飛行安全のためのパイロットの服薬に関する指針と考え方

抄録

It has been issued that many accidents are caused by impaired driving or impaired flying due to side effects of medications. In 2013, US Federal Aviation Agency (FAA) warned about aircraft accidents due to side effects of medications. Japan Ministry of Internal Affairs and Communications (JMIAC) also made recommendations to Japan Ministry of Health, Labor and Welfare (JMHLW) to confirm notification about driving ban in the patient package insert. The aviators who use an impairing medication are required to wait an appropriate periods after last medications before flying. FAA defines a waiting time from last medications to flight as five times of pharmaceutical half-lives. Japan Ministry of Land, Infrastructure, Transport and Tourism (JMLIT) also defines as two times the dosing interval. The dosing interval is generally determined by pharmaceutical half-lives. Considering above situations, Japan Air Self-Defense Force, Aeromedical Laboratory (JASDF AML), recommends a waiting time from last medications to flight as five times of pharmaceutical half-lives. Newly marketed medications are monitored through post-marketing surveillance and reviewed qualification for aviators. Monitoring periods are three years or more in US Air Force, but one year in FAA, JMLIT and JASDF. We review aeromedical decision making for the safe flight with medicated aviators and related articles.