30TH ANNUAL CONFERENCE, Port of Spain, Trinidad & Tobago, 22-26 April 1991WP No. 70Substance Abuse in ATC |
Introduction
Committee C at the 29th conference charged SC4 with the task of producing a Working Paper on “Mandatory Drug Testing” for the Trinidad conference. This paper has been prepared for the information of MAs.
Discussion
Definition of Abuse
Because of the wide spectrum of medication alone, which can affect the performance of those engaged in work requiring intense concentration such as Air Traffic Control, it is not surprising that there is no universally accepted definition of such terms as “drugs”, “drug abuse” or “drug dependency”. However, there seems to be a growing international acceptance of the comprehensive term “substance abuse”. It should be noted here that this term includes abuse of even simple medication such as aspirin …. or alcohol, which is known to have been a subject of abuse for more than a thousand years … as well as other more recent illicit-drug substances.
Incidence of Abuse
Does a problem exist? If there is a problem, what is its nature, extent, and growth? Even Aeromedical experts are unwilling to answer these questions because of the lack of sufficient factual data in ATC-related abuse of:
- Medication.Ideally, anyone requiring medication for the treatment of an illness should not attempt to carry out Air Traffic Control duties. But the illness may appear to be relatively mild of the medication needed may not, or may seem not, to conflict with the standard of fitness required.
- Alcohol.A significant level of alcohol can remain in the body for 8 hours or more, subject to individual variation depending on excretion efficiency, liver function, metabolism, body mass and food intake.
- Illicit substances.One example is taken from the American Journal of Psychiatry, 1985,: the effects of cannabis on pilot performance showed an impairment of performance in one instance for more than 24 hours. Disturbingly, the pilots involved had not noticed any difference in their skills.
Impairment of Ability
No Air Traffic Controller should attempt to undertake Air Traffic Control duties unless confident of an unimpaired ability to carry them out. However, any form of medication, whether or not prescribed by a doctor, may have serious consequences in the ATC environment. Types of medicines which may impair work performance include:
- Sleeping Tablets;
- Tranquillisers;
- Sedatives;
- Pep-pills;
- Antibiotics;
- Anti-histamines;
- Blood Pressure drugs;
- Anti-malarials
Air Traffic Controllers should therefore be aware of the possibility that some of these prescriptions drugs could show a “positive” drugs test result and should always ascertain how, and for how long, they may be affected, either directly or through possible side effects, before reporting for duty.
Legislation on Abuse
ICAO legislation provision already exists in Annex 1 (Personnel Licensing) which is appropriate. Para 1.2.6.1 states “The holder of a licence shall not exercise the privileges of his licence and related ratings at any time when he is aware of any decrease in his medical fitness which might render him unable to safely exercise these privileges.
Detection of Abuse
It is difficult for an individual to know when any particular substance has been eliminated from the system. Biochemical analysis is therefore the recognised objective method of testing. Some tests identify specific chemicals, and even their concentrations, but fail to show the presence of any other possible drug. Other tests, on the other hand, only indicate the presence of one or more of a family substances, some of which might have been prescribed by a doctor. False- positive results are not unknown. It is therefore essential to obtain an independent analysis with as high an accuracy as possible.
Drug Testing
There are five routines which might be appropriate to drug testing for Air Traffic Controllers:
1) Initial Recruitment;
2) After an ATC accident;
3) Regular basis (annual medical examination);
4) Reasonable cause for suspicion;
5) Random basis.
SC4 agree with the ANB of ICAO which has concluded that drug testing could only be considered cost affective and significant in the context of 1) and 2) at present.
Prevention of Abuse
Prevention is always better than cure. Thus a programme of education on the subject of substance abuse should be set up by the employer with the MA in consultation from the very beginning. This should highlight the positive aspects of prevention before any problem could arise.
Rehabilitation
If a problem with substance abuse is recognised in an individual, a programme of rehabilitation should be made available. The MA should be involved in the setting up (and feedback) of any such programme for Air Traffic Controllers in order to maintain the confidence of the individual concerned.
Conclusions
Adequate legislation already exists to cover the situation where an Air Traffic Controller is aware of the decrease in his medical fitness, but the position is less clear when he is not aware of such decrease. Drugs, whether prescribed by a doctor or not, can cause a lowering of awareness of an individual’s medical fitness. Where an Air Traffic Controller is using medication he should obtain medical advice on his fitness for duty and should inform any mandatory drug-tester of his medication at the time.
There is little empirical evidence of substance abuse in Air Traffic Control, but this not obviate IFATCA from its responsibility to caution MAs seriously concerning this matter.
Not all drug tests are infallible and it is essential that individuals always receive a sealed identical sample in order to obtain an independent and accurate analysis when subjected to a drug test. Mandatory drug tests are acceptable on initial recruitment of Air Traffic Controllers in order to prevent any erosion of entry medical standards. Mandatory drug tests of Air Traffic Controllers involved in an ATC accident are acceptable in order to demonstrate positively their medical fitness at the time.
Recommendation
IFATCA views substance abuse with concern and cautions MA’s against it.
It is recommended that a programme of education of substance abuse be made available to Air Traffic Controllers by their employer in consultation with the MA.
It is recommended that all appropriate safeguards and redress procedures should be established before the introduction of any mandatory drug-test scheme.
That mandatory drug tests subject to the provisions above are acceptable on initial recruitment of Air Traffic Controllers to prevent any erosion of entry medical standards.
That mandatory drug tests subject to the provisions above of Air Traffic Controllers in an ATC accident are acceptable in order to demonstrate positively their medical fitness at the time.
That any Air Traffic Controller subjected to a drug test receive a sealed identical sample in order to obtain an independent analysis, paid by the employer.
It is recommended that a programme of rehabilitation from substance abuse be made available to an Air Traffic Controller where a problem is recognised. This programme should be set up and conducted in consultation with the MA in order to maintain the confidence and preserve the employment in ATC of the individual concerned.
Last Update: September 20, 2020