1% rule (aviation medicine)

Risk threshold applied to the medical fitness of pilots December 2022 article October 2009 In aviation medicine, the 1% rule is a risk threshold that is applied to the medical fitness of pilots. The 1% rule states that a 1% per annum risk (See also risk management) of medical incapacitation is the threshold between acceptable and unacceptable. In other words:Applying this 1 percent rule would result in an airline pilot being denied a medical certificate if their risk of a medical incapacitation (e.g. heart attack, convulsion, stroke, faint etc) was determined as being greater than 1% during the year. This 1 percent rule began in the late 1980s and early 1990s in a series of British and then European aviation cardiology workshops. The application of this "1 percent rule" has subsequently spread beyond the domain of aviation cardiology to all potential causes of medical incapacitation. The reasoning that was used in the development of the original aviation medical 1 percent rule is well described in Flight Safety and Medical Incapacitation Risk of Airline Pilots (see references). In this article the authors argue that changes in the underlying assumptions, that were the basis of the 1 percent rule, have been such that a 2 percent rule may be an appropriate modern analogue. The application of this one percent rule is controversial. The civil aviation regulatory authorities of some nations employ such numerical risk thresholds while others do not. Of those that use numerical risk criteria there are differences in the levels of measured / calculated risk that are applied (1% per annum, 2% per annum etc.). There is also debate concerning the application of population statistics to an individual pilot and the utility and validity of the risk screening tools that are used by the civil aviation regulatory authorities (e.g. data from the Framingham Heart Study). References Further reading 15018295 March 2004 Stuart J. Mitchell Anthony D. Evans Flight safety and medical incapacitation risk of airline pilots 75 3 260–8 Aviation, Space, and Environmental Medicine http://www.ingentaconnect.com/content/asma/asem/2004/00000075/00000003/art00011 6373281 March 1984 Hugh Tunstall-Pedoe Risk of a coronary heart attack in the normal population and how it might be modified in flyers 5 Suppl A 43–9 European Heart Journal 10.1093/eurheartj/5.suppl_A.43 3402499 May 1988 Hugh Tunstall-Pedoe Acceptable cardiovascular risk in aircrew. Introduction 9 Suppl G 9–11 European Heart Journal 10.1093/eurheartj/9.suppl_G.9 3402489 May 1988 Hugh Tunstall-Pedoe Acceptable cardiovascular risk in aircrew. The concept of risk 9 Suppl G 13–5 European Heart Journal 10.1093/eurheartj/9.suppl_G.13 1493822 December 1992 Hugh Tunstall-Pedoe Cardiovascular risk and risk factors in the context of aircrew certification 13 Suppl H 16–20 European Heart Journal 10.1093/eurheartj/13.suppl_H.16 1817937 September 1991 Niedermeier W. Küblbeck K. Factors involved in endosseous implant function 46 9 589–94 Deutsche Zahnärztliche Zeitschrift Faktorenerfassung zur Funktion enossaler Implantate German 15672988 January 2005 Dougal B. Watson Aeromedical decision-making: an evidence-based risk management paradigm 76 1 58–62 Aviation, Space, and Environmental Medicine http://www.ingentaconnect.com/content/asma/asem/2005/00000076/00000001/art00010 Mulloy, A.; Wielgosz, A. (August 2019). "Cardiovascular Risk Assessment in Pilots" Aerosp Med Hum Perform. 2019 Aug 1;90(8):730–734. Category:Aviation medicine