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privileges.
6.4.2.5.1 An applicant who has undergone coronary
by-pass grafting or angioplasty (with or without stenting) or
other cardiac intervention or who has a history of myocardial
infarction or who suffers from any other potentially incapacitating
cardiac condition shall be assessed as unfit unless the
applicant’s cardiac condition has been investigated and evaluated
in accordance with best medical practice and is assessed
not likely to interfere with the safe exercise of the applicant’s
licence or rating privileges.
6.4.2.5.2 An applicant with an abnormal cardiac rhythm
shall be assessed as unfit unless the cardiac arrhythmia has
been investigated and evaluated in accordance with best medical
practice and is assessed not likely to interfere with the safe
exercise of the applicant’s licence or rating privileges.
Note.— Guidance on cardiovascular evaluation is contained
in the Manual of Civil Aviation Medicine (Doc 8984).
6.4.2.6 Electrocardiography shall form part of the heart
examination for the first issue of a Medical Assessment after
the age of 40.
6.4.2.6.1 Electrocardiography shall be included in reexaminations
of applicants after the age of 50 no less than
every two years.
6.4.2.6.2 Recommendation.— Electrocardiography should
form part of the heart examination for the first issue of a Medical
Assessment.
Note 1.— The purpose of routine electrocardiography is
case finding. It does not provide sufficient evidence to justify
disqualification without further thorough cardiovascular
investigation.
Note 2.— Guidance on resting and exercise electrocardiography
is contained in the Manual of Civil Aviation Medicine
(Doc 8984).
6.4.2.7 The systolic and diastolic blood pressures shall be
within normal limits.
6.4.2.7.1 The use of drugs for control of high blood
pressure shall be disqualifying except for those drugs, the use
of which is compatible with the safe exercise of the applicant’s
licence and rating privileges.
Note.— Guidance on the subject is contained in the Manual
of Civil Aviation Medicine (Doc 8984).
6.4.2.8 There shall be no significant functional nor structural
abnormality of the circulatory system.
6.4.2.9 There shall be no disability of the lungs nor any
active disease of the structures of the lungs, mediastinum or
pleura likely to result in incapacitating symptoms during
normal or emergency operations.
6.4.2.9.1 Recommendation.— Chest radiography should
form part of the initial and periodic examinations in cases
where asymptomatic pulmonary disease can be expected.
6.4.2.10 Applicants with chronic obstructive pulmonary
disease shall be assessed as unfit unless the applicant’s condition
has been investigated and evaluated in accordance with
best medical practice and is assessed not likely to interfere
with the safe exercise of the applicant’s licence or rating
privileges.
6.4.2.11 Applicants with asthma causing significant
symptoms or likely to cause incapacitating symptoms during
normal or emergency operations shall be assessed as unfit.
6.4.2.11.1 The use of drugs for control of asthma shall be
disqualifying except for those drugs, the use of which is
compatible with the safe exercise of the applicant’s licence and
rating privileges.
Note.— Guidance on hazards of medication and drugs is
contained in the Manual of Civil Aviation Medicine (Doc 8984).
6.4.2.12 Applicants with active pulmonary tuberculosis
shall be assessed as unfit.
6.4.2.12.1 Applicants with quiescent or healed lesions,
known to be tuberculous or presumably tuberculous in origin,
may be assessed as fit.
Note 1.— Guidance on assessment of respiratory diseases is
contained in the Manual of Civil Aviation Medicine (Doc 8984).
Note 2.–– Guidance on hazards of medication and drugs is
contained in the Manual of Civil Aviation Medicine (Doc 8984).
Chapter 6 Annex 1 — Personnel Licensing
6-9 23/11/06
6.4.2.13 Applicants shall be completely free from those
hernias that might give rise to incapacitating symptoms.
6.4.2.13.1 Applicants with significant impairment of the
function of the gastrointestinal tract or its adnexa shall be
assessed as unfit.
6.4.2.14 Applicants with sequelae of disease of or surgical
intervention on any part of the digestive tract or its adnexa,
likely to cause incapacitation in flight, in particular any
obstruction due to stricture or compression, shall be assessed
as unfit.
6.4.2.14.1 Recommendation.— An applicant who has
　
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