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CASA Medical Standards Discussion Paper

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CASA Medical Standards Discussion Paper

Old 27th Dec 2016, 00:19
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CASA Medical Standards Discussion Paper

See here: https://www.casa.gov.au/standard-pag...tion-standards
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Old 27th Dec 2016, 23:02
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Is this the latest version of the Xmas eve fax - want to avoid discussion, put out a discussion paper when no one will see it?
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Old 27th Dec 2016, 23:56
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Medical Proposals

The one thing that is missing from the list of subjects is that of service by the AvMed department or lack thereof.


My experience is one of less than satisfactory response by CASA AvMed. I have been right up to and past the two months extension expiry date and no word from AvMed.
I have then had to follow up with AvMed but no 'sorry' or apology.
As a commercial pilot I need to know where I stand so that I can make plans around that lack of service, for which I am asked to pay a fee.


I am of the view that AvMed section needs to sharpen up its customer relations and work with the punters rather than against them which is the ways it is as present.
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Old 28th Dec 2016, 05:32
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Quite simple really, empower the DAME to issue the full 12 Month certificate on the spot. A whole load of conditions should be 'normalised' especially in Multicrew ops. I have thought for a while now that the whole aviation medical lark is a bit of a waste of time, there should just be a basic checkup each year and barring any horrendous developments you should be good to go, if you develop a serious condition then and only then should you be referred to AVMED for management, otherwise for he majority of conditions surely the DAME can manage the plan. I have know 4 pilots now over the last 10 years who have died due to unexpected cardiac events, all were relatively young 45 - 55 and on the face of it fit and healthy and in possession of Class 1 medical Certificates including recent ECG's. Can you see, hear, talk and pee on a stick please should be the extent of the checkup, along with blood pressure and weight readings for tracking.
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Old 28th Dec 2016, 13:35
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Ollie,

On the face of it, what you say sounds sensible. But it's not as simple as that. A friend of mine recently went through the Class 1 process, he'd hit a milestone age that required the whole shebang. His markers whilst being high were 'within tolerance' but led him to a stress ECG. And there it was, a congenital issue that required open heart surgery. Interestingly the normal ECG was fine and the stress ECG met the required standard for a Class 1 to be issued (and it was!) It was abnormal electrical activity that triggered concern and further tests.

Long story short, with your solution this fella would have gone undiagnosed. A sudden cardiac event would have happened, it was not a matter of if but when. This fella was not overweight nor did he have any glaring symptoms. There are some pilots that are quite happy to do the Class 1 medical process as it stands, it's the one time of the year they'll see the inside of a doctors office!
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Old 29th Dec 2016, 02:57
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Yep, drpixie, this IS the current version of the Christmas Eve fax. All 45 pages of it.
AOPA have pushed for a similar medical standard to that which will be used in the USA for PRIVATE PILOTS. The UK has brought in something similar.
Porter, nobody is even questioning the Class 1 yet CASA puts this and many other considerations on the table and has pulled the wool over the Minister's eyes.
The medical isn't for YOUR benefit, it is a risk mitigation exercise to protect people on the ground and others in the air. There is a complete lack of evidence that it does any good. Both in the US and Australia glider pilots operate on a self certification basis and RAAus pilots in Australia on a State car driver's licence (around 40% of pilots in Australia) so the experiment has been run for decades. You are at greater risk of killing an innocent pedestrian or a car full of of passengers coming the other way in the event of sudden incapacitation than you are of hurting anyone else in a small aircraft for the same reason.
Regulation should be evidence based and if there is no evidence, it should be abolished.
The CASA paper looks to me like a calculated insult to AOPA Australia.
CASA will manage to keep this whole thing going for decades to avoid taking action.
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Old 30th Dec 2016, 14:10
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what a load of bullshit this all is.
the greatest risk is the microsleep in hot weather ending up hitting a tree.

the casa medical started out after the second world war when they realised that the civilian pilots could be called up to save the bacon of the RAAF.
Donald Anderson decided that all civilian pilots would pass an RAAF medical so that they could be immediately drafted into the RAAF in the event of war breaking out again.

from that simple start the whole medical empire has grown to employ "thousands" and run the world.
does it actually achieve much. doubt it.

the pilots who fail the medical all drive home through the traffic without incident.

the real question is "can you still be functional at the end of a 3 hour flight and land safely?"
I doubt that a CASA medical would ever be able to determine that.

