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MOZAMBIQUE CIVIL AVIATION
TECHNICAL STANDARDS
MOZ-CATS-MR
MEDICAL REQUIREMENTS
Mozambique Civil Aviation Technical Standards – Part 67 – Medical Requirements MOZAMBIQUE CIVIL AVIATION TECHNICAL STANDARDS: CATS
Each Chapter is re-printed from the amended page onwards.
Parts Title
Control Date
MOZ-CATS-FCL63 Flight Engineer Licensing MOZ-CATS-GSPL Ground Service Personnel Licensing MOZ-CATS- AMEL Aircraft Maintenance Engineer Licensing MOZ-CATS-OPS-91 General Operating and Flight Rules MOZ-CATS-OPS 103 Microlight Aircraft Operations MOZ-CATS-OPS-121 Air Transport Operations – Large Aeroplanes MOZ-CATS-OPS-127 Air Transport Operations – Helicopters MOZ-CATS-OPS-135 Air Transport Operations – Small Aeroplanes MOZ-CATS-AH Licensing and Operation of Aerodromes and Heliports MOZ-CATS-ATO Aviation Training Organizations MOZ-CATS-AMO Aircraft Maintenance Organizations MOZ-CATS-TMS Aeronautical Telecommunication Service MOZ-CATS-ATS Air Traffic Service Organizations MOZ-CATS-AIS Aeronautical Information Service Organizations MOZ-CATS-MR – Part 67 – October 15, 2006 Mozambique Civil Aviation Technical Standards – Part 67 – Medical Requirements MOZAMBIQUE CIVIL AVIATION TECHNICAL STANDARDS: CATS
RECORD OF REVISIONS
Revision
Revision of Parts
No of pages
MOZ-CATS-MR – Part 67 – October 15, 2006 Mozambique Civil Aviation Technical Standards – Part 67 – Medical Requirements MOZAMBIQUE CIVIL AVIATION TECHNICAL STANDARDS:
CATS RELATING TO MEDICAL REQUIREMENTS
Decree 41 of 2001 and the Mozambique Flight Safety Law empowers the Director for Civil Aviation to issue technical standards for civil aviation on the matters, which are prescribed by regulation. Note: The Mozambique Flight Safety Law is still awaiting approval. Document MOZ-CATS-MR contains the standards, rules, requirements, methods, specifications, characteristics and procedures, which are applicable in respect of medical requirements. Each reference to a technical standard in this document, is a reference to the corresponding regulation in the Mozambique Civil Aviation Regulations, 1999, for example, technical standard 67.00.3 refers to regulation 3 of Subpart 00 of Part 67 of the Regulations. The abbreviation “MCAR” is used throughout this document when referring to any regulation. The abbreviation “TS” refers to any technical standard. SCHEDULES AND NOTES
Guidelines and recommendations in support of any particular technical standard are contained in schedules to, and/or notes inserted throughout the technical standards. MOZ-CATS-MR – Part 67 – October 15, 2006 Mozambique Civil Aviation Technical Standards – Part 67 – Medical Requirements LIST OF TECHNICAL STANDARDS
67.00.2 MEDICAL REQUIREMENTS AND STANDARDS. 6 67.00.3 DESIGNATION OF BODY OR INSTITUTION . 7 67.00.4 DESIGNATION OF AVIATION MEDICAL EXAMINERS. 9 67.00.6 APPLICATION FOR ISSUING OF MEDICAL CERTIFICATE. 12 67.00.7 ISSUING OF MEDICAL CERTIFICATE . 13 67.00.8 DUTIES OF THE HOLDER OF THE MEDICAL CERTIFICATE . 14 Medications generally acceptable for flight crew . 14 MOZ-CATS-MR – Part 67 – October 15, 2006 Mozambique Civil Aviation Technical Standards – Part 67 – Medical Requirements 67.00.2 MEDICAL REQUIREMENTS AND STANDARDS
a. The medical requirements and standards to be complied with by an applicant for, or the holder of, a Class 1, 2 or 3 medical certificate shall be as prescribed in Chapter 6 of Annex 1. b. All Standards contained in Chapter 6 of Annex 1 must be complied with for the medical certification of aviation personnel in Mozambique. However, any approved exceptions due to special circumstances, which are applicable to Mozambique, are specified in paragraph number 2. c. All Recommended Practices contained in Chapter 6 of Annex 1 must be complied with for the medical certification of aviation personnel in Mozambique. Any approved exceptions due to special circumstances, which are applicable to Mozambique, are specified in paragraph number 3. Standards

No exceptions to the Standards of Annex 1 are allowed for the medical certification of aviation personnel for the purposes
of licensing.
