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RESOLUTION OF THE MINISTRY OF TRANSPORT AND COMMUNICATIONS OF THE REPUBLIC OF BELARUS AND MINISTRY OF HEALTH OF THE REPUBLIC OF BELARUS

of January 24, 2019 No. 5/10

About approval of the aviation rules "Procedure for Medical Support of Flights of Civil Air Vehicles"

Based on part two of article 38-1 of the Air code of the Republic of Belarus Ministry of Transport and Communications of the Republic of Belarus and Ministry of Health of the Republic of Belarus POSTANOVLYAYUT:

1. Approve the aviation rules "Procedure for Medical Support of Flights of Civil Air Vehicles" (are applied).

2. This resolution becomes effective after its official publication.

Minister of Transport and Communications of the Republic of Belarus

A. N. Avramenko

Minister of Health of the Republic of Belarus

 V. A. Malashko

Approved by the Resolution of the Ministry of Transport and Communications of the Republic of Belarus and the Ministry of Health of the Republic of Belarus of January 24, 2019 No. 5/10

Aviation rules "Procedure for Medical Support of Flights of Civil Air Vehicles"

Chapter 1. General provisions

1. These aviation rules "Procedure for Medical Support of Flights of Civil Air Vehicles" (further - Aviation rules) establish procedure and regulate questions in the field of medical support of flights of civil air vehicles.

2. For the purposes of these Aviation rules the main terms and their determinations according to the Air code of the Republic of Belarus of May 16, 2006 and the Law of the Republic of Belarus of June 18, 1993 No. 2435-XII "About health care", and also the following terms and their determinations are used:

the aviamedical center - the organization of health care which is performing medical examination of aeronautical personnel and having the certificate on medical support of flights;

the flight surgeon - the doctor determined by authority by issue of certificates, who had training on aviation medicine and having sufficient competence for medical observation of owners of certificates during the intercommission period and performing the regulated medical examinations;

flight-surgeon commission of experts - the medical commission created based on the aviamedical center to which functions on medical examination of candidates for receipt (prolongation) of certificates of aeronautical personnel and qualification marks are assigned;

the medical expert - the doctor determined by authority by issue of certificates, who is qualified and experience of practical work in the field of aviation medicine, and also qualification in range of definition and estimates of medical indications which can mention aviation safety;

the medical certificate - the medical certificate about the state of health which is issued by the aviamedical center based on results of medical examination by flight-surgeon commission of experts and contains the necessary information confirming (confuting) possibility of safe fulfillment of duties and implementation of the rights granted by the certificate of aeronautical personnel and qualification marks;

medical examination - set organizationally the events connected among themselves held by flight-surgeon commission of experts directed to studying and assessment of the state of health of the candidates for receipt of the medical certificate who are carried out in the amounts necessary and the rights, sufficient for forming of the reasonable conclusion about its suitability to fulfillment of duties and implementation, granted by the certificate or qualification marks.

the intercommission period - the period between medical surveys of aeronautical personnel;

the official medical certificate - the conclusion acceptable for authority made in relation to specific case by one or several medical experts in issue of certificates, with attraction in need of specialists in production of flights or other experts;

pre-flight (prereplaceable) medical examination - the medical examination of aeronautical personnel performed for the purpose of determination of possibility of the admission to safe fulfillment of duties and implementation of the rights granted by the certificate during flight (change);

professional and important qualities - specific mental and psychophysiological features of the person which availability provides possibility of effective fulfillment of obligations and implementation of the rights granted by the certificate of aeronautical personnel and qualification marks;

psychoactive agents - alcohol, opioids, kannabinoida, sedatives and hypnotic (somnolent) medicines, cocaine, other psychoexcitants, hallucinogens and flying solvents. Tobacco and caffeine are excluded;

the regulated medical examination - the medical examination performed by the flight surgeon during the intercommission period for the purpose of assessment of dynamics of the state of health of aeronautical personnel and control of execution of recommendations of flight-surgeon commission of experts;

the use of psychoactive agents connected with risk - the use by aeronautical personnel of one or several psychoactive agents in such a way that it constitutes direct danger for the person using them or threatens life, health or wellbeing of other people, creates or aggravates problem or disorder of professional, social, mental or physical nature;

the certificate on medical support of flights - the document of the established sample, confirmatory that the legal entity or physical person meets the requirements established in the Republic of Belarus and is capable to perform activities for the permitted directions of medical support of flights.

3. Action of these Aviation rules extends on:

aviamedical centers, flight surgeons and medical experts;

aviation organizations;

faces of aeronautical personnel of civil aviation of the Republic of Belarus and candidates for receipt of certificates of aeronautical personnel (further - certificates);

citizens of foreign states, if those are owners of the certificates granted according to requirements of the legislation of the Republic of Belarus or apply for their obtaining.

4. These Aviation rules determine:

procedure for the organization and performing medical examination of candidates for receipt (prolongation) of certificates;

requirements to the state of health of candidates for receipt (prolongation) of certificates;

procedure for recognition of medical certificates (certificates) issued by foreign states;

procedure for medical observation of owners of certificates during the intercommission period and the admission to execution of professional obligations after diseases and injuries;

the principles of medicamentous therapy of diseases at faces of aeronautical personnel and the list of the medicines which are not influencing safe fulfillment of duties and implementation of the rights granted by certificates and qualification marks;

forms of the medical documents used in civil aviation of the Republic of Belarus;

the list of diseases and conditions in case of which passengers should refrain from flight on air transport;

the principles of first-aid treatment and emergency medical service to members of crews and passengers of the air vehicles performing the international passenger traffic and to persons which are in the territories of the international airports;

procedure and the principles of health maintenance organization of wreckings in the territories of the international airports;

general procedure and the principles of holding sanitary and anti-epidemic actions on boards of the air vehicles performing the international passenger traffic and in the territories of the international airports.

