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Use of psychoactive substances .................................................... I-1-5
Flight crew fatigue and fitness ....................................................... I-1-5
Use of oxygen in flight .................................................................. I-1-6
Definitions .................................................................................................. I-1-6
Appendix 1 .................................................................................................
INTRODUCTION
The Chicago Convention
The Convention on International Civil Aviation, which was signed in Chicago on 7 December 1944,
includes several articles which call for adoption of international regulations in all fields where uniformity
facilitates and improves air navigation.
These regulations, known as Standards and Recommended Practices (SARPs) have been promulgated in
Annexes to the Convention which are amended from time to time when necessary. Each Annex deals with
a specific aspect of international civil aviation. Aviation medicine is included mainly in Annex 1
(Personnel Licensing) and to some degree in Annex 2 (Rules of the Air), Annex 6 (Operation of Aircraft)
and Annex 9 (Facilitation). Issues involving Annex 9, preparedness planning for a communicable disease
of public health concern, are not considered in this manual.
Standards and Recommended Practices are defined as follows:
Standard. Any specification for physical characteristics, configuration, material, performance, personnel
or procedure, the uniform application of which is recognized as necessary for the safety or regularity of
international air navigation, and to which Contracting States will conform in accordance with the
Convention. In the event that a State finds it impracticable to comply in all respects with any such
international standard but allows a less stringent practice, immediate notification to ICAO is compulsory
under Article 38 of the Convention. In case a more stringent regulation is adopted, notification to ICAO
is compulsory only when such regulation is applied also on foreign licence holders and aircraft. However,
in a Resolution of 5 February 1999, the ICAO Council made it clear that, in principle, national
requirements “more exacting” than the SARPs would be detrimental to the framework of the Chicago
system within which international civil aviation has developed and continues to develop. In this
Resolution the Council also called upon each Contracting State to utilize the multilateral mechanism of
ICAO where it believes that changes to the content or level of implementation of the Standards and
Recommended Practices in the Annexes to the Chicago Convention are necessary or desirable.
Recommended Practice. Any specification for physical characteristics, configuration, material,
performance, personnel or procedure, the uniform application of which is recognized as desirable in the
interest of safety, regularity or efficiency of international air navigation, and to which Contracting States
will endeavour to conform in accordance with the Convention.
Although the purpose of SARPs is to provide provisions only for international air navigation, they have
greatly influenced national regulations governing domestic aviation in most Contracting States.
ICAO also originates guidance material which is intended to assist States in the implementation of
SARPs, but places no regulatory responsibility upon States for compliance. The ICAO Manual of Civil
Aviation Medicine (Doc 8984) falls into this category since it offers guidance on the implementation of
the SARPs contained in Annex 1.
PERSONNEL LICENSING
General
Civil aviation includes different types of operations which, for convenience, can be divided into three
major categories.
Commercial air transport (airlines). This category includes all operations conducted with large and
sophisticated aircraft which used to be piloted by several crew members. In recent years the need for more
efficiency has produced some dramatic technological changes which directly involve flight personnel:
- In the early 1960’s, the typical crew on the flight deck of an airliner consisted of five members (two
pilots, a flight engineer, a flight navigator and a flight radio operator). It now consists of two or three
members, depending on the type of aircraft.
- The tasks of the flight crew are changing. On modern aeroplanes, computers are handling the systems
and the pilot is becoming more and more of a systems manager and decision maker rather than a control
operator.
Aerial work and small air transport. All professional flying except airlines is included in this category.
Typical operations are flying instruction, crop spraying, aerial surveying, small commuter operations, air
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Manual of Civil Aviation Medicine 1(4)
