FAA adds another hoop for medicals
- Thread starter westslopeco
- Start date
We bury our mistakes, as simple as that.
As there is no pathologic proof of someone dozing off or doing something stupid from fatigue, there is no way to collect that data. Trucks, commuter trains and ferries have on board data recorders, if someone runs into the back of the truck in front of him without ever hitting the brakes, you can assume he was incapacitated. If someone flies a helicopter into the ground for no good reason at midnight after a long day, we are left to speculate.
That is one of the things we may learn. The problem is that we don't know why people make the bad decisions they do and all evidence of OSA disappears in the crash with no toxicological or other post Mortem method of discovery. This is why we do trials and experiments, to see what happens and learn.
timwinters
Ejection Handle Pulled
There are quite a few more photos roaming around the web today. It looks to me like he's pushing 40...or more...
Matthew
Touchdown! Greaser!
I'm one of those guys, and I'll jump in.
It's like any other medical deal - it's a health issue first, and safety of flight issue next. Take care of yourself first.
Passenger cars have had black-boxes for a while now, too.
The latest word on the commuter train is the union saying the engineer had a version of "highway hypnosis". Nice spin, but it's a real thing.
I get the pleasure of spending many hours behind the wheel driving through western KS and eastern CO, but it doesn't have to be that extreme. We've all had those days where we drive our normal commute, stop at a light and say to ourselves, "I don't remember a thing for the last couple minutes." Whatever the cause - fatigue, complacency, distractions, all of the above. In a car, it normally ends up as a fender-bender at worst. But I personally know folks who have fallen asleep behind the wheel - one's in a wheelchair, the other is OK after a stint in the hospital. OSA can leave (in my case) you feeling like you have just pulled an all-nighter, and there is not enough coffee in the world to keep you sharp. And that's an everyday, normal, good day. I can understand FAA wanting to get a handle on OSA, and I understand why it's a grounding if untreated condition. Complacency and distractions are bad enough that FAA trains us on them and their effects during primary training. Adding a medical condition into the mix that can exacerbate the problem is something FAA medical has the power to do something about.
All that said, I don't like the idea of forcing an expensive test on airmen just to see how many can be caught. But Dr Chien, FAA, NIH, and any number of studies show a correlation of BMI to OSA. If we as a pilot community took better care of ourselves, we wouldn't be stuck with this. Yeah, we'd still have to pay for the tests just so we'd know for our own benefit, but we wouldn't be stuck being told we have to. I am of the opinion that the threat and reality of a long wait in deferral limbo keeps many pilots from seeking treatment for a whole range of issues - what you don't know can't hurt you. How many times have we seen questions posted on this forum asking, "How can I get around an FAA medical deal if I have "x"?" If FAA trusted their own AMEs to be able to handle common SIs in-office, our lives would be so much easier.
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So, I get it, that OSA is a safety risk (although an unquantified one), and that the benefits of treatment are substantial. But is it really right, in a supposedly free country, to force people to spend a lot of money and jump through bureacratic hoops if we don't have the data to show whether it is justified? AOPA and other organizations are saying "Show me the data," and until the FAA can do so, I predict that they will continue to get pushback from the alphabet organizations and members of Congress.
I don't think individuals should be forced to spend thousands of dollars a piece to fund the FAA's studies.
What about the methodology in the DOT study at the link in post #368? It's apparently still a work in progress, but they do seem to be coming up with ways to quantify the safety risk.
tmyers
En-Route
If the cost is the true breaking point for the sleep study then we need a less expensive method for determining who is at risk. Seems the medical community and the FAA is using BMI and neck measurements for that low cost indicator to trigger a sleep study.
Has anyone taken one of the home studies? What do they cost and how hard are they to falsify?
Maybe there is a lower cost way to find this out before going in for the full sleep study, but I haven't heard of one.
You are only being forced to take the study if you have the risk associated numbers and WANT to fly.
Am I missing something?
Has anyone taken one of the home studies? What do they cost and how hard are they to falsify?
Maybe there is a lower cost way to find this out before going in for the full sleep study, but I haven't heard of one.
You are only being forced to take the study if you have the risk associated numbers and WANT to fly.
Am I missing something?
Matthew
Touchdown! Greaser!
And - you don't already have an OSA diagnosis.
I am still not sure what happens if you meet all the criteria to be tested, but test negative. Then what? Do you have to repeat it at every medical until you fall out of the BMI risk pool?
denverpilot
Tied Down
We'll spend the money on black boxes but not an automatic braking system that obeys the track speed limits even if the fat man falls asleep. Shows what idiots we are.
tmyers
En-Route
That is a good question. Kinda like my random weigh in in the Air Force that happened every month.
Once you have been tested negative there should be a minimum time before they put you through it again.
Once you have been tested negative there should be a minimum time before they put you through it again.
The rest of the population over which you fly doesn't care what the **** you think, and they think you can get the test or sit on the ground. THAT my friend is the reality of freedom.
