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Travel Med Infect Dis ; 40: 101973, 2021.
Article in English | MEDLINE | ID: covidwho-1065626


Aircrew fitness-to-fly is among the elements that make aviation the safest form of long-distance transport. The health of cabin crew is a crucial determinant in carrying out safety-related duties. 'Fitness-to-fly' is associated with defined workplace conditions, for which airlines have a legal duty to ensure fitness for employment. We explored the literature on fitness-to-fly to obtain a pragmatic assessment of the challenges for aeromedical examinations. Regulations promulgated by aviation regulatory authorities and airline-internal policies have similar status and meaning, yet there is no harmonised approach internationally, and an inability to conform periodic medical assessments to actual operational fitness. The COVID-19 pandemic has highlighted the need to better understand fitness-to-fly criteria. Fitness-to-fly measures are mainly based on self-reported data and there is a need for a 'safety' factor for self-reports. Aeromedical evaluations should evolve from meeting medical standards to include pandemics as an element of the overall risk of aircraft operations. Re-evaluating criteria for fitness-to-fly assessment will further the goal of linking research to the actual needs of public health decisionmakers. If airlines are to resume operations at pre-pandemic levels, they must demonstrate to the public and public health agencies that fitness-to-fly assessment is appropriate and effective.

Aircraft/standards , Aviation/standards , COVID-19/epidemiology , Workplace/standards , COVID-19/prevention & control , COVID-19/transmission , COVID-19 Testing , Health Knowledge, Attitudes, Practice , Health Workforce , Humans , Occupational Health/standards , Pandemics/prevention & control , Policy , SARS-CoV-2/isolation & purification , Self Report