Chapter 2. Procedure for performing medical examination of aeronautical personnel of civil aviation. The admission to fulfillment of duties and implementation of the rights granted by certificates

§ 1. General requirements

5. The candidate for receipt of the certificate has when it is offered, the medical certificate issued according to provisions of Chapter 2 of these Aviation rules.

6. Duration of effective period of the medical certificate begins from the date of performing medical examination.

7. The validity of the medical certificate can be extended by authority on issue of certificates in coordination with the aviamedical center which issued it, or the medical expert, for the period to 45 dney1.

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1 Calendar day of expiration of the medical certificate remains to constants every year. Medical examination is carried out during effective period of the existing medical certificate, but no more than in 45 days prior to date of the expiration of its effective period.

8. Except as specified, stipulated in Item 40 these Aviation rules, faces of aeronautical personnel do not use the certificates if have no the existing medical certificate corresponding to their certificates.

9. Medical examination of candidates for receipt (prolongation) of certificates is performed only in the aviamedical centers flight-surgeon expert komissiyey2 (further - VLEK).

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2 Powers on performing medical examination, and also the requirement to equipment of the aviamedical center, to education and level of competence of the health workers performing activities in the field of medical support of flights of air vehicles are determined by the state authority in certification process, carried out according to the procedure, established by the corresponding aviation rules.

10. Members of VLEK, flight surgeons and medical experts shall study advanced training in aviation medicine at least once in three years and advanced training on the main specialty according to the current legislation.

11. Members of VLEK, flight surgeons and medical experts shall own practical knowledge of conditions in which owners of certificates and qualification marks satisfy the obligations.

12. The medical certificate is drawn up in case of the personal appeal of candidates for receipt (prolongation) of certificates of aeronautical personnel and qualification marks to the aviamedical center based on the analysis of medical documents, results of laboratory and tool methods of researches, results of medical examination, medical examination of VLEK as a part of specialists doctors: therapist (general practitioner), neurologist (general practitioner), otorhinolaryngologist (general practitioner), ophthalmologist (general practitioner), surgeon (orthopedist-traumatologist, general practitioner).

The chairman of VLEK (responsible for coordination and generalization of results of survey, assessment of conclusions concerning the validity for health reasons, registration and signing of the protocol according to appendix 3 and the medical certificate) is the medical expert.

13. In case of execution of the medical certificate the chairman of VLEK without fail considers results of survey of the doctor of the addiction psychiatrist, and also results of the psychophysiological and psychological examination conducted according to Item 55 of these Aviation rules.

14. In some cases, in case of pronouncement of the conclusion about worthlessness holding meeting of VLEK with participation in it at least two of her members in the absence of doubts in objectivity of the passed decision is allowed to fulfillment of duties and implementation of the rights granted by the certificate.

15. In case of the appeal to the aviamedical center the candidate for receipt of the medical certificate fills in the questionnaire according to appendix 2 and submits the documents provided by subitem 7.6 of Item 7 of the list of the ministerial procedures performed by state bodies and other organizations for petitions from citizens, No. 200 approved by the Presidential decree of the Republic of Belarus of April 26, 2010.

In case of the written consent of the candidate, VLEK according to the procedure established by the legislation of the Republic of Belarus requests statements from medical documents from the organizations, from the individual entrepreneurs participating in medical attendance of the citizen, data on lack (availability) of psychiatric and narcological accounting, except as specified, when the candidate provides such information independently.

Statements from medical documents for the purposes of these Aviation rules are understood as statements from medical documents of the organizations of health care at the place of residence (the place of stay) (for foreign citizens - the reference from the family doctor performing medical observation) with indication of data on requests for medical care and the inoculative status preceding medical examination (or from the moment of the previous survey).

16. All inspections, consultations and inspections by specialists doctors are performed after the identity certificate of osvidetelstvuyemy.

17. About any false declaration, and also in case of not provision of reliable information about the state of health, to the member of VLEK by the candidate for receipt (prolongation) of the certificate or qualification mark, it is reported to authority on issue of certificates for acceptance of adequate measures.

18. Upon termination of medical examination of the candidate the chairman (the medical expert, the appointed member of the medical commission) generalizes results of survey, draws up the protocol according to appendix 3, makes logging of protocols of meetings of VLEK according to appendix 6 and hands out to the candidate the drawn-up medical certificate in the established form.

19. In case of discrepancy to the medical requirements specified in this Chapter and appendix 1 to these Aviation rules, the corresponding medical certificate is not issued or does not renew if the official medical certificate is not drawn up and the following conditions are not complied:

in the official medical certificate, it is specified that in special circumstances discrepancy of the candidate to some requirement designated or not designated by the corresponding number does not threaten aviation safety;

the corresponding capabilities, qualification and experience of the candidate, and also condition of its work are properly considered;

in the certificate the mark about any special restriction or restrictions is made when accomplishment properly of service duties by the owner of the certificate depends on observance of such restriction or restrictions.

20. For pronouncement of the official medical certificate the chairman (the medical expert, the appointed member of the medical commission) reports authority on issue of certificates (the medical expert) on each separate case when discrepancy of the candidate to any requirement designated in appendix 1 to these Aviation rules, such is that implementation of the rights of the requested or available certificate will probably not threaten aviation safety. In the protocol which is drawn up according to appendix 3 and certified, in this case, by the medical expert and the involved specialists the corresponding mark becomes and restrictions are specified.

