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House Transportation Cmte. Approves Apnea Bill

Reacting sharply to a plan announced by the Federal Air Surgeon to require testing of overweight pilots for obstructive sleep apnea (OSA), the House Transportation Committee on Dec. 4 approved legislation that would require the FAA to go through the normal rulemaking process before making such a change. The bill, introduced by Aviation subcommittee chairman Frank LoBiondo (R-N.J.) within days of the change announcement, passed the full committee by voice vote. The bill will now go to the full House for consideration, but exactly when has not yet been determined.

HAI President Matt Zuccaro had earlier sent a letter to LoBiondo expressing the association’s strong support for the bill. “Any changes to existing regulation must involve thorough review and scientific study, and impacts that could affect pilot medical certificates must be taken into consideration and be vetted by medical and safety experts,” wrote Zuccaro.

In a column in an FAA newsletter for aviation medical examiners (AMEs), Federal Air Surgeon Fred Tilton announced what was described as a policy change that would require AMEs to determine a medical certification applicant’s body mass index (BMI — a measurement of height vs. weight). If an applicant has a BMI of 40 or greater (considered morbidly obese by medical professionals) and a neck size of 17” or more, the AME must require the applicant be tested and, if necessary, successfully treated for obstructive sleep apnea. Untreated OSA is a disqualifying condition.

The policy change would apply immediately to pilots and would eventually be applied to air traffic controllers as well. And Dr. Tilton said after the initial roll-out, the BMI limit would eventually be pushed down to 30 – the borderline between overweight and obese. If the U.S. pilot population has the same percentage of people with BMIs over 30, then more than 1 in 3 pilots could eventually be affected.

Sleep apnea testing could impose a significant financial burden on pilots and air traffic controllers. It involves an overnight stay at a testing facility and can cost between $2,000 and $3,000. Not all insurance policies cover testing and treatment, and many of those that do provide only partial coverage.

The entire aviation industry reacted angrily when the policy change first came to light. Health concerns notwithstanding, HAI and others argued that there is nothing in the safety record to indicate that OSA contributes to the accident rate. Additionally, the industry argued, such a change to medical certification requirements should be the subject of regulation, not policy.

“The rulemaking process must involve industry stakeholders, allow for the opportunity of experts and pilots to weigh in, and serve to enhance operational safety within the aviation industry,” concluded Zuccaro’s letter. “HAI… supports a commonsense approach to any rule revision requiring the screening, testing, or treatment of an airman or an air traffic controller for a sleep disorder.”

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