Recommended Practices

No exceptions to the Recommended Practices of Annex 1 are allowed for the medical certification of aviation personnel for
the purposes of licensing.
MOZ-CATS-MR – Part 67 – October 15, 2006 Mozambique Civil Aviation Technical Standards – Part 67 – Medical Requirements 67.00.3 DESIGNATION OF BODY OR INSTITUTION
(1) The designated body has the responsibility to ensure that medical standards within Mozambique are fully implemented by all aviation medical examiners in terms of all aviation personnel required to be issued with medical certificates. (2) To properly perform the duties associated with its responsibilities defined in MCAR Part 67, the designated body must: a. Keep abreast of the general medical knowledge applicable to aviation; b. Have detailed knowledge and understanding of all rules, regulations, policies and procedures relating to the medical certification of aviation personnel and the implications for Mozambique; and c. Possess acceptable equipment and have adequate facilities necessary to carry out its designated mandate. Requirements and conditions
a. The applicant for designated body would only be considered if it is recognized as a professional organization in the field of medicine and is in good standing in Mozambique. b. The applicant must be able to fulfill the functions and responsibilities covered by the designation, as described in c. The applicant must have or have access to the necessary facilities and equipment required to carry out its d. The applicant must prove that it has the required systems and processed in place to carry out all responsibilities fully and to the satisfaction of the Director. (2) The applicant for designated body must submit the following together with application: a. Letter of request or application; b. Proof of professional status; c. List of equipment and facilities available certified by its auditor; d. Procedures Manual, describing the system and processes which would be implemented to ensure that it could carry out its responsibilities satisfactorily, including at least the following procedures: i. For the control of medical assessments and the oversight of designated medical examiners, ii. For the evaluation and assessment of medical evaluation forms and reports, iii. For the verification/confirmation medial certificates issued by the designated medical examiners, iv. For verification/confirmation of ‘unfit’ and ‘fit on condition’ assessments, v. For dealing with complaints and appeals against designated medical examiners, vi. For dealing with special examinations and assessments required for the verification/confirmation of vii. For the decisions taken and recommendations made to the Director regarding amendment, suspension and cancellation of medical certificates, viii. For review of international developments in the field of aviation medicine and the incorporation of new medical standards into Part 67 and MOZ-CATS-MR, when required, ix. For keeping abreast of medical developments in the field of aviation medicine, x. For the development, communication and motivation of new standards and special circumstances xi. For communication with the Director on any matters of concern, including the filing of differences with xii. For the development of standards for the examination and testing of designated medical examiners, xiii. For the recommendation of designated medical examiners for appointment, xiv. For the record keeping of all documentation, reports, records concerning the execution of its designated xv. For reporting and advice to the Director on all matters concerning its designated mandate, and xvi. For liaison with any stakeholder or party concerning the medical standards for Mozambique. (3) On designation, the designated body would be allowed to carry out its responsibilities as covered through the designation. (4) The designated body must notify the Director within 14 days, should there be a change in its status or ability to perform the MOZ-CATS-MR – Part 67 – October 15, 2006 Mozambique Civil Aviation Technical Standards – Part 67 – Medical Requirements (5) For re-designation, the designated body must confirm its continued ability to perform the responsibilities prescribed by Part Duration of designation
(1) Designations of the body is effective for 3 years following the date of issue, unless terminated earlier by the Director due to non-fulfillment of designated responsibilities. Procedures for designation
(1) On receipt of the request for designation, the Director shall evaluate the request and assess the body’s ability to perform (2) The Director shall issue the designation in writing containing information on the scope and details of the designation and the period of the designation, as well as any condition that applies to the designation. Role of designated body
(1) The designated body or institution must carry out all responsibilities defined in sub regulation 67.00.3 and in paragraph 2 of this technical standard, as well as any other responsibility that has been agreed to with the Director. (2) The designated body or institution must identify those DME/s committing examination and certification errors and notify the Director, in writing, for appropriate action to be taken. (3) In addition the designated body or institution must collect the following information: a. Data on the completeness of information on reports of medical examination; b. Errors made on reports of aviation medical examinations; c. DME interest and participation in aviation medical programmes and conferences; and d. Reports from the aviation and/or medical community concerning the DME/s professional performance and Termination of designation
