CIVIL AVIATION AUTHORITY (REVISED CROSS FUNCTIONAL ACCIDENT REDUCTION PLAN 2016/ /19 IMPLEMENTATION PLAN)

Transcription

1 CIVIL AVIATION AUTHORITY ( ) AVIATION MAINTENANCE ENVIRONMENT)

2 Table of Contents Description TABLE OF CONTENTS DEFINITION 5 1)AUTHORIZATION 6 2) PREAMBLE 13 3)PURPOSE 14 4) APPLICABILITY-SAFETY SENSETIVE AVIATION ACTIVITY REFFERENCES BACKGROUND DRUG AND SUBSTANCE ABUSE ) INTERNATIONAL CIVIL AVIATION ORGANIZATION PERSPECTIVE: ) BIOCHEMICAL TESTING ) TESTING PROCEDURE GUIDANCE FOR THE CIVIL AVIATION AUTHORITY OF THE SACAA ) Development of Regulations ) Incapacity or misconduct 24 Page# 8.3) Alcohol in the workplace; when does misconduct become incapacity ) Acts relating to scheduled substances and drugs 25 (7.4.1) Manufacture and supply of scheduled substances 25 (7.4.2) Use and possession of drugs ) Presumption relating to samples of substances ) Presumption relating to possession of drugs ) Liability of employers and principals. 27 (9) PROPOSED LEGISLATION TO BE INCORPORATED INTO PART 145 OF THE SACAA REGULATIONS 27 (10) GUIDANCE FOR ORGANIZATIONS IMPLEMENTATION OF THE DASAMP AMONG AVIATION MAINTANCE 29 (11) DRUG AND ALCOHOL POLICY 30 New Version 1 of 2017 Page 2 of 72

3 11.1 CONSIDERATIONS DRUG AND SUBSTANCE ABUSE EDUCATION PROGRAMME EDUCATION OF THE SSAA EMPLOYEES EDUCATION OF DASAMP SUPERVISORS DRUG AND SUBSTANCE ABUSE EDUCATION PROGRAMME RECORDS OF TRAINED STAFF AND SUPERVISORS DRUG AND SUBSTANCE ABUSE TESTING PROGRAMME 33 (12) PROCEDURES TO BE FOLLOWED BY ORGANIZATIONS WHILE CONDUCTING TESTING ALCOHOL TESTING ALCOHOL TESTING PROCESS ANALYSIS OF BREATH SAMPLE FOR ALCOHOL ) ANALYSIS OF THE BLOOD SAMPLE FOR ALCOHOL (LABORATORY ANALYSIS) ) INTERPRETATION AND REVIEW OF THE ANALYTICAL ALCOHOL TEST RESULTS RECORDS 37 13) TRAINING ) MOCK TEST ) RETRAINING ) ERROR CORRECTION TRAINING 39 14) RESTRICTIONS ) COLLECTING SUPPLIES FOR BREATH ALCOHOL TESTING ) COLLECTION SITE ) BREATH ALCOHOL COLLECTION, TESTING AND REPORTING PROCEDURE 40 15) ON-SITE TESTING/SCREENING FOR ALCOHOL IN EXHALED BREATH 41 16) TRAINING BLOOD SPECIMEN COLLECTION, BLOOD COLLECTION OFFICER ) RESTRICTIONS 42 New Version 1 of 2017 Page 3 of 72

4 16.2) COLLECTION SITE ) BLOOD COLLECTION PROCEDURE AND COLLECTION SUPPLIES ) ON-SITE SCREENING ) TRANSPORT TO THE LABORATORY 44 17) ALCOHOL ANALYSIS 44 18) QUALITY ASSURANCE PLAN 45 19) SHY-LUNG 45 20) EMPLOYER SENDS DONOR FOR A SHY LUND EVALUATION 46 21) FOR A SHY-LUNG EVALUATION 46 22) EXAMINING PHYSICIAN REPORT 46 23) ALCOHOL TEST ERRORS 47 24) REPORTING OF RESULTS 47 25) LABORATORY CONFIRMATORY ALCOHOL ANALYSIS IN BLOOD ) Analytical procedure for alcohol testing in blood 48 26) REPORTING OF RESULTS 49 27) STORING OF BLOOD SAMPLES 50 28) FITNESS-FOR-DUTY DETERMINANTS 50 20) FATAL ERRORS IN ALCOHOL TESTING 51 30) PROCEDURE TO BE FOLLOWED IF THE SCREENING TEST IS POSITIVE 51 31) DRUG TESTING PROCESS ) Analysis of the urine sample for the presence of drugs (laboratory analysis) ) Review of the analytical result (interpretation and records) ) Urine Specimen Collection ) Collecting officer 53 New Version 1 of 2017 Page 4 of 72

