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CONGRESS-2019 REVIEW AND RESULTS

Second International Congress “Current Issues of Aviation Medicine” dedicated to the 110th Anniversary of Aviation Medicine in Russia  — the outcomes.

The participants will address federal authorities with a number of proposals based on the result of the discussions.

The Second International Congress “Current Issues of Aviation Medicine” was held  from 31 October to  03 November 2019 in the Conference Hall of the Radisson Blu Hotel at Sheremetyevo airport, Moscow. The Congress was initiated and organized by Aviation Medicine Doctors Association (AMDA) of Russia, with the participation of the Federal Air Transport Agency (Russia) and under the auspices of the European Society of Aerospace Medicine (ESAM).

Among the range of events there were sectional and plenary discussions, workshops and round tables on the topics related to flight safety and air passengers health issues. On 30th November, the day before the official opening, there was a meeting of Working Group of CIS Executive Committee on sanitary-epidemiological provision of civil aviation flights. On the third day of the congress, participants took part in off-site event at the Central Clinical Hospital of Civil Aviation.

According to Dr. Olga Verba, the Vice-President, AMDA: “That was not only an overview all clinical and screening facilities provided for foreign and Russian colleagues, but it was followed by a very interesting round table discussion about important issues of the medical assessment and flight expert medical examination of civil aviation personnel.  The site was a venue for the meeting of the Working Group of medical flight expertise. That was all about health fitness of aviation personnel.”

The range of points discussed during the meeting is of crucial importance, such as: medical assessment of civil aviation crew members taken at Central Flight Expert Medical Commission of Civil Aviation, organization of activities of flight expert medical commission of civil aviation, risks based approach during medical assessment, considerations concerning fitness of aircrew with cardiac diseases, psychological  and neurological diseases, ophthalmological diseases, deviations affecting overall performance, HIV, anti-coagulant use, diabetes mellitus etc.

In frames of the Congress there was the contest of Young Scientists in aviation medicine. The winner is a the sixth-year student of the faculty of Fundamental Medicine at Moscow State University. In his research he studied the effect of inhalation with xenon-oxygen mixture on the bioelectric activity of the brain in pilots. The winner received a grant for participation in ICAM 2020 in Paris.

The Congress “Current Issues of Aviation Medicine” brought together more than 200 participant from 19 countries. 45 presentations, including 13 given in English covered the complete scope of issues that are important for the fitness and safe performance of aircrew and air traffic controllers. Subjects that were discussed included aviation medical standards, training and certification of aviation doctors, aircrew selection, epidemiology, preventive medicine, clinical medicine, medical and psychological assessment of aviation personnel, human factors, and onboard medical assistance for passengers.

As Dr. Ries Simons, MD, Consultant Aerospace Medicine, noted in his brief remarks: “Special reference was made to fatigue risk management, mental health issues, and cognitive functioning of (aging) aviation personnel. In a workshop session, board members of the European Pilot Peer Support Initiative (EPPSI) presented the principles of pilot peer support programs that are designed to encourage pilots to self-refer any mental well-being issues, or to allow others to raise concerns about a pilot’s fitness to operate, in a safe and confidential environment whilst knowing that they will be appropriately supported”.

The Minister of Transport of Russia Evgeniy Ditrikh addressed the participants of the Congress in a telegram: “I am sure, regular events like the one is held will contribute the development of new approaches in management of risks related to human factor as well as health promotion of aviation personnel and passengers. It is the second time the Congress received the support of the Ministry of Transport of the Russian Federation, the Federal Air Transport Agency and the leading aviation personnel trade unions”.

The Head of the Federal Air Transport Agency (Rosaviatsiya) Alexandr Neradko joined in the welcome words addressed to the Congress.

The Resolution of the Congress defined the main route map of improvements and development of aviation medicine in Russia.

As it is highlighted in the document, despite being a big aviation state the Russian Federation has not so far had a single structural unit performing administrative procedures on organizing medical assessment of civil aviation personnel in any of designated authorities, including within a body authorized to issue certificates  to Russian Civil Aviation personnel (Federal Air Transport Agency),  thereby contravening international practice. The participants suggest considering the possibility of forming such a structural unit of the Federal Air Transport Agency.

Nor has the Federal Air Transport Agency a specialist in human factor and aviation psychology. Aviation specialists offer to bridge the gap, because according to international and Russian statistics of accidents confirms the fact 85% of cases aviation accidents are caused by human factor.

