Page 381 - UK AirCrew Regulations (Consolidated) March 2022

Part MED - ANNEX IV - Medical

MED.B.010 GM5 Cardiovascular system
VENTRICULAR PRE-EXCITATION
Asymptomatic applicants with pre-excitation may be assessed as fit if they meet the following criteria:
(a) no inducible re-entry tachycardia;
(b) refractory period > 300 ms;
(c) no induced atrial fibrillation;
(d) no evidence of multiple accessory pathways.
MED.B.015 Respiratory System
(a) Applicants with significant impairment of pulmonary function shall be assessed as unfit.
However, they may be assessed as fit once pulmonary function has recovered and is
satisfactory.
(b) Applicants for a class 1 medical certificate shall undertake pulmonary morphological and
functional tests at the initial examination and when clinically indicated.
(c) Applicants for a class 2 medical certificate shall undertake pulmonary morphological and
functional tests when clinically indicated.
(d) Applicants with a medical history or diagnosis of any of the following medical conditions
shall undertake respiratory evaluation with a satisfactory result before they may be
assessed as fit:
(1) asthma requiring medication;
(2) active inflammatory disease of the respiratory system;
(3) active sarcoidosis;
(4) pneumothorax;
(5) sleep apnoea syndrome;
(6) major thoracic surgery;
(7) pneumonectomy;
(8) chronic obstructive pulmonary disease.
Before further consideration is given to their application, applicants with an established
diagnosis of any of the medical conditions specified in points (3) and (5) shall undergo
satisfactory cardiological evaluation.
(e) Aero-medical assessment
(1) Applicants for a class 1 medical certificate with any of the medical conditions
specified in point (d) shall be referred to the medical assessor of the CAA.
(2) Applicants for a class 2 medical certificate with any of the medical conditions
specified in point (d) shall be assessed in consultation with the medical assessor of
the CAA.
(f) Applicants for a class 1 medical certificate who have undergone a pneumonectomy shall
be assessed as unfit.
MED.B.015 AMC1 Respiratory system
(a) Examination
(1) Spirometry
A spirometric examination is required for initial examination and on clinical
indication. Applicants with an FEV1/FVC ratio of less than 70 % should be evaluated
by a specialist in respiratory disease.
(2) Chest radiography
Posterior/anterior chest radiography may be required at initial, revalidation or
renewal examinations if clinically or epidemiologically indicated.
(b) Chronic obstructive pulmonary disease
Applicants with chronic obstructive pulmonary disease should be assessed as unfit.
Applicants with only minor impairment of pulmonary function may be assessed as fit.
(c) Asthma
Applicants with asthma requiring medication or experiencing recurrent attacks of asthma
may be assessed as fit if the asthma is considered stable with satisfactory pulmonary
function tests and medication is compatible with flight safety. Applicants requiring
systemic steroids should be assessed as unfit.
(d) Inflammatory disease
For applicants with active inflammatory disease of the respiratory system a fit
assessment may be considered when the condition has resolved without sequelae and
no medication is required.
(e) Sarcoidosis
(1) Applicants with active sarcoidosis should be assessed as unfit. Investigation should
be undertaken with respect to the possibility of systemic, particularly cardiac,
involvement. A fit assessment may be considered if no medication is required, and
the disease is investigated and shown to be limited to hilar lymphadenopathy and
inactive.
(2) Applicants with cardiac or neurological sarcoid should be assessed as unfit.
(f) Pneumothorax
(1) Applicants with a spontaneous pneumothorax should be assessed as unfit. A fit
assessment may be considered if respiratory evaluation is satisfactory:
(i) 1 year following full recovery from a single spontaneous pneumothorax;
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