(1) The designation may be terminated by the Director when the period of designation has lapsed or when considered to be MOZ-CATS-MR – Part 67 – October 15, 2006 Mozambique Civil Aviation Technical Standards – Part 67 – Medical Requirements 67.00.4 DESIGNATION OF AVIATION MEDICAL EXAMINERS
Definitions
(1) Any word or expression to which a meaning has been assigned in the Mozambique Flight Safety Law, and the Mozambique Civil Aviation Regulations, bears, when used in this technical standard, the same meaning unless the context indicates otherwise. a. “DAME” means designated aviation medical examiner; b. “designated aviation medical examiner” means a doctor who is qualified in aviation medicine and is designated by the Director, on recommendation by the designated body or institution, and granted the authority to perform medical examinations or tests required for the issuing of classes of medical certificated specified under Part 67; c. “designation” means the authority to exercise the powers and perform the duties of a designated aviation medical examiner, which commences on the date on which the document of designation is issued by the Director to the designated aviation medical examiner and remains in force for a period of 12 months following this date; d. “termination of designation” means the revoking of a designation before the expiry of the 12 month period. (3) DAMEs have the responsibility to ensure that only those applicants who are physically and mentally capable of performing safely, may exercise the privileges of their medical certificates. (4) To properly perform the duties associated with these responsibilities, DAMEs must: a. Keep abreast of the general medical knowledge applicable to aviation; b. Have detailed knowledge and understanding of all rules, regulations, policies and procedures relating to the medical certification of applicants; and c. Possess acceptable equipment and have adequate facilities necessary to carry out the prescribed examinations. Requirements and conditions
(6) In the selection and retention of DAMEs, the designated body or institution will recommend only professionally qualified, practicing physicians and/or specialists who have an expressed interest in promoting aviation safety. a. The applicant for designation to perform medical examinations for Classes 1, 2, 3 and 4 medical certificates must be a professionally qualified physician/specialist in good standing. b. The applicant must possess an unrestricted license(s) to practice medicine, including an unrestricted license to practice in Mozambique, or the area in which the designation is sought. c. The applicant’s past professional performance and personal conduct must be suitable for a position of d. The applicant must have completed training and acquired competence in aviation medicine. e. The applicant must have obtained or have access to the necessary facilities and equipment required to carry out the examinations for the classes of medical certificates applied for. (8) At the time of initial application for designation, the physician/specialist must submit the following documents or certified a. Initial application; b. Medical degree; c. Certificate, diploma or degrees of any postgraduate professional training; d. Medical Council Registration certificate; e. Medical Council examination results; and f. a statement from the Council confirming that there are no current restrictions of medical practice. (9) On designation, the DAME are only allowed to carry out the examinations for which he/she has been designated. (10) The physician/specialist must demonstrate to the designated body or institution that he/she is able to comply with the policies, rules and requirements of the regulations. (11) The DAME must promptly notify the designated body or institution, should there be a change in the DAME’s status. MOZ-CATS-MR – Part 67 – October 15, 2006 Mozambique Civil Aviation Technical Standards – Part 67 – Medical Requirements (12) The designated body or institution continuously evaluates the performance of each DAME. Only physicians/specialists who have demonstrated satisfactory performance in the past and who continue to show a definite interest in the field of aviation will be re-designated. (13) For re-designation, the physician/specialist must: a. Submit a report from the designated body or institution verifying that the physician has performed the medical examinations to the required level for the specific class; and b. attend at least one aviation medical conference and/or CME course within each 4-year interval. (14) A DAME may not perform self-examination for the issuing of a medical certificate nor issue a medical certificate to himself (15) In the event of office relocation or change in practice, a designation will terminate and may be reissued, on request from Duration of designation