AMDA is going to develop proposals on the requirements for psychological state of pilots in the form of an additional article in “Federal Aviation Regulations on Medical Assessment in Civil Aviation”

The participant will also address the executives of the Ministry of Labor of Russia and the Research Institute of Occupational Medicine with a proposal to consider adjusting the framework and tasks of the research related to the work intensity in pilots in the way to focus on studying mechanisms of increasing performance and developing guidelines for morbidity prevention and reducing fatigue affecting pilots.

It was also proposed to apply to the Ministry of Transport of the Russian Federation with a proposal to develop health requirements on fitness to flight operations, air traffic control and educational trainings based on international standards and recommended ICAO practices taking into consideration the latest achievements of clinical medicine in the field of diagnostics and medical treatment as well as European practices of certification of civil aviation personnel.

Another proposal is addressed to Association of Air Transport Operators of Russia. That is about developing and bringing “Doctor on board” program – the loyalty program targeted at frequently flying doctors – into the practice of Russian airlines.

 It was also decided to contact the Ministry of Transport of Russia with a request on the development of a program of implementation of telemedicine technologies to provide emergency medical assistance to passengers and crew on board an aircraft.

The participants of the Congress discussed an issue of trust between aviation doctors and civil aviation personnel, noting that while taking a medical examination aviation personnel often conceal true information about existing diseases and medication intake. The solution is through activities on the development of a questionnaire for aviation personnel to be used by an aviation medical practitioner, based on international experience, as well as writing a memo on ethics and deontology and establishing trust with aviation personnel. The participants of the congress highlighted that currently there appear some educational centers that provide distance education in the field of aviation and space medicine using the programs that do not meet educational standards and international requirements

It was decided to appeal to the Federal Air Transport Agency with an initiative of identifying educational institutions that provide training for aviation medicine practitioners, experts and members of Flight Expert Medical Commissions and medical experts; coordination of training programs in compliance with ICAO recommended practices

On top of that the participants of the Congress approved the activities taken by Aviation Medicine Doctors Association (AMDA) and offered AMDA members to continue their participation in the Working Group on Medical and Sanitary Epidemiological Support for Flights of Members of the Executive Committee of the CIS, in the Aviation Psychology Section of AMDA, further interaction and cooperation of AMDA with ESAM and AsMA, Institute of Biomedical Problems of the Russian Academy of Sciences, State Research Institute of Civil Aviation.

RESOLUTION

Second International Congress

of Aviation Medicine Doctors Association

“Current Issues of Aviation Medicine” dedicated to 110th anniversary of aviation medicine in Russia

Having listened and discussed the reports under the program the participants of the Congress defined the main route map of improvements and development of aviation medicine in Russia and adopted the following resolution:

  1. The participants of the Second International Congress emphasized that despite being a big aviation state the Russian Federation  has not so far had a single  structural unit performing administrative procedures on organizing medical assessment of civil aviation personnel in any of designated authorities, including within a body authorized to issue certificates  to Russian Civil Aviation personnel (Federal Air Transport Agency),  thereby contravening  international practice, which is stipulated  by the “Manual of Procedures for Establishment and Management of a State’s  Personnel Licensing System ” ICAO, Doc 9379 AN \ 916 Part I Chapter 5, Part II Chapter 8.

Solution:

Appeal to the Head executives of the Ministry of Transport of the Russian Federation and the Federal Air Transport Agency with a proposal to consider the possibility of forming a structural unit of the Federal Air Transport Agency responsible for administrative procedures in organizing medical assessment of civil aviation personnel in compliance with the provisions of Doc 9379, ICAO.

  1. International and Russian statistics of accidents confirms the fact 85% of cases aviation accidents, including those with a large number of victims, are caused by “human factor”. Experts in aviation psychology draw attention to the fact that the reliability of a pilot (an air traffic controller) depends not only on professional training, but also on their health fitness and psychological readiness to perform professional duties both during normal and emergency operations.
    The Federal Air Transport Agency does not have a specialist in human factor and aviation psychology, who would be responsible for developing measures on mitigating a negative impact of “human factor” on operational safety in civil aviation.

Solution:

Invite the Working Group of the Expert Council of the Federal Air Transport Agency on the Human Factor to consider a possibility of developing a draft Target Program on Human Factor, including a possibility of updating methods of professional and psychological selection of aviation specialists, as well as developing programs of social and psychological support for pilots considering the experience of implementation of a such programs in airlines of the European Union.

Apply to the Federal Air Transport Agency with a proposal to introduce a position of a human factor specialist (aviation psychologist) in the Federal Air Transport Agency in order to provide better coordination and analysis of current situation in the field as well as developing and implementing the Targeted Program on human factor with the subsequent development of measures to reduce the negative impact of human factor on flight safety.

