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densoo

Well-known member
Joined
Nov 2, 2004
Posts
2,054
Pilots and controllers who may be obese will have an extra hoop to jump for their medical certification to ensure they don't have obstructive sleep apnea (OSA). Federal Air Surgeon Dr. Fred Tilton has notified Air Medical Examiners (AME) that they will soon be required to measure the body mass index (BMI) of all pilots and controllers during their medicals. Anyone with a BMI of 40 or more (up to 25 is normal) and with neck circumference of 17 inches or more will automatically have to be evaluated for OSA by a doctor who is a "board certified sleep specialist." Anyone who has OSA has to get it treated successfully before he or she can fly again because OSA is a disqualifying condition. And, chances are, if their BMI is that high (five feet eight inches and 260 pounds) and their neck is that thick they do have OSA according to Tilton "OSA is almost universal..." in those individuals, Tilton tells the AMEs. OSA disrupts restorative sleep and causes daytime sleepiness, cognitive impairment and can even cause sudden cardiac death but Tilton doesn't say in his brief note what data (how many OSA-related accidents have been recorded, for instance) his staff have used to draft the new rule. But it doesn't end with the obviously fat.

Tilton says that while the initial action will target those with the BMIs above 40, his plan is to root out all sleep apnea victims and ensure they don't fly until they're treated. "Once we have appropriately dealt with every airman examinee who has a BMI of 40 or greater, we will gradually expand the testing pool by going to lower BMI measurements until we have identified and assured treatment for every airman with OSA," he wrote. That means even the moderately overweight (BMI of 30 or less) can likely expect the referral to a sleep specialist because Tilton says that up to 30 percent of those who carry an extra 20 or 30 pounds have OSA. For unknown reasons, pilots will be targeted first. There are "logistical details" to be dealt with before the rule is implemented for controllers but Tilton said the plan is to include them, too.

http://www.avweb.com/avwebflash/news/FAA-Targets-Fat-Pilots-And-Controllers220978-1.html
 
That's a pretty hefty pilot there. At 6'2" I would have to weigh about 320 to hit a bmi of 40. Even then you can diagnosed with sleep apnea, use a cpap and start flying again

The threshold should be much lower.
 
That's a pretty hefty pilot there. At 6'2" I would have to weigh about 320 to hit a bmi of 40. Even then you can diagnosed with sleep apnea, use a cpap and start flying again

The threshold should be much lower.

You missed this tidbit-
"Once we have appropriately dealt with every airman examinee who has a BMI of 40 or greater, we will gradually expand the testing pool by going to lower BMI measurements until we have identified and assured treatment for every airman with OSA," he wrote. That means even the moderately overweight (BMI of 30 or less) can likely expect the referral to a sleep specialist because Tilton says that up to 30 percent of those who carry an extra 20 or 30 pounds have OSA.
 
Is this because they might pass out while sleeping in the cockpit?
 
BMI's greater than 40 is morbid obesity. I'd be ok with not issuing a medical based solely on that fact. I mean, c'mon!

Ok, rant over, back to figuring out what spring ultra-marathon to put on the sched. this spring ;-)
 
The issue I have with this is how it might be applied to people with more muscle mass than average.

Many former wrestlers, boxers, or football players have necks larger than 17" and a higher than "average" BMI, but are physically fit.

Hopefully, they are going to give the AME's enough latitude to not have to subject physically fit Pilots to unnecessary "sleep studies" which are expensive and time-consuming.

Ty
 
The issue I have with this is how it might be applied to people with more muscle mass than average.

Many former wrestlers, boxers, or football players have necks larger than 17" and a higher than "average" BMI, but are physically fit.

Hopefully, they are going to give the AME's enough latitude to not have to subject physically fit Pilots to unnecessary "sleep studies" which are expensive and time-consuming.

Ty
This was a big issue in the military. There was a time they used BMI as a rough estimate for fitness and a few folks who worked weights for fitness were told they were out of shape in spite of an atlas profile. Had to jump through hoops like caliper measurements and even "Hydrodensitometry Weighing (Underwater Weighing)" to prove they weren't fat even though it was obvious they weren't. It was nuts.

As to your other point, who pays for this testing? If an AME required it your doctor may or may not refer you to a specialist, and your medical plan may or may not cover it.

