Taking Charge with Fitness to Fly

Recently, in collaboration with the International Federation of Airline Pilots’ Associations (IFALPA) and the International Air Transport Association (IATA), ICAO published a new guide for pilots that identifies ways they can maintain their fitness to fly. The recommendations outlined in the guide are also applicable for cabin crew and air traffic controllers. 


This article was first published in InterPilot, the magazine produced by the International Federation of Air Line Pilots’ Associations (IFALPA), the not-for-profit organization that represents more than 100,000 pilots in nearly 100 countries worldwide.

Pilot careers are lasting much longer, and pilots are retiring later than they retired in the past. Annual flying hours and work-related demands are constantly increasing. It is crucial, now more than ever, that professional pilots maintain not only their medical certificates, but also optimal physical and mental health both during, and after their flying careers.

ICAO’s historic approach to medical fitness in licence holders has been based on detecting increased medical incapacitation risk (from ill-health) once it has occurred, and by taking action to reduce the impact on aviation safety, such as restricting a licence or removing the licence holder from operations.

Fitness to Fly focuses on prevention by providing guidance to pilots on how to stay healthy, thereby minimizing the need for interventions involving licence restrictions. Recent research in the science of preventive medicine has demonstrated that following appropriate recommendations on health maintenance can be expected to significantly reduce the number of medical problems experienced during a career.

...research in the science of preventive medicine has demonstrated that following appropriate recommendations on health maintenance can be expected to significantly reduce the number medical problems experienced during a career.

The guide recognizes that background knowledge and interest in the subject of maintaining and improving health varies considerably from one individual to the next.  It is structured so that those who wish to quickly learn how to avoid the main causes of ill-health, can read the summary at the end of the guide for a brief overview.

Those who desire more detail will find that reading the entire guide provides a comprehensive look at all the major issues affecting fitness to fly. Each chapter ends with a section on the relevance to aviation of the condition under consideration. Chapters are written for pilots, in their language, giving proper guidance without judgement. ICAO can customize the publication and provide bulk order options for air operators. Additionally, this guide can be distributed through the electronic flight bag (EFB), allowing pilots to access the reference material without carrying hard copies with them.

The guide consists of eleven chapters:

  1. Cardiovascular
  2. Mental Health and Wellbeing
  3. Alcohol and Drugs
  4. Cancer
  5. Musculoskeletal Injuries
  6. Nutrition and Weight management
  7. Sleep
  8. Travel Health
  9. Vision and Hearing
  10. Summary
  11. Annexes

A healthy lifestyle helps to ensure that professional pilots pose a minimal risk to safety and their fitness to fly from the beginning of their careers until they retire. In short, this can be accomplished by:

  • Maintaining a healthy heart
  • Developing mental health resilience
  • Adopting a low risk strategy towards alcohol
  • Avoiding illicit drugs
  • Adopting cancer avoidance habits
  • Managing diet and weight
  • Managing risks associated with accidental injury
  • Getting sufficient sleep
  • Understanding and reducing travel related risks
  • Protecting their hearing and vision

Fitness to Fly has been developed to inform pilots of the known risk factors concerning pilots´ medical certification and personal well-being, and how to reduce them. The earlier the risks are identified, the more effectively they can be addressed, and the better the results will be. With the guidelines outlined, it will be easier for pilots to focus on the right preventive measures.

This medical guide also reflects the shared responsibility of pilots, operators, and authorities in keeping pilots fit. While pilots make their own personal decisions, operators can facilitate these decisions and authorities can guide their national regulation in the right direction.

IFALPA hopes our fellow pilots will find this guide useful, and that it will enable them to fly healthier.