5 32.2) Collecting supplies ) Chain-of-Custody form ) Link between the chain-of-custody form and specimen bottles ) Collection site ) Collection procedure ) On-site preliminary testing in urine ) Transport to laboratory ) Laboratory urine analysis-receiving specimens ) Analytical procedure 63 33) SAMHSA RECOMMENDED CUT-OFF CONCENTRATIONS FOR PRELIMINARY DRUG TESTS 64 34) REPORTING OF RESULTS 66 35) URINE SAMPLE STORAGE 67 36) CONCLUSION AND RECOMMENDATIONS 68 New Version 1 of 2017 Page 5 of 72

6 1. AUTHORISATION This is a living document. If, as a result of development in, or due to an amendment to the scope and functions of the Labour Laws,regulations or international practices, changes might occur, that will necessitate a review of this procedure, it will have to be amended accordingly. This document has been developed for future usage by SACAA Technical staff members who are responsible for AMO safety oversight and will be applicable to SACAA approved AMOs and technical personnel involved in Aircraft Maintenance. This material is disseminated for comments. Comments should be forwarded to: airworthiness@caa.co.za DEVELOPED BY: AIRWORTHINESS AND AVIATION MEDICINE DEPARTMENTS New Version 1 of 2017 Page 6 of 72

7 ABBREVIATIONS AND DEFINITIONS 1.1. ABBREVIATIONS ABBREVIATION AIID AME AMO ASD ATF BAT CFARP DCA DER EBT GC-MS HPCSA HS-GC-FID MRO LOQ LOD PEL QAP SAMHSA SOP SSAA STT MEANING Accident and Incident Investigation Division Aircraft Maintenance Engineer Aircraft maintenance Organisation Alcohol Screening device Alcohol testing form breath alcohol technician Cross Function Accident Reduction Plan Director of Civil Aviation designated employer representative evidentiary breath testing device Gas Chromatography-Mass spectrometry Health Provisions Council of South Africa Gas Chromatography-Flame Ionization Detection medical review officer the limit of quantitation limit of detection Personnel Licensing quality assurance plan Substance Abuse and Mental Health Services Administration standard operating procedures Safety Sensitive Aviation Activity screening test technician 1.2. DEFINITIONS For the purposes of this document the following definitions are adopted: Adulteration: Any process by which an individual knowingly interferes with (or attempts to interfere with) the processes of specimen collection, transport or analysis with the intention of avoiding a legitimate test result. The actions undertaken can include (but are not limited to) the addition of water or New Version 1 of 2017 Page 7 of 72

8 foreign substances to the specimen, specimen substitution, damaging bottle seals or packaging and the deliberate consumption of interfering substances or copious volumes of water prior to specimen collection Aliquot: A fractional part of a specimen (taken as a sample representing the whole specimen) used for testing Authorizing Scientist: A person who reviews all pertinent data and quality control results in order to attest to the validity of the laboratory's test reports. This person may also function as the Toxicologist (see Toxicologist) Approved breathalyser means a breathalyzer approved by SACAA under paragraph for alcohol testing Approved drug testing device means a device approved by SACAA under paragraph for testing for testable drugs Approved laboratory means a person authorised under sub regulation 145 to conduct confirmatory drug tests for Approved person, in relation to an approved laboratory, means a person who is authorized under the laboratory s National Association of Testing Authorities (equivalent in SA) accreditation to declare the results of drug tests conducted by that laboratory Approved tester means a person who is authorized to: a. take body samples for drug or alcohol tests under sub regulation 145; and b. Conduct initial drug tests or alcohol tests under sub regulation Calibrator: A solution of known concentration used to calibrate a measurement procedure or to compare the response obtained with the response of a test sample/unknown sample. The concentration of the analyte of interest in the calibrator is known within limits ascertained during its preparation. Calibrators may be used as single point measurements or to establish a calibration curve over a range of interest Chain of Custody: Procedures to account for each specimen by tracking its handling and storage from point of collection to final disposal. These procedures require that the donor identity is confirmed and that a chain of custody form is used from time of collection to receipt by the laboratory. Within the laboratory appropriate chain of custody records must account for the samples until disposal. New Version 1 of 2017 Page 8 of 72

