Journal
TRAVEL MEDICINE AND INFECTIOUS DISEASE
Volume 40, Issue -, Pages -Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.tmaid.2021.101973
Keywords
Cabin crew; Fitness-to-fly; Health; Safety; Aviation; Occupational risks; COVID-19
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Aircrew fitness-to-fly is crucial for aviation safety. However, there is no harmonised approach internationally, presenting challenges in aeromedical examinations. The COVID-19 pandemic has emphasized the need for better understanding of fitness-to-fly criteria.
Aircrew fitness-to-fly is among the elements that make aviation the safest form of long-distance transport. The health of cabin crew is a crucial determinant in carrying out safety-related duties. 'Fitness-to-fly' is associated with defined workplace conditions, for which airlines have a legal duty to ensure fitness for employment. We explored the literature on fitness-to-fly to obtain a pragmatic assessment of the challenges for aeromedical examinations. Regulations promulgated by aviation regulatory authorities and airline-internal policies have similar status and meaning, yet there is no harmonised approach internationally, and an inability to conform periodic medical assessments to actual operational fitness. The COVID-19 pandemic has highlighted the need to better understand fitness-to-fly criteria. Fitness-to-fly measures are mainly based on self-reported data and there is a need for a `safety' factor for self-reports. Aeromedical evaluations should evolve from meeting medical standards to include pandemics as an element of the overall risk of aircraft operations. Re-evaluating criteria for fitness-tofly assessment will further the goal of linking research to the actual needs of public health decisionmakers. If airlines are to resume operations at pre-pandemic levels, they must demonstrate to the public and public health agencies that fitness-to-fly assessment is appropriate and effective.
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