Page 411 - UK AirCrew Regulations (Consolidated) March 2022

Part MED - ANNEX IV - Medical

(ix) arterial or venous thrombosis; or
(x) pulmonary embolism
should be evaluated by a cardiologist before a fit assessment may be considered.
(c) Thromboembolic disorders
Whilst anticoagulation therapy is initiated, cabin crew members should be assessed as
unfit. After a period of stable anticoagulation, a fit assessment may be considered with
limitation(s), as appropriate. Anticoagulation should be considered stable if, within the last
6 months, at least 5 INR values are documented, of which at least 4 are within the INR
target range and the haemorrhagic risk is acceptable. In cases of anticoagulation
medication not requiring INR monitoring, a fit assessment may be considered after a
stabilisation period of 3 months. Cabin crew members with pulmonary embolism should
also be evaluated by a cardiologist. Following cessation of anticoagulant therapy, for any
indication, cabin crew members should undergo a reassessment.
(d) Syncope
(1) In the case of a single episode of vasovagal syncope which can be satisfactorily
explained, a fit assessment may be considered.
(2) Cabin crew members with a history of recurrent vasovagal syncope should be
assessed as unfit. A fit assessment may be considered after a 6-month period
without recurrence, provided cardiological evaluation is satisfactory. Neurological
review may be indicated.
(e) Blood pressure
Blood pressure should be recorded at each examination.
(1) The blood pressure should be within normal limits and should not consistently
exceed 160 mmHg systolic and/or 95 mmHg diastolic, with or without treatment,
taking into account other risk factors.
(2) Cabin crew members initiating medication for the control of blood pressure should
be assessed as unfit until the absence of any significant side effects has been
established and verification that the treatment is compatible with the safe exercise
of cabin crew duties has been achieved.
(f) Coronary artery disease
(1) Cabin crew members with:
(i) cardiac ischaemia;
(ii) symptomatic coronary artery disease; or
(iii) symptoms of coronary artery disease controlled by medication
should be assessed as unfit.
(2) Cabin crew members who are asymptomatic after myocardial infarction or surgery
for coronary artery disease should have fully recovered before a fit assessment
may be considered. The affected cabin crew members should be on appropriate
secondary prevention treatment.
(g) Rhythm/conduction disturbances
(1) Cabin crew members with any significant disturbance of cardiac conduction or
rhythm should undergo cardiological evaluation before a fit assessment may be
considered.
(2) Cabin crew members with a history of:
(i) ablation therapy; or
(ii) pacemaker implantation
should undergo satisfactory cardiovascular evaluation before a fit assessment may
be made.
(3) Cabin crew members with:
(i) symptomatic sinoatrial disease;
(ii) symptomatic hypertrophic cardiomyopathy
(iii) complete atrioventricular block;
(iv) symptomatic QT prolongation;
(v) an automatic implantable defibrillating system; or
(vi) a ventricular anti-tachycardia pacemaker
should be assessed as unfit.
MED.C.025 AMC3 Content of aero-medical assessments
RESPIRATORY SYSTEM
(a) Cabin crew members with significant impairment of pulmonary function should be
assessed as unfit. A fit assessment may be considered once pulmonary function has
recovered and is satisfactory.
(b) Cabin crew members should undergo pulmonary morphological or functional tests on
when clinically indicated.
(c) Cabin crew members with a history or established diagnosis of:
(1) asthma;
(2) active inflammatory disease of the respiratory system;
(3) active sarcoidosis;
(4) pneumothorax;
(5) sleep apnoea syndrome/sleep disorder; or
March 2022 411 of 554