President’s Corner, 2Q14, “Fit to Fly? How Can We Know?”

by Quay Snyder, MD, MSPH

All pilots know that a medical certificate is required to operate an aircraft…with certain exceptions (LSA, gliders and balloons). That requirement may be modified in the future, but all pilots still must conduct a personal assessment of their fitness to fly under FAR 61.53 before every flight. How can we know?

The most basic Risk Management tool provided by the FAA is the I’M SAFE checklist. This tool allows airmen to make quick self assessments, similar to preflighting their aircraft prior to each takeoff.

• I   —  Illness  —  Do I have an illness that compromises my ability to meet the physiological demands?
• M —  Medications  —  Do they cloud judgment, reduce alertness or G-tolerance?  Are they prohibited by FAA?
• S   —  Stress  —  Am I too distracted to focus fully on the flight?
• A  —  Alcohol  —  Have I complied with the 8 hour and 0.04 mg% rules? What about a hangover?
• F   —  Fatigue  —  Acute and chronic fatigue both take a toll.  Am I well rested and sleeping soundly?
• E   —  Eating and Hydration  —  do I have the nutrition to start and available to complete the flight?

Pilots conduct a self assessment and can supplement their knowledge with information from their physician, their AME or an aviation medicine specialist. FAA Pilot Safety Brochures also help.  As useful as the I’M SAFE checklist is, it only scratches the surface. Pilots are very self reliant and confident individuals who may believe that they are not negatively affected by these conditions or may not even recognize them. The number of conditions that may compromise a pilot’s flying ability rivals the number of aircraft types we are flying. Unfortunately, they are not as easily recognizable or widely known.

We have all seen pilots who just don’t seem to be at their peak function when they are flying. They may routinely miss checklist items, readbacks, altitudes or have problems programming the FMS (or Garmin). Some may be found on other crew members “Do Not Pair” lists because of previous experiences, have a reputation for filing NASA ASRS or ASAP reports nearly every flight. Some may have trouble passing training in new aircraft of even those aircraft they have flown well before. Some may not seem physically or mentally capable of performing their full range of duties for safe flight. Whatever the cause, we have all seen it….but what tools do we have to deal with it?

Help is on the way! The National Business Aviation Association’s Safety Committee has named “Fitness For Duty” one of its 2014 Safety Focus areas. I am fortunate to lead a team of very knowledgeable and passionate safety experts in the FFD Working Group. With the full support of the NBAA, the FFD WG has outlined a three year project to culminate in providing easily implementable tools for the individual pilot and the flight department to conduct more rigorous assessments and return pilots safely to the cockpit.

Phase 1 consists of awareness building and information gathering from users who have experienced problems addressing the compromised pilot, but do not have a consistent systematic approach to explore the underlying causes. The kickoff will be a panel session seeking audience feed back at the NBAA’s Orlando Business Aviation Convention and Exhibition from 9:00 – 10:00 am on Wednesday 22 October.  Other presentations will follow at a half dozen other aviation safety meetings in the coming year.

Phase 2 will continue the awareness campaign and focus on data gathering, both what experiences to date are and what products would be useful for the operator. Preliminary data indicate that many seemingly hopeless fitness for duty situations can be remedied and the pilot safely returned to the cockpit as an effective crew member or individual pilot.

Phase 3 will provide deliverable products to the user in a format they identify as most helpful. This may be informational brochures, manuals, information resources through aviation organizations or vendors and educational opportunities. Seminars and workshops and webinars will be available to those requesting assistance.

My column next quarter will address preliminary findings on causes of fitness for duty compromise, rates of return to flying duty and strategies to address concerns with a previously successful pilot.  As has always been the core principles of Aviation Medicine Advisory Service, our goal is to enhance aviation safety, protect pilot health and preserve flying careers.