December 18, 2013
By Thomas B Haines
Today there’s a pilot flying his Piper Super Cub low over a farm field, enjoying the view. The upper door is open, his arm in the breeze. The smell of freshly cut hay drifts into the cockpit. As the mighty Cub slides over a fencerow, the next vista unfolds for the pilot who knows the fields, the country roads, the individual houses as well as the rooms in his own home. A neighbor in his driveway looks up and waves, the Cub a familiar sight.
What the pilot doesn’t know is that this is his last day of flying. For tomorrow he goes in for his third class medical exam. But this time the doc for the first time ever will be required to measure his body mass index and record it on the form that gets sent to the FAA. BMI is a ratio of height to weight. While frequently cited as a means of determining who is overweight and obese, the measure itself is controversial as a health tool. In addition, the aviation medical examiner will measure our pilot’s neck; if he finds it is more than 17 inches and he has a BMI of 40, the doc must defer (or withhold) the pilot’s medical certificate until he can be evaluated by “a physician who is a board certified sleep specialist.” If the pilot is determined to have obstructive sleep apnea (OSA), he may no longer fly his Super Cub from his farm strip in Iowa (see “Member News and Notes: Suspend Sleep Apnea Policy, AOPA Insists,” page 100).
According to Federal Air Surgeon Fred Tilton, M.D., the danger of our pilot falling asleep during his weekly 45-minute flight over farm country or making a poor in-flight decision because of interrupted sleep is just too great a risk. A cornfield could be damaged. Dairy cows in a nearby pasture might be frightened should he drift too low over a field because of his “cognitive impairment.” Milk production could suffer. This FAA mandate comes despite no reports by said cows of such incidents.
The testing by that sleep specialist will require multiple trips to the city and thousands of dollars of investment for our pilot. If diagnosed with OSA, our pilot will need to spend hundreds of dollars more on gear to allow him to sleep more restfully, and he will have to go through an FAA special issuance process in order to regain his ability to fly his Super Cub over the countryside. Forever more he will have to show annually that he is complying with the requirements of the special issuance and diligently using his sleep-aid gear, a machine with a recording device that will rat him out if he doesn’t use it regularly.
The agency’s move to require screenings for all pilots is the result of a 2009 recommendation from the NTSB that cites a single incident of a regional airline crew falling asleep and overflying a Hawaiian island before waking and safely landing as intended. The captain had undiagnosed OSA. The sleepy first officer was simply a victim of regional airline scheduling. The NTSB concludes “that efforts to identify and treat the disorder in commercial pilots could improve the safety of the traveling public,” although it’s unable to cite any accidents related to OSA. The NTSB report is focused on commercial pilots, but the final board recommendations encompass screening and treatment for all pilots.
In addition, Tilton plans to continue ratcheting down the BMI number “until we have identified and assured treatment for every airman with OSA.” Sounds like a witch hunt. But most disturbing is that the FAA is using policy to set regulation—with no opportunity for comment, no safety data to make its case. What’s next? People with freckles must be screened for skin cancer by a dermatologist before they can get a medical?
AOPA’s Medical and Government Affairs staffs are calling for a stop to the policy’s implementation. At press time, AOPA was supporting a group of legislators in the House GA Caucus who introduced legislation to require the FAA to go through rulemaking before making the policy change. No one is advocating that pilots should fly with OSA, but how about education and regulatory process rather than policy edict? The new mandate will cost thousands of dollars each for tens of thousands of pilots and overwhelm the FAA with new cases—and to what end, given no data to back it up? Will we really see the accident rate decline? Or will we see pilots like the one described above simply call it a day—the last day for flying?
AOPA Editor in Chief Tom Haines joined AOPA in 1988. He owns and flies a Beechcraft A36 Bonanza. Since soloing at 16 and earning a private pilot certificate at 17, he has flown more than 100 models of general aviation airplanes.
Pilot Health and Medical,
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