Unfit Assessments of Class 1 Medical Certificate Holders.

An aviation safety management system should consider and mitigate against all potential risks to flight safety. In addition to in-flight incapacitation, pilots falling below regulatory standards who are assessed as unfit may have represented a risk prior to that assessment. An analysis was undertaken of Class 1 certificate holders to determine factors correlated with unfit assessments. Fitness assessments of pre-existing Class 1 certificate holders following medical examinations (to EASA Part-MED standards) or between medicals were studied between 1 January 2016 and 31 December 2019. Assessments where the outcome was 'fit' (= 99,406) were compared with those where the outcome was 'unfit' (= 7925). Analyses for correlation between unfit assessments against age, declared coexisting medical conditions, and the number of days since last assessed as fit were undertaken using SPSS. Unfit assessment likelihood and age were strongly correlated; there is, however, evidence for the 'healthy worker effect', with a fall in unfit assessments between 60-65 yr of age. There was no association between coexisting medical condition declaration and the likelihood of becoming unfit. The time interval between a fit and unfit assessment was significantly lower when comparing 20-60 and 61-63 yr old individuals. The analysis of unfit assessments shows strong correlation with increasing age and the possible presence of the healthy worker effect among commercial pilots. The decreased time from a previous fit assessment to an unfit assessment supports the reduced certificate validity period of Class 1 applicants over 60 yr of age..