9 Chain of Custody Form: A form used to document the procedures from time of collection until receipt by the laboratory Collecting officer: A person trained to collect specimens from donors Collection Site: A place where individuals present themselves for the purpose of providing a specimen for subsequent analysis Confirmation Test: An analytical procedure to identify and quantify the presence of a specific drug or analyte which is independent of the initial test and which uses a different technique and chemical principle from that of the screen test in order to ensure reliability and accuracy Cut-off: A concentration level set to determine whether the sample is positive or negative for the presence of a drug Customer: The organisation requesting the drug testing service Comprehensive assessment, in relation to a person s drug or alcohol use, means an examination of the person s physiological and psychosocial indicators carried out: a. by a psychiatrist; or b. by a medical practitioner who is a Specialist according to the HPCSA; or c. a person entitled to practice as a medical practitioner under a law of a State or Territory; and d. an appropriately qualified drug and alcohol Professional Confirmatory alcohol test means an alcohol test given in respect of an initial alcohol test to determine the presence and level of alcohol in a body Confirmatory drug test means a drug test given in respect of an initial drug test to determine the presence and level of a testable drug in a body sample DASAMP or Drug and Substance Abuse Management Plan means a drug and alcohol management plan that complies, or purports to comply, with the requirements of regulation DASAMP contact officer, in relation to a DASAMP organisation, means a person appointed by the DASAMP organisation to liaise with the CAA in relation to the organization s responsibilities under this Part DASAMP contractor means a person, or the employee of a person, who is: a. a party to an ongoing written or ongoing oral contract with a DASAMP organisation; or New Version 1 of 2017 Page 9 of 72

10 b. DASAMP subcontractor to an ongoing written or ongoing oral contract with a DASAMP organisation DASAMP medical review officer means a medical practitioner who for drug or alcohol testing under a DAMP has: a. competence in the field of interpreting drug and alcohol test results; and b. knowledge of substance use disorders; and c. knowledge of the contents of this Part DASAMP subcontractor, means a person who is a party to an ongoing written or oral contract with a DASAMP contractor within the meaning of paragraph (a) of the definition of Part DASAMP supervisor, in relation to a DAMP organisation, means a person who: a. has had relevant training to form an opinion as to whether a person may be adversely affected by a testable b. drug or under the influence of alcohol; and c. Is authorised by the organisation to do so for the purposes of paragraph Part Drug and alcohol education program, for a DASAMP organisation, means a program that includes the following components for SSAA employees awareness of: a. the organisation s policy on drug and alcohol use; and b. drug and alcohol testing in the workplace; and c. support and assistance services for people who engage in problematic use of drugs and alcohol; and d. information about the potential risks to aviation safety from problematic use of drugs and alcohol; e. For DASAMP supervisor s education and training to manage people who engage in problematic use of drugs or alcohol Donor means a person who is asked to give, or has given, a body sample to an approved tester Drug and alcohol education program, for a DASAMP organisation, means a program that includes the following components: a. for SSAA employees - awareness of: New Version 1 of 2017 Page 10 of 72

11 b. the organisation s policy on drug and alcohol use; and c. drug and alcohol testing in the workplace; and d. support and assistance services for people who engage e. in problematic use of drugs and alcohol; and f. information about the potential risks to aviation safety, from problematic use of drugs and alcohol; g. For DASAMP supervisors - education and training to manage people who engage in problematic use of drugs or alcohol Drug or alcohol intervention program, in relation to a person who has a drug or alcohol problem, means a program that includes any of the following measures for that problem: a. assessment; b. treatment, including any of the following: c. education; d. counselling; e. consultation with health care professionals; f. pharmacotherapy; g. residential or non-reside h. Monitoring and follow-up action Employee, in relation to a DASAMP organisation, includes a DASAMP contractor of the DASAMP organisation Initial alcohol test means an alcohol test to determine the presence of alcohol in a body sample Initial drug test means a drug test to determine the presence of a testable drug in a body sample Laboratory: The facility providing the analytical services to detect drugs of abuse Medical Review Officer (MRO): A medical physician responsible for receiving laboratory results from the drug-testing laboratory that has knowledge of substance abuse and has appropriate training or experience to interpret and evaluate an individual's positive test result, in light of declared information Negative result (screen): A preliminary result established by screening test that indicates a drug possibly present in the sample is not detected above a specified cut-off. New Version 1 of 2017 Page 11 of 72

12 Negative result (confirmation): A result reported by the laboratory that indicates that a suspected drug present in the sample is below a specified cut-off Non-negative result: A preliminary result established by screening test that indicates a drug possibly present in the sample is detected above a specified cut-off. A urine specimen that is reported as adulterated, substituted or invalid Non-negative result: A preliminary result established by screening test that indicates a drug possibly present in the sample is detected above a specified cut-off. A urine specimen that is reported as adulterated, substituted or invalid Nominated drug or alcohol intervention program, in relation to a person who has undergone a comprehensive assessment, means a drug or alcohol intervention program considered suitable for the person by: a. if the person is an employee of a DASAMP organization - a DASAMP medical review officer; or In any other case - a CASA medical review officer Positive result (confirmation): A result reported by the laboratory as positive means that there is conclusive evidence that a drug is present in the sample tested at level greater than or equal to the confirmation cut-off concentration Quality control sample: A sample used to evaluate whether or not an analytical procedure is operating within pre-defined tolerance limits Reference method: A method in analytical chemistry considered to be acceptable for confirmation of results (e.g. mass spectrometry, refractometry, ph electrode) Sample: A representative portion of a specimen submitted to a laboratory for testing Screen Test: A test to eliminate negative samples from further consideration and to identify the nonnegative specimens that require confirmation testing Specimen: The portion of (normally) urine, blood or breath that is collected from a donor Standard (1): A reference material of known purity or a solution containing a reference material at a known concentration Reference method: A method in analytical chemistry considered to be acceptable for confirmation of results (e.g. mass spectrometry, refractometry, ph electrode). New Version 1 of 2017 Page 12 of 72

