The following are the UK requirements for the medical certification of cabin crew which will apply from 8 Apr 2014, following implementation of the EASA Part-MED requirements for cabin crew.
Cabin crew members shall only perform the duties and responsibilities required by aviation safety rules on an aircraft if they comply with the applicable requirements of this Part.
(a) Cabin crew members shall undergo aeromedical assessments to verify that they are free from any physical or mental illness which might lead to incapacitation or an inability to perform their assigned safety duties and responsibilities.
AMC1 MED.C.005 Aeromedical assessments
(a) When conducting aeromedical examination and/or assessments of cabin crew, their medical fitness should be assessed with particular regard to their physical and mental ability to:
(1) undergo the training required for cabin crew to acquire and maintain competence, e.g. actual fire-fighting, slide descending, using Protective Breathing Equipment (PBE) in a simulated smoke-filled environment, providing first aid;
(2) manipulate the aircraft systems and emergency equipment to be used by cabin crew, e.g. cabin management systems, doors/exits, escape devices, fire extinguishers, taking also into account the type of aircraft operated e.g. narrow-bodied or wide-bodied, single/multi-deck, single/multi-crew operation;
(3) continuously sustain the aircraft environment whilst performing duties, e.g. altitude, pressure, re-circulated air, noise; and the type of operations such as short/medium/long/ultra long -haul; and
(4) perform the required duties and responsibilities efficiently during normal and abnormal operations, and in emergency situations and psychologically demanding circumstances e.g. assistance to crew members and passengers in case of decompression; stress management, decision-making, crowd control and effective crew coordination, management of disruptive passengers and of security threats. When relevant, operating as single cabin crew should also be taken into account when assessing the medical fitness of cabin crew.
UK GM1 MED.C.005 Aeromedical assessments
Applicants who meet the DVLA Medical Standards of Fitness to Drive for Group 1 driving [https://www.gov.uk/government/publications/at-a-glance] may be assessed as having an acceptable risk of incapacitation, except as indicated in the UK AltMOCs and in the further guidance material below.
Cabin crew periodic medical assessments may be carried out no more than 45 days prior to the expiry date of the previous Medical Report and shall be valid for 60 months from that expiry date.
If the Medical Report has expired, the AME or OHMP need only carry out a periodic medical assessment.
Requirements for aeromedical assessment of cabin crew
Cabin crew members shall be free from any:
(a) abnormality, congenital or acquired;
(b) active, latent, acute or chronic disease or disability;
(c) wound, injury or sequelae from operation; and
(d) effect or side-effect of any prescribed or non-prescribed therapeutic, diagnostic or preventive medication taken that would entail a degree of functional incapacity that might lead to incapacitation or an inability to discharge their safety duties and responsibilities.
Aeromedical examinations and/or assessments of cabin crew members should be conducted according to the medical requirements in UK AltMOC2 to AMC18 MED.C.025:
(1) an assessment of the applicant cabin crew member’s medical history; and
(a) An applicant should not have any established medical history or clinical diagnosis of any disease or disability, condition or disorder, acute or chronic, congenital or acquired, that would entail a degree of functional incapacity likely to lead to incapacitation or an inability to discharge their
safety duties and responsibilities.
(2) a clinical examination of the following:
(i) cardiovascular system;
UK AltMOC2 MED.C.025 Cardiovascular system
(a) Examination (1) A standard 12-lead resting electrocardiogram (ECG) and report should be completed on clinical indication.
(2) Extended cardiovascular assessment should be required when clinically indicated.
(b) Cardiovascular system - general (1) Cabin crew members with any of the following conditions:
(i) aneurysm of the thoracic or supra-renal abdominal aorta, before surgery;
(ii) significant functional abnormality of any of the heart valves;
(iii) heart or heart/lung transplantation should be assessed as unfit. A fit assessment may be considered following satisfactory treatment and recovery.
(2) Cabin crew members with an established diagnosis of one of the following conditions:
(i) peripheral arterial disease before or after surgery;
(ii) aneurysm of the abdominal aorta, before or after surgery;
(iii) minor cardiac valvular abnormalities;
(iv) after cardiac valve surgery;
(v) abnormality of the pericardium, myocardium or endocardium;
(vi) congenital abnormality of the heart, before or after corrective surgery;
(vii) a cardiovascular condition requiring systemic anticoagulant therapy;
(viii) recurrent vasovagal syncope;
(ix) arterial or venous thrombosis; or
(x) pulmonary embolism should be evaluated by a cardiologist before a fit assessment can be considered.
(ii) respiratory system
UK AltMOC3 MED.C.025 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 be required to undergo pulmonary function tests on clinical indication.
(c) Cabin crew members with a history or established diagnosis of:
(2) active inflammatory disease of the respiratory system;
(3) active sarcoidosis;
(5) sleep apnoea syndrome/sleep disorder; or
(6) major thoracic surgery should undergo respiratory evaluation with a satisfactory result before a fit assessment can be considered.
UK GM2 MED.C.025 Respiratory system
Applicants with impaired pulmonary function e.g. due to COPD, may require additional assessment such as hypoxic challenge testing or functional assessment during flight.
