BOOK PREVIEW FIUTINE|s|s) |T/o) |FiLly —p MEDICAL GUIDE ol P GRGDSSSmuoNGED eur 5 Ney Ne eee aeMAINTAIN GOOD HEALTH THROUGHOUT YOUR CAREER AS A PILOT Fitness to Fly — A Medical Guide for Pilots is a preventive-medicine handbook that is easy-to read, motivating and educational, with engaging content, graphics and charts to empower you to limit your health risks and set your own goals, and strategies to maintain fitness to fly and a balanced lifestyle. This guide was developed by the International Chil Aviation Organization (CAO) in collaboration with the International Federation of Airline Pilots! Associations (IFALPA) and the International Air Trensport Association (IATA). tis focused on the health risks pilots face during the'r careers and the medical recommendations that help them mitigate those risks. performance This book helps you to © Understand the most common health issues facing pilots today © Learn how to reduce major risks to mental and physical health © Manage your nutrition, sleep and medication for optimal flight This hancbook is intended to close the gaa between pilots’ medical requirements in order to fly and the preventive measures that can hela ‘them full those requirements, The recommendations contained in this guide are also applicable for cabin crew, air traffic controllers and anyone working within the aviation industry. They will help improve the personal health of aviation personnel throughout their careers, bringing positive outcomes for all aviation stakeholders in the long-term, This is |CAO’s contribution to promoting the well-being of the aircrew community -@ priory shared by all aviation stakeholders.TABLE OF CONTENTS ) CHAPTER 1 UNDERSTANDING CARDIOVASCULAR RISK CHAPTER 2 HOW TO KEEP MENTALLY WELL. CHAPTER 3 IMPACT OF ALCOHOL AND DRUGS ON PERFORMANCE AND HEALTH CHAPTER 4 WHAT WE KNOW ‘ABOUT CANCER CHAPTER 5 HOW TO REDUCE YOUR HEALTH RISKS FROM MUSCULOSKELETAL INJURY CHAPTER 6 NUTRITION AND WEIGHT MANAGEMENT CHAPTER 7 SLEEP AND THE IMPACT OF MEDICAL CONDITIONS CHAPTER 8 ‘TRAVEL HEALTH CHAPTER 9 HEARING AND VISIONSa US aN Te) CARDIOVASCULAR UY ARE YOU EXPERIENCING ANY OF THESE WARNING SYMPTOMS? 1. Irregular heart beat 2. Pressure, tightness or chest pain 3. Dizziness 4, Difficulty breathing or shortness of breath under Oren Caan er To learn more about: get your handbook at wwiiIn Fitness to Fly, find 7 WAYS TO MITIGATE THESE RISKS AND ACHIEVE OPTIMUM CARDIOVASCULAR HEALTH: 1. Get active! 2. Understand your blood fat (lipid) levels 3. Manage your blood pressure 4, Eat a healthy diet 5. Maintain a healthy weight 6. Understand the risk of diabetes 7. Stop smoking Drink plenty | ‘water ey exercise i rer | intake of ae | fo learn more aboutawd HOW TO KEEP MENTALLY WELL There are several challenges pilots face during their career that can result in emotional and mental stress: Job insecurity Irregular work Work/Life ‘schedules balance Adapting to time CHALLENGES Changes zone changes © , Sey worey ¥ inthe aviation , Pees tnawsey eg 23" relationship Fatigue/ lack of steep strain sickness ff “ Financial la Regular tests add to anxiety 3s, get your handbook al nmendati To learn more about these \wwewuntingaviation.comftnesstofiy/HAPTE HOW TO KEEP MENTALLY WELL In Fitness to Fly, find 5 PRACTICAL WAYS TO ACHIEVE OPTIMUM MENTAL HEALTH AND. WELL-BEING: 1. Connect socially with others 2. Get Active 3. Keep learning - Give to others 5. Be mindful A ind creative pe ays to touch spend time we ere bh rr ana a Zz saa To learn more about these recommendations, get your handbook at \wwwuntingaviation.comfitnesstofy’There is a clear flight safety risk associated with problematic use of alcohol, or other psychoactive substances. Among a variety of other detrimental effects, the following are some effects of alcohol intake: * Increased self-confidence and reduced anxiety that can adversely affect decision making * Coordination problems + Impaired reaction time and double