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European Cabin Crew Medical Fitness Requirements

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Category: Personnel Licensing Personnel Licensing
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The requirements for periodic attestation of the medical fitness of persons acting as cabin crew on commercial air transport flights introduced under EU-OPS 1.995 are superseded by the applicable part of the EASA Aircrew Regulation, IRs contained in Subpart C of Part-MED. Implementation is mandatory with effect from 8 April 2014. States may utilise transition arrangements after that date where permitted under the Regulation. An example of the latter is the UK, which has announced that all cabin crew must hold a valid EU medical report from 8 April 2019 but until that date, assessment of fitness for cabin crew duties under EU-OPS requirements will remain valid.

The Regulatory Background

The European Commission Regulation (EU) No 1178/2011 lays down the technical requirements and administrative procedures for civil aviation aircrew in EU and EEA countries. In respect of Cabin Crew, it establishes Implementing Rules for their periodic aero-medical assessment and the conditions under which general medical practitioners may act as aero-medical examiners. These rules also cover the conditions for issuing, maintaining, amending, limiting, suspending or revoking attestations of cabin crew medical fitness and detail both the privileges and responsibilities of the holders of such attestations.

The above Regulation has seven Annexes. Annex IV is known as Part-MED and contains the EASA Implementing Rules (IRs) for medical assessment of both pilots and cabin crew. Subpart C of Part-MED contains the IRs applicable to cabin crew medical assessment.

The Part-MED Requirements

In summary, the requirements are that:

  • cabin crew must be in possession of a valid medical report in order to act in that capacity
  • there is a system for arranging periodic medical assessment of cabin crew by appropriately qualified persons
  • a written medical report in a prescribed format shall be provided to the person assessed after the completion of each assessment
  • the holder of a medical report is responsible for providing a copy of their report or equivalent information to any operator of aircraft on which they intend to work
  • the maximum elapsed interval between assessments is 3 years

Detailed Implementation of Part-MED

EASA published Acceptable Means of Compliance (AMC) and Guidance Material (GM) in respect of the IRs for Part-MED on 15 December 2011. States may develop and seek approval from EASA for Alternative Means of Compliance (AltMOC). Such action has, for example, been taken by the UK

Accidents & Incidents

Events in the SKYbrary database which include Pilot Medical Fitness as a contributory factor:

  • A320, en-route Alpes-de-Haute-Provence France, 2015 (On 24 March 2015, after waiting for the Captain to leave the flight deck and preventing his return, a Germanwings A320 First Officer put his aircraft into a continuous descent from FL380 into terrain killing all 150 occupants. Investigation concluded the motive was suicide, noted a history of mental illness dating from before qualification as a pilot and found that prior to the crash he had been "experiencing mental disorder with psychotic symptoms" which had not been detected through the applicable "process for medical certification of pilots". Conflict between the principles of medical confidentiality and wider public interest was identified.)
  • A320, vicinity Abu Dhabi UAE, 2012 (On 16 November 2012, Captain of an A320 positioning for approach to Abu Dhabi at night became incapacitated due to a stroke. The First Officer took over control and declared a MAYDAY to ATC. The subsequent approach and landing were uneventful but since the First Officer was not authorised to taxi the aircraft, it was towed to the gate for passenger disembarkation. The investigation found that the Captain had an undiagnosed medical condition which predisposed him towards the formation of blood clots in arteries and veins.)
  • A332, vicinity Melbourne Australia, 2013 (On 8 March 2013, the crew of a Qantas A330 descended below controlled airspace and to 600 feet agl when still 9nm from the landing runway at Melbourne in day VMC after mismanaging a visual approach flown with the AP engaged. An EGWS Terrain Alert was followed by an EGPWS PULL UP Warning and a full recovery manoeuvre was flown. The Investigation found degraded situational awareness had followed inappropriate use of Flight Management System)
  • B734, Lahore Pakistan, 2015 (On 3 November 2015, a Boeing 737-400 continued an unstabilised day approach to Lahore. When only the First Officer could see the runway at MDA, he took over from the Captain but the Captain took it back when subsequently sighting it. Finally, the First Officer took over again and landed after recognising that the aircraft was inappropriately positioned. Both main gear assemblies collapsed as the aircraft veered off the runway. The Investigation attributed the first collapse to the likely effect of excessive shimmy damper play and the second collapse to the effects of the first aggravated by leaving the runway.)
  • B734, en-route, New South Wales Australia, 2007 (On 11 August 2007, a Qantas Boeing 737-400 on a scheduled passenger service from Perth, WA to Sydney, NSW was about three quarters of the way there in day VMC when the master caution light illuminated associated with low output pressure of both main tank fuel pumps. The flight crew then observed that the centre tank fuel pump switches on the forward overhead panel were selected to the OFF position and he immediately selected them to the ON position. The flight was completed without further event.)
  • CRJX / AT75, Tambolaka Indonesia, 2018 (On 11 May 2018, a Bombardier CRJ1000 climbing on departure from Tambolaka and an ATR72-500 descending inbound there lost safe separation when during opposite turns in visual flight in uncontrolled airspace. Prompt response to both coordinated TCAS RAs resolved the conflict. The Investigation found the departing flight Captain mixed up left and right downwind circuit joining by the ATR 72 and that his inexperienced First Officer had not picked this up. It also noted that this Captain may not have been fit for duty and that all parties may have failed to fully recognise the limitations of ANSP ‘information’ service.)


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