(2) Designations of physicians/specialists as DAMEs are effective for 1 year following the date of issue, unless terminated earlier by the Director on recommendation of the designated body or institution or on request by the physician/specialist. (3) For continued service as a DAME, the physician/specialist must reregister annually. Procedures for designation
(3) Physicians/specialists who request designation to perform medical examinations or parts thereof must submit a written (4) The Director would forward the request to the Designated body for consideration and recommendation. (5) Once a recommendation is received from the designated body or institution, the Director will make a decision and inform the applicant in writing of his or her designation. (6) The Director will issue a Certificate of Designation, which contains the details of the designation. (7) The designee must obtain the required medical examination forms from the designated body or institution. These forms must be afforded an appropriate degree of security, and any loss must immediately be reported to the designated body or institution. (8) All medical examinations must be performed in accordance with the requirements of Part 67. (9) All medical examinations must be treated confidentially and may not be disclosed without the permission of the designated Role of designated body
(4) The designated body or institution must monitor the performance of DAMEs. (5) The designated body or institution must identify those DAMEs committing examination and certification errors and notify the Director, in writing, for appropriate action to be taken. (6) In addition the designated body or institution must collect the following information: a. Data on the adequacy of information on reports of medical examination; b. errors made on reports of aviation medical examinations; c. DAME interest and participation in aviation medical programmes and conferences; and d. reports from the aviation and/or medical community concerning the DAME’s professional performance and Termination of designation
(2) Termination or non-renewal of designation may be based on the following: a. Loss or restriction (whole or in part) of a license to practice medicine; b. Failure to re-register; c. Any action that compromises public trust; d. No examinations performed during the 12 months of designation; MOZ-CATS-MR – Part 67 – October 15, 2006 Mozambique Civil Aviation Technical Standards – Part 67 – Medical Requirements e. DAME’s ability to fulfill the responsibilities of his or her designation; f. Performing less than 15 examinations per year; g. Disregard of the rules, regulations, policies and procedures; h. Conviction for violation; i. Failure to demonstrate knowledge of the legal requirements; k. Any illness or medical problem that affects the performance of the physician; l. Failure to attend required conferences; or m. Request by the physician for termination of designation. MOZ-CATS-MR – Part 67 – October 15, 2006 Mozambique Civil Aviation Technical Standards – Part 67 – Medical Requirements 67.00.6 APPLICATION FOR ISSUING OF MEDICAL CERTIFICATE
Form of application
The form in which the application for the medical certificate is made is form MZ 67-01, which is available from the Director and the designated body or institution. MOZ-CATS-MR – Part 67 – October 15, 2006 Mozambique Civil Aviation Technical Standards – Part 67 – Medical Requirements 67.00.7 ISSUING OF MEDICAL CERTIFICATE
Form of medical certificate
The form in which the medical certificate is issued is determined by the Director and contained in Annex A. MOZ-CATS-MR – Part 67 – October 15, 2006 Mozambique Civil Aviation Technical Standards – Part 67 – Medical Requirements 67.00.8 DUTIES OF THE HOLDER OF THE MEDICAL CERTIFICATE
Medication and flying
(1) Due to the hostile, unnatural, and particularly unforgiving environment within which flight crew have to operate, it is particularly important that these people are able to function at an exceptional level if a high degree of aviation safety is to be maintained. (2) Apart from the stressors of hypoxia, hypothermia, noise, vibration, fatigue, disturbed sleep cycles, and boredom (often interspersed with periods of intense concentration / sensory overload), flight crew sometimes have to contend with disorientating low-visibility conditions, combined with complex multi-axis movements. (3) Any impairment of ability, even to the extent that would be considered totally insignificant in day to day activities, could have disastrous effects in the flight crew member, claiming perhaps not only his or her own life, but possibly that of many passengers, and even innocent people on the ground. (4) It is for this reason that many medications which non-flight crew uses without any problems at all are totally unacceptable for flight crew. Many conditions mentioned above are also true for "ground based flight crew" such as air traffic controllers, and therefore the medication is equally unacceptable even though they do not fly. (5) The following guidelines have been compiled to assist practitioners who treat flight crew, and also the DAMEs who do their regular medical examinations. Please note that these are only guidelines, and not blanket authorizations.
