How aviation medicine is working to prevent incidents like Germanwings 9525

Dr. Roland Vermeiren reports on collaboration between medical doctors, pilots, psychologists and international bodies

After the crash of Germanwings Flight 9525 on 24 March last year owing to actions taken by the co-pilot, there is a lot happening at the aviation medicine level in terms of looking at ways of prevention or better risk identification. Changes are taking place at all levels: worldwide with ICAO, at the European level with EASA, and also at regional level.

EUROCONTROL has a role to play in this discussion and other aviation medical issues: as the past president of the European Society of Aerospace Medicine (ESAM) and liaison officer between ESAM & EASA, I am closely involved in technical meetings that are looking at ways of developing proposals for changes in the rules and how they could be successfully implemented.  

Many different actors are involved in these improvement processes, such as the BEA (Bureau d'Enquêtes et d'Analyses (BEA) pour la Sécurité de l'Aviation Civile), which reported conclusions about what happened and how, EASA in cooperation with the national European Civil Aviation Authorities, the FAA , ESAM and AsMA (the global Aerospace Medicine association).

In the European discussions, the professional knowledge and dialogue of three different groups is crucial: the aeromedical doctors, represented by the European Society of Aerospace Medicine (ESAM), the pilots – the European Cockpit Association (ECA), and the psychologists – the European Association for Aviation Psychology (EAAP). Only when combining and harmonizing the knowledge of all actors can we can reach improvements. 

Legislation related to medical or psychological treatment is not regulated by ICAO or EASA and therefore differs from country to country. For example, medical confidentiality is very strict in some countries, and if psychotherapists or doctors are consulted, they are often not allowed to share any information. Consequently, one of the discussed topics has been an evaluation of the obligation to disclose information in certain strictly defined cases e.g. when aviation safety is at stake. The European Commission will contact the World Health Organization (WHO), and adapted rules for certain circumstances will be discussed and could be proposed to individual countries.  

More importance will be given to the Peer Support Program (PSP) in which pilots organize themselves to help each other. Being able to talk openly to their peers, the fear of sharing health-related issues and the fear of losing one’s pilot’s license can be reduced. By removing the stigma surrounding mental illness, pilots are more likely to self-report. Many pilots have conditions that are treatable, while of course certain severe medical conditions can prohibit them from flying. Discussions are also ongoing to see how we can change the rules that would improve the situation of pilots who have to quit their job.   

Another important change is that AMEs (Aviation Medical Examiners) will receive more specialized training to improve the aeromedical fitness assessment, increasing their knowledge on mental health issues and their ability to identify warning signs. It is important that these examiners keep in touch and network to help each other.

Applying new legislation takes time, but most of the proposals have largely been agreed on. After the technical Opinion (for the Implementing Rules) and Decision (for the Acceptable means of Compliance) of EASA, foreseen for Q4 2016, a (normally one-year) period of consultation between the European Institutions (the European Commission, Parliament and Council) will take place…

I like this work a lot, even if it’s a long process, as it is a contribution to improve aviation safety, and that’s what we do here at EUROCONTROL.