Time for a Shakeup

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Last November the Federal Air Surgeon, Fred Tilton, unilaterally declared that mandatory screening for obstructive sleep apnea (OSA) in pilots would begin “shortly”.

The initial BMI threshold would be 40, with an ominous vow that “once we have appropriately dealt with every airman examinee who has a BMI of 40 or greater, we will gradually expand the testing pool by going to lower BMI measurements until we have identified and assured treatment for every airman with OSA.”

Tilton noted that “up to 30% of individuals with a BMI less than 30 have OSA”. Between the fact that people with normal-range BMIs have been diagnosed with sleep apnea and his apparent zest for uncovering “every” airman with OSA, logic dictates that the eventual threshold would be in the mid-20s, if not lower.

The aviation community was up in arms pretty quickly, and for good reason. For one thing, the mid-20s are the upper end of the normal BMI range. It’s also worth noting that even the World Health Organization acknowledges that the BMI scale was never designed for application to individual people, but rather for statistical modeling of entire populations. BMI is based solely on weight and height, so it does not account for differing body types. Nor does it obey the law of scaling, which dictates that mass increases to the 3rd power of height.

In plain English, a bigger person will always have a higher BMI even if they are not any fatter. This penalizes tall individuals, as well as bodybuilders and athletes who are in prime physical shape by assigning them absurdly high BMI numbers. Likewise, short people are misled into thinking that they are thinner than they are.

Nevertheless, Tilton declared his intention to press on anyway, without any industry input or following established rulemaking procedures despite the fact that this scavenger hunt would break invasive new ground in aeromedical certification.

Then, even the Aviation Medical Examiners objected to the new policy, noting that “no scientific body of evidence has demonstrated that undiagnosed obesity or OSA has compromised aviation safety” and that providing long term prognoses is not part of the FAA’s job. The medical certification exists soley to “determine the likelihood of pilot incapacitation for the duration of the medical certificate.”

Without the support of the civil aviation medicine community, Tilton was literally standing alone. At that point, Congress jumped into the fray on the pilot community’s behalf and eventually forced the Air Surgeon to back down… for now.

While the battle may have been won, the war is far from over. Mark my words, this is not the last you’ll hear about this bogeyman. Tilton may be forced to consult with the aviation community or follow a rulemaking procedure of some sort, but his zeal for the topic means OSA screening will be back in one form or another.

To effectively combat such overreach, we’ve got to attack the problem from it’s true source. In this case, the Air Surgeon’s ammunition came from National Transportation Safety Board recommendations issued in the wake of a 2008 regional airline flight which overflew its destination by 26 miles when both pilots fell asleep.

… the National Transportation Safety Board recommends that the Federal Aviation Administration:

Modify the Application for Airman Medical Certificate to elicit specific information about any previous diagnosis of obstructive sleep apnea and about the presence of specific risk factors for that disorder. (A-09-61)

Implement a program to identify pilots at high risk for obstructive sleep apnea and require that those pilots provide evidence through the medical certification process of having been appropriately evaluated and, if treatment is needed, effectively treated for that disorder before being granted unrestricted medical certification. (A-09-62)

The NTSB serves a useful purpose in assisting transportation disaster victims and investigating accidents, but when it comes to safety recommendations, the agency operates in a kind of vacuum, divorced from some of the most pressing realities of the modern general aviation world. The reason is simple: their mission statement. It calls for the Board to “independently advance transportation safety” by “determining the probable cause of the accidents and issuing safety recommendations aimed at preventing future accidents.”

While there’s nothing objectionable about their mission, note how there’s no mention of the cost these recommendations impose on those of us trying to make a go of it in the flying industry. Since it’s not part of their mission statement, it is not a factor the Board takes into account. It doesn’t even appear on their radar. The Board’s federal funding and their lack of rulemaking authority negates any such considerations. So a sleep apnea study costs thousands of dollars — so what? If it prevents one pilot from falling asleep in the cockpit in next half century, it’s well worth the decimation to an already down-and-out sector of the economy.

That’s been the logic for the NTSB since it was conceived by the Air Commerce Act in 1926. It worked well when aerospace safety was at its nadir — but that was nearly ninety years ago. As air transportation evolved during the 20th century, attempts at increasing safety have reached the point of diminishing returns and exponentially increasing cost. At some point the incessant press toward a perfect safety record will make aviating such a sclerotic activity that it will, in effect, cease.