If the FAA is really that hard over about ferreting out apnea and think it's such a hidden problem they should just require everyone to do a baseline sleep study in order to get a Class One medical. Ha. Then there would really be a pilot shortage and the LTD funds would be drained.

Sleep apnea tests require sleeping on the back. In that position many if not most people snore and many will be diagnosed with apnea. While apnea is a far more serious condition than simple snoring, sleeping on the side "cures" it for many people. IOW they don't normally have sleep apnea but the sleep study on the back will say they do. There will be a lot of false positives.
 
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This was a big issue in the military. There was a time they used BMI as a rough estimate for fitness and a few folks who worked weights for fitness were told they were out of shape in spite of an atlas profile. Had to jump through hoops like caliper measurements and even "Hydrodensitometry Weighing (Underwater Weighing)" to prove they weren't fat even though it was obvious they weren't. It was nuts.

As to your other point, who pays for this testing? If an AME required it your doctor may or may not refer you to a specialist, and your medical plan may or may not cover it.

Obamacare will cover it.
 
...Hopefully, they are going to give the AME's enough latitude to not have to subject physically fit Pilots to unnecessary "sleep studies" which are expensive and time-consuming.

Ty

You do understand this is a government operation, right?

HA, you're dreaming.....
 
Some of the most severe cases of sleep apnea my doctor has ever seen where on " normal" or " skinny" people. It is not always a weight thing....
 
This was a big issue in the military. There was a time they used BMI as a rough estimate for fitness and a few folks who worked weights for fitness were told they were out of shape in spite of an atlas profile. Had to jump through hoops like caliper measurements and even "Hydrodensitometry Weighing (Underwater Weighing)" to prove they weren't fat even though it was obvious they weren't. It was nuts.

As to your other point, who pays for this testing? If an AME required it your doctor may or may not refer you to a specialist, and your medical plan may or may not cover it.

If the FAA is really that hard over about ferreting out apnea and think it's such a hidden problem they should just require everyone to do a baseline sleep study in order to get a Class One medical. Ha. Then there would really be a pilot shortage and the LTD funds would be drained.

Sleep apnea tests require sleeping on the back. In that position many if not most people snore and many will be diagnosed with apnea. While apnea is a far more serious condition than simple snoring, sleeping on the side "cures" it for many people. IOW they don't normally have sleep apnea but the sleep study on the back will say they do. There will be a lot of false positives.

Exactly... The only time my snoring leads to apnea is when my wife puts a pillow over my head. :D
 
I'm all in favor of it.
Why, exactly?

The BMI issue is just a starting point. Eventually every pilot will have to undergo this testing and perhaps be forced to wear a CPAP mask for the rest of their careers. I understand the parallels with EKG testing, but sleep apnea is very subjective and with enough pressure from CPAP manufacturers on AME's, many pilots will be stuck wearing one every night for 20 or 30 years.

And should you want to eventually fly under Sport Pilot rules without a medical, you may find this puts that in jeopardy. Going to look for another flying job overseas. The Special Issuance you may require could disqualify you from many jobs.

Sleep Apnea is not caused by being fat. And losing weight does not necessarily make it go away (most of the time it doesn't). It does come on generally in later middle age and maybe you just have a grudge against older pilots. I hope you get the chance to become one some day.

But I don't share your enthusiasm for something that adds very little safety benefit, but comes at potentially a very high cost.
 
Was this an actual problem? Because I do not recall this being causal too, well, anything...

What's the plan when a third of us are grounded?
 
It does come on generally in later middle age and maybe you just have a grudge against older pilots. I hope you get the chance to become one some day.

I'm 54 years old. Most would consider that to be later middle age - except for those over 60 bulletproof pilots who want to fly until they die.

You're taking this change poorly; is it safe to assume that you're obese and suffer from apnea?
 
I'm 54 years old. Most would consider that to be later middle age - except for those over 60 bulletproof pilots who want to fly until they die.

You're taking this change poorly; is it safe to assume that you're obese and suffer from apnea?
Wrong assumption. I won't be in the first couple of groups, but eventually I will have to put my medical on the line for nothing. So what's next? Where should it stop? I don't think it's a crime for someone to be obese. It's not even a valid criteria by which to judge someone.

And Andy, you still haven't answered my question: What is behind your enthusiasm for unnecessarily jeopardizing someone's livelihood?