vision * Errors of judgment of distance or speed ia * ate of alana intake wee Py Low Level of alcohol intake WH 7s of abottle strongly @ decision-making attcted gy Alcohol poisoning increase rik + Impairment ot risk-based + Contusion eee eeslone 2 curs «+ Less abitty to respond to changing stuatons «Errors of utgemont testane an peed + Loss ofalancaleortnation * Unconsciousness To learn more about these recommendations, get your handbook at \wwwuntingaviation.comfitnesstofy’In Fitness to Fly, find 9 PRACTICAL WAYS TO MINIMIZE RISK FROM ALCOHOL INTAKE: an ‘Comply with = Learn about the amounts of drinking habits your company's alcohol in different drinks alcohol policy ¢__» i Toke the AUDIT Find ut the drinking i ® questionnaire guidelines. Spirits : Beer © Wine inyour country MH atcohot | 40% 5% 12% oe Know where (i 9 PRACTICAL i Set sensible drinking levels to seek help ways UNIT smal lass / 12% ABV to minimize risk ‘Max 1é units/week Mitigate the short-term en Ores from alcohol Al 3 Spread over 2 ays with: prior to USguidelines 53,, §)1 [12 water Grinking “ Dally f eo Have several e Don't “binge drink” 5+ alcohol-free a days per week The effects of binge drinking Canlastforupto72hours Blood alcohol evel or + 0.08 grams To learn more about these recommendations, get your handbook at \wwwuntingaviation.comfitnesstofy’a) Le ey ABOUT CANCER Studies indicates that cer incidence ere OVERWEIGHT AND OBESITY IS 4 generally lower in professional pilots THE UK'S BioGesT CAUSE OF 4 the general population. However, CANCER AFTER SMOKING an increased frequency of skin cance Hats ad cies corel nro feta has been reported in pilots which could Trnaid be due to exposure to UV from sunlight onophagus ovens Other types of cancer are caused ver by the five leading lifestyle risks Stomach high body mass index, lo’ Xe vegetable intake, lack of phy cotbiodder activity, tobacco use and alco! Seiterse owe ory rene myeloma CANCER LET'S BEAT CANCER RESEARCH crukorg/prevention UK > learn more about these recommendations, get your handbook at ‘comfitnesstofiy worunitingsa) Le ey ABOUT CANCER In Fitness to Fly, find 8 PRACTICAL WAYS TO MINIMIZE THE RISK OF CANCER 1. Stop smoking 7. Reduce the risk of 2. Eat a healthy diet certain infections 3, Maintain ahealthy weight 8. Discuss with a health 4. Cut back on alcohol professional which cancer 5. Avoid sunburn screening tests you 6. Get active! should undergo SKIN CANCER @ CHECKLIST Donotdsiberey [7] Stayintheshadel) 7] wearcttingnn [7] the sun is highest ‘overs as wich of fesstsiha) wen (rot your skin as possible @ vrons y 2 | eS ee) mn Ee | Gee face and back ofthe with factor (SPF) ‘tanning bed, neck eg. wear ahat (of 15 or higher boath or sunlamp wath a wide brim) - should protet — you against both ee Uyhand UvE > learn n Jations, get your handbook at ‘comfitnesstofiyNasa HOW TO REDUCE ee U a NBD te) FROM MUSCULOSKELETAL INJURY In professional pilots, musculoskeletal problems consistently rank among the most common reasons for unfitness, both temporary and long term with the potential to create a flight safety risk due to distraction and performance decrements While back pain is the single most important musculoskeletal problem in pilots, there are other types of musculoskeletal conditions that should be considered (e.g. those related to sporting injuries and home-based activities). Back pain Domestic injuries/ accidents Sports injuries 108 of he population per year 7% ofthe population par year 3.1% f the population per year Major cause of discomtor for plot 22 yan 8 Helicopter pilots are most afectedNasa HOW TO REDUCE ee U a NBD te) FROM MUSCULOSKELETAL INJURY In Fitness to Fly, find 9 PRACTICAL WAYS TO REDUCE MUSCULOSKELETAL INJURY RISKS: Get active! Build up levels of physical activity slowly, and warm up before undertaking sporting activities Avoid exercise when feeling unwell Adopt an ergonomically neutral posture Keep your back straight and not twisted