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Flight Crews: Health Self-Assessments and Safety

Integrating fitness for duty checklists into a flight department’s safety management system (SMS) is an effective way to identify health issues that could impact a pilot’s performance. These valuable processes should also be extended to non-pilot team members, whose critical functions also have the potential to be negatively impacted by personal health situations.

Every safety-sensitive occupation is susceptible to the consequences of fatigue and/or illnesses – chronic or acute, said Dr. Paulo Alves, global medical director of aviation health with MedAire. A mistake by a maintenance technician or scheduler can certainly factor into a chain of events leading to a mishap, he added.

Alves notes that fitness-for-duty issues are often caused by acute conditions that typically are not apparent at periodic medical exams, and that these impairments, or even full incapacitation events, could have been prevented through the application of a fitness-for-duty checklist from the SMS.

The popular “IM-SAFE” assessment – which checks illness, medications, stress, alcohol, fatigue and eating – is one way to identify possible acute symptoms, said Mark Larsen, CAM, NBAA’s senior manager of safety and flight operations. This simple check should be done before each flight to determine if crew members are sick, using medications that may impair abilities, experiencing high levels of stress, have consumed any alcohol over the previous 24 hours, are suffering from fatigue, and eating and hydrating enough.

“Adding procedural assessment steps to your SMS, such as the IM-SAFE checklist, provides another level of safety redundancy.”

Mark Larsen Senior Manager of Safety and Flight Operations, NBAA

“Adding procedural assessment steps to your SMS, such as the IM-SAFE checklist, provides another level of safety redundancy,” said Larsen. “It’s human nature to underestimate or wish to gloss over symptoms with the potential to disrupt work, so it’s important to provide another opportunity to catch potential problems.”

Today’s most robust wellness programs involve a multi-layered system that identifies potential issues and provides support for employees. Components of a successful approach to assessing and treating fitness-for-duty concerns include:

  • A company culture that encourages openness and honesty
  • Resources such as access to medical professionals (including mental health specialists)
  • Support for peer-to-peer wellness groups

“Today it is possible to coordinate quick mental health support from a well-established global network of mental health professionals for acute situations demanding immediate assessment and intervention,” said Alves. “Privacy and understanding the peculiar environment of crew members is crucial, and triaging and follow-up are frequently necessary when long-term problems are identified or anticipated.”

In recent years, NBAA has joined other aviation stakeholders, including the FAA, EASA and ICAO, in urging that more attention be paid to mental health.

“There’s a growing understanding within aviation that a proactive and sensitive approach to mental health is an important part of safety,” said Larsen.

With the COVID-19 pandemic adding new stressors and exacerbating existing ones, it’s never been more important to have built-in procedures that help crew members assess fitness for duty. Alves encourages aircraft operators to view health self-assessments for all team members as a pillar of a strong safety culture.

“Safety could be compromised if any individual, not just those on the flight deck, isn’t at his or her best,” he said.

Review the NBAA Flight Plan podcast “Determining Fitness for Duty” at
nbaa.org/fitness
.

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