a sip of water and a few barleyscotch lollies probably work more wonders than all the CASA medicals ever will.

of course if you actually have some health issues why arent you seeing your GP?
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Old 31st Dec 2016, 01:10
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Eyrie,

I was just responding to Ollie's comment, the rest of the review obviously has merit
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Old 31st Dec 2016, 01:28
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dubbleyew eight, correct. Remember also glider pilots fly for up to 8 hours or more in turbulence most of the time, hand flying the aircraft continuously. These folk self certify both here and the USA. The experiment has been run. There is nothing to discuss.
Oh yes, Sir Don Anderson. I once heard an interesting story about his visit to the Waikerie World Gliding contest in 1974 in the new Departmental Merlin.
As for the RAAF, we certainly aren't going be to defending Australian cities with Spitfires flown by hastily drafted private pilots any time soon.
Here's what a friend of mine found after some research:
"As at least 40% of Australia's aircraft fleet is piloted by people who simply submit a declaration that they are fit to fly (RA-Aus and GFA predominantly) and as the statistics do not support an increase of regulation in this area the underlying thrust of the discussion paper should be disregarded. For example, in its report entitled "Pilot incapacitation occurrences 2010�2014" the ATSB found::
Why the ATSB did this research
Occasionally pilots become incapacitated during flight. Incapacitations can arise from different reasons. They include the development of an acute medical condition, changes in environmental conditions during the flight, or the effects of a pre-existing medical condition. The effect of incapacitation on a pilot can be restricting their flight duties for the remainder of the flight, or for single-pilot operations, a collision with terrain.

This research report documents pilot incapacitation occurrences in high capacity air transport, low capacity air transport, and general aviation to help educate industry about the causes and risks associated with inflight pilot incapacitation.

What the ATSB found
In the past 5 years, there have been 23 pilot incapacitation occurrences reported per year on average. Nearly 75 per cent of the incapacitation occurrences happened in high capacity air transport operations (about 1 in every 34,000 flights), with the main cause being gastrointestinal illness, followed by [email protected] strikes. In the majority of the occurrences reported, the incapacitation was severe enough for the pilot to be removed from duty for the remainder of the flight. With multi-pilot crews in high capacity operations, these occurrences usually had minimal effect on the flight.

Low capacity air transport and general aviation had fewer occurrences with a wider variation of causes of incapacitation. These ranged from environmental causes, such as hypoxia, to medical conditions, such as heart attack. Furthermore, 70 per cent of pilot incapacitation occurrences in general aviation had an effect on flight operations, namely return to departure aerodrome or collision with terrain.


In other words 6 pilot incapacitations per annum for low capacity air transport and general aviation would be beyond the predictive capabilities of medicine.
In fact, the ATSB report "Accident Occurrence Statistics 2005-2014" do not record pilot incapacitation as an accident or incident cause so the claim that "70 per cent of pilot incapacitation occurrences in general aviation had an effect on flight operations, namely return to departure aerodrome or collision with terrain." may be without foundation."

Note the Gastro-intestinal and [email protected] strikes, neither of which are going to be predicted by an aviation medical. Neither are hypoxia and hyperventilation, the latter of which I suspect as a cause of otherwise unexplained accidents.
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Old 31st Dec 2016, 01:31
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It probably comes back to the requirement to issue a licence to carry fare paying passengers. When CASA does that it takes on some of the responsibility on behalf of the Australian Government, it is not all borne by the individual pilot. So how does CASA determine for itself that you are a fit and proper person to hold the licence?
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Old 31st Dec 2016, 02:56
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So how does CASA determine for itself that you are a fit and proper person to hold the licence?
CASA does this via a network of delegated DAME's. The trouble is that CASA neither trusts them, nor the specialists to whom they seek additional opinion, nor the drug companies who make recommendations about side effects, etc, nor indeed the FAA who publish a much more comprehensive DAME manual than CASA.

Instead CASA centralises all decision making and review, but employs people with inadequate qualifications or experience, thus they have guidelines & protocols provided. But these are inadequate, contradictory and incomplete. And none of the administrative staff will take responsibility for going outside the guidelines (more than their jobsworth). So anything that is not black & white, enters a spiral of review until the pressure for a decision finally becomes overwhelming.