(6) Commonly, the medication itself is relatively innocuous, but the underlying disease / indication is disqualifying. Some
of these medications, while being acceptable, have certain conditions that must be complied with – e.g. a pilot whose
hypertension is well controlled on an ACE inhibitor must still comply with the hypertension protocol contained in Schedule
10. Despite using acceptable medication, the flight crew member should not fly until it has been demonstrated that that
individual does not experience unwanted side-effects from the medication.
(7) Medications that do not appear on this list are either unacceptable, or are acceptable only in very specific circumstances. (8) The decision whether to allow an flight crew member to continue flying while using them will be made by the designated body or institution on an individual basis on receipt of a written motivation to do so. Medications generally acceptable for flight crew
(1) Simple antacids, Sucralfate and Colloidal bismuth (short term only). (2) The systemic antihistamine currently accepted is Clarityne. (Not Clarityne D or any other). (3) Zantac as nocte dose only, and no flying within 12 hours of the dose. Proton pump inhibitors like Lanzor may be approved on an individual basis. Also note that the underlying disease is generally disqualifying if active, and pilots may only fly if they are on maintenance therapy. (4) Kaolin preparations. (5) Cholesterol lowering substances: a. Fibrates (eg Lopid), HMG Co-A inhibitors (eg Zocor).
b. Cholestiramine is acceptable but not a drug of first choice.
c. Lurselle (Probucol) is not acceptable.
(6) Vitamins, minerals, fatty acids - not in combination preparations containing stimulants.
(7) Allopurinol
(8) Aspirin - as prophylactic / anticoagulant in low doses - ie 75 mg/d.
(9) Paracetamol - (short term). Not during flying.
(10) Malaria prophylaxis (excluding Lariam and Halfam).
(11) Prophylaxis currently recommended:
a. Chloroquine alone b. Chloroquine and Proguanil c. Chloroquine and Doxycycline d. Maloprim (12) Low dose oral contraceptives after a 3 month stabilization period. (13) Hormone replacement therapy (eg thyroid replacement, oestrogen replacement) also requires a three month stabilization period. Prerequisite: Serum hormone levels must be normal on treatment. Other hormones and antihormones are generally not acceptable, and will be decided on an individual basis. (14) Sodium chromoglycate nasal spray, respiratory inhalers, and eye drops. (15) Inhaled Steroids (eg Inflammide) (16) Steroid or decongestant nasal sprays (short term) MOZ-CATS-MR – Part 67 – October 15, 2006 Mozambique Civil Aviation Technical Standards – Part 67 – Medical Requirements (17) Cardioselective ß-blockers: Atenolol, Acebutalol, etc. Not recommended for aerobatic / fighter pilots. (18) Hydrochlorothiazide with triamterene / amiloride. Acceptable for hypertension control in pilots, though not drugs of first choice. Not acceptable for other indications except on an individual basis. (19) ACE inhibitors.
(20) Calcium channel blockers (excluding Verapamil)
(21) Topical preparations (antifungal, antiseptic, antibiotic, steroid, sunscreen, etc).
(22) Immunisation & Desensitisation (may fly 12 hours after Rx if no side effects or complications have occurred).
(23) Simple bulk laxatives.
(24) Carbocysteine
(25) Antibiotics:
a. Doxycycline (not Minocycline) for acne.
b. For the other antibiotics, the underlying condition and/or the antibiotic is generally disqualifying.
c. Roaccutane is unacceptable.
(26) Non Steroid Anti Inflammatories: Some of the newer drugs such as Mobic can be acceptable in certain conditions. MOZ-CATS-MR – Part 67 – October 15, 2006 Mozambique Civil Aviation Technical Standards – Part 67 – Medical Requirements
ANNEXURE A: Medical Certificate

REPUBLIC OF MOZAMBIQUE
MOZAMBIQUE CIVIL AVIATION REGULATIONS, 1999
MEDICAL CERTIFICATE
This certifies that
Licence Number
Identity Number
Date of birth
VALIDITY PERIOD
RESTRICTIONS
Aviation Medical Examiner
Examiner Number
Examination Date
Verified by Designated Body (PRINT NAME) Date verified:
MOZ-CATS-MR – Part 67 – October 15, 2006

Source: http://www.iacm.gov.mz/doc/circulares_informacao_tecnica/5.MOZ-CATS-MR%20Part%2067.pdf