Safety Recommendation A-00-006

In addition to creating and distributing this brochure to all AMEs, the FAA took several actions to ensure that pilots are aware of the brochure, including publishing an article in the Federal Air Surgeon's Medical Bulletin (FASMB) informing AMEs that the brochure and a poster with the same information are available for downloading. An editorial written by the Federal Air Surgeon in the FASMB also stressed the need for AMEs to communicate medication information to airmen.

In addition, the FAA issued a news release encouraging advocacy groups such as the Air Line Pilots Association, the Aircraft Owners and Pilots Association, and other aviation organizations to disseminate information to their members regarding the brochure and its contents.

Although we would have preferred that every active pilot (that is, one with a current medical certificate) be provided with a copy of the brochure, the FAA has developed and implemented a program for distributing to pilots this important information and brochure. Therefore, Safety Recommendation A-00-6 is classified "Closed-Acceptable Action."

Letter Mail Controlled 1/18/2006 7:55:12 AM MC# 2060042 Marion C. Blakey, Administrator, FAA, 1/9/06 The Federal Aviation Administration has completed its efforts to address these safety recommendations. The following is a list of these items: Issued a brochure and poster entitled "Medications and Flying." The brochure informs the reader of specific things to consider when making the decision to go/no go after taking over-the-counter drugs. The brochure also lists common side effects of frequently used medications. The brochure is available at the FAA's Web site at the following address: www.faa.gov/pilots/safety/pilotssafetybrochures.

The brochure was mailed to all aviation medical examiners (AME) with instructions on how to obtain additional brochures. Published an article in the Federal Air Surgeon's Medical Bulletin informing AMEs that the brochure and poster are available for download from the Civil Aerospace Medical Institute at: http://www.cami.jccbi.gov/AAM-400A/fasmb.html. Published an editorial written by the Federal Air Surgeon in the Federal Air Surgeon's Medical Bulletin to stress the need for AMEs to communicate medication information to airmen.

The FAA issued an FAA News release encouraging advocacy groups (i.e., the Airline Pilots Association, the Aircraft Owners and Pilots Association, and other aviation organizations) to disseminate information to their members regarding the brochure and its content. I have enclosed a copy of the brochure, the Federal Air Surgeon's Medical Bulletin, and the FAA News release for the Board's information. I believe that the FAA has satisfactorily responded to this safety recommendation, and I look forward to your response.

The distribution plans outlined by the FAA for the updated brochure will make it available in a variety of venues to the pilots who are looking for the information. As discussed at the June 21, 2004, meeting, the Safety Board believes that every active pilot (that is, one with a current medical certificate) must be provided with a copy of the brochure to ensure that they are aware of this source of information. To address the intent of Safety Recommendation A-00-6, the FAA needs to develop a plan to distribute the information using a variety of methods such as direct mail, electronic mail, distribution by AMEs during recurrent medical examinations, or some other process.

Pending development and implementation of an acceptable distribution plan, Safety Recommendation A-00-6 is classified "Open--Acceptable Response."

The FAA has educational programs and regulatory requirements in place that address these recommendations. 14 CFR 61.53, Prohibition of Operations During Medical Deficiencies, restricts airmen from aircrew duties while taking any medication or receiving any treatment that would render them unfit to meet the requirements of their medical certificates.

The FAA has information on its Website and in a brochure regarding the use of over-the-counter medications and the dangers associated with the use of other prescription medicines. The FAA is currently developing a new brochure for completion by the end of calendar year 2004. It will update the information from the old brochure and expand it to include a section on prescription medications and flying. Once completed, the brochure will be electronically published on the Website. The brochure will also be available in paper form for distribution at AME seminars, safety seminars, "fly-in" meetings such as Oshkosh, and in AMEs' offices.

The FAA also plans to periodically update its Website to assure that the latest information is available to airmen and AMEs.

The FAA agrees that providing education programs and materials to airmen regarding the hazards of unapproved medications is beneficial. In addition to regulatory requirements regarding the prohibitions on flying while impaired, the FAA has ongoing educational programs that discuss this topic. Some of these ongoing programs are:

· Regional monthly aviation safety seminars, sponsored by the flight standards district offices, include topics on medical issues. In these seminars, airmen are urged to discuss these issues with their physicians and AME's and to identify the adverse effects that may occur with their prescribed medications. Most importantly, airmen are counseled that it may be better to avoid performing aviation duties while medications are required.

· All AMEs are required to attend a basic seminar prior to being designated and to take refresher training at least once every three years. The refresher training can be accomplished through attendance at theme seminars that are provided by the FAA several time a year, or through a modular based program that the AMEs can complete on their computers at home. If the AME elects to use the computerized training, he or she must alternate that training by attendance at one of the theme seminars to satisfy the next training requirement. So, the AME must attend a theme seminar in person at least once every six years.

We believe that it may be productive to invite staff from the DOT and/or each of the modal agencies to discuss with our staff their concerns, priorities, and resource limitations before the Safety Board classifies the open recommendations to the DOT and other modal agencies. Based on our experience with the public meeting and the RSAC, it seems possible that such a meeting could result in some potentially acceptable alternate actions with regard to the current recommendations. We also recognize that each individual modal administration has a unique perspective and approach to the issue of medication use.

A meeting between staff could allow a complete discussion of the various distinctive concerns in each transportation mode. If desired, the FDA staff who participated in the public meeting could also be invited for their technical expertise. We are available to meet individually with the modal agencies or as a group.