21. Criteria of the validity for health reasons to which it is necessary to adhere in case of renewal of the medical certificate do not differ from the criteria used in case of the initial conclusion, cases which except for are specifically stipulated.

22. The aviamedical center provides confidentiality of medical information.

Medical documents are stored in the protected room, access to them is provided only to authorized personnel.

When it is justified by aviation safety reasons, the head of the aviamedical center or the chairman of VLEK informs authority on issue of certificates on the existing (possible) risk for safe fulfillment of duties and implementation of the rights granted by the certificate of aeronautical personnel or qualification marks.

23. After completion of primary survey in VLEK and recognitions of the candidate suitable for health reasons to fulfillment of duties of aeronautical personnel (training in aviation specialties), on it the medical book in form according to appendix 4 is drawn up and the personal record in which the protocol is filed is created (appendix 3), advisory proceedings of specialists doctors, results of laboratory and tool inspections, and also other documents taking into account which the diagnosis was established and was passed the decision on the validity (worthlessness) for health reasons to fulfillment of duties and implementation of the rights granted by the certificate.

24. The personal record is replenished after each survey of the owner of the certificate in VLEK and at least 50 years are stored in the aviamedical center (after the end of professional activity of the owner of the certificate - at least 10 years).

25. The medical book is property of the owner of the medical certificate and is shown them when passing of the regulated medical examinations and in case of survey in VLEK.

26. Records are made by flight surgeons in case of any survey of the owner of the certificate to appropriate sections of the medical book and health workers of the aviamedical center in case of its survey to VLEK.

27. The documents confirming carrying out the laboratory and tool inspections necessary for medical examination of the candidate for VLEK are stored in its personal record and their results (description) are transferred to appropriate sections of the medical book and certified by seal of the doctor or the aviamedical center.

28. Owners of certificates cease to have the rights provided by certificates and the corresponding qualification marks when they learn about deterioration in the state of health which could prevent them safely and properly perform these rights. The owner of the certificate shall see the flight surgeon in the cases listed in Item 106 of these Aviation rules.

29. Owners of certificates do not perform the rights granted by their certificates and qualification marks, being under the influence of any psychoactive agent which can make them incapable to perform these rights safe and properly.

30. Owners of certificates do not use psychoactive agents in that degree in which effects of their use would create risk for safe fulfillment of duties and implementation of the rights granted by certificates and qualification marks.

31. In case of recognition of the owner of the certificate unusable in connection with disease, on it the certificate on disease in which dynamics of the state of health and the analysis of the reasons which caused its deterioration is given is drawn up. The certificate on disease is certified by the head of the aviamedical center or the authorized medical expert and filed in the personal record.

§ 2. Classes of medical certificates

32. The following three classes of medical certificates are established.

32.1. First class. It is applied to candidates and owners:

certificates of the pilot of commercial aviation (the airplane, the airship and the helicopter), including for the student pilot when training for receipt of the certificate of the pilot of commercial aviation;

certificates of the pilot of polynomial crew;

certificates of the linear pilot of airline (airplane and helicopter);

certificates of the pilot for receipt of qualification mark about the right to fly-by-wires.

32.2. Second class. It is applied to candidates and owners:

certificates of the navigator;

certificates of the flight engineer (aircraft mechanic);

certificates of the flight radio operator;

certificates of the operator;

certificates of the pilot observer;

certificates of the private pilot (the airplane, the airship, the helicopter), including for the student pilot when training for receipt of the certificate of the private pilot or the pilot of commercial aviation (the extralight flight vehicle, glider, free aerostat);

certificates of the pilot-glider pilot;

certificates of the pilot of free aerostat;

certificates of the flight attendant.

32.3. Third class. It is applied to candidates and owners:

certificates of the dispatcher on air traffic control (dispatcher of the Department of Internal Affairs), including for the dispatcher-trainee before passing of preparation in field environment;

certificates of operators of unmanned aerial vehicles.

33. Except as specified, 37 and 40 these Aviation rules provided in Items 34, of 35, of 36,, the medical certificate issued according to provisions of Chapter 2 of these Aviation rules on condition of passing of the regulated medical examinations, can be prolonged automatically to the terms which are not exceeding from the date of medical examination:

24 months - for the certificate of the private pilot (the airplane, the helicopter);

24 months - for the certificate of the pilot-glider pilot;

24 months - for the pilot of free aerostat;

12 months - for the certificate of the pilot of commercial aviation (the airplane, the helicopter);

12 months - for the certificate of the pilot of polynomial crew (airplane);

12 months - for the certificate of the linear pilot of airline (the airplane, the helicopter);

12 months - for the certificate of the navigator;

12 months - for the certificate of the flight radio operator;

12 months - for the certificate of the flight engineer (aircraft mechanic);

24 months - for the certificate of the operator;

24 months - for the certificate of the flight attendant;

24 months - for the certificate of the pilot observer;

24 months - for the certificate of the dispatcher on air traffic control;

24 months - for the certificate of the operator of unmanned aerial vehicles;

12 months - for the certificate of the pilot with qualification mark about the right to fly-by-wires.

34. Effective period of the medical certificate can be reduced according to the solution of flight-surgeon commission of experts or medical expert in medical indications.

35. In case of achievement of the linear pilot of airline by owners of the certificate (the airplane, the helicopter) and certificates of the pilot of commercial aviation (the airplane, the airship and the helicopter) who are carrying out commercial flights on public conveyance by the airplanes managed by one pilot, age of 40 years, the effective period of the medical certificate specified in the item 33, is reduced to 6 months.