Applicants may be assessed as fit:
• Six weeks after recovery from a single spontaneous pneumothorax
• Following definitive surgical treatment for recurrent pneumothorax
• On recovery (full absorption) from traumatic pneumothorax
Metabolic and endocrine systems
(a) Cabin crew members should not possess any functional or structural metabolic, nutritional or endocrine disorder which is likely to interfere with the safe exercise of their duties and responsibilities.
(b) Cabin crew members with metabolic, nutritional or endocrine dysfunction may be assessed as fit, subject to demonstrated stability of the condition and satisfactory aero-medical evaluation.
UK AltMOC7 MED.C.025 Genitourinary system
(a) Urine analysis should form part of the initial aero-medical examination. The urine should not contain any abnormal element(s) considered to be of pathological significance.
(b) Cabin crew members with any sequelae of disease or surgical procedures on the kidneys or the urinary tract, in particular any obstruction due to stricture or compression likely to cause incapacitation, should be assessed as unfit.
A fit assessment may be considered following satisfactory treatment and recovery.
(c) Cabin crew members with a genitourinary disorder, such as:
(i) renal disease; or
(ii) a history of renal colic due to one or more urinary calculi may be assessed as fit subject to satisfactory renal/urological evaluation.
(d) Cabin crew members who have undergone a major surgical operation in the urinary apparatus involving a total or partial excision or a diversion of its organs should be assessed as unfit and be re-assessed after full recovery before a fit assessment can be made.
Following pregnancy, the AME, AeMC or OHMP shall assess the medical fitness of the cabin crew member and decide whether she is fit to resume her safety duties.
UK AltMOC10 MED.C.025 Musculoskeletal system
(a) A cabin crew member should have sufficient standing height, arm and leg length and muscular strength for the safe exercise of their duties and responsibilities.
(b) A cabin crew member should have satisfactory functional use of the musculoskeletal system
UK GM5 MED.C.025 Neurology
Cabin crew members who have a first unprovoked seizure should be assessed as unfit. A fit assessment may be considered 6 months after the date of the seizure, or 12 months after the date of the seizure if there are clinical factors or investigation results which suggest an unacceptably high risk of a further seizure, i.e. 20% or greater per annum.
Cabin crew members who have a history or diagnosis of epilepsy may be assessed as fit provided that they have been free from any unprovoked seizure for a minimum of one year from the date of the assessment (on or off treatment).
They must be under regular review and should have a requirement to undergo specific regular medical examinations or assessments (SIC).
UK AltMOC14 MED.C.025 Visual system
(1) a routine eye examination should form part of the initial examination; and
(2) an extended eye examination should be undertaken when clinically indicated.
(b) Distant visual acuity with both eyes, with or without correction, should be 6/9 or better.
(c) A cabin crew member should be able to read an N5 chart (or equivalent) at 30–50 cm, with or without correction.
(d) Cabin crew members should have normal fields of vision.
(e) Cabin crew members who have undergone refractive surgery may be assessed as fit subject to satisfactory ophthalmic evaluation.
(f) Cabin crew members with diplopia should be assessed as unfit.
(g) Spectacles and contact lenses:
If satisfactory visual function is achieved only with the use of correction:
(1) In the case of myopia or hypermetropia, spectacles or contact lenses should be worn whilst on duty;
(2) in the case of presbyopia, spectacles or contact lenses should be readily available for immediate use whilst on duty;
(3) the correction should provide optimal visual function and be well tolerated;
(4) orthokeratologic lenses should not be used.
Cabin crew with hypoacusis should demonstrate satisfactory functional hearing abilities, either by a clinical test such as the forced whisper test, or a functional test such as satisfactory completion of Safety Equipment and Procedures (SEP) training.
Applicants with a history of recurrent otitis media or recurrent sinusitis may require assessment by an ENT specialist.
UK AltMOC17 MED.C.025 Dermatology
In cases where a dermatological condition is associated with a systemic illness, full consideration should be given to the underlying illness before a fit assessment may be made.
(b) Each subsequent aero-medical assessment shall include:
(c) For the purpose of (a) and (b), in case of any doubt or if clinically indicated, a cabin crew member’s aeromedical assessment shall also include any additional medical examination, test or investigation that are considered necessary by the AME, AeMC or OHMP.
UK GM9 MED.C.025
Subsequent aeromedical assessment
A specimen questionnaire that could be used for periodic medical assessment is attached at Appendix B.
Additional requirements for applicants for, or holders of, a cabin crew attestation
Cabin crew medical report
(a) After completion of each aero-medical assessment, applicants for, and holders of, a cabin crew attestation:
(a) Cabin crew medical report
The medical report to be provided in writing to the applicants for, and holders of, a cabin crew attestation after completion of each aeromedical examination and/or assessment should be issued:
(1) in the national language(s) and/or in English; and
(2) according to the format below, or another format if all, and only the elements specified below are provided:
Specimen Cabin Crew Medical Report
(a) If holders of a cabin crew attestation do not fully comply with the medical requirements specified in Section 2, the AME, AeMC or OHMP shall consider whether they may be able to perform cabin crew duties safely if complying with one or more limitations.
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