51ST ANNUAL CONFERENCE, Kathmandu, Nepal, 12-16 March 2012
WP No. 159
ATCOs with Disabilities
Presented by PLC
IFATCA does not have policy on controllers with either temporarily or permanent disabilities. Every day people are exposed to certain dangers or can suffer from various diseases, which could cause a loss of licence either temporarily or permanently. There are some disabilities, which are compatible with ATC work. Unfortunately others are not.
1.1 The first article about “disabilities” was written in ‘The Controller’ Magazine, in the article “ATC from a wheelchair” in issue Winter 2010/2011, and again at the 2011 conference in the WP158 Diabetes.
1.2 This paper will give a basis for discussion what IFATCA can do to assist ATCOs with disabilities.
2.1 IFATCA has no policy on ATCOs with disabilities.
2.2 Disability is a physical or mental impairment of an individual. Disability may be physical, cognitive, mental, sensory, emotional, and developmental or some combination of these.
2.2.1 “Disabilities” is a term, covering impairments, activity limitations, and participation restrictions. Impairment is a problem in body function or structure; an activity limitation is a difficulty encountered by an individual in executing a task or action; while a participation restriction is a problem experienced by an individual in involvement in life situations.
Thus disability is a complex phenomenon, reflecting an interaction between features of a person’s body and features of the society in which he or she lives. (World Health Organisation)
2.2.2 The correct term to distinguish deviation from normal is impairment. One is not able to make a muscle movement or is not able to control an unwanted movement. Disability is the term used to define a restriction in the ability to perform a normal activity of daily living, which someone of the same age is able to perform. (For example, a three-year-old child who is not able to walk has a disability because a normal three year old can walk independently). Handicapped is the term used to describe a person, who because of the disability is unable to achieve the normal role in society commensurate with his age and socio-cultural milieu. (As an example, a sixteen-year-old who is unable to prepare his own meal or care for his own toileting or hygiene needs is handicapped. On the other hand, a sixteen-year-old who can walk only with the assistance of crutches but who attends a regular school and is fully independent in activities of daily living is disabled but not handicapped.) All disabled people are impaired, and all handicapped people are disabled, but a person can be impaired and not necessarily be disabled and a person can be disabled without being handicapped.
2.2.3 An individual may also qualify as disabled if they had had impairment in the past or is seen as disabled based on a personal or group standard or norm. Such impairments may include physical, sensory, and cognitive or developmental disabilities. Mental disorders (also known as psychiatric or psychosocial disability) and various types of chronic disease may also qualify as disabilities.
2.2.4 A disability may occur during a person’s lifetime or may be present from birth. A disability can be time limited e.g. after an accident or operation, or the person can suffer it permanently.
2.3 Medical Certification
2.3.1 Air traffic controllers must maintain some of the strictest medical and mental requirements. Conditions such as diabetes type 2, epilepsy, heart disease, and many mental disorders (e.g., bipolar disorder, a history of drug abuse) typically disqualify people from obtaining certification. Conditions such as hypertension, while not disqualifying, are taken seriously and must be monitored with medical examinations by certified doctors. Controllers must take precautions to remain healthy and avoid certain medications that are banned for them. I.e. many drugs approved by the U.S. Food and Drug Administration (FDA) such as SSRI antidepressants are banned without specialized certification.
2.3.2 To carry out the job effectively, the Controller must meet the Standards specified for a Class 3 Medical Assessment as laid down in Annex 1. Medical procedures should include a full history, including family history, and a full physical examination carried out in accordance with 6.5 in Chapter 6 of Annex 1. Medical certificate of an ATCO is valid for 2 years until the age of 40, then 1 year.
2.3.3 Medical certification is the process of establishing and issuing evidence that guarantees that a licence holder meets the medical requirements. The ATC licence cannot be used for carrying out ATC duties without evidence that the holder of the licence meets the medical requirements for fitness. Many States issue medical certificates, valid for a limited period only, and they are designed to be valid together with the licence.
126.96.36.199 The detailed medical requirements appear in chapter 6 of Annex 1.
An applicant for a Medical Assessment shall undergo a medical examination based on the following requirements:
a) Physical and mental;
b) Visual and colour perception; and
The applicant shall not suffer from any disease or disability, which could render that applicant likely to become suddenly unable to perform duties safely.
An ATCO should not have suffered any head injury, the effects of which are likely to interfere with the safe exercise of the applicant’s licence and rating privileges.
2.4 Characteristics of disabilities
2.4.1 There can be invisible and visible disabilities. Invisible disabilities are those disabilities that are not immediately apparent. Several chronic disorders are counted as invisible disabilities, such as asthma or epilepsy and even sleep disorders.
The following is a list of disabilities and illnesses that may affect a controller’s ability to carry out the privileges of their licence. This is not an exhaustive list.
