Physical Standard No. 3

(1) The medical examination and assessment will be based on the following requirements of mental and physical fitness– (a) the applicant shall be required to be free from any congenital or acquired disability causing such degree of functional incapacity as is 186 Civil Aviation likely to interfere with the safe handling of aircraft under ordinary conditions of flight; (b) the medical examination will include a full inquiry into the family and personal history of the applicant. The information obtained shall be given in a statement made and signed by him and will be taken into consideration by the medical examiner; (c) examination of the nervous system – The applicant shall have no history of significant mental or nervous trouble. He shall be required to be free from any mental impairment, or presumptive evidence of latent epilepsy. He shall be required to be free from any progressive disease of the nervous system and from any non-progressive disease of that system, the effects of which are likely to interfere with the safe handling of aircraft in flight. Cases of past or present insanity and cases in which syphilis, past or present, has affected the central nervous system will be assessed as permanently unfit. (2) As to injuries of the head– (a) cases of simple concussion, or simple fracture of the skull without associated intracranial injury will be assessed as temporarily unfit until such time as the medical examiner is satisfied that the effects of the concussion or fracture are no longer likely to jeopardise safety in flight; (b) cases of head injury associated with intracranial injuries will be assessed as permanently unfit if a local lesion of the brain or meninges persists; Civil Aviation 187 (c) cases of head injury in which there has been an operation on the skull with loss of bony substance involving the two tables of the cranial vault will be assessed as permanently unfit; cases repaired by plates ensuring present and future integrity of the central nervous system may be assessed as fit subject to a period of one year elapsing from the time of the repair. (3) General surgical examination – (a) the presence of hernia will not necessarily entail an assessment of unfitness. Cases in which the medical examiner is satisfied that a well-fitting appliance will adequately control the hernia may be assessed as fit, subject to the appliance being worn by the applicant whilst exercising the privileges of the licence; (b) cases of active disease of the bones, joints, muscles or tendons and all serious functional sequelae of congenital or acquired disease will be assessed as unfit. Cases of certain qualifying functional after effects of lesions affecting the bones, joints, muscles or tendons and certain anatomical defects compatible with the safe handling of aircraft in flight may be assessed as fit; (c) cases of sequelae of disease or surgical intervention on any part of the digestive tract and its adnexae, liable to cause sudden incapacity in flight, in particular any obstruction due to stricture or compression will be assessed as unfit; (d) cases of extensive mutilation of the chest wall with collapse of the thoracic cage and 188 Civil Aviation sequelae of surgical procedures resulting in decreased respiratory efficiency at altitude will be assessed as unfit; (e) cases of sequelae of disease or surgical procedures on the kidneys and the urinary tracts liable to cause sudden incapacity, in particular any obstructions due to stricture or compression will be assessed as unfit. Cases of compensated nephrectomy without hypertension or uraemia may be assessed as fit; (f) an applicant who has undergone a major surgical operation on the biliary passages or the digestive tract or its adnexae, or the urinary system, which has involved a total or partial excision or a diversion of any of these organs will be assessed as unfit until such time as the medical examiner having access to the details of the operation concerned considers that the effects of the operation are not liable to cause sudden incapacity in the air. (4) General medical examination – (a) the heart shall not possess any abnormality, congenital or acquired, which is likely to interfere with the safe handling of aircraft in flight. Respiratory arrhythmia, occasional extra systoles which disappear on exercise, increase of pulse rate from excitement or exercise, or a slow pulse not associated with auriculoventricular dissociation may be regarded as coming within “normal” limits; (b) the cystolic and diastolic blood pressures shall be within normal limits; Civil Aviation 189 (c) there shall be no significant functional nor structural abnormality of the circulatory tree. The presence of varicosities will not necessarily entail an assessment of unfitness; (d) there shall be no acute disability of the lungs nor any active disease of the structures of the lungs, mediastinum or pleura. Radiography will form a part of the medical examination in all doubtful clinical cases; (e) cases of pulmonary emphysema will not be assessed as unfit unless the condition is causing symptoms; (f) cases of active pulmonary tuberculosis will be assessed as unfit; (g) cases of quiescent or healed lesions which are known to be tuberculous, or are presumably tuberculous in origin, may be assessed as fit; (h) cases of disabling disease with important impairment of the functioning of the gastro- intestinal tract and its adnexae will be assessed as unfit. Proven cases of diabetes mellitus will be assessed as permanently unfit; doubtful cases will be assessed as unfit until the condition is proven to be non-diabetic; (i) cases of significant localised and general enlargement of the lymphatic glands and of diseases of the blood will be assessed as unfit; those due to a transient condition may be assessed as temporarily unfit; (j) cases presenting any signs of organic disease of the kidneys will be assessed as unfit; those due to a transient condition may be assessed 190 Civil Aviation as temporarily unfit. The urine shall contain no abnormal element considered by the medical examiner to be pathological. Cases of affections of the urinary passages and of the genital organs will be assessed as unfit; those due to transient conditions may be assessed as temporarily unfit; (k) an applicant who has a personal history of syphilis shall be required to furnish evidence, satisfactory to the medical examiner, that he has undergone adequate treatment; (l) in the event of pregnancy, the applicant will be assessed as temporarily unfit until, at least, after the pregnancy has been terminated; (m) after confinement or miscarriage, the applicant will not be permitted to exercise the privileges of the licence until she has undergone a medical examination and been assessed as fit. (5) Eye examination - There shall be no active pathological condition, acute or chronic, of either eye or adnexae which is likely to interfere with its proper function to an extent that would jeopardise safety in flight. (NOTE: The details of the Visual Requirements are specified in regulations 200 to 204 and those for Colour Perception in regulations 205 and 206 of these Regulations). (6) Ear examination - There shall be – (a) no active pathological process, acute or chronic, of the internal ear or middle ear cleft; (b) no permanent disturbances of the vestibular apparatus. Civil Aviation 191 (NOTE: The details of the Hearing Requirements are specified in regulations 207 to 210 of these Regulations). (7) Nose, throat and mouth examination – There shall be free nasal air entry on both sides. There shall be no serious malformation nor serious, acute or chronic, affection of the buccal cavity or upper respiratory tract. Applicants with significant defects of speech will be assessed as unfit.