The U.S. Experience with Waivers for Insulin-Treated Pilots

Area of Science:

• Aviation Medicine
• Aerospace Human Factors
• Medical Certification Standards

Background:

• Explores U.S. Federal Aviation Administration (FAA) waivers for insulin treatment in pilots.
• 1500 waivers approved 1997-2014; 450 active as of Dec 31, 2014.
• No accidents attributed to medical issues among 25 involved pilots.

Purpose of the Study:

• To assess the safety and accident risk associated with insulin treatment waivers for third-class medical certificates.
• To evaluate pilot compliance with FAA medical certification protocols for diabetes.
• To compare accident rates of insulin-waiver pilots to the general third-class pilot population.

Main Methods:

• Utilized FAA aeromedical certification and NTSB accident databases.
• Employed logistic regression to compare accident rates, adjusting for covariates.
• Applied a novel methodology for accident rate calculation.

Main Results:

• No statistically significant link found between insulin waivers and increased accident risk.
• Accident rates for insulin-waiver pilots (7.0/100,000 flight hours) matched the general third-class pilot population.
• Only 8% of insulin waivers were terminated due to diabetes complications; 8% had co-existing coronary artery disease.

Conclusions:

• Pilots with insulin waivers are not detectably less safe than other airmen.
• Most pilots with insulin waivers successfully adhere to FAA medical certification requirements.
• The FAA's protocol for insulin-treated pilots is effective in maintaining aviation safety.