36. In case of achievement of the linear pilot of airline by owners of the certificate (the airplane, the helicopter), certificates of pilots of commercial aviation (the airplane, the airship and the helicopter), certificates of the navigator, flight engineer, flight radio operator and certificate of the pilot of polynomial crew (airplane) occupied with accomplishment of commercial air transportations, age of 60 years, the effective period of the medical certificate specified in the item 33, is reduced to 6 months.

37. In case of achievement of the private pilot by owners of the certificate (the airplane, the airship, the helicopter), certificates of the pilot of free aerostat, the certificate of the pilot-glider pilot, certificates of the flight attendant and the operator, the certificate of the operator of unmanned aerial vehicles and the certificate of the dispatcher on air traffic control, age of 45 years, the automatic prolongation of effective period of the medical certificate is not allowed and it is valid within 12 months.

38. The amount and frequency rate of kliniko-diagnostic testings, medical examinations by specialists doctors and other medical examinations of owners of the certificates of aeronautical personnel listed in the item 32, determined by these Aviation rules, consider the current legislation of the Republic of Belarus in the field of health care and labor protection for staff employees of the aviation organizations.

39. For certificates of the air engineer, aviation technician, flight servicing specialist and other employees of the aviation organizations, are not established by these Aviation rules of the requirement to the state of health. The above-stated workers have in the aviamedical centers obligatory medical examinations taking into account harmful (dangerous) production factors and features of attended operation in amount and in the terms determined by the legislation.

40. The next medical examination of the owner of the certificate which is carrying out flights in the outlying area can be delayed at the discretion of authority on issue of certificates provided that such delay will be granted only as exception and will not exceed:

one period lasting 6 months for the member of flight crew of the air vehicle which is occupied with non-commercial transportations;

two consecutive periods lasting 3 months everyone for the member of flight crew of the air vehicle which is occupied with commercial transactions provided that in each case the corresponding person has medical examination at the medical expert or in flight-surgeon commission of experts for this area or, in case of their absence, at the doctor having the formal permission to be engaged in medical practice in this area. The conclusion about results of medical examination is sent to the authority which granted this certificate;

for the private pilot - one period lasting no more than 24 months if medical examination is performed by the medical expert or in flight-surgeon commission of experts, appointed authority on issue of certificates and relevant requirements of Item 9 of these Aviation rules in the territory of which temporarily there is candidate. The conclusion about medical examination is sent to the authority which granted this certificate.

41. Persons arriving in organizations of education for training in specialties of aeronautical personnel for the purpose of determination of possibility of implementation of the rights and the fulfillment of duties provided by the certificate are recommended to undergo medical examination in the aviamedical center before submission of documents in selection committee.

42. In case of need parachutists undergo medical examination in VLEK on the 2nd class.

§ 3. Procedure for recognition of the medical certificate (certificate)

43. The medical certificate (certificate) issued by other state is recognized if the state of health of its owner conforms to the requirements established in appendix 1 to these Aviation rules.

44. The owner of the certificate who addressed to the aviamedical center for recognition of the medical certificate (certificate) issued by foreign state processes documents according to Item 15 of these Aviation rules.

45. After confirmation of conformity of the state of health of the owner of the certificate to the established requirements documents according to Item 18 of these Aviation rules are processed. In the protocol (appendix 3), becomes the corresponding mark.

46. Recognition of medical certificates (certificates) issued by foreign states without passing of medical examination is allowed if the Republic of Belarus and the state which issued the medical certificate (certificate):

apply general rules of issue svidetelstv3 and single requirements to the state of health of their owners;

signed the official agreement recognizing the procedure of automatic giving of force;

entered system of supervision for the purpose of permanent ensuring application of general rules of issue of certificates;

registered this agreement in the International Civil Aviation Organization founded by the Convention on international civil aviation of December 7, 1944 (further - ICAO).

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3 General rules of issue of certificates mean general normative system of issue of certificates which is legally binding and is directly applied to the countries - agreement parties, the recognizing procedure of automatic giving of force. The general rules of issue of certificates applied by these states contain identical requirements for issue of certificates, maintenance of skill level and the previous experience.

§ 4. Requirements to the state of health of candidates for receipt (prolongation) of certificates

47. Requirements to the state of health of candidates for receipt (prolongation) of certificates (further - candidates) and criteria for evaluation of functional condition of bodies and systems contain in appendix 1 to these Aviation rules.

48. The list of the methods of physical examination which are carried out in case of medical examination to VLEK is reflected in appendix 5.

49. Instructive material for the aid to authorities on issue of certificates and health workers of the aviamedical centers contains in the Management on aviation medicine (ICAO Doc 8984).

50. In the absence of other instructions in this paragraph, owners of certificates renew the medical certificates determined in Item 32 according to the procedure established by subitem 7.6 of Item 7 of the list of the ministerial procedures performed by the state bodies and other organizations for petitions from citizens, No. approved by the Presidential decree of the Republic of Belarus of April 26, 2010 bucketed 200, which are not exceeding the intervals specified in Item 33 of these Aviation rules.

51. Candidates for receipt of the medical certificate undergo medical examination taking into account:

physical and mental condition;

visual perception and color sensation;

hearing.

52. The candidate has no diseases or restriction of working capacity which could lead to sudden loss of capability of this candidate to carry out the charged obligations. Namely:

the inborn or acquired anomalies;

active, hidden, sharp or chronic inability;

wounds, injuries or effects of transaction;

any effects or side effect from acceptance of any therapeutic, diagnostic or preventive medicines registered by the doctor or available on open sale 4, which could cause such degree of functional disability that would lead to violation of safety of aircraft flight or safety of implementation of obligations by this person.