13 Specimen: The portion of (normally) urine, blood or breath that is collected from a donor Standard (1): A reference material of known purity or a solution containing a reference material at a known concentration Standard (2): An agreed protocol or procedure (e.g. ISO:17025) Standard Operating Procedure (SOP): A written document giving the detailed steps to be followed when undertaking a particular task (e.g. the analysis of a given drug in a urine sample) SACAA medical review officer/assessor means a medical practitioner who for drug and alcohol testing under Subpart 145, and for Subparts : a. been appointed by SACAA under sub regulation 145for the purposes of Subpart 145; and training and competence in the field of interpreting drug and alcohol test results; and b. knowledge of substance use disorders; c. knowledge of the contents of this Screening officer Person responsible for screening and has been appointed by the Regulator or DoT Substantial compliance, in relation to a drug or alcohol test, has the meaning given in sub regulation SSAA means a safety-sensitive aviation activity Sample identifier means a number allocated to a body sample using the method specified in a legislative instrument made by 145 under regulation Permitted level: the permitted level for each testable drug is specified in the following in Part PREAMBLE Accordingly the Airworthiness Department is pleased to bring out this document on the CFARP Implementation in the Airworthiness context. This Document has been developed broadly in line with requirement of the Revised Cross Functional Accident Reduction Plan (CFARP) 2016/17 to 2018/19. The Document provides the necessary guidance and tools for CFARP management; it also emphasizes the importance of CFARP and the benefits that could be derived following proper implementation of its plan. This is a living document; contents may be subject to revision New Version 1 of 2017 Page 13 of 72

14 3. PURPOSE 3.1. This document is a supplement to the DCA s approved CFARP management Plan, it was created to outline the CFARP implementation plan, its objective is to provide guideline regarding processes to be followed to ensure that CFARP plans and recommendations are fulfilled and implemented respectively by both the SACAA and the Aviation industry, in so doing, the execution of the CFARP s plan s and recommendation will be deemed as successful. The successful execution of the plan will be carried out in collaboration with the Airworthiness,Personnel licencing (PEL) and Accident and incidents Investigation (AIID) and AVMED Departments 3.2. In terms of CFARP the SACAA is required to consider business case for mandatory testing of substance abuse and alcohol in all major accidents and fatalities, further to this the SACAA is required to consider introducing mandatory substance abuse testing of aircraft maintenance personnel 3.3. Further to the above, this document will provide guideline for the proposed program to address the alcohol and substance abuse in safety sensitive aviation activities based on international and national legislation and practices on problematic use of substances in the aviation workplace as required by CFARP. The purpose of this paper is to define the processes to be followed by the aviation maintenance department in order to implement a successful programme for drug and alcohol, which will include consultation with industry and experts to draft of regulations, train industry through various mediums such as workshops, implementation of the legislation and oversight. The document plans to identify areas of legislation to be considered. Based on international best practice, it is recommended that the SACAA adopts the Civil Aviation Authority Model -Drug(DASAMP) 4. APPLICABILITY-SAFETY SENSETIVE AVIATION ACTIVITY a. AVIATION MAINTANANCE 5. REFFERENCES This manual was developed using the content of the following International Aviation Organizations, whose contributors are acknowledged New Version 1 of 2017 Page 14 of 72