Aviation psychology section at AMDA is to develop proposals on the requirements for psychological state of pilots in the form of an additional article in “Federal Aviation Regulations on Medical Assessment in Civil Aviation” – 2002

  1. When discussing the report of The Scientific Research Institute of Occupational Medicine on the research on the assessment of work load intensity in aviation personnel the participants came to the conclusion that the proposal to raise the index the work load intensity for pilots to class 3.3 contradicts the official statistics of the field which estimates:in the structure of operating pilots the proportion of aged ones without loss of professional and general ability increases. That proves the low importance of labor intensity as a factor affecting pilots’ health, which is also confirmed by the available research and statistics presented in Russian and international well-accepted periodicals.

Solution:

Address the executives of the Ministry of Labor of Russia and the Research Institute of Occupational Medicine with a proposal to consider adjusting the framework and tasks of  the ongoing research related to the work intensity in pilots to study mechanisms of increasing performance and developing guidelines for morbidity prevention and reducing fatigue affecting pilots, and consequently effective aeromedical risks management.
Recommend in the mentioned above work to involve specialists in aviation medicine from the State Research Institute of Civil Aviation, Central Clinical Hospital of Civil Aviation, Central Flight Expert Medical Commission, leading departments of aviation medicine and AMDA.

  1. The participants of the Congress approved the initiative of establishing a state system of flight risk management associated with fatigue in pilots (FRMS) in accordance with Manual for the Oversight of Fatigue Management Approaches © ICAO 2016 Doc 9966 (Title in First Edition, Fatigue Risk Management Systems — Manual for Regulators).

Solution:

Address the officials at the Ministry of Transport of the Russian Federation, the Federal Air Transport Agency and the Expert Council for Civil Aviation with a proposal to consider developing state level system of pilots’ fatigue risk management.

  1. Congress participants note the necessity to review health fitness requirements to crew members of civil aviation aircrafts, air traffic controllers, students and cadets of civil aviation educational organizations aimed at training pilots, air traffic controllers, candidates applying for pilot training (air traffic controllers), as well as criteria of admission applied to private pilots, pilots of ultra-light planes, glider pilots to flight work (ATC), training and flights when under various diseases.

Solution:

Apply to the Ministry of Transport of the Russian Federation with a proposal to develop health requirements based on international standards and recommended ICAO practices which stipulate fitness criteria for flight work, air traffic controlling and training.

  1. Having discussed the reports on the provision of medical aid on board, the participants of the Congress recognized the necessity to introduce “Doctor on Board” loyalty program for doctors frequently flying by major Russian airlines. Aviation Medicine Doctors Association is ready to take part in the development of the program.

Solution:

Apply to the Association of Air Transport Operators of Russia with a proposal to develop and implement the practice of Russian airlines “Doctor on board” loyalty program targeted at frequently flying doctors.

Contact the Ministry of Transport of Russia with a request on the development of a program of implementation of telemedicine technologies to provide emergency medical assistance to passengers and crew on board an aircraft.

  1. The participants of the Congress discussed an issue about trust between aviation doctors and civil aviation personnel, noting that during a medical examination aviation personnel often conceal true information about existing diseases and medication intake that may affect flight safety or air traffic control performance. To some extend that is caused by outdated health requirements and medical treatment approaches to civil aviation personnel.

Solution: 

Organize activities on the development of a questionnaire for aviation personnel to be used by an aviation medical practitioner, based on international experience, as well as writing a memo on ethics and deontology and establishing trust with aviation personnel.

  1. Having listened to the reports on training in aviation and space medicine provided for medical practitioners, chairmen and medical specialists of Flight Expert Medical Commissions of Civil Aviation as well as medical experts, the participants of the congress highlighted that currently there are some educational centers that provide distance education in the field of aviation and space medicine using the programs that do not meet educational standards and international requirements on trainings for aeromedical practitioners and aeromedical experts designated to conduct medical assessment of civil aviation personnel.

Solution:

Appeal to the Federal Air Transport Agency with an initiative to identify educational institutions and coordinate training programs for chairmen and members of Flight Expert Medical Commissions and medical experts in compliance with ICAO standards and recommended practices (Appendix 1, Doc 9379, Doc 8984).

  1. Congress participants approved the activities of Aviation Medicine Doctors Association (AMDA) and offered to continue participation of AMDA members in the Working Group on Medical and Sanitary Epidemiological Support for Flights of Members of the Executive Committee of the CIS, in the Aviation Psychology Section of AMDA, further interaction and cooperation of AMDA with ESAM and AsMA,  Institute of Biomedical Problems of the Russian Academy of Sciences, State Research Institute of Civil Aviation.
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