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4 The instruction for use of medicines is given by faces of aeronautical personnel of the Republic of Belarus in appendix 7 to these Aviation rules.

53. At the candidate it is not registered in the anamnesis or not established in the course of medical examination of conditions or diseases which can result in its inability safely to perform the rights granted by the requested or available certificate:

organic mental disturbance;

the mental or behavioural disturbance caused by the use of psychoactive agents (including syndrome of dependence on alcohol or other psychoactive agents);

schizophrenia, shizotipichesky, crazy frustration;

affective frustration;

neurotic, connected with stress, or somatoformny frustration;

the behavioural syndrome connected with physiological violations or physical factors;

frustration of the personality or behavior;

intellectual backwardness;

disorders of mental development;

disorders of behavior or emotional frustration.

54. The candidate having depression is considered unsuitable.

55. For exception of the conditions and diseases listed in Items 53 and 54 of these Aviation rules, candidates and owners of certificates pass psychophysiological and psychological obsledovaniye5 by the approved techniques according to the following indications:

before training in specialties of aeronautical personnel and in case of primary passing of VLEK;

on achievement of age of 50 and 55 years;

on achievement of age of 60 years and, in subsequent, every two years;

in case of breaks in flight work more than four months and reeducation on the new equipment;

in case of promotion to positions of the aircraft commander, flight instructor, dispatcher-instructor, senior dispatcher, flight operations director;

in case of the direction to the states with adverse climate, for work in zones of radioactive infection;

pilots before receipt of qualification mark about the right to fly-by-wires;

faces of dispatching structure in case of increase in class and receipt of the admission to air traffic control with bigger complexity of work;

persons before employment in the aviation organizations for work on specialties of aeronautical personnel;

in case of suspicion of epilepsy;

in case of the residual phenomena of diseases of the central nervous system;

after craniocereberal injury of varying severity;

in the presence of clinical and/or tool instructions on atherosclerotic defeat of vessels of brain;

after postponed short-term somatogenno caused (the infectious, toxic, reactive reasons) mental disturbances (after recovery);

in case of frustration of the personality and behavior (irrespective of form and expressiveness), neurotic frustration;

in case of the direction the specialist doctor of VLEK or the flight surgeon in case of suspicion on abuse of alcohol, the use of drugs or psychotropic substances;

to destination the specialist doctor of VLEK in case of diseases and conditions, including connected with chronic stress which, in his opinion, can negatively influence mental functions;

by the written request of the head of the aviation organization, including after the aviation event.

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5 Examination is conducted not earlier than in 1 days after introduction of the medicines expanding pupil.

The program of psychological and psychophysiological inspection of candidates and owners of the certificates specified in paragraphs the second, the fifth, the sixth, ninth and tenth to part one of this Item joins additional testing of the emotional sphere and some personality characteristics for identification and the forecast of dezadaptivny conditions.

Low resistance to stress, high emotional lability, excessive impulsiveness, aggression as manifestations of urgent condition, or lines of the personality, can with high degree of probability negatively affect in the conditions of professional stresses and lower the forecast of success even with the sufficient level of development of professional and important qualities (further - PVK).

By results of psychophysiological and psychological inspection the concluding observation with indication of the level of development of PVK, the forecast of success of training and work on this specialty, and also recommendations concerning acceptance in organizations of education for training in aviation specialties or for work in the aviation organizations, further work, position assignment or increase in class is created.

56. At the candidate it is not registered in the anamnesis or not established in the course of medical examination:

diseases of nervous system which can interfere with safe implementation of the rights granted by the certificate and qualification marks;

epilepsies;

cases of loss of consciousness without satisfactory medical explanation of the reason.

57. The candidate had no head injuries which effects can interfere with safe implementation of the rights granted by its certificate and qualification marks.

58. The candidate has no inborn or acquired violations of warm activities which can interfere with safe implementation of the rights granted by the certificate and qualification marks.

59. The candidate who transferred angioplasty of coronary artery (with stenty or without him) or other transaction to heart or in the anamnesis at which is registered myocardial infarction, or having other cardiological disease which can lead to disability it is considered unsuitable, except cases when the cardiological condition of the candidate was inspected and evaluated according to the best medical practice and was acknowledged that it cannot interfere with safe implementation by the candidate of the rights granted by its certificate or qualification marks.

60. The candidate with violation of warm rhythm is considered unsuitable, except cases when assessment of warm rhythm was carried out according to the best medical practice and was acknowledged that this disease (condition) cannot interfere with safe implementation by the candidate of the rights granted by its certificate or qualification marks.

61. The electrocardiography and other methods of physical examination given in appendix 5, are necessary and obligatory in case of medical examination in VLEK.

62. Arterial pressure of the candidate is in regulation limits.

63. In case of use of medicines for lowering of arterial pressure, the candidate is considered unsuitable. The exception is constituted by only those medicines which use sovmestimo6 with safe implementation by the candidate of the rights granted by its certificate and qualification marks.

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6 Purpose of medicamentous therapy is performed according to appendix 7 to these Aviation rules.

64. The cardiovascular system of the candidate has no serious functional or structural aberrations.

65. The candidate has no diseases of breathing system, sredosteniye or pleura which can cause disability during the work in regular or emergencies.

66. Candidates reckon unsuitable with obstructive diseases of lungs, except cases when the condition of the candidate was inspected and evaluated according to the best medical practice and was acknowledged that it cannot interfere with safe implementation by the candidate of the rights granted by its certificate or qualification marks.