2.4.2 Examples of invisible disabilities
Depressive mood disorders are common disorders, known by depressed mood, reduced energy, impaired concentration and memory, loss of interest and surroundings, difficulty in making decisions, alteration of appetite and sleep, guilt feelings and low self-esteem. Depression is one of the most common reasons for committing suicide.
Depression is by nature a recurrent disorder, and although single episodes do occur, the history of a depressive episode should alert the medical examiner to ask specific questions to ensure that the ATCO does not currently have the illness. It should be noted that even with good responses, there may be a potential for impairment of cognition and decision making ability.
The ATCO should be under the care of a medical practitioner experienced in the management of depression.
The ATCO should:
a) Be stable on an established and appropriate dose of medication for at least four weeks before returning to ATC duties and:
i) Have minimal, acceptable side effects;
ii) Have no medication interactions or allergic response.
b) Be subject to regular clinical review by the medical practitioner with progress reports provided to the medical section of the Licensing Authority. The ATCO may be involved in other concurrent treatment (e.g. psychotherapy);
c) Have no other significant psychiatric co-morbidities;
d) Require no other psychoactive medications;
e) Demonstrate symptoms of depression being well controlled, without evidence of psychomotor retardation;
f) Have no suicidal ideation or intent;
g) Have no history of psychotic symptoms;
h) Have no features of arousal (e.g. irritability or anger);
i) Have a normal sleep pattern;
j) Have resolution of any significant precipitating factors of the depression.
188.8.131.52 Psychiatric disorders
The term psychiatric disorder means a mental disorder or illness that interferes with the way a person behaves, interacts with others, and functions in daily life. In some cases, people with psychiatric disorders may pose a threat to themselves or others. It is also possible to have potentially life-threatening side effects from medications used to treat psychiatric disorders.
There are many mental disorders, in the Diagnostic and Statistical Manual of Mental Disorders (DSM) there are published more than 400 different definitions of mental disorders. E.g.: Alzheimer’s, Autistic disorder, bipolar disorder, bulimia nervosa, clinical depression, impulse control disorder, learning disorders, manic episode, obsessive-compulsive disorder and many others.
These illnesses have caused a number of ATCOs to have their licenses withdrawn on medical grounds. In solving problems of this nature, peer and family support appears to be significant and the opportunity to discuss such problems with sympathetic management or the designated colleague or personnel is important. Experience has shown, however, that some controllers still report a build-up of stress because none of these channels is available to them. An ATCO shall be assessed as unfit unless the medical assessor considers their condition as unlikely to interfere with the safe exercise of licence and rating privileges.
184.108.40.206 Chronic diseases
A chronic disease is a health condition, which is persistent or long lasting in nature. It is usually applied when the disease lasts for more than three months.
220.127.116.11.1 Oncology and other
After treatment for malignant disease ATCOs shall undergo satisfactory medical evaluation before a fit assessment can be made. Nevertheless a medical check should be mandatory as well.
Having epilepsy or recurring episodes of disturbance of consciousness by uncertain cause, results in losing medical certification.
Under special evaluation ATCOs with an established history or clinical diagnosis of:
- epilepsy without recurrence after age 5, epilepsy without recurrence and off all treatment for more than 10 years, epileptiform EEG abnormalities and focal slow waves, progressive or non-progressive disease of the nervous system, disturbances or loss of consciousness, brain injury; spinal or peripheral nerve injury;
could have their medical certification reinstated.
Type 2 diabetics can receive medical certification under ICAO SARPs “subject to satisfactory control”.
This topic was presented in WP 158 in Amman, 2011.
18.104.22.168 Sleeping disorders
If an ATCO is diagnosed with a sleeping disorder such as sleep apnoea, it may cause them to lose their medical certificate, but under special conditions and successful treatment, reissuing of medical certification is possible.
This topic was presented in The Controller in the article Sleep Apnoea in issue Winter 2010/2011, and in WP 165 in Dubrovnik 2009.
22.214.171.124 Visual Problems
ATCOs should be able to read radar screens, visual displays and written or printed material and also to make use of distant vision through control tower windows. One could need correction to perform one or more tasks, but one pair of glasses should meet the requirements, so that it is unnecessary to remove or change the glasses when doing operational work. Contact lenses may also be appropriate.
Normal colour vision is necessary, both at TWRs and working multi-colour radar screens.
2.4.3 Examples of visible disabilities
Visible disabilities are clearly apparent, e.g.: an ATCO in a wheelchair or any other impairment, which limits the physical function of one’s limbs.
A physical disability is any impairment, which limits the physical function of one or more limbs or fine or gross motor ability.
Mobility impairment is a category of disability that includes people with varying types of physical disabilities. This type of disability includes upper limb disability, manual dexterity and disability in co-ordination with different organs of the body. Disability in mobility can either be congenital or acquired with age problem. This problem could also be the consequence of some disease. People who have a broken skeletal structure also fall into this category of disability.
126.96.36.199 An ATCO with a disability should be able to perform their role effectively. Certain limitations of range of motion may not be acceptable for certain specific options or positions, for example TWR controllers should be able to see from control tower windows.