15 a) ICAO Annex 1 and 2 b) Manual Of Civil Aviation Medicine Preliminary Edition 2008 (Document 8984) Part III c) Manual on Prevention of Problematic Use of Substances in the Aviation Workplace (ICAO Document 9654) d) IFALPA Position on the Problematic Use of Substances in the Aviation Workplace e) German Wing Accident Recommendations f) Civil Aviation Australia(DAMP Programme) g) Department of Labour Act h) University of Pretoria 6. BACKGROUND The Revised Cross Functional Accident Reduction Plan (CFARP) 2016/17 to 2018/19 - Airworthiness context document was derived from the Revised Cross Functional Accident Reduction Plan (CFARP) 2016/17 to 2018/19 approved by the DCA.This Document serves to provide guidance to the Airworthiness Technical personnel who are responsible for safety oversight functions within the Aviation Industry. The plan development process revolves around the following strategic themes: Man Machine Environment Information gathering and awareness The following is a brief description of the themes as outlined by the approved revised CFARP Management plan 6.1. Human performance can be degraded by physical factors (lack of strength), physiological factors (fatigue, illness), psychological factors (stress, depression) and psychosocial factors(conflict at work).the Man theme considers the currency of Aircraft Maintenance Engineers (AMEs) and deal with other related challenges such as curbing overtime hours, testing for substance abuse as these may have undetected safety implications. Any introduced measures will have to be supported by a solid business case and appropriately consulted with industry. This function resides with PEL and the Airworthiness and AVMED Departments will play a role in terms of carrying oversight and verifying compliance to requirements. New Version 1 of 2017 Page 15 of 72

16 6.2. The Machine Theme addresses inherent weaknesses of the Mandatory Periodic Inspection (MPI). The SACAA usually requires documentation only when an aircraft reaches the MPI or is due for renewal of C of A, however various aircraft still require maintenance before this land mark is reached. Current evidence points towards a lack-luster approach towards pre-mpi maintenance. In this regard, the plan calls for interventions to ensure that these periodic maintenance milestones are adhered to and audited including out of phase maintenance or inspections The Environment theme covers reductions of air-infringements based on in-depth analyses of near misses. It may include problems such as violation of systems operating limits, unsuitable weather conditions or unsuitable ambient environment The fourth strategic theme revolves around obtaining quality safety data and sharing it with affected users to reduce accidents. The Accident and Incident Investigation Division (AIID) plays a critical role in gathering accident statistics. The four elements mentioned above (if not managed properly) may contribute to a large reduction in safety margins and physical distress which could lead to fatigue which in turn could lead to injury, death or damage to equipment. This article will focus on the Development of the Drug and Substance Abuse Management Plan which will address the CFARP Implementation Plan 7. DRUG AND SUBSTANCE ABUSE 7.1. INTERNATIONAL CIVIL AVIATION ORGANIZATION PERSPECTIVE The general availability and ever increasing numbers of addictive users internationally is seen as a threat to both society and sometimes also a threat to aviation safety. Aviation workers have a special obligation to ensure that they are capable of performing their duties to the best of their abilities. Similarly, aviation regulatory authorities and industry employers have an obligation to ensure that aviation safety is maintained to avoid potential catastrophic consequences. The nature of aviation places a special responsibility on aviation workers, employers, regulators and governments to protect public safety and prevent harm. New Version 1 of 2017 Page 16 of 72

17 It is generally accepted that psychoactive substances has a potential for creating mental and physical problems. Most psychiatric illnesses affect the ability to process information, to make a decision after the information processing, and then to undertake a course of action, any decrement in functioning could have a serious impact in an environment where events usually occur at a swift pace and where human beings are far from their natural habitat. The impact of alcohol and drugs can lead to errors slow or incorrect judgement and decisions poor cognitive function, slow reaction times, mood changes and poor coordination, tracking or concentration and risk-taking behaviour or inappropriate action. The side effects from certain types of medication can also lead to a flight safety risk. It is for these reasons that psychoactive medicines may be used in the aviation environment only with the greatest degree of judiciousness and caution. Drugs refer to those non-prescription mood altering substances that are ingested for the purpose of changing ones mental state, for non-medical purposes. The purpose of taking these substances may be to induce pleasure or to reduce pain or suffering. There is a wide range of substances that may be abused and the type will vary in different parts of the world, and this is usually determined by customs, accessibility, legality, and societal acceptances. The most commonly used substances are alcohol, cannabis, opiates, amphetamines, sedative/hypnotics, and hallucinogens. Accepting these precepts ICAO has decided to recommend measures that focus on: a. Preventing the problematic use of substance by aviation workers; b. Preventing the adverse effects of problematic substance use from threatening use aviation workplace. According to the International Classification of Diseases, the use of these substances may lead to abuse or dependence, or harmful use or dependence. Such use is likely to result in considerable medical, social, legal, and/or vocational difficulties. Substance Dependence is defined as excessive use of the substance, inability to curb the use of the substance despite complications, increased tolerance to its effect and the occurrence of withdrawal symptoms. Substance Abuse is defined as the continued use of the substance even at times when its use is harmful to health, excessive use of the substance, problems (family, friends, and work) related to the use of the substance, or legal problems related to its use. The purpose of the use of these New Version 1 of 2017 Page 17 of 72

