REPORT FROM CIMP (Commission Internationale Medico-Physiologique) to CIA PLENARY MEETING
& First FAI International Symposium on Air Sports Medicine,
June 25-27, 2001.

Summary from minutes, by John Grubbström (did not attend all parts since I competed simultaneously)

The meeting and symposia were held in Jerez de la Frontera, Spain, during the WAG.

Detailed reports are available on the CIMP home-page, http://www.fai.org/medical/

1. CIMP Plenary Meting.

The meeting was chaired by Dr. René Maire (Switzerland). 20 delegates and others attended. (Austria, Cyprus, Czech Republic, Finland, France (Dr. Thierry Villey), Germany, Ireland, Italy, Japan, Lithuania, Luxembourg, Netherlands, Poland, Spain, Sweden, Switzerland, Turkey, United States of America, United Kingdom). Countries have been asked to nominate a delegate to CIMP even if they were not able to attend (to receive documents). (Do you know who your CIMP delegate is?)

Doping. Unfortunately, some cases of prohibited substances have been detected in doping tests. These have been assessed by a CIMP panel. None have been proved to be intentional cheating.

Medical Licensing (Europe). The FAI has been represented at the JAA Flight Crew Licensing Medical Sub Committee (MSC). Recreational flying is best managed locally with mutual recognition to allow free movement. The observers on the MSC have gained some successes in changing the rules but difficulties remain.

Elections. Dr. Maire had previously notified his intention to step down. Dr Pedro Ortiz, Spain, was elected new President. Dr. Peter Saundby, United Kingdom, will lead a working group on JAA-FCL Medical Sub Committee, Prof. Antonio Dal Monte, Italy, a group on doping, and Dr. Phivos Christophides, Cyprus, a group on the CIMP Meeting 2002.

Next meting. Larnaca, Cyprus, 07-09 June.

2. First FAI International Symposium on Air Sports Medicine. (Abstracts are available on the CIMP home page).

The Symposium was well attended. It was arranged (very nicely by Dr. Ortiz et al) at the same time and location as the meeting of the Medical Sub Committee (MSC) of the Joint Aviation Authorities (JAA), with a joint opening session. While the prime aim of the symposium was the extension of scientific knowledge, another reason was to establish contact and improve the mutual understanding between those doctors working in air sports organisations and those responsible for regulation. The specific issues addressed were airworthiness requirements for pilots, licensing, and doping/misuse of drugs. Problems caused by over-stringent and expensive regulations cause a reduction in aeronautical activity, including air sports, which are basic resources for all professional aviation.

In the second session, Dr Ortiz presented statistics concerning accident rates, were human factors are the cause mostly. Even aeromodelling had not been free from fatal accidents. The systematic collection of incident/accident data is the basis for safety improvement. Research has provided many safety improvements. Regulations can be counterproductive, and validation of pilot licensing, the currency requirements, maintenance rules as well as competition rules all influence safety. Prof. Dal Monte demonstrated how psychological parameters can be measured in the air. He also gave an overview on doping matters, and in the discussion it became evident that in some air sports some have developed the cultural use of recreational drugs which could have serious flight safety implications.

In the third session the Aviation Medicine Centre in Prague was presented by Dr Oldrich Truska. Dr. Rios, Spain, then explained the planning required for a high altitude balloon flight to FL 420, to be followed by a parachute jump (see abstract). Dr. Sokol, Czech Republic, presented fifty years of accident investigations, which exposed the problems of alcohol in sports pilots, and now the increasing problems associated with the advancing age of pilots.

The fourth session delt with various cardiological conditions and flying. In particular, narrowing of heart blood vessels and how they should be evaluated were discussed. The JAR 3 Medical manual cardiology section on angiography should be amended.  

On the second day, Hang and Paragliding accidents were discussed. There is a serious accident rate. Head, upper limbs and back injuries are frequent. In paragliding, many accidents occur from obstructions, wires or trees. In paragliding, analysis of back or spinal injuries cases show that pilots are reluctant to use their emergency parachute. Amongst paragliders, 1 in 150 will suffer back injury. Dr. Knueppel, Germany, gave a review of performance limitations. How can information acquired by professional pilots be passed to recreational pilots? How can we involve the specialist in aviation sport medicine? Dr. Truska advocated examination by specialist ophthalmologist of private pilots over the age of 40. Dr. Saundby, UK, related a British case of a dishonest epileptic glider pilot who (in 1967) killed himself and a pupil despite holding a valid private pilot medical certificate. This led to a new approach to the assurance of pilot fitness in which the prime responsibility was put on the individual pilot. Medical advice is available to assist the pilot in making decisions and medical validation is required to preclude dishonesty. Less fit pilots are restricted and prevented from carrying pupils or passengers. This system has proved to be as safe as traditional methods based on clinical examinations.

On the third day, Dr. Jon Jordan, Federal Air Surgeon of the United States presented the situation in the US, where there are some 280,000 professional and some 380,000 private pilots. Compared with the JAA, few special screening examinations are required. Only about 0,5% of applications result in a denial of certification. Limited certification of diabetics has proved safe. Numbers of both commercial and private pilots are flying with only one eye.

In the tenth and last scientific session, Dr. Schober, Austria, presented a short paper on the need for haemoglobin testing. Dr. Saundby developed further his proposals for pilot responsibility by establishing the minimum requirements and showing how these can be proven by a combination of instructor assessment, pilot declaration, and validation of this honesty by a doctor with access to clinical records. The ability of a periodic medical examination to detect previously unknown disease is small. Short term illness, fatigue and alcohol or drug abuse must be a pilot responsibility. Reassessment after serious illness is important. Pilots with some disease process, but who meet driving license standards should not be responsible for others in the air but may continue to fly.

The last session was held jointly with the MSC of the JAA. The MSC consists of the Chief Medical Officers of (now) 24 countries and observers from international organisations (as FAI). It was probable that the JAA would be absorbed into a new European Aviation Safety Authority (EASA) from 2003. Ten out of 24 countries are complying with the JAR (Joint Aviation Regulations). There is no intention of harmonising licensing rules for glider or balloon pilots.

I am now stepping down from the job as CIA observer at the CIMP as I have become national delegate to the CIMP. There is at least one very qualified medical doctor who is also a top competitor, and I suggest you install such a person as my successor.