All CASA needs to do is:
a) harmonise its medical standards with other Australian bodies / overseas agencies. Australian aviation does not need unique standards for blood pressure, blood sugar, etc.
b) make the DAME guidelines clear & easy (or copy the FAA one)
c) allow DAME's to have proper authority. They are well qualified, serious people, seriously, why can't they be the arbiter of who is fit to fly? They or their colleagues do it for driving, boating, scuba diving and a range of occupations. As much as we would like to think otherwise, pilots aren't a special breed.
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Old 31st Dec 2016, 03:36
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I think you missed the point that Mr Approach was trying to make Akro. The DAME DOES NOT decide if you are a "fit and proper person" to hold a licence. They simply assess your HEALTH indicators against a set of standards.

Fit and proper is a whole other ball of wax.
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Old 31st Dec 2016, 05:44
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Icarus

Got it now. But, without having read the relevant legislation, I would expect that a pretty much identical phrase appears regarding driving licences, boat licences and a whole range of other things from gun licences to explosives licences.

CASA stands alone in creating such convoluted, contradictory, ill defined medical requirements. It also stands alone in the bureaucratic structure it has created to administer this.

Other bodies find easy, cheap, efficient ways of dealing with these requirements. CASA pretty much stands alone in wanting to not delegate any authority and administer it all centrally in Canberra.

Don't believe me? Go and get a heavy truck licence (administered Nationally, but delegated to the state bodies). It involves medical requirements, skill & knowledge requirements and fit & proper person requirements. And a truck driver can do a whole lot more damage in a 40 tonne truck than I can in a 1.9 tonne light twin.
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Old 31st Dec 2016, 09:40
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W8
Agreed, if you have a problem see your doc however you don't always know you have an issue

If it wasn't for my casa medical a few years back I doubt I'd be here to write this

I look forward to my medicals, blood tests stress ect ect and this year Casa excelled themselves by completing the paperwork inside 10 working days
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Old 1st Jan 2017, 03:20
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holdingagain, posting again: The medical isn't for YOUR benefit, it is a risk mitigation exercise to protect people on the ground and others in the air.
There is NOTHING to prevent you from having a medical every year to whatever extent you wish to pay for including blood tests, stress tests, colonoscopy and what ever else you wish to do.
This has exactly ZERO to do with the requirement for a formal aviation medical. This whole discussion paper is a result of medical reform for PRIVATE pilots in the UK and USA and AOPA Australia's push for the same here. The wide terms of reference of the CASA discussion paper are completely unnecessary. AOPA wasn't talking about Class 1 medicals for Commercial or ATPL nor for extending the RAMPC to recreational aviators in RAAus and GFA, just bringing the Class 2 medical requirement to that required to drive a private car in an Australian State. This experiment has already been run by GFA and RAAus and by private glider and balloon pilots in the USA and there are no adverse results.
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Old 1st Jan 2017, 04:57
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Eyrie, this all seems to be bugging you, relax
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Old 1st Jan 2017, 07:11
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The problem is that CASA will pervert the idea of a relaxed medical standard for private pilots. They will do this by restricting existing privileges available to the new class (for example IFR, controlled airspace,etc.) or by hedging the new class with restrictions so as to make it meaningless (for example limitations in respect of cancer, diabetes and other common conditions).

What we have now is a meaningless system and I don't believe CASA is going to do anything but window dressing. The phrase "all assistance except actual help" comes to mind.

I could go on.
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Old 2nd Jan 2017, 04:06
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Sunfish, you got it in one. There won't even be any window dressing. This will drag on until everyone forgets it or there is a change of government which kills it. All according to plan.
I hope AOPA is on to this perversion of their proposal. BTW glider pilots currently can fly in controlled airspace in Australia on their self declaration medical so the experiment has been run.
All the evidence I've seen says medical incapacitation WHICH MAY HAVE BEEN DETECTABLE IN A CLASS 2 MEDICAL is a very, very small cause of aviation accidents.
holdingagain, BOHICA may be your style but it isn't mine.
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Old 2nd Jan 2017, 06:10
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BTW why is IFR not in the new medical discussion paper for drivers licence?

I just flew 5hrs from Hobart > Adelaide IFR, and it was 10x lower workload, safer, stress-free, less fuel (optimum altitude) and relaxing than doing it VFR. A good 0.5 IMC.

Unfortunately when they release the drivers license medical I'll do that and be banned from operating IFR. Safety will have decreased.

IFR is a training/currency thing, not a physical one.
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Old 2nd Jan 2017, 09:51
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Shagpile, it is, in the AOPA proposal.
Download the CASA discussion paper proposal from the CASA website and go your hardest in your reply.
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