when lifting Maintain a healthy weight Take care to avoid accidents or falls Stop smoking. Sit less, move more - reduce risks from a sedentary lifestyle sre as Aerobic Core Strengh Balance Flexibility fitness exercises training training and streching 3 “ co Lg : PL , ow Running, Muscles of Push-ups, For example, Stretching walking, the abdomen, squats, exercise —standingon’—_exercises when using stairs lower back with weights onelegand the muscles are and pelvis ‘switching warmed up your handbook atoases NUTRITION AND WEIGHT MANAGEMENT One of the main health risks for pilots is an unhealthy diet. Obesity is linked to a number of chronic health conditions. Diabetes is one of the top 10 diseases that cause long-term unfitness in professional pilots and is linked to diet and weight issues. Healthy weight loss isn’t about @ ‘diet’ or ‘programme’ It's about lifestyle changes in daily eating and exercise habits. x eer BODY MASS. . INDEX (BMI) FE Body weight n kilograms Q Diabetes Cardiovascular Certain ypes Height lin metres ‘dseaseofeancer though widely used, ithas some Umitations 7 Vr / @ \ Y fealty weight or = safety eases lescaph Aterpatmeasrement: inanemergency To lea more about these recommendations, get your handbook at wwwuntingaviationcomftnesstotly/Tai NUTRITION AND WEIGHT MANAGEMENT In Fitness to Fly, find 7 WAYS TO MAINTAIN GOOD NUTRITION AND SUCCESSFULLY MANAGE BODY WEIGHT: 1. Consume the number of calories required to obtain and maintain a healthy weight 2, Minimize intake of food with high refined sugar content 3, Eat a balanced diet 4, Reduce salt intake 5. Make healthy choices when eating away from home 6, Take an interest in reading and understanding food labels 7. Lower your risk of developing Type 2 diabetes Shousconpren Gaetano tos conpn seats. apr tay sine” ietietogpetendst alo stores me ‘fouroos Iraitan vegetables aday ata ond e pannice) a fee! Poverecesie ‘osname, © me nrersses eee aa = on ‘ovets, raising LOL, Heer snot, cans Chosselamer at Cheese can cc | covktoas Tottsupardown tard sat ores ‘horoushy Soya sed products re good alternatives tory To learn more about these recommendations, get your handbook at \wwwuntingaviation.comfitnesstofy’aw RSS tay Vea OF MEDICAL CONDITIONS Most of the scientific work related to sleep issues and professional pilots has involved the effect of fatigue on alertness and performance. Obstructive Sleep Apnoea (OSA) is probably the most common medical cause of poor sleep in pilots. It consists of repeated pauses in breathing during sleep. The effects of OSA are seen when awake, with the individual feeling very tired the next day due to repeatedly disturbed sleep, resulting in an increased susceptibility to fatigue. eaten ceca opesiry LARGENECKSIZE —CIGARETTESMOKING MALE GENDER Increases rek Over Tincesformen Inflation andewaling Man aretafea a8 ‘ybtimes. and Téinche fo women inupper airway het fo fare OSA @Q@: AGEOVER MENOPAUSE FAMILY CERTAIN FACIAL, AOYEARS —Rckries ahr HISTORY BONE STRUCTURE ‘menopause OF OSA (eg. shortloverian, targe tongue! To learn more about these recommendations, get your handbook at \wwwuntingaviation.comfitnesstofy’Tae RSS tay Vea OF MEDICAL CONDITIONS In Fitness to Fly, find 6 SIMPLE WAYS TO REDUCE THE RISK OF MEDICAL CAUSES OF POOR SLEEP: 1, Maintain a healthy weight 2. Get active! 3, Avoid drinking alcohol before bedtime 4, Stop smoking 5, Use sleep opportunities wisely 6. Avoid caffeine and other stimulants before bedtime Bre usd eens > Tytogotosleop circadian rhythms” atatime you are most 2 hours likly to drop off } 2a Light steep, Effect diminishes inthe early Withdrawal stage partofthe night develops Smokers aremore Smokers are 25 " lapping i a useful Uikelytofeet ess times more likely ritgation for lack restedaafter sleep _tohave sleep apnoea 24h of sleep ee Quitting reduces the risks IRtakes a day to fully tothe same level asa adapt to each hour of ea person who never smoked time zone shift 