualifying condition, judged by aeromedical practice [incapacity risk]. What levels of acceptable risk are appropriate for recreational pilots? Do we need more than one level? Could we defend whatever level is chosen?
EASA Essential Requirements[medical and for all pilots] 2. Able to perceive the environment. Is this not automatically assessed by flying instructors? Have the medical standards of special senses cited by JAR-FCL 3 actually been validated?
EASA Essential Requirements[medical and for all pilots] 3. Mitigation measures permitted. A problem for recreational pilots is the need for colour discrimination. 4% of male population red/green unsafe. Proposed mitigation, abolition of coloured light signals in all recreational aviation. Other mitigation measures exist that can be applied by applying pilot limitations.
By examination Costly, especially if screening tests done. Depends entirely upon the pilot declaration because not all disease can be detected [Epilepsy]. From records Cheaper. Basic medical screening is now routine in Europe. Reliable, past disease cannot be concealed. Less expertise of validating doctor. Medical Validation
EASA Expectations(My interpretation) • All pilots comply with ERs. • Common Implementing Rules [IRs] for all Recreational Pilots. • Acceptable Means of Compliance [AMC] can be air sport specific. • Guidance material can be sport and nation or language specific.
Proposed Implementing Rule 1 1. Medical review at intervals prescribed by ICAO (60 months to age 40, then 24 months). 2. Review to consist of a declaration supported by an aceptable validation. (Examination, validation from records, or self declaration). 3. Standard to follow ICAO Class 2, but to take into account the effect of age, the level of aeromedical risk is not to exceed 2%. 4. With mitigation measures applied, the acceptable risk can be 20%. (EU private driver)
Proposed Acceptable Means of Compliance • By medical examination. • By validation from clinical records. • Self declaration without further validation (Certain air sports and subject to limitations).
Proposed Implementing Rule • Associations are to appoint doctors, suitably qualified and also experienced in the air sport concerned to advise on individual cases. Human factors guidance is to be published by each airsport. Individual certificates may have specific limitations imposed.
Air Sports Medical Advisers(not examiners) Qualified in medicine Training in aero-medicine (60 hrs lectures) Practical knowledge and experience of flying. (Hold or have held licence) Note: Few AMEs meet all 3 !!!
The Debate What are the issues? • Recreational Pilot Licence ? • Acceptable level of aeromedical risk? • Cost of validation of pilot fitness? • Colour vision?