67. Candidates reckon with the bronchial asthma which is followed by essential symptoms which can lead to disability during operating time in normal or emergencies as unsuitable.

68. Use of medicines for treatment of bronchial asthma is the basis for recognition of the candidate unsuitable.

69. Candidates reckon with active tuberculosis of lungs as unsuitable.

70. Candidates with the inactive or cured pulmonary diseases which were diagnosed or presumably were diagnosed as tuberculosis, can be recognized as suitable.

71. Candidates reckon with considerable violation of functions of digestive tract as unsuitable.

72. Candidates have no surgical diseases which can lead to disability.

73. In case of any complication after disease or surgical intervention in areas of digestive tract (in particular in case of intestinal impassability) which can cause disability in flight, candidates are considered as unsuitable.

74. The candidate who underwent the surgery on bilious channels, bodies of digestive tract connected with complete or partial removal or functional violation of any of bodies should be considered unsuitable for such term until the surgeon of VLEK (general practitioner), after detailed studying of effects of transaction at this candidate, takes out the conclusion that effects of operational treatment will not be able to lead to disability in flight.

75. Candidates with metabolic disorders, functions of digestive tract or endocrine glands which can interfere with safe implementation of the rights granted by their certificates and qualification marks are considered as unsuitable.

76. Candidates reckon with insulin-dependent diabetes as unsuitable.

77. Candidates reckon unsuitable with insulinonezavisimy diabetes, except as specified, when the disease can well be controlled by means of diet.

78. Candidates reckon unsuitable with diseases of blood and/or lymphatic system, except as specified, when as a result of proper inspection it is determined that their condition cannot interfere with safe implementation of the rights granted by their certificates and qualification marks.

79. Candidates reckon unsuitable with diseases of urinogenital system and kidneys, except as specified, when as a result of proper inspection it is determined that their condition cannot interfere with safe implementation of the rights granted by their certificates and qualification marks.

80. The analysis of urine is part of medical examination, and aberrations are properly researched.

81. In case of any complication after disease or surgical intervention in areas of urinogenital system which can cause disability when implementing of the rights granted by their certificates and qualification marks candidates are considered as unsuitable.

82. Candidates reckon unsuitable with remote kidney, except as specified stable compensation.

83. Candidates reckon with seropozitivny reaction to the human immunodeficiency virus (HIV) as unsuitable.

84. Pregnant candidates are considered as unsuitable.

85. After the delivery or the pregnancy terminations the candidate is not allowed to perform the rights granted by the certificate before passing of survey to VLEK.

86. The candidate has no anomalies of bones, joints, muscles, sinews or the related structures which can interfere with safe implementation of the rights granted by its certificate and qualification marks.

87. Eyes and their appendages within regulation. The candidate has no sharp or chronic pathological violations of sight, either any effects of surgical intervention, or injury of eyes or their appendages which can weaken visual function in such degree which will interfere with safe implementation of the rights granted by its certificate and qualification marks.

88. Requirements to visual acuity afar and to visual acuity for bliza are given in appendix 1 to these Aviation rules, sharpness of binocular sight with correction or without it makes 1,0 or above.

89. If admissible visual acuity is reached only by means of corrective lenses, the candidate can be acknowledged suitable provided that:

points with such corrective lenses carry when implementing of the rights granted by the requested or available certificates or qualification marks;

besides, when implementing by the candidate of the rights granted by its certificate always on workplace there is reserve pair of glasses with the corresponding corrective lenses. If the candidate carries contact lenses 7, in which he meets the requirements for sight, he shall have reserve couple of contact lenses during implementation of the rights granted to it by the certificate. In addition to reserve set of contact lenses it needs to have reserve pair of glasses (it is desirable with lenses from material with high index of refraction) for use in emergency situation when it is impossible to put on reserve contact lenses;

corrective lenses shall be without toning.

______________________________

7 Members of flight crew and flight surgeons need to understand that use in flight time of soft contact lenses is not desirable as the low relative humidity onboard the air vehicle reduces time of their carrying and causes certain discomfort in case of their use. In case of need, during prolonged flight, there can be desirable use of substitutes of plaintive liquid without preservatives. The artificial tears containing preservatives can cause irritation when using with contact lenses owing to what it is desirable to avoid their application.

90. When passing medical examination the candidate shall show that to it one pair of glasses for fulfillment of requirements to sight suffices. Use of different points for sight afar and for bliza unacceptably because of possible problems with change of points in critical situation.

91. Candidates with considerable violation of refraction use contact lenses or points with lenses with high refraction coefficient to minimize misstatement of the field of peripheral sight.

92. The candidates who underwent to the surgery which entailed changes of characteristics of refraction of eye are recognized suitable on condition of lack of effects which can influence safe implementation of the rights granted by their certificates and qualification marks.

93. The candidate, is capable to read the text No. 5 of the table for visual acuity determination close (or its analog) at distance in the range of 30-50 cm, and the text No. 8 at distance of 100 cm in corrective points or without them.

94. The candidate has normal field of view.

95. The candidate has steady binocular sight.

96. Decrease in sharpness of binocular sight, the abnormal convergence which is not breaking sight on short distance, and misalignment of lenses in case of which fusional characteristics exclude asthenopia and diplopiya are not the reason for disqualification in case of the next passing of VLEK.

97. The candidate inspected by means of chistotonalny audiometry has no loss of hearing on each ear separately more than 35 dB on any of three frequencies 500, of 1000 or 2000 Hz or more than 50 dB at frequency of 3000 Hz.

98. The candidate has no anomalies or diseases of ear or ENT organs which can interfere with safe implementation of the rights granted by its certificate and qualification marks.

