Cabin Crew Medical Report

Implementing rules, Acceptable Means of Compliance, UK Guidance

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

Implementing Rules

UK Alternative Means of Compliance

Guidance Material

Section 1

General requirements

MED.C.001
General

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.

MED.C.005
Aeromedical assessments

(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.

UK AltMOC1 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;

(2) operate the aircraft systems and emergency equipment to be used by cabin crew;

(3) perform their duties in the aircraft cabin environment and during shorthaul, longhaul or ultralonghaul operations; and

(4) perform the required duties and responsibilities efficiently during normal and abnormal operations, and in an emergency.

UK GM1 MED.C.005
Aeromedical assessments

Applicants who meet the DVLA Medical Standards of Fitness to Drive for Group 1 driving would normally be assessed as fit, i.e. have an acceptable risk of incapacitation, except as indicated in the UK AltMOCs and in the further guidance material below.

(b) Each cabin crew member shall undergo an aeromedical assessment before first being assigned to duties on an aircraft, and after that at intervals of maximum 60 months.

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.

(c) Aeromedical assessments shall be conducted by an AME, AeMC, or by an OHMP if the requirements of MED.D.040 are complied with.

 

Implementing Rules

UK Alternative Means of Compliance

Guidance Material

Section 2

Requirements for aeromedical assessment of cabin crew

MED.C.020
General

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.

MED.C.025
Content of aeromedical assessments
UK AltMOC1 MED.C.025
Content of aeromedical assessments
UK GM1 MED.C.025
Content of aeromedical assessments
(a) An initial aeromedical assessment shall include at least:

Aeromedical examinations and/or assessments of cabin crew members should be conducted according to the medical requirements in UK AltMOC1 to UK AltMOC7 MED.C.025:

A specimen questionnaire that could be used for the initial medical assessment is attached at Appendix A.
(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) An applicant should not have any cardiovascular disorder that would entail a degree of functional incapacity likely to lead to incapacitation or an inability to discharge their safety duties and responsibilities.

(ii) respiratory system

UK AltMOC3 MED.C.025
Respiratory system

(a) An applicant should not have any significant impairment of pulmonary function that would entail a degree of functional incapacity likely to lead to incapacitation or an inability to discharge their safety duties and responsibilities.

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.

Pneumothorax. 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

Implementing Rules

Acceptable Means of Compliance

Guidance Material

(iii) musculoskeletal system;

UK AltMOC4 MED.C.025
Musculoskeletal system

(a) An applicant should not have any abnormality of the bones, joints, muscles or tendons, 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.

(iv) otorhinolaryngology;

UK AltMOC5 MED.C.025
Otorhinolaryngology

(a) An applicant should not possess any abnormality of the function of the ears, nose, sinuses or throat, including oral cavity, teeth and larynx, or any active pathological condition, congenital or acquired, acute and chronic, or any sequelae of surgery or trauma, that would entail a degree of functional incapacity likely to lead to incapacitation or an inability to discharge their safety duties and responsibilities.

UK GM3 MED.C.025
Otorhinolaryngology

Hearing should be satisfactory for the safe exercise of cabin crew duties and responsibilities. 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.

(v) visual system; and

UK AltMOC6 MED.C.025
Visual system

(a) An applicant should not possess any abnormality of the function of the eyes or their adnexa or any active pathological condition, congenital or acquired, acute or chronic, or any sequelae of eye surgery or trauma, that would entail a degree of functional incapacity that might lead to incapacitation or an inability to discharge their safety duties and responsibilities.

UK GM4 MED.C.025
Visual system

(b) Distant visual acuity, with or without correction, should be 6/9 or better.

(c) An applicant should be able to read an N5 chart (or equivalent) at 30-50cm with correction if required.

(d) Applicants with diplopia should be assessed as unfit.

Visual acuity should be assessed with both eyes open, or in the only eye if monocular.

(vi) colour vision.

