(a)Examination
(1)Spirometric examination is required for initial examination. An FEV1/FVC ratio less than 70 % should require evaluation by a specialist in respiratory disease before a fit assessment can be considered.
(2)Posterior/anterior chest radiography may be required at initial, revalidation or renewal examinations when indicated on clinical or epidemiological grounds.
(b)Chronic obstructive airways disease Applicants with chronic obstructive airways disease should be assessed as unfit. Applicants with only minor impairment of their pulmonary function may be assessed as fit after specialist respiratory evaluation. Applicants with pulmonary emphysema may be assessed as fit following specialist evaluation showing that the condition is stable and not causing significant symptoms.
(c)Asthma Applicants with asthma requiring medication or experiencing recurrent attacks of asthma may be assessed as fit if the asthma is considered stable with satisfactory pulmonary function tests and medication is compatible with the safe execution of the privileges of the licence. Use of low dose systemic steroids may be acceptable.
(d)Inflammatory disease
(1)For applicants with active inflammatory disease of the respiratory system, a fit assessment may be considered when the condition has resolved without sequelae and no medication is required.
(2)Applicants with chronic inflammatory diseases may be assessed as fit following specialist evaluation showing mild disease with acceptable pulmonary function test and medication compatible with the safe execution of the privileges of the licence.
(e)Sarcoidosis
(1)Applicants with active sarcoidosis should be assessed as unfit. Specialist evaluation should be undertaken with respect to the possibility of systemic, particularly cardiac, involvement. A fit assessment may be considered if no medication is required, and the disease is limited to hilar lymphadenopathy and inactive. Use of low dose systemic steroids may be acceptable.
(2)Applicants with cardiac or neurological sarcoid should be assessed as unfit.
(f)Pneumothorax Applicants with a spontaneous pneumothorax should be assessed as unfit. A fit assessment may be considered:
(1)six weeks after the event provided full recovery from a single event has been confirmed in a full respiratory evaluation including a CT scan or equivalent;
(2)following surgical intervention in the case of a recurrent pneumothorax provided there is satisfactory recovery.
(g)Thoracic surgery
(1)Applicants requiring thoracic surgery should be assessed as unfit until such time as the effects of the operation are no longer likely to interfere with the safe exercise of the privileges of the licence.
(2)A fit assessment may be considered after satisfactory recovery and full respiratory evaluation including a CT scan or equivalent. The underlying pathology which necessitated the surgery should be considered in the aero-medical assessment.
(h)Sleep apnoea syndrome/sleep disorder
(1)Applicants with unsatisfactorily treated sleep apnoea syndrome and suffering from excessive daytime sleepiness should be assessed as unfit.
(2)A fit assessment may be considered subject to the extent of symptoms, including vigilance, and satisfactory treatment. ATCO operational experience, sleep apnoea syndrome/sleep disorder education and work place considerations are essential components of the aero-medical assessment.