Driving and Flying: US and European Recommendations

Abstract

Professional cardiology organizations have compiled guidelines for advising patients if and when they may drive a car or pilot an aircraft following a diagnosis of syncope. Legal jurisdictions have compiled laws governing driving and flying, but the laws range from being very specific to very broad. For driving, medical guidelines have largely adopted a mathematical model for risk stratification such that a private individual driving a passenger car should be allowed to drive if their annual risk of sudden incapacitation is less than 22% because they pose the same risk of harm to others as a commercial truck driver in North America who has been legally allowed to drive with medical conditions that carry no more than a 1% risk of sudden incapacitation. The aviation literature has adopted a ``1% rule'' such that commercial airline pilots should have no more than a 1% annual chance of sudden incapacitation. All pilots must be evaluated by a designated medical examiner with specific legal guidelines by which they cannot certify a pilot to fly without referral to their specific national aviation authority.