01_i Pages 2004-03-05 11:37 AM Page 1–i TP 13312E *TP13312E* (03/2004) Handbook for Civil Aviation Medical Examiners http://www.tc.gc.ca/CivilAviation/Cam/menu.htm Également disponible en français sous le titre de : Guide pour les médecins examinateurs de l’aviation civile 01_i Pages 2004-03-05 11:37 AM Page 1–ii Catalogue No. T52-103/2004E ISBN 0-662-35838-4 RDIMS Locator No. 701877 © Her Majesty the Queen in Right of Canada, as represented by the Minister of Transport, 2004 All rights reserved. No part of this information (publication or product) may be reproduced, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, or stored in a retrieval system, without prior written permission of the Minister of Public Works and Government Services, Ottawa, Ontario, Canada K1A 0S5 or at [email protected]. The information in this publication is to be considered solely as a guide and should not be quoted as or considered to be a legal authority. It may become obsolete in whole or in part at any time without notice. 01_i Pages 2004-03-05 11:37 AM Page 1–iii TRANSPORT CANADA RECORD OF AMENDMENT RECORD OF AMENDMENT No. Date of amendment Date inserted Inserted by HANDBOOK FOR CIVIL AVIATION MEDICAL EXAMINERS 01_i Pages 2004-03-05 11:37 AM Page 1–iv 01_i Pages 2004-03-05 11:37 AM Page 1–v TRANSPORT CANADA TABLE OF CONTENTS TABLE OF CONTENTS FOREWORD TABS SECTION 1 SECTION 2 NEUROLOGY CARDIOVASCULAR DIABETES ASTHMA OTHER POLICIES CONTACTS NOTE This handbook has been produced at Civil Aviation Medicine Headquarters in Ottawa. Any errors, omissions or suggestions should be forwarded to: Dr. James M. Wallace Civil Aviation Medicine Branch (AARG) Transport Canada 330 Sparks Street Place de Ville, Tower “C”, Room 617 Ottawa, Ontario K1A 0N8 HANDBOOK FOR CIVIL AVIATION MEDICAL EXAMINERS 01_i Pages 2004-03-05 11:37 AM Page 1–vi 01_i Pages 2004-03-05 11:37 AM Page 1–vii TRANSPORT CANADA FORWORD Civil Aviation Medical Standards The history of medical standards in civil aviation delegation of validation authority to the examiner dates back to just after World War I when the have not resulted in increasing the exposure to International Commission on Air Navigation (ICAN) litigation, and will therefore not result in increases to was established following the Paris Air Convention malpractice insurance premiums for CAMEs. of 1919. This organization was set up to establish rules and regulations for the safe conduct of civil Accompanying this book is a video outlining the aviation. ICAN established a medical sub- changes that have taken place in the medical commission which set about producing the first ever certification process, and showing you how to medical standards for civil aircrew which were complete the Medical Examination Report form extremely strict. In 1944, towards the end of World (26-0010) completely. The medical handbook part of War II, the International Civil Aviation Organization this document is not a text on aviation medicine, it is (ICAO), an agency of the United Nations, was merely an introduction to the subject and covers the formed to carry on the work of ICAN, which had basic facts that you must have to understand the ceased to exist during World War II. Over the years, medical problems associated with flight. It will help the international standards and those of Canada have you deal with many of the questions you may be become more liberal to the point now that the asked and hopefully will encourage you to further majority of the population over the age of 16, if they study the subject. More detailed information on the so wished, would pass aviation medical certification subject of aviation medicine can be obtained from the examinations. following books: In Canada, the regulations pertaining to medical Aviation Medicine – J. Ernsting, A. Nicholson and requirements are contained in Part 404 of the D. Rainford, Third Edition (1999), Butterworth – Canadian Aviation Regulations (CARs) while the Heinemann. actual medical standards are in Part 424 of the Fundamentals of Aerospace Medicine – R. DeHart Canadian Aviation Regulations. Both Part 404 and and J. Davis, Third Edition (2002), Williams and Part 424 form part of this Handbook. CAR 424.05 Wilkins. permits the Civil Aviation Medicine Branch to exercise flexibility in medical certification of pilots Clinical Aviation Medicine – R. Raymond, Third and air traffic controllers who technically do not meet Edition (2000), Castle Connolly Graduate Medical the standard, but for whom a c c redited medical Publishing, LLC. conclusion is such that the failure to meet the Civil Aviation Medicine Branch has developed an standard is such that the exercise of the privilege of Internet website which will be used more and more the licence is not likely to affect air safety. for the dissemination of information between the Over the