18 substances is to alter perception and this would clearly affect one s ability to make rational and judicious decisions. Based on the above, drugs and alcohol use should be prohibited before maintenance personnel commences to carry out maintenance on an aircraft and for the amount of time that it would take to fully clear the substance from the body. Traditionally this time has been said to be 12 hours before commencement of the maintenance activity, however this rule must be used with care as the degree of intoxication may require a longer period of time for the individual to achieve a return to baseline function. An individual who appears to meet the criteria for dependence syndrome or harmful use should not undertake safety-critical duties until evaluated by an appropriate specialist. It is also important to consider that the use of many of these substances is illegal in many jurisdictions and therefore using these substances would imply poor judgment on the part of someone who intends to exercise license or rating privileges. The treatment of substance abuse and dependence is difficult and recurrences of use after treatment are common. A history of abuse or dependence should be the basis for withholding a for an employee to perform their duties unless there is clear evidence that the condition has been adequately treated and that there is a comprehensive follow-up plan that would uncover any relapses. Alcohol is generally the most available drug in the world as it is legally available in most countries and is often considered to be a part of normal socialization. However in Western countries about 7 per cent of the population are either alcohol-dependent or are alcohol abusers. Many people use alcohol for its anti-anxiety effects (e.g. in social settings) or as a sedative (e.g. for insomnia) even though these very effects will result in impaired judgment and/or decreased cognitive abilities. The key to making the diagnosis depends on a level of suspicion, collateral information, and medical and laboratory investigations. The diagnoses of alcohol abuse or dependence should lead to a suspension of an employee from their duties until the person has shown a period of sobriety in a context of medical and psychological follow-up. More than one regulatory authority is achieving success in rehabilitating professional New Version 1 of 2017 Page 18 of 72

19 pilots by early intervention, treatment, follow-up and the possibility of re-certification within three to four months. The system utilizes: a) Peer group, consisting of fellow workers, union or association members and family members, reinforced by exposure to recovering pilot alcoholics and Alcoholics Anonymous. b) Management and supervisors, including the flight operations manager, supervisory and check pilots, simulator and other course instructors. c) Medical consultants such as the airline medical officer, where available, gather valuable data for early recognition, out-patient counseling, evaluation and referral to a psychologist/addiction specialist. d) Residential treatment in a recognized treatment facility and psychiatric assessment is followed by a full medical review and tripartite debriefing of the pilot. e) Regulatory agencies: The medical and Licensing Authorities review each case on its individual merits and may recommend medical re-certification with close follow-up monitoring by the airline medical officer, peers, flight operations and regulatory agencies for at least two years The initial process takes approximately one month of clinical evaluation, one month of residential treatment and one month of rehabilitation. Provided that the full protocol is followed, successfully treated aviation personnel (pilots) have been returned to flying in three to four months. The fact that the treatment of alcohol dependence or abuse does not necessarily lead to the end of a professional pilot s career has had the effect of overcoming a conspiracy of silence when pilots are aware that a colleague is having problems related to alcohol.therefore, the ICAO guidance on the prevention of problematic use of substances in the aviation workplace focuses on: a) Education of the workforce: This document emphasize that there is a consensus from the global experts that education is the single most important tool in preventing problematic use of substances. Therefore the employees need to be fully aware of the effects that substance use may have on their lives, jobs and public safety. Messages about the prevention of problematic use of substances should be added to routine safety-related training or information dissemination, and it should emphasize on prevention, New Version 1 of 2017 Page 19 of 72

20 familiarize themselves in recognizing potential problems and know the established procedures, the consequences of engaging in problematic substance use, train employers and co-workers on how to identify such issues relating to the declining performance and employees and labour organizations should be invited to the development of any educational programme; b) Identification, treatment and rehabilitation: Any programme designed to address problematic substance use in the workplace must consider the individual user and focus is on identifying employees with a substance use problem, and providing guidance on treatment and rehabilitation. Workplace employee assistance programme, especially those that provide confidentiality are likely to encourage selfidentification, however; most employees once they become drug dependent they do not self-identify. Co-workers and supervisors may be in the best position to identify employees who may engage in problematic use of substance. Companies and regulators may establish a peer identification and intervention, these employees are not diagnosticians or counsellors, but they have special skills and knowledge that can be used to assist other employees in recognizing their problems and obtaining help. Problematic substance use can be identified through biochemical testing or law enforcement agencies. Treatment involves Psychotherapy (therapeutic community or individual in patient programme, behavioural therapy, aftercare and long term follow-up programme and others. c) Employment consequences of problematic use of substances: When establishing a preventative programme that concerns the interrelationship between the substance use and health qualifications, it is pertinent that guidance be provided on policies regarding the employee returning to duty after treatment, and on how to manage the employment conditions and the workplace requirements when substance use problem has been identified. Depending on the constraints, the available options for an individual engaged in substance use includes: immediate termination of employment, temporary removal pending evaluation, disciplinary action, treatment and rehabilitation, conditional or unrestricted return to duty Biochemical Testing: With the exception of post-accident toxicology, biochemical testing, biochemical testing is not a general requirement and not all workplace conditions dictate the implementation of such testing programme. It is recognized that in appropriate circumstances biochemical testing can be a useful part of a preventative programme. New Version 1 of 2017 Page 20 of 72