Letter Mail Controlled 03/26/2001 7:57:42 PM MC# 2010257: The FAA has reviewed its previous position in response to this safety recommendation and believes that the ongoing educational programs outlined in the FAA's letter dated March 30, 2000, adequately address the hazards of medication and flying. These educational programs include distribution of medical publications to Aviation Medical Examiners (AME) to make available to airmen, providing material to AME's for presentation to airmen at flight safety meetings, providing FM support for training airmen at aviation events and activities.

The FAA fully understands the intent of this safety recommendation and has educational programs currently in place to address this safety recommendation completely. I consider the FAA's action to be completed in response to this safety recommendation.

THE SAFETY BOARD IS CONCERNED THAT THE FAA MAY HAVE MISUNDERSTOOD THE INTENT OF THIS RECOMMENDATION. THE BOARD'S INTENT IN ISSUING THIS RECOMMENDATION WAS FOR THE FAA TO EFFECTIVELY DISSEMINATE THE INFORMATION PRODUCED IN RESPONSE A-00-5. UNTIL ACTIONS TAKEN IN RESPONSE TO A-00-5 ARE NEARING COMPLETION, THE BOARD RECOGNIZES THAT THE FAA CANNOT ESTABLISH AND IMPLEMENT THE NEEDED EDUCATIONAL PROGRAM. THE BOARD ASKS THE FAA TO RECONSIDER ITS RESPONSE TO THIS RECOMMENDATION.

PENDING ESTABLISHMENT AND IMPLEMENTATION OF AN EDUCATIONAL PROGRAM THAT ENSURES THAT ALL PILOTS ARE AWARE OF THE SOURCE OF INFORMATION DESCRIBED IN A-00-5 REGARDING THE HAZARDS OF USING SPECIFIC MEDICATIONS WHEN FLYING, A-00-6 IS CLASSIFIED "OPEN--UNACCEPTABLE RESPONSE."

Letter Mail Controlled 04/04/2000 11:34:53 AM MC# 2000479 THE FAA AGREES THAT PROVIDING EDUCATION PROGRAMS AND MATERIALS TO AIRMEN REGARDING THE HAZARDS OF UNAPPROVED MEDICATIONS IS BENEFICIAL. IN ADDITION TO REGULATORY REQUIREMENTS REGARDING THE PROHIBITIONS ON FLYING WHILE IMPAIRED, THE FAA HAS ONGOING EDUCATIONAL PROGRAMS THAT DISCUSS THIS TOPIC.

SOME OF THESE ONGOING PROGRAMS ARE: REGIONAL MONTHLY AVIATION SAFETY SEMINARS, SPONSORED BY THE FLIGHT STANDARDS DISTRICT OFFICES, INCLUDE TOPICS ON MEDICAL ISSUES; AME'S ARE TRAINED THROUGH AVIATION MEDICAL SEMINARS AND COMPUTER-BASED TRAINING PROGRAMS TO EDUCATE PILOTS ON MEDICAL ISSUES AND MEDICATIONS; AIRMEN, AME'S, AND FLIGHT STANDARDS EMPLOYEES RECEIVE MEDICALLY RELEVANT EDUCATIONAL MATERIAL THROUGH THE FEDERAL AIR SURGEON'S MEDICAL BULLETIN PUBLISHED QUARTERLY AND MEDICALLY ORIENTED SAETY PAMPHLETS AND; THE AERONAUTICAL INFORMATION MANUAL, AVAILABLE TO ALL PILOTS, DEVOTES AN ENTIRE CHAPTER TO MEDICAL FACTS FOR PILOTS.

THIS CHAPTER STATES, IN PART, THAT PILOT PERFORMANCE CAN BE SERIOUSLY DEGRADED BY BOTH PRESCRIBED AND OVER-THE-COUNTER MEDICATIONS, AS WELL AS THE MEDICAL CONDITIONS FOR WHICH THEY ARE TAKEN. ANY MEDICATION THAT DEPRESSES THE NERVOUS SYSTEM LIKE A SEDATIVE, TRANQUILIZER, OR ANTIHISTAMINE CAN MAKE A PILOT MUCH MORE SUSCEPTIBLE TO HYPOXIA. THE FAA BELIEVES THAT THESE ONGOING EDUCATIONAL PROGRAMS ADEQUATELY ADDRESS THE HAZARDS OF MEDICATION AND FLYING. THE FAA IS CURRENTLY DEVELOPING A SERIES OF PRESENTATIONS AT CIVIL AEROMEDICAL INSTITUTE TO BE RELEASED WITHIN THE NEXT YEAR THAT WILL ADDRESS NUMEROUS AEROMEDICAL ISSUES, INCLUDING MEDICATIONS AND FLYING.

IN ADDITION, THE FAA WILL ADDRESS THIS ISSUE IN THE SUMMER EDITION OF THE FEDERAL AIR SURGEON'S BULLETIN, WHICH IS DISTRIBUTED TO ALL AME'S. THE FAA IS COMMITTED TO REVIEWING AND UPDATING THESE PROGRAMS PERIODICALLY TO ENSURE THAT THE LATEST INFORMATION IS DELIVERED TO PILOTS. I BELIEVE THAT THE FAA'S EDUCATION PROGRAMS CURRENTLY IN PLACE ADDRESS THE FULL INTENT OF THIS RECOMMENDATION, AND I PLAN NO FURTHER ACTION IN RESPONSE TO THIS RECOMMENDATION.

Letter Mail Controlled 02/14/2000 4:22:54 PM MC# 2000244