By now you may have heard that the federal air surgeon has decreed that someone who is overweight with a fat neck is a hazard in the cockpit. That’s not the diplomatic way of putting it, but there it is. I am more concerned about fat heads and the occasional lack of judgment, but that’s not what this is about. One could surmise all kinds of potential hazards, but the fear is that a large person with a 17-inch neck will (my emphasis) suffer from obstructive sleep apnea (OSA). This is a condition where someone does not sleep well at night and therefore is likely to fall asleep almost anywhere, anytime. Reminds me of many college students, but I digress.
This is not to make light of the condition or the individuals who suffer from OSA, but to point out that pilots—as a group—have exercised good judgment relative to medical hazards. There are exceptions, but regulation by anecdote is a bad idea and unfair to the vast majority who play by the rules.
Never mind that there is no general aviation accident or incident data that supports this level of intervention. The NTSB investigated a regional airline crew falling asleep and overflying the destination. Here is what the NTSB said, “Contributing to the incident were the captain’s undiagnosed obstructive sleep apnea (OSA) and the flight crew’s recent work schedules, which included several consecutive days of early-morning start times.” There are some air carrier ASRS reports on file regarding OSA but these are few and far between.
So this and some other anecdotal evidence is the basis for such a sweeping change? The airline industry has been under the gun for sometime about work schedules, but instead of addressing Part 121 operations, the blunt tool is used and we take in all pilots.
A friend, Dr. Brent Blue, who is a senior aviation medical examiner said, “So let us say this pilot has a neck size over 17 inches and a body mass index (BMI) over 40. (BMI was developed and only supposed to be valid for use with populations of people, not individuals. Use with individuals has been shown not to be valid. Tom Cruise’s BMI is 26 putting him in the ‘fat’ category. LeBron James is 27.5—fat as well!) Now the FAA says that I must delay his medical until he sees a ‘sleep specialist’ and either does not have OSA, or is treated successfully.”
At the Air Safety Institute we keep close tabs on GA accidents, and the number of pilot incapacitation accidents does not appear to support keeping the 3rd class medical in its entirety, let alone adding OSA as a major incapacitation hazard. And if it was such a big problem, how come the GA safety education community wasn’t notified much sooner before an edict was issued? Was this just a failure to communicate?
Another case of the bureaucracy creating a solution in search of a problem? Maybe the FAA should just work on the backlog of 50,000 special issuances that they claim is overwhelming them.
Don’t misunderstand—we are all for reasonable safety and regulation but the adjective describes all. OSA can be a problem and should be dealt with, but there are other conditions as well that might need attention. We give individuals the latitude to make the right choice. One-off events just are not the basis for good regulation. AOPA is opposing this until compelling and valid data is forthcoming. Join us in this effort, won’t you?