It’s a problem for any industry, and it’s especially so for one that’s teetering on the edge of oblivion the way ours is. The good news is that this can be fixed. It’s time to shake things up at the NTSB by revising their mission statement to make cost analysis a major part of the Board’s function. They should work with stakeholders to carefully study the long-term effect each recommendation would have on the health and size of the aviation industry before they make it.

For what it’s worth, the FAA needs this mission statement adjustment just as much as the NTSB. More, in fact, because the NTSB can recommend anything it wishes, but the regulatory power to act upon those suggestions is outside their purview and rests with the Federal Aviation Administration. From medical approval to burdensome aircraft certification rules, the FAA is the hammer. We have to start somewhere, though, and the NTSB is in many ways the top of the heap, the place where these ideas get their start. It would be nice to see the industry’s lobbyists in Washington, D.C. suggest such a bill to members of Congress.

One final thought: if government’s power really does derive from the “consent of the governed”, this should be an idea even the NTSB (and FAA) can get behind. Otherwise, they may convene one day and find that there’s not much of an industry left for them to prescribe things to.


This article first appeared on the AOPA Opinion Leaders blog at http://blog.aopa.org/opinionleaders/2014/01/22/time-for-a-shakeup/.

Should GA Be More Like the Airlines?

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When it comes to regulation, training, currency, and experience requirements, should Part 91 general aviation become more like the airlines in order to achieve a better safety record? That question was prompted by Scott Spangler’s article, Safety May Be the Death of General Aviation.

Upon reading the title, I figured it was just a provocative title. Alas, he was responding to a speech given by the NTSB Chairman, who noted that the organization recently lost one of it’s own in a general aviation accident. That crash, a mid-air collision, is an interesting story all on it’s own. The pilots of both airplanes were federal employees (one at the FAA and the other at the NTSB), so the United States government has recused itself from the accident investigation and turned it over to the Canadian Transportation Safety Board.

So the question remains, should GA be more like the airlines? If you’re the NTSB, the answer is probably yes. Their mission is to investigate accidents and promote safety recommendations, not worry about what the financial or regulatory burden will do to the industry. I, on the other hand, would argue against such a change.

As I’ve previously noted, modern society has little tolerance for risk anymore. Whether it’s driving, walking, or flying, the only thing acceptable is 100% safety. Of course, we cannot achieve that unless we stay on the ground. Sadly, that’s becoming the norm for too many of us due to the financial constraints of the “new economy”. There are other ways to kill general aviation, however, and the NTSB seems focused on one of them with the continual push to mandate new regulations, equipment, training, and oversight. It’s a pity the NTSB is focused solely on safety without paying heed to what that safety will cost. The price isn’t always measured in dollars.

GA has a higher accident rate that the airlines for many reasons, but the primary one is that GA pilots have the freedom to do many things that the airline guys do not. And I hope that never changes. To paraphrase Dick Rutan, where would we be without those who were willing to risk life and limb using their freedom to do these things? We’d be safe and sound, on the ground, still headed west as we look out over the rump of oxen from our covered wagons.

Whether it’s cruising down the coast at 500′ enjoying the view, taking an aerobatic flight, flying formation, flight testing an experimental airplane, or landing on a sandbar, beach, grass strip, or back-country field, it’s important that private individuals not find themselves restricted to the ways and means of Part 121 operations. We do the stuff that make flying fun! Doing it “like the airlines” can only drive up the price and suck out the fun of aviation. Part of that cost is in increased risk.

Richard Collins stated this quite elegantly last year:

Lumping general aviation safety together is an accepted practice but it is not realistic. The activities are too diverse and need to be considered separately. There is instructional flying, recreational flying, agricultural flying, private air transportation flying and professional flying. The airplanes range from ultralights to intercontinental jets.

Even in the same area, different airplanes have varying accident rates. The only safety concern that spans everything is crashing but the frequency of and reasons for the crashing vary widely according to the type flying and even the type aircraft flown.

In each area, the safety record we get is a product of the rules, the pilots involved, the airplanes, and the environment in which the pilots fly those airplanes. To make any change in the record, one or all those elements would have to be modified.

One of the beauties of our Part 91 is that the pilot gets the freedom to choose how far he wants to go in that regard. If you want to file IFR everywhere and only fly with multiple turbine engines in day VMC, fine. That’s your choice. For others, flying in the mountain canyons in a single engine piston and landing on a short one-way strip on the side of a steep hill is well within their risk tolerance.

I’m certainly not opposed to better equipment, more training, or higher standards. Those things are all important, and I advocate for them constantly. But they will only be effective when they come from within rather than being imposed from a bureaucracy which already demands so much.