21 7.2. BIOCHEMICAL TESTING Biochemical testing is a process whereby a sample of breath, blood, urine or other body fluids or tissues is procured from an individual and submitted for biochemical or biophysical laboratory examination and analysis, and whereby the result of this test is cited as proof of a particular conduct. The decision on whether to institute a testing programme should be supported by careful analysis of the relevant situation (size of the problem), which must include ethical, legal (local law should support this process), practical, types of tests and when to test, cost effectiveness (costs of the programme and adverse effects on staff morale should be considered), testing methodology and chain of custody as well as the goals to be reached. A decision will have to be made on when to test the applicant and there are various types of testing: a) Pre-Employment Testing b) Post-Accident Testing c) Reasonable Suspicion d) Periodic Testing-Regular Announced Testing(example is during annual checks) e) Return to duty/follow-up Testing of confirmed cases f) Voluntary Testing g) Random Testing, controversial and the theory is that of deterrence 7.3. TESTING PROCEDURE Testing procedures that could have negative employment consequences necessitate forensic testing as opposed to clinical testing. Programs meeting forensic requirements are those that produce test results that are supportable if challenged in court or another legal forum. Forensic testing is characterized by strict procedures to ensure the integrity of every aspect of the testing process. Forensic procedures must be used in any situation in which adverse consequences could result from evidence of substance. Regulators and Employers should ensure that testing procedures adhere to the following: a) Those high standards of forensic reliability are maintained to ensure that the specimen tested came from the specified person, that it was not tampered with or adulterated, that the results are accurate and that all records are maintained in a secure and confidential manner; New Version 1 of 2017 Page 21 of 72

22 b) The chain of custody must ensure that all specimens are sealed upon receipt from the donor to prevent undetected tampering and that specimens are handled by the minimum number of persons; c) A sample must not be declared substituted unless there is no possibility that a valid sample has been obtained and the circumstances have been confirmed by a Medical Review Officer; d) The documentation, as well as instruments and analytical devices used in the testing process, must comply rigidly with specific requirements; e) The laboratories that will perform workplace testing should be required to undergo certification by a national agency or appropriate independent professional organization; f) All drug-testing events should provide for a split sample to minimize exposure to a false-positive test result due to tampering, faulty test equipment, or fault by laboratory procedures; g) The second or split sample should remain secure until the test results of the first sample are known; h) Provision should be made for testing a split sample at a different laboratory, appropriately certified to the same standard as the original laboratory. Any deviation from the above requirements will automatically invalidate the test sample. 8. GUIDANCE FOR THE CIVIL AVIATION AUTHORITY OF THE SACAA 8.1. Development of Regulations It is proposed that the SACAA Part 145 be promulgated and the additional legislation be developed to supplement the part incorporating the heading below. The proposal is based on the Australian Civil Aviation Model, which has identified Safety Sensitive Aviation Activities, and promulgated the legislation for drug and alcohol in 2013.It is advisable that the SACAA consult multidisciplinary medical experts local and internationally,industry and legislation prior to submitting the proposed changes to the legislation below for consideration.lessons can be learned from companies that are implementing these programmes such as the National Department of Transport (Drinking and Driving Laws, Mining, and Road Traffic Legislation others).section 65(1) of the National Road Traffic Act,93 of 1996(NRTA) makes it a criminal offence to drive vehicle or occupy the driver s seat with the engine is running while under the influence of intoxicating liquor or drug having a narcotic effect. To be under the influence of intoxicating liquor or a drug having narcotic effect does not,the driver does not have to have consumed a specific amount, you just need to be considered by a New Version 1 of 2017 Page 22 of 72