99. At the candidate it is not allowed:

disorders of vestibular function;

considerable dysfunction of Eustachian tubes;

not cured perforation of eardrum;

obstructions of nasopharynx;

defects and diseases of oral cavity or the upper airways which can interfere with safe implementation by the candidate of the rights granted by its certificate and qualification marks.

100. The candidates having stutter or other defects of the speech which will interfere with maintaining voice service are considered as unsuitable.

101. The aeronautical personnel directed to work to the countries with adverse climatic conditions for the term of over three months is subject to extraordinary survey in VLEK.

102. The following Articles of Requirements to the state of health of candidates for receipt (prolongation) of certificates and criteria for evaluation of functional condition of bodies and systems are determined (according to appendix 1), providing worthlessness:

for work in the countries with frigid climate: 1b, 2b, 5b, 7b, 8b, 11b, 15b, 20b, 21b, 23b, 24b, 25b, 26b, 35b, 42b, 43b, 44b, 46b, 47b, 51b, 53b, 62b, 63b, 65b, 66b;

for work in the countries with hot climate: 1b, 5b, 6b, 7b, 8b, 11b, 15b, 20b, 21b, 22b, 36b, 44b, 51b, 53b, 62b, 63b, 65b;

for aerotechnical works (using agricultural chemicals): 1b, 5b, 6b, 7b, 8b, 11b, 21b, 22b, 24b, 25b, 26b, 38b, 44b, 51b, 53b, 62b, 63b, 65b, 66b.

§ 5. Delivery of health care to owners of certificates. Medical observation during the intercommission period

103. Delivery of health care to owners of certificates is performed according to the clinical protocols or methods of delivery of health care approved by the Ministry of Health of the Republic of Belarus (further - clinical protocols).

104. Medical observation of faces of aeronautical personnel during the intercommission period, and also the admission to fulfillment of duties and implementation of the rights granted by certificates and qualification marks is performed by the flight surgeon.

105. The flight surgeon performs the regulated medical examinations of owners of certificates in the following cases:

once a year between medical surveys in VLEK for owners of certificates which effective periods of medical certificates can last up to 24 months (annual medical examination) according to Item of 33 presents Aviation pravil8;

once in 6 months between medical surveys in VLEK for owners of certificates, with effective periods of the medical certificate of 12 months (semi-annual medical examination) 8;

before the next medical examination;

in terms according to recommendations of VLEK;

on the medical indications listed for owners of certificates in Item 106 of these Aviation rules;

after the business trips to the countries, unsuccessful on epidemic and climatic conditions;

after stay in business trip more than 3 months;

after discharge from flight (work) on pre-flight (prereplaceable) medical examination on medical indications;

after the aviation event;

in case of employment in the aviation organizations.

______________________________

8 In amount according to appendix 5 to these Aviation rules.

106. Owners of certificates shall see the flight surgeon prior to implementation of the rights granted by certificates and qualification marks in the following cases:

in case of the changes in indicators of analyses and variations in the state of health which are again revealed in case of any physical examination;

after any case of loss of consciousness;

after pain attack in heart and/or violation of warm rhythm after completion of treatment or in the course of it;

after any operational treatment;

after hospitalization completion at the slightest pretext;

upon termination of temporary disability;

before prescription of medicines for permanent acceptance;

after requests for emergency medical service (challenge of crew of emergency medical service, the appeal to healthcare institution);

in the cases specified in Item 105 of these Aviation rules;

in other cases when there are doubts in possibility of safe fulfillment of duties and implementation of the rights granted by the certificate and qualification marks.

107. In case of non-compliance by the owner of the certificate of aeronautical personnel of the requirements specified in Item 106, to it measures according to Item 17 of these Aviation rules are taken.

108. After survey and the analysis of the submitted medical documents the flight surgeon makes the decision on the admission of face of aeronautical personnel to implementation of the rights granted by the certificate and qualification marks or on its direction in the aviamedical center (for extraordinary survey in VLEK or for consultation by specialists doctors of VLEK) and draws up the medical book.

109. The flight surgeon draws up Sections III, IV, V, VI, VII, VIII, IX, XXVII, XXVIII, XXIX, XXX of the medical book according to appendix 4 to these Aviation rules.

110. When performing medical examinations of aeronautical personnel by the flight surgeon data on requests for medical care in the organization of health care for the place of stay (accommodation) and registration are considered.

111. Medical examinations of aeronautical personnel in case of establishment (suspicion on availability) violations in the state of health, diseases are carried out by the flight surgeon according to clinical protocols.

112. The admission to fulfillment of duties of faces of aeronautical personnel and implementation of the rights granted by certificates in case of purpose of medicines it for permanent acceptance, is performed according to the Instruction for use of medicines faces of aeronautical personnel of the Republic of Belarus, according to appendix 7 to these Aviation rules.

113. The owners of certificates who are employees of the aviation organizations without fail have pre-flight (prereplaceable) medical examinations. The amount and frequency rate of performing pre-flight (prereplaceable) medical examinations are determined by heads of the aviation organizations in coordination with the aviamedical center taking into account the current legislation and recommendations of VLEK.

114. Owners of certificates are not allowed to fulfillment of duties and implementation of the rights granted by certificates and qualification marks in case of identification at them on pre-flight (prereplaceable) medical examination of the following signs and conditions:

availability of signs of sharp diseases (injuries), exacerbations (decompensation) of chronic diseases;

availability of vapors of alcohol in expiratory air when using the device;

availability of drugs or other substances in biological samples when using rapid tests;

availability of clinical signs of state of intoxication in the absence of alcohol vapors in expiratory air, drugs or other substances in biological samples;

refusal of accomplishment of the instructions of the health worker concerning performing pre-flight (prereplaceable) medical examination.