If you have no answer, or are just looking for some group to pick on, then at least be honest about it.
 
What happens when the Flight Surgeon of liberal choice suddenly decides that coffee and ex-wives cause too, much anxiety in the cockpit/flying by crew-members?

No more women in aviation and no more joe to wake you on a 4am show or keep you going on an overnight crossing the pond?

It all starts somewhere Gents. Welcome to a brave new world of statism by fiat from ideologues. We deserve every single thing we vote for. Just the other day, a nearby county passed ANOTHER $1.4M School "LEVY" by 2/1 in favor. Stupid, idiotic county of 30,000 people where only 2k useless voters (10% voted) failed to realize this was the 8th "LEVY" in 14 years for a total of $20 MILLION in ADDITIONAL TAXES above what was already directed toward school district resources (~$1.8M annually) for only 10,000 Students!!! do the math:

20M / 15 years = $ 1,333,333.33 additional taxes

$1,800,000.00
+$1,333,333.33
=$3,133,333.33 per year in taxes "Oh, but it is 'for' the children"???

$3,133,333.33 / 10,000 Annual Student Enrollment
=$313,333.33 per Student in taxes collected!!!

The county has 20% unemployment and the worst drop-out/graduation rate in the state.

100-1/2
 
And Andy, you still haven't answered my question: What is behind your enthusiasm for unnecessarily jeopardizing someone's livelihood?

Unnecessarily jeopardizing someone's livelihood? Are you an MD? Are you an expert on sleep apnea? Funny; you didn't have a problem with Tilton supporting age 65; why do you have a problem with him starting to tighten up our ridiculously loose medical standards?

I've been in favor of tighter medical standards for a very long time; this sounds like a good first step.
 
And Andy, you still haven't answered my question: What is behind your enthusiasm for unnecessarily jeopardizing someone's livelihood?




What Are the Side Effects of Sleep Apnea?
Answer
The side effects of sleep Apnea include cardiovascular problems, metabolic side effects, mental illness and a general poor quality of life. Untreated sleep Apnea can be dangerous and detrimental to your health if not treated by a doctor.


It's not about your(or my)livelihood. It's about our passengers safety.
 
I have been on both sides of this medical situation now. The U.S.A. standard of finding the easiest AME to get past and the one I currently cannot escape, the Chinese. I have mentioned this before on these boards that at least a third of the U.S. pilot force would fail a Chinese medical on several fronts. This is simply a difference in standards. I think the U.S. probably has close to the same ones on the books but they are not followed or adhered to. It's odd how it used to be the six month sim check I got excited about, now it's the medical. The running joke here is this is a six month job based entirely on the medical outcome. By the way I have been pulled off line twice due to a crazy claimed medical situation that was cleared up each time and I was continually paid each time.
I guess my opinion is that as a whole the U.S. pilot group is a reflection of our society as a whole and needs to shape up.

The Health Effects of Overweight and Obesity
Research has shown that as weight increases to reach the levels referred to as "overweight" and "obesity,"* the risks for the following conditions also increases:1
Coronary heart disease
Type 2 diabetes
Cancers (endometrial, breast, and colon)
Hypertension (high blood pressure)
Dyslipidemia (for example, high total cholesterol or high levels of triglycerides)
Stroke
Liver and Gallbladder disease
Sleep apnea and respiratory problems
Osteoarthritis (a degeneration of cartilage and its underlying bone within a joint)
Gynecological problems (abnormal menses, infertility)
 
... county of 30,000 people where only 2k useless voters (10% voted) failed to realize this was the 8th "LEVY" in 14 years for a total of $20 MILLION in ADDITIONAL TAXES above what was already directed toward school district resources (~$1.8M annually) for only 10,000 Students!!! do the math:

20M / 15 years = $ 1,333,333.33 additional taxes

$1,800,000.00
+$1,333,333.33
=$3,133,333.33 per year in taxes "Oh, but it is 'for' the children"???

$3,133,333.33 / 10,000 Annual Student Enrollment
=$313,333.33 per Student in taxes collected!!!

100-1/2
OK. I did the math correctly . Instead of over $313 thousand per student, I got $313.33 per student. Would that make a difference on your opinion of your fellow voters?
 
Has a plane ever crashed in the United States because one of the pilots died/medicaled out in flight? Has it ever even been close?
 

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