That's tougher than first glance leads on, not impossible, but expensive as a retrofit in the system especially when speed restrictions can change. There was a bit of timing bad luck there as well. Trains have a 'deadman' switch that needs to be periodically depressed or the braking system is actuated.
Then why has the FAA already backpedaled and started calling this a "proposal"?
The rest of the population doesn't care what you think either, my friend.
bbchien
Touchdown! Greaser!
Dr. Tilton is retiring.
Everyone understand that Fred is NOT a politician.
!!!
Everyone understand that Fred is NOT a politician.
!!!
Over this ?
The whole hubub is strictly a political one. You can't got up directly against the fat lobby. A universal screening approach would have left a lot less room for discussion.
This is not going away. The next FAS will just put out the policy statement, open it for comments, ignore the comments and institute a universal screening strategy that conforms with the recommendations brought up by the NTSB several times.
Same thing is happening on the motor carrier side and the federal railroad administration (and after what happened two days ago at the more obscure agency that regulates non-federal railroads like metro-north).
Why do you think he/she will ignore the comments? The regulatory side of FAA doesn't. As Bruce pointed out, some of the comments are pretty wacko, but I've observed that well thought out ones have had significant influence on rulemaking in the past.
flyingcheesehead
Touchdown! Greaser!
Trucks do not have data recorders like what you're describing. And what some trucks do have is purely optional - You can run a truck without one perfectly legally.
What the majority of trucks do have is a GPS unit that phones home via cell network or satellite (where the cell network isn't available). This happens anywhere from once a minute to once an hour. These same boxes have some data regarding maximum speed, average speed, time spent above x speed, fuel consumption and efficiency, and *some* will measure deceleration to find hard braking events, though I'm pretty sure they'd be set off by an accident even if the brakes weren't touched. Some of these also keep track of driver logs automatically, though that system is far from perfect.
It's another source of information for putting the pieces together, but you certainly can't make any assumptions about incapacitation from the data they provide.
It was somewhat tongue in cheek. In my following of the rulemaking process, the 'beef' of a proposed regulation remains unchanged, comments may nibble at the edges a little bit.
Looking back to the SSRI SI policy change, there are a couple of things that would be worthwhile to bring into the OSA policy. From this thread and others, it is clear that there are lots of pilots out there who see their flying threatened because they either knowingly fly with OSA or because they are already on treatment but have been lying on their medicals. A carrot that would help to get those people into the system would be A. a forgiveness period where the FAA doesn't take action against people who come clean. B. the ability to prove absence of OSA with a portable study rather than a in-house polysomnogram, but only if this is done during the initial grace period.
They are not required by law, yet many fleet operated trucks have them as condition of lowered insurance rates and to limit litigation exposure. I have family in that industry, their fleet had recorders dating back into the 80s. The data situation for commercial trucks is a lot better than that for private and small part 135 aircraft.
Glass panels are going a long way in the providing of data in accidents.
TMetzinger
Final Approach
Fixed that for ya.
Doggtyred
En-Route
Not entirely relevant to the thread, but relevant to the subject. Just got it in my email today
http://www.medpagetoday.com/Primary...0r&email=david.staten@gmail.com&mu_id=5380476
http://www.medpagetoday.com/Primary...0r&email=david.staten@gmail.com&mu_id=5380476
Granted I haven't seen them all, but can you tell me one that doesn't?
flyingcheesehead
Touchdown! Greaser!
I know - I have experience with them - And I doubt there's a fleet out there without 'em now. However, they're not really useful in the way it sounds like you're saying they are when coming to accident investigation. They're nothing like an FDR, they won't log things like steering wheel position and that sort of thing. When it comes to accident investigation, they're much more useful for tracing the breadcrumbs of the last 24 hours to establish whether or not the driver was driving legally at the point in time where the accident occurred.
They're definitely a lot more prevalent than data recorders in GA, but that's starting to change with glass panels.
TMetzinger
Final Approach
According to a guy on my miata forum, the MEtro North trains had deadman switches but not the ones that check for wakefulness as you describe.
And he's an FRA guy.
Deadman switch is a deadman switch, if Metro North still has the old style ones that you can 'flag', then Metro North left a liability window wide open.
JimNtexas
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Jim - In Texas!
I'm one of the guys who has greatly benefited from getting treated for OSA.
I still am uncomfortable with the FAA just issuing a decree without first getting input from the aviation public. After all, even the FAA flight surgeons are supposed to be 'public servants'.
I still am uncomfortable with the FAA just issuing a decree without first getting input from the aviation public. After all, even the FAA flight surgeons are supposed to be 'public servants'.
That seems very relevant, since, as Bruce pointed out, there is a need to find ways of reducing the cost of screening and treatment.
Considering the costs, and the fact that many AMEs are said to not know how to avoid avoid grounding an OSA-positive pilot for four months, I would think that a universal screening approach would encounter even more pushback.
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Because he was given a dose of economic reality in his experimental thread.
For a lot of us (and NB: my BMI is low) it's the precedent.
Tilton has clearly said he's going to lower the screening level until he gets "all" the OSA, and I know people with BMI in the low 20's. So it's not just the fat people. Read his statement, he's very clear.