115. For the purpose of increase in level of aviation safety and ensuring smooth functioning of the aviation organizations, their heads have the right to make the decision on need of performing additional medical examinations and physical examinations of any employees of the organization.

Chapter 3. First-aid treatment and emergency medical service to crew members and passengers of the air vehicles performing the international passenger traffic and persons which are in the territories of the international airports

116. Rendering the first and emergency medical service to crew members and passengers of the air vehicles performing the international passenger traffic and persons which are in the territories of the international airports in case of origin sharp and/or exacerbation of chronic diseases is made according to clinical protocols.

117. Responsibility for creation of conditions for rendering high-quality and available medical care to members of crews of air vehicles, to passengers in flight time, before and after it, and also to the other persons which are in the territories of the international airports heads of the aviation organizations within their competence bear.

118. The minimum and recommended lists of stackings and their content for equipment of the international airports and air vehicles of civil aviation are given in appendices 8, of 9, of 10, of 11, 12 to these Aviation rules.

119. The list of stackings for equipment of the international airports and their content, and also content of stackings for equipment of air vehicles of civil aviation, can extend taking into account requirements and specifics of the tasks assigned to persons rendering the first and emergency medical service and also in case of threat of deterioration in epidemiological situation according to the decision of bodies of public health care.

120. The health worker, in case of the address of person to him for consultation with the purpose of determination of possibility of implementation of flight on the civil air vehicle, considers general condition of the patient, availability of sharp and chronic diseases at the time of the address, the anamnesis gathers, data on the accepted medicines are specified and recommendations taking into account the data given in appendix 13 to these Aviation rules are taken out.

121. Powers in the field of medical support of flights are determined by implementation of activities as a result of the certification which is carried out by the body authorized in the field of civil aviation based on the corresponding aviation rules.

Chapter 4. The organization and holding sanitary and anti-epidemic actions on boards of the air vehicles performing international carriages and in the territories of the international airports

122. The organization and holding sanitary and anti-epidemic actions on boards of the air vehicles performing international carriages and in the territories of the international airports are performed according to the legislation of the Republic of Belarus.

123. Responsibility for creation of conditions for the organization and holding sanitary and anti-epidemic actions is assigned to heads of the aviation organizations (operators, the airports) within their competence.

124. The Sections determining actions of workers in emergency situations in the field of public health care and having the international value shall be provided in local regulatory legal acts of the aviation organizations (The Contingency plan of the airport, the Management on production of flights, the Management of cabin crew and so forth).

125. Methodical recommendations about the organization and holding sanitary and anti-epidemic (preventive) actions in case of identification of the patient (suspicious on infection, corpse) are given by the infectious disease representing the emergency situation in the field of public health care having the international value when implementing flights of air vehicles of civil aviation in appendix 14 to these Aviation rules.

Appendix 1

to the Aviation rules "Procedure for Medical Support of Flights of Civil Air Vehicles" of January 24, 2019 No. 5/10

Requirements to the state of health of candidates for receipt (prolongation) of certificates and criteria for evaluation of functional condition of bodies and systems

Name of diseases and physical defects, extent of malfunction

Class of the medical certificate

 

I

II

III

 

Class I.Инфекционные and parasitic diseases

 

Article 1

Infectious and parasitic diseases (except infections of TsNS) A00-09, A20-32, A34-49, A75-99, B00-01, B03-19, B25-34, B50-89, B92-99

I

II

III

and

not giving in or difficult giving in to treatment, the complicated current or with the resistant residual phenomena

are unusable

are unusable

are unusable

temporary functional frustration after sharp infectious and parasitic diseases from the outcome in recovery

Release from implementation of the rights and fulfillment of duties provided by certificates and qualification marks. On recovery – are suitable.

 

Explanations to  Article 1 of Requirements to the state of health of candidates for receipt (prolongation) of certificates and criterion for evaluation of functional condition of bodies and systems (further in this appendix – Requirements).

 

The Item "and" provides:

the chronic recidivous forms of infectious diseases which are not giving in or difficult giving in to treatment;

resistant bakterionositelstvo after the postponed dysentery, tifoparatifozny diseases and salmonellosis.

Conditions after the postponed sharp infectious, parasitic diseases in the presence of temporary functional violations when upon completion of treatment at osvidetelstvuyemy the asthenic syndrome and the phenomena of exhaustion remain belong to the Item.

When assessment of firmness of functional violations and complete recovery of professional working ability of aeronautical personnel requires long term, it is represented on meeting of the medical and consulting commission (further – VKK) according to the legislation.

Medical examination of the aeronautical personnel which had acute viral hepatitis A in easy or medium-weight form is carried out in case of the defined medical and expert outcome.

The candidates for receipt of the medical certificate of the third class who transferred not complicated easy or medium-weight form of acute viral hepatitis, typhoid, paratyphus are allowed to management of flights in case of absence or insignificant dysfunction of liver and digestive tract.

Owners of certificates can be allowed to air-chemical works in case of the defined medical and expert outcome.

In case of defeat of other bodies and systems, owing to the postponed infectious and parasitic diseases, medical examination is made on the main disease.

Persons arriving in organizations of education on training of pilots, dispatchers of the Department of Internal Affairs on recovery are fit.

 

Article 2

Tuberculosis, effects of tuberculosis of A15-19, B90

I

II

III

and

active, any localization

are unusable

are unusable

are unusable

inactive

are suitable

are suitable

are suitable

 

Explanations to  Article 2 of Requirements.

 

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