aviationcardiology.com - about aviation cardiology

About aviation cardiology

Introduction

Aviation is the only system of mass transportation regulated by international statute. All nations are signatories to the International Convention on Civil Aviation, and thereby are members of the International Civil Aviation Organisation (ICAO), based in Montreal. ICAO publishes its International Standards and Recommended Practices (ISARP's) which are adapted by individual States. There is some variation on account differing legal and administrative systems. In Europe an attempt has been made to harmonise the Standards and their implementation. The responsible body in Europe is the Joint Aviation Authorities (JAA).

The medical standards for personnel licensing are entrained in ICAO Annex I, Chapter 6. The paragraphs relevant to cardiology in Europe are enshrined in the Joint Aviation Requirements (JAR) FCL Part 3 (Medical), Sub-parts B & C. Paragraphs B 3:130-150 and C 3:250-270 refer. The appendices to sub parts B and C also apply (paragraphs 1-15) as well as the related guidance material in Section 2. In the United States of America the Federal Aviation Administration is the responsible agency and FAR Part 67 relates to medical standards and certification. Sub-parts B paragraphs 67.111, C paragraphs 67:211 and D paragraphs 67:3111 refer specifically to cardiovascular problems.

An airman undergoing routine medical examination by an Authorised Medical Examiner (AME) will normally be issued with a medical certificate if the required standard is reached. He/she may be required to undergo further cardiological review by the licencing authority (the Civil Aviation Authority (CAA) in the UK) if a clinical or electrocardiographic abnormality is detected, or, if certificability is brought into doubt by illness. At the discretion of the licencing authority such a review may require further investigation such as exercise electrocardiography or echocardiography. Most of such reviews end favourably with no need for further follow up. Ultimately certificatory judgement is not delegated and the subsequant issuance of the medical certificate is the responsibility of the relevant authority (i.e. the UK CAA) which may issue, withdraw, or impose a restriction on a licence.

What is aviation cardiology?

Aviation medicine is the branch of occupational medicine which encompasses all aspects of the man/machine interface in the aviation environment. It applies not only to flight crew, their fitness, certification and operational environment, but also to passengers, and for example the safe carriage of those who are unwell. Specialists in aviation medicine may be responsible for both the development of fitness standards and in their application. Aviation cardiology is thus a sub-speciality of aviation medicine (and of cardiology) and specifically relates to aircrew fitness.