The studies are expensive and often include significant down time.
The bureaucracy needs to be shrinking, not growing.
The problem with shrinking bureaucracy is then individuals have to assume the responsibilities that were assigned to the bureaucracy. Well, that wasn't happening to begin with which is why the bureaucracy was formed.
The fact of the matter is, when it comes to issues of public safety and welfare, our society will always choose to do the cheap thing vs the right thing.
JimNtexas
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Jim - In Texas!
I had this fantasy where the FAA sent out an email to all the pilots in the country that said something like
Naw, that could never happen. Better and cheaper to just rule by decree.
The FAA knows what's best for us, why should tax payer dollars be wasted listening to a bunch of ignorant yahoos?
After all, we all belong to the government anyway.
Naw, that could never happen. Better and cheaper to just rule by decree.
The FAA knows what's best for us, why should tax payer dollars be wasted listening to a bunch of ignorant yahoos?
After all, we all belong to the government anyway.
It would be a waste of time as is obvious right now, the answer would be a giant "No, We don't wanna!!!!" Why waste the time?
What I would like to see is the FAA come out and say "We're looking at these results from OSA studies and they don't look good for the safety of people with it, nor is it healthy to live with. If you snore or have BMI >34 and a neck >16", go get yourself checked out and get on CPAP if you need it." ... and then pilots actually went out and did it!
Dav8or
Final Approach
I think what those of us that are very concerned about with this new decree, or proposal is, the questions of is this good for the health of GA at this time and is there much prospective used in making this decision?
We all know GA and the pilot population is shrinking quite rapidly due to host of reasons. We also know that the fewer of us participating in GA, the worse things get for GA. I think it is safe to say that adding one more obstacle for people to participate in GA will have an effect on pilot population. There will be a cost associated with this ruling if it comes to be. Smaller pilot population means lost revenues, closed airports, GA industries quitting, depressed aircraft values, higher fuel and use costs, etc, etc, etc.
We all know Americans are largely over weight. It's the curse of our success. Dr. Chien says that he has no airmen that see him for their medicals that are skinny and in fact he reports that they are all over weight to some degree. That means that 90% of his airmen are likely suffering from OSA and we now know that means they are legally drunk on sleep deprivation. Sounds pretty bad. So how are these drunk pilots doing?
According to the 2012 Nall report, in 2010 there were 1388 aircraft involved in accidents in the US for the whole year. Of those, 420 people were killed. Accidents are terrible and the lives lost are tragic, but can we really say that 90% of these accidents were caused by drunken, sleepless airmen? Aside from people quitting and less people flying, if we screen just the over weight pilots, how much lower will these numbers go? 90%, 50%, 10%??
Nobody knows of course because we won't know until it's done. The question is, is this the right time to be doing an experiment like this now when GA is so fragile, it's looking to congress and the president to sign a bill for relief? We know people generally take the path of least resistance and we know that GA already requires pushing much harder against resistance then any other competing pass time, hobby, or means of transportation. It seems pretty clear to me that this would be a breaking point for many certificated pilots and an additional obstacle for many prospective pilots. How many, we don't know.
Can GA afford this experiment right now and is it really worth it?
We all know GA and the pilot population is shrinking quite rapidly due to host of reasons. We also know that the fewer of us participating in GA, the worse things get for GA. I think it is safe to say that adding one more obstacle for people to participate in GA will have an effect on pilot population. There will be a cost associated with this ruling if it comes to be. Smaller pilot population means lost revenues, closed airports, GA industries quitting, depressed aircraft values, higher fuel and use costs, etc, etc, etc.
We all know Americans are largely over weight. It's the curse of our success. Dr. Chien says that he has no airmen that see him for their medicals that are skinny and in fact he reports that they are all over weight to some degree. That means that 90% of his airmen are likely suffering from OSA and we now know that means they are legally drunk on sleep deprivation. Sounds pretty bad. So how are these drunk pilots doing?
According to the 2012 Nall report, in 2010 there were 1388 aircraft involved in accidents in the US for the whole year. Of those, 420 people were killed. Accidents are terrible and the lives lost are tragic, but can we really say that 90% of these accidents were caused by drunken, sleepless airmen? Aside from people quitting and less people flying, if we screen just the over weight pilots, how much lower will these numbers go? 90%, 50%, 10%??
Nobody knows of course because we won't know until it's done. The question is, is this the right time to be doing an experiment like this now when GA is so fragile, it's looking to congress and the president to sign a bill for relief? We know people generally take the path of least resistance and we know that GA already requires pushing much harder against resistance then any other competing pass time, hobby, or means of transportation. It seems pretty clear to me that this would be a breaking point for many certificated pilots and an additional obstacle for many prospective pilots. How many, we don't know.
Can GA afford this experiment right now and is it really worth it?
ClimbnSink
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Greg
Whole dang country is under a thumbscrew, this is small potatoes big picture, and a perfectly lovely sounding idea to our masters. I think it kind of funny, old fat guys, the ones this affects, ran the country to this point let em get a taste of what they built before they pass.