UK AltMOC7 MED.C.025
Colour vision

(a) Applicants should be required to demonstrate the ability to perceive readily the colours that are necessary for the safe performance of cabin crew duties.

UK GM5 MED.C.025
Colour vision
(b) An applicant should be able to correctly identify 9 of the first 15 plates of the 24-plate edition of the 24-plate Ishihara pseudoisochromatic plates. Alternatively the applicant should demonstrate the ability to safely perform their duties by means of a suitable functional assessment.Suitable functional tests would include the successful completion of Safety Equipment & Procedures (SEP) training.

(b) Each subsequent aero-medical assessment shall include:

(1) an assessment of the cabin crew member’s medical history; and
(2) a clinical examination if deemed necessary in accordance with aero-medical best practice.

(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 GM6 MED.C.025
Subsequent aeromedical assessment

A specimen questionnaire that could be used for periodic medical assessment is attached at Appendix B.

 

Implementing Rules

Acceptable Means of Compliance

Guidance Material

Section 3

Additional requirements for applicants for, or holders of, a cabin crew attestation

MED.C.030
Cabin crew medical report

(a) After completion of each aero-medical assessment, applicants for, and holders of, a cabin crew attestation:
   (1) shall be provided with a cabin crew medical report by the AME, AeMC or OHMP; and
   (2) shall provide the related information, or a copy of their cabin crew medical report to the operator(s) employing their services.

AMC1 MED.C.030
Cabin crew medical report

(b) Cabin crew medical report
A cabin crew medical report shall indicate the date of the aeromedical assessment, whether the cabin crew member has been assessed fit or unfit, the date of the next required aeromedical assessment and, if applicable, any limitation(s). Any other elements shall be subject to medical confidentiality in accordance with MED.A.015.

(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

Implementing Rules

Acceptable Means of Compliance

Guidance Material

MED.C.035
Limitations

(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.

AMC1 MED.C.035
Limitations
UK GM1 MED.C.035
Limitations
(b) Any limitation(s) to the exercise of the privileges granted by the cabin crew attestation shall be specified on the cabin crew medical report and shall only be removed by an AME, AeMC or by an OHMP in consultation with an AME.

(a) When assessing whether the holder of a cabin crew attestation may be able to perform cabin crew duties safely if complying with one or more limitations, the following possible limitations should be considered:

An AME or OHMP may add or remove any of the specified limitations.

(1) a restriction to operate only in multi- cabin crew operations (MCL);

There is likely to be little indication for the MCL limitation. You should discuss the case with the AMS before applying this limitation to a UK member of cabin crew.
(2) a restriction to specified aircraft type(s) (OAL) or to a specified type of operation (OOL);There is likely to be little indication for the OAL and OOL limitations. You should discuss the case with the AMS before applying this limitation to a UK member of cabin crew.

(3) a requirement to undergo the next aeromedical examination and/or assessment at an earlier date than required by MED.C.005 (b) (TML);

The TML limitation may be used for applicants who require review of their fitness at an interval less than that specified at MED.C.005. You should annotate your report to indicate the period of validity: ‘Valid for ……. months.’
(4) a requirement to undergo specific regular medical examination(s) or assessments (SIC);The SIC limitation may be used for applicants who have a medical condition which requires regular review of their fitness at an interval less than that specified at MED.C.005. You should annotate your report to indicate the period of validity: Valid for …….months/years.
(5) a requirement for visual correction (CVL), or by means of corrective lenses only (CCL);Used for applicants who can only meet the requirements of UK AltMOC6 MED.C.025 by using visual correction.  The CVL limitation should be used for all UK crew who require visual correction, including contact lens wearers.
(6) a requirement to use hearing aids (HAL); andUsed for applicants who can only meet the requirements of UK AltMOC5 MED.C.025(2)(iv) by wearing a hearing aid(s).

(7) special restriction as specified (SSL).

You should discuss the case with the AMS before applying this limitation to a UK member of cabin crew.