2.5 Time limited disability
Time limited disabilities are most common after an accident or when an ATCO suffers from a disease, which can be successfully treated. In such cases ATCO may lose medical certification for a period of time, but after successful treatment reissuing of medical certification is possible. In some cases an ATCO may also have a type of disability that may not affect a controller’s ability to carry out the privileges of their licence (E.g. a minor injury such as a broken limb).
2.6 Loss of license
An ATCO may lose their licence due to a disability. In such cases an ATCO is not capable performing their role effectively. And if medical requirements are and will not be met, an ATCO should not lose their job in the company. The ANSP should take steps to keep an ATCO in the company and offer them another position where they could use their experiences and skills in order to benefit themselves and the ANSP (E.g. ab-initio or simulator instructor, working in aeronautical information management, etc.)
2.7 Rights of persons with disabilities
The Convention on the Rights of Persons with Disabilities is an international human rights instrument of the United Nations intended to protect the rights and dignity of persons with disabilities. Parties to the convention are required to promote, protect and ensure the full enjoyment of human rights by persons with disabilities and ensure that they enjoy full equality under the law.
Article 27 requires that States Parties recognize the right of persons with disabilities to work on an equal basis with others. This includes the right to have the opportunity to gain a living by work freely chosen or accepted in a labour market and a work environment that is open, inclusive and accessible to persons with disabilities. Also State Parties shall safeguard and promote the realization of the right to work, including for those who acquire a disability during the course of employment, by taking appropriate steps, including legislation, to inter alia:
1) Prohibit discrimination on the basis of disability with regard to all matters concerning all forms of employment, continuance of employment, career advancement and safe and healthy working conditions;
2) Protect the rights of persons with disabilities, on an equal basis with others, to just and favourable conditions of work, including equal opportunities and equal remuneration for work of equal value, safe and healthy working conditions, including protection from harassment, and the redress of grievances;
3) Ensure that persons with disabilities are able to exercise their labour and trade union rights on an equal basis with others;
4) Enable persons with disabilities to have effective access to general technical and vocational guidance programmes, placement services and vocational and continuing training;
5) Promote employment opportunities and career advancement for persons with disabilities in the labour market, as well as assistance in finding, obtaining, maintaining and returning to employment;
6) Promote opportunities for self-employment, entrepreneurship, the development of cooperative and starting one’s own business;
7) Ensure that reasonable accommodation is provided to persons with disabilities in the workplace;
8) Promote the acquisition by persons with disabilities of work experience in the open labour market;
9) Promote vocational and professional rehabilitation, job retention and return- to-work programmes for persons with disabilities.
2.8 When an ANSP is trying to take steps in helping disabled ATCOs and providing the necessary adjustments, they should consider the following:
i) Whether the proposed adjustment would meet the needs of the disabled person
ii) Whether the adjustment is affordable and communicates the outcome in a transparent way to the person(s) involved
iii) Whether the adjustment would have a serious effect on other people and communicate this in a transparent way.
Whether someone should be able to work as an ATCO with a disability cannot always be easily assessed. An ATCO has to fulfil all necessary and regulated medical requirements. These requirements are well defined in a way which can be judged as being fair and equal to everyone.
People who are suffering from disabilities but who still meet the requirements should not be treated unfairly or kept away from working positions. In most countries there is a legal framework which forbids discrimination against this.
There are no known occurrences or incidents where an ATCO with disabilities was a contributing factor.
No reason, neither safety nor regulatory, that allows ATCOs to be withdrawn if they are suffering from disabilities was identified during the research for this paper. As long as the disability does not disqualify an ATCO from obtaining a medical certification, the ATCO shall be allowed to work as fully licensed and fully qualified person.
4.1 To be added in the IFATCA Technical and Professional manual, a new section Med 2.9 on page 188.8.131.52.
4.2 It is recommended that IFATCA policy states as follows:
An ATCO who is suffering from a disability, but still meets all medical and regulatory requirements defined by the competent authority or ICAO, shall retain their full qualifications as an ATCO.
If an ATCO is suffering from any kind of disability or serious illness, a medical check should be performed in order to prove that medical requirements are met and that safety is not infringed.
If an ATCO loses their license due to a permanent disability they should where possible be offered an alternative position.
The employer should make reasonable changes for disabled ATCOs. These apply to the working arrangements or any physical aspects of the workplace (e.g. access to buildings).
Chronic diseases such as asthma, cancer or diabetes should not be disqualifying, if the required treatment does not interfere with the safe exercise of license and rating privileges.
ICAO Annex 1.
Guidance material to support the proposal changes to the medical provisions contained in Annex 1 (ICAO).
Employment rights and the Equality Act 2010.
Anti-Discrimination Act 1991.
Americans with Disabilities Act of 1990.
The Controller Magazine, issue Winter 2010/2011.
Last Update: September 30, 2020