10-20 minutes: To learn more about these recommendations, get your handbook at \wwwuntingaviation.comfitnesstofy’ERB TRAVEL HEALTH Due to the nature of the work, professional pilots travel often abroad and are exposed to a number of increased health risks such as poor food quality, road transport accidents and accidents when undertaking outdoor activities. The risk of injury is increased when under the influence of alcohol or drugs. When eating out while on a layover/ night-stop away from home base & @ @ % Win doubt about the Ina tocaton where wa & &® hygiene ofa cafe or vata is ot drinkable, restaurant don'teatthere avoid salads, fut and ice Operating ight crew should ‘eat alitferent dishes when night meals are served Don't eat street oo Ensue all meat and ashygjene standards fish are completely cooked A separation of ‘sreaften poor Pilots at the east 30 minutes controls should eat js agusable 7 at diferent times — —_ Always eat ect ood Avoid shellfish To learn more about these 1 nmendations, get your handbook at \wwewuntingaviation.comftnesstofiy/Ta TRAVEL HEALTH In Fitness to Fly, find 9 WAYS TO REDUCE MEDICAL RISKS WHEN TRAVELLING ABROAD 1. Keep your vaccinations up to date 2. Check risks from insects and take preventive action as necessary 3. Be careful about food and water hygiene 4. Reduce transport, recreational and assault risks 5. Know your blood group 6. Avoid unnecessary exposure to sunlight 7. Do not use medications from unreliable sources 8. Avoid sex with casual partners 9. Stay away from animals Beware of Check the depth of the water Donel ster orn one ars king alc animals — ‘avoid diving into murky water aye check the state af itstires, aera ‘seat bets, lights, brakes: aA Gea siete wows szam. ©) Repuce 3 TYPES ‘Avoid consummation OF RISKS. peered son senean Pe eerie a unlit roads, 7 oy hidbeconing nvted | Bedetiowe | tetas | Anidaigioconene nwanieginetsietoud | ‘posbyel | fompichle | sueshhe latter peste ei ee To learn more about these recommendations, get your handbook at \wwwuntingaviation.comfitnesstofy’Tai HEARING AND VISION The main concern with hearing loss is the risk of reduced ability to communicate clearly and the increased possibility of misunderstanding an ATC instruction. As with hearing, loss of vision has the potential to cause major safety risks for a pilot. NOISE LEVEL REGULATION ‘An increase of 9 dB DOUBLES ‘the sound pressure level cepationa iit 82dBIA) 85dB(A) 88 dBIA) If you are operating noisy aircraft, the risk of NIHL is increased, so be particularly careful about protecting your hearing, both at work and during leisure time. The most frequent eye diseases with the potential to significantly reduce vision in pilots are cataracts, age-related macular degeneration, diabetic retinopathy, glaucoma and eye injuries, Allof these diagnoses can be prevented, or progression delayed. To learn more about these recommendations, get your handbook at \wwwuntingaviation.comfitnesstofiy!Tai HEARING AND VISION Find in Fitness to Fly ESSENTIAL TIPS AND RECOMMENDATIONS ON HEARING AND VISION PROTECTION: Protect your hearing from long duration high level background noise and from loud noises even if itis for short duration Keep the volume down Use ear protectors See your doctor if you notice any hearing loss Reduce exposure to ultraviolet radiation Wear eye protection Eat healthy balanced diet Reduce risk from diabetes SNe ON SUMMARY HOW TO PROTECT YOUR VISION QO & “wy Reduce exposure Wear eye protection Eat ahealthy, balanced diet - to ultraviolet nen undertaking ‘one that rich in green, radiation (UN risky activities leafy vegetables and fish Reduce risk Manage blood duit smoking from diabetes cholesterol vols To learn more about these recommendations, get your handbook at wwrw.unitingaviaton.comfitnesstofyGBGOGSSRGONGED o = ORDER NOW Are you an aviation medical examiner? ‘Your opinion is valuable to us. 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