1. EVOLUTION OF AEROMEDICAL DISPOSITION ASSESSMENT Jiří ŠULC Institute of Aviation Medicine Prague, Czech Republic European Airline Training Symposium, Prague November 10 th – 11 th 2009

2. HISTORY Early attempts Early attempts 1887 Russia 1888 Germany Based on aeromedical knowledge 1907 Russia 1915 Germany 1918 USA, GB, France, Italy 1924 Czechoslovakia etc.

3. HISTORY Request of absolute fitness of a licence holder First Czechoslovak Regulation on Flight Crew Medical Licensing [1924] ( Examination of airmen with a physician)

4. HISTORY  Convention on International Civil Aviation Annex 1  FARs [USA]  JAR-FCL 3 [Europe]

5. MEDICAL CERTIFICATE  Warrants that an airman 1. 1.is physically and mentally capable of performing his/her flying duties … for the period of validity of his/her certificate; 2. 2.is free of disease which may render him/her incapable of performing the duties on board in a safe manner; 3. 3.is free of disease which may slowly, but within the period of validity of relevant certificate reduce the capacity for performing his/her duties on board below the acceptable level

6. PROBLEMS   Some specific health disorders, which may without warning strike the pilot´s ability to perform his/her obligations  unfitness   Aeromedical tourism

7. SUDDEN IN-FLIGHT MEDICAL EVENTS 1. 1.Pilot´s incapaciation [ complete inability to perform any in-flight duties] 2. 2.Pilot´s impairment [some degree of degradation of his/her performance]

8. SUDDEN IN-FLIGHT MEDICAL EVENTS 1. 1.Relatively low risk of sudden decompensation of controlled disease 2. 2.Relatively higher risk in presence of subtle complaints and/or of physiological incidents [fatigue, hypoxia, CO 2 intoxication]

9. CONCLUSION 1. 1.Today´s system of medical flight crew licensing is highly effective 2. 2.Without active cooperation of aircrew can significant impairments of medical fitness pass unnoticed