years, guidelines have been produced in the Branch and CAMEs. Those of you who have Internet major areas which cause problems with aeromedical access are welcome to browse the website and submit certification, namely neurology, cardiology and your comments. The address is: diabetes. A copy of these guidelines is available in http://www.tc.gc.ca/CivilAviation/Cam/menu.htm this Handbook. In your role as a Civil Aviation Medical Examiner (CAME), you are usually the only person who physically examines the pilot or ATC and makes a recommendation for medical certification. You are therefore the most important link in the chain of safety in the medical certification process. While performing your CAME function, you are acting as an agent of the Minister of Transport, so Transport Canada will indemnify you for any litigation that may come from your aviation medical examination activity which is conducted in good faith. Recent changes in the medical certification process, and HANDBOOK FOR CIVIL AVIATION MEDICAL EXAMINERS 01_i Pages 2004-03-05 11:37 AM Page 1–viii 02_Section 1 2004-03-12 10:38 AM Page i TRANSPORT CANADA SECTION 1 SECTION 1 HANDBOOK FOR CIVIL AVIATION MEDICAL EXAMINERS 02_Section 1 2004-03-12 10:38 AM Page ii 02_Section 1 2004-03-12 10:38 AM Page iii TRANSPORT CANADA SECTION 1 Table of Contents SECTION 1 Page Civil Aviation Organization and Administration . 1–1 CAM HQ . 1–1 CAM Regional Offices . 1–1 Figure 1 – TC Aviation Regions . 1–1 Licensing . 1–2 Civil Aviation Medical Examiners (CAMEs) . 1–2 Termination of Appointments . 1–2 The Medical Examination . 1–3 Figure 2 – Medical Examination Requirement Chart . 1–4 Civil Aviation Medical Examination Report Form . 1–5 Completing the Medical Examination Report Form . 1–7 Chart 1 – Body Mass Index (BMI) . 1–9 Figure 3 – Vision Standards . 1–10 Figure 4 – Medical Certificate . 1–12 APPENDIX 1 – The Maddox Rod Test . 1–14 APPENDIX 2 – Colour Vision . 1–15 HANDBOOK FOR CIVIL AVIATION MEDICAL EXAMINERS 02_Section 1 2004-03-12 10:38 AM Page iv 02_Section 1 2004-03-12 10:38 AM Page 1 TRANSPORT CANADA SECTION 1 Civil Aviation Medical Branch Organization and Administration The Civil Aviation Medicine (CAM) Branch is one of The mission is to ensure aircrew and air traffic several branches of the Directorate General of Civil c o n t rollers are medically fit, to close gaps in Aviation in Transport Canada. The Director of Civil scientific knowledge of Canadian aviation medicine, Aviation Medicine reports to the Director General of to promote health and safety in the field of aviation Civil Aviation. and to prevent aircraft accidents due to medically related human factors. CAM Headquarters CAM Headquarters is located in the Tr a n s p o r t CAM Regional Offices Canada Building, 330 Sparks Street, Tower “C”, There are currently four Regional offices across Place de Ville, Ottawa, K1A 0N8. Canada located in Montreal, Toronto, Edmonton, and Vancouver. The Edmonton, Toronto, and Montreal The mandate of CAM is to provide medical advice offices are under the direction of a Regional Aviation and assistance in setting out physical standards for Medical Officer (RAMO) while the office in Civil Aviation personnel; to advise in all problems Vancouver is staffed by an Aviation Medical Officer. connected with the health of travellers by air. The RAMOs are responsible for the selection and Figure 1 TRANSPORT CANADA REGIONS HANDBOOK FOR CIVIL AVIATION MEDICAL EXAMINERS 1–1 02_Section 1 2004-03-12 10:38 AM Page 2 SECTION 1 TRANSPORT CANADA training of CAMEs, for reviewing the medical All CAME appointments are valid for a period of examination reports of pilots, flight engineers, and air four years, renewable upon the recommendation of traffic controllers, and for approving an appropriate the RAMO. Re-appointment will depend on the medical category for aviation personnel. CAM does quality and timeliness of reports, demonstrated not issue licences, it issues Medical Certificates continuing interest in aviation medicine, and (MCs). Licensing is a responsibility of Transport feedback from the aviation community. There must Canada, General Aviation. As a CAME, you may also be a continuing requirement for services in the now renew MCs, for the full validity period, of CAME’s designated geographic area. licensed aviation personnel for renewal medical examinations only. Initial medical reports, category Termination of Appointments upgrades and removal or addition of restrictions to a It is rare for a CAME appointment to be terminated. MC must be sent to the RAMO for assessment. If there are significant problems with the quality of the medical information being submitted, the RAMO Licensing will contact the CAME and take whatever remedial All pilots, flight engineers, and air traffic controllers action is necessary to assist in solving the problem.