CCFB 79

Fit to Fly?

It’s not only passengers who can become unwell in the air.

A high proportion of in-flight emergencies are medical related and passengers sometimes fly with medical conditions without informing the airline or checking if they are fit to fly. Whether intentionally or not, this could be because passengers may not appreciate the susceptibility of their condition in the cabin environment at altitude i.e. the effects that flying can have on their body.  Certain medical conditions may not tolerate the changes in cabin pressure on board the aircraft. Flight times, time zone changes and the associated ‘jet lag’ feeling may aggravate their medical condition if medication schedules and usual meal times are disrupted. Any one of these factors could contribute to a medical incident on board.

Occasionally cabin crew also become unwell during a flight, cabin crew are human too! If you feel unwell, please inform one of your crew members as soon as possible. Remember that cabin crew first aid training doesn’t just apply to passengers, but to crew as well.

As part of the recruitment stages and prior to cabin crew starting to fly, all UK airlines require a medical to be passed. Pre-existing conditions must be declared, as must any prescribed medications and any illnesses/medical procedures within a certain time period. This not only meets the requirements of the airline but also the Regulator. When you report for a duty, you are confirming that you are fit to operate.  It is a crew members responsibility to advise your operator if you suffer from a deterioration in your medical fitness.  Remember, the role of cabin crew is a safety critical role.

The CAA stipulate in MED.A.020 Decrease in medical fitness:

Cabin crew members shall not perform duties on an aircraft and, where applicable, shall not exercise the privileges of their cabin crew attestation when they are aware of any decrease in their medical fitness, to the extent that this condition might render them unable to discharge their safety duties and responsibilities.

It is usual practice across all industries for sickness and absence days to be closely monitored. Airlines will have different sickness and absence policies in place, and these will be specified within your terms and conditions. The monitoring of sick days is to be expected but it should be recognised within the company that those who fly have more stringent requirements only to operate when fit to do so, whereas working with blocked ears or sinuses might be ok in an office job, it is not ok in the flying environment and could make an illness worse. CHIRP do not investigate reports that involve industrial relations, terms and conditions of employment or personality-based conflicts.

The implications of operating as a cabin crew member when unfit to do so are clear and a safety concern for everyone on board as well as for your own health.  A pre-existing illness or injury could be exacerbated and your ability to perform the safety critical role (at any stage of flight) of cabin crew could also be affected. When you report for a duty, you are confirming that you are fully fit, rested and able to complete all duties and requirements during the subsequent period of your duty, it is important for the safety of all onboard (and yourself) that this is the case.  Inevitably some crew will have operated sectors when they shouldn’t have: blocked ears, an upset stomach, toothache and even appendicitis;  these are all symptoms of conditions that are amplified at altitude.  Please also remember that cabin crew are food handlers and gastroenteritis-related illnesses are communicable to others, even when you are might feel you are clear of symptoms, follow your companies’ procedures.

In the event of a crew member becoming incapacitated during the flight review your operations manual. ‘Incapacitation’ means a sudden degradation of medical fitness that occurs during flight duty period either in-flight or during a flight transit of the same flight duty period away from operator’s base that prevents any cabin crew member from performing their duties.

in unforeseen circumstances and/or when down route, if the number of cabin crew members is reduced below the applicable legal minimum required number, there may be procedures in place that require the passengers to be moved for landing or offloaded.  There could also be procedures to permit the flight to operate back to base with a reduced crew complement.  If this is the case the Regulator is notified via a Mandatory Occurrence Report (MOR). Effective communication during any flight is essential, for some operators, passengers may need to be accommodated in specific seats for trim requirements, therefore any seat movements in this instance will need to be authorised by the flight crew.  Medical assistance might also be required once the aircraft has landed.

Jennifer Curran, CHIRP Cabin Crew Programme Manager