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Medical fails may climb

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densoo

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Nov 2, 2004
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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.....
 

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