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Aviation Decision Making

Human Factors, Fitness

Human factors is a combination of aviation medicine, psychology, engineering and ergonomics. It encompasses all of these factors trying to understand the man/machine interface in the aircraft. It has its roots in aviation accident investigations resolving these where no clear technical cause could be found when aircraft became more and more reliable over the years.

An airplane should be preflighted and fit to fly, but what about the pilot? Be aware that there are a number of medical conditions which could lead to the pilot be grounded, and here we take a look at some of them.

To withstand all demands of the flying environment the pilot must be healthy, fit and maintain a healthy life style for a clear body and mind. The pilot must also be aware when he or she is not fit or even fatigued or is using drugs to counter minor illnesses which could affect performance or even flight safety.

Fitness to Fly, I

Pilots who become incapacitated during flight are a real danger to passengers and the aircraft. The risk is much less with a multi-crew flight but if this happens during a bad weather night approach in a busy environment it could develop in an real emergency real fast. And for private pilots flying with passengers during low visibility conditions the danger is the same.

Medical examinations

Before an aspiring pilot may fly solo (and to keep exercising the privileges of the license) he/she must pass the required regular medical examinations for the license. There are several so called classes, with different requirements depending on the license. Commercial pilots usually must be able to pass the highest requirements and standards.

These examinations are designed to exclude those medical conditions not compatible with flying.

Heart diseases

Coronary Artery Disease

Humans with a possible change on a heart condition as coronary artery disease, which is likely to cause chest pain and a heart attack or infarct, must be detected in a early stage to make sure that this condition does not develop during flight, with possible fatal results.

The risk factors for a coronary artery disease are: family history, smoking, elevated blood pressure or cholesterol level, lack of exercise, high blood sugar level, overweight and stress. All but family history can be dealed with by living a healthy life, diet and exercise.

Blood sugar

The human body needs energy to function and this gets into the system through food. The level of glucose is regulated by the pancreas, which secretes insulin into the blood stream to keep the level of glucose at the right level. Problems can arise if the pancreas delivers too much (low blood sugar, hypoglycemia) or not enough insulin (diabetes 2).

Low blood sugar can also occur by not eating enough (think of missing meals or not drinking enough) and this can cause fainting, shakiness, nervousness and or cold sweating. High blood sugar can cause kidney failure, blindness and heart attacks if not treated properly. Pilots who develop diabetes are likely to loose their license.

For pilots it is important to eat and drink regularly to keep their blood sugar at normal levels. A good breakfast, lunch and dinner and a small sandwich with a mixed filling in between and drinking at enough fluids should prevent low blood sugar levels and the pilot fit to fly.

Eating healthier

Having a diet with too much carbohydrates or sugary drinks / food (the socalled western 'healthy' diet) will eventually lead to a situation where the pancreas stops producing insulin (diabetes 2), a body with a high blood sugar level where you need insulin injections, increased body weight (insulin converts blood sugar into fat and makes you feel hungry again), problems with high cholesterol and all other commonly known western deseases.
More information to be found at The Dietdoctor. Go there, it will increase your quality of life and an early preventable death!


On this we can be short: if there is any doubt about the pilots ability to fly the aircraft safely due to any illness - its a clear decision: do not fly! Minor illnesses as: sore throat, hay fever, head ache, diarrhea can be cured by mild medications or even be overcome by drinking clear fluids. Over the counter medicines should be avoided because of possible unknown side effects on the body or brain. Think of anti-histamines which are known to cause sleepiness or inattention.

Mental illness or a psychiatric problem could render a pilot incapable of flying an aircraft safely and a medical examination is required with follow ups to assess if the pilot safe again to fly after treatment or therapy.


Of interest to female pilots as they may wish to continue flying when pregnant. As long as the mother-to-be and her child remain in good health there is no reason why she can not fly. Regular checks would be needed to make sure everything is and remains good. Pregnancy symptoms could prevent the pilot of acting properly, but this will differ from female to female. As the pregnancy progresses there may be more risk involved for mother and child.


Hospital Sign

Some countries will invalidate a pilots medical license if he or she acquires aids. The reason is that subtle central nervous system (the brain) symptoms could develop into full blown aids.


Cancer is abnormal cell growth in the body resulting in tumors and sometimes death. With some forms of cancer a pilot is able to fly, certain treatments are also compatible with flying but this has to be assessed by the AME and the treating physician in each and every case.

Those of you whom survived cancer and aspiring to be pilots, I can assure you that getting a medical certificate is not a problem at all. But you will need to supply the AME all the information they need to fully assess your case in detail.

Written by EAI.

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