23 doctor usually to be under the influence of one of those. Even single hit of marijuana, a little ecstacy etc. will show up in a blood sample and is sufficient for conviction. Although law enforcement officer rarely charge anyone using Section 6591) of the NRTA, the fact is the offence still exists. It is however more common for the law enforcement agencies to prosecute people based on the blood or breathe alcohol samples, except that currently, the only forensic evidence being used in prosecutions is blood samples. Blood Alcohol Content: Section 65(2) of the NRTA makes it an offence to drive a vehicle or occupy the driver s seat with the engine running while the driver s blood is not: Less than 0.05g/100mls of blood sampled if you are an ordinary driving licence holders Less than 0.02g/100mls of blood sampled if you are a holder of a Professional Driving Permit driving licence holders In order for a blood sample to be used in evidence, it must be taken within 2 hours of arrest. Breath Alcohol Contents: Section 65(4) of the NRTA makes it an offence to drive a vehicle or occupy the driver s seat with the engine running while the driver s blood is not: Less than 0.24g/1000 mls of breath sampled if you are an ordinary driving licence holders Less than 0.10g/1000mls of breath sampled if you are a holder of a Professional Driving Permit driving licence holders In order for an evidential breath sample to be used in evidence, it must be taken within 2 hours of arrest. It is illegal to refuse the breath or alcohol sample. Alcohol screening at the road side uses a handheld alcohol screening device (breath analyser). Handheld alcohol screening devices are set up to produce a breath alcohol level and extrapolate the reading to blood a blood alcohol level. This has led to confusion made by law enforcement officers, and lessons can be learned from these agencies on how to approach this in aviation without repeating the same mistakes. In 2012, the use of evidential breath testing was suspended. If you are suspended for these offences, you are liable to a fine or imprisonment for a period not exceeding 6 years. General Regulations and the company policy, Section 2(a) of the above mentioned regulations relating to intoxication and states that: New Version 1 of 2017 Page 23 of 72

24 a. Subject to the provisions of sub regulation (3), an employer or a user, as the case may be, shall not permit any person who is or who appears to be under the influence of intoxicating liquor or drugs, to enter or remain at a workplace. b. Subject to the provisions of sub regulation (3), no person at a workplace shall be under the influence of or have in his or her possession or partake of or offer any other person intoxicating liquor or drugs. c. An employer or a user, as the case may be, shall, in the case where a person is taking medicines, only allow such person to perform duties at the workplace if the side effects of such medicine do not constitute a threat to the health or safety of the person concerned or other persons at such workplace. From the general regulations above it is clear that there is a duty on employers to ensure that employees. a. Who appears to be under the influence of intoxicating liquor or drugs are not allowed to work, enter or remain at the workplace; b. are not under the influence of intoxicating liquor or drugs at the workplace; c. do not have intoxicating liquor or drugs in their possession; d. do not offer intoxicating liquor or drugs to other employees Incapacity or misconduct Schedule 8 of the Labour Relations Act further recommends that employers should treat situations where it is suspected or known that an employee is dependent on intoxicating liquor or drugs as incapacity and not misconduct. The policy (in terms of assistance, counselling, rehabilitation, etc.) will only be applied to those employees who have (or who demonstrate that they have) a genuine desire to be helped, and where it can be reasonably concluded that the rehabilitation program will result in success for this employee Alcohol in the workplace; when does misconduct become incapacity In terms of the Occupational Health and Safety Act General Regulations, employers are responsible to ensure that employees that seem to be under the influence of an intoxicating substance, or consume such a substance in the workplace are not allowed on the premises of the company. Many employers, as a result of New Version 1 of 2017 Page 24 of 72

25 the mentioned regulations, implemented strict rules in the workplace dealing specifically with the use of alcohol (or any other intoxicating substances) and measures that may taken against offenders Acts relating to scheduled substances and drugs Manufacture and supply of scheduled substances No person shall manufacture any scheduled substance or supply it to any other person, knowing or suspecting that any such scheduled substance is to be used in or for the unlawful manufacture of any drug Use and possession of drugs. No person shall use or have in his possession any dependence-producing substance; or any dangerous dependence-producing substance or any undesirable dependence- Producing substance, unless--- aa) he is a patient who has acquired or bought any such substance aa) from a medical Practitioner, dentist or practitioner acting in his professional capacity and in accordance with the requirements of the Medicines Act or any regulation made thereunder; or bb) from a pharmacist in terms of an oral instruction or a prescription in writing of such Medical practitioner, dentist or practitioner, and uses that substance for medicinal purposes under the care or treatment of the said medical practitioner, dentist or Practitioner; (ii) He has acquired or bought any such substance for medicinal purposes (aa) from a medical practitioner, veterinarian, dentist or practitioner acting in his professional capacity and in accordance with the requirements of the Medicines Act or any Regulation made thereunder; (bb) from a pharmacist in terms of an oral instruction or a prescription in writing of such Medical practitioner, veterinarian, dentist or practitioner; or (cc) from a veterinary assistant or veterinary nurse in terms of a prescription in writing of such veterinarian, with the intent to administer that substance to a patient or animal Under the care or treatment of the said medical practitioner, veterinarian, dentist or Practitioner; New Version 1 of 2017 Page 25 of 72

26 (iii) He is the Director-General: Welfare who has acquired or bought any such substance in Accordance with the requirements of the Medicines Act or any regulation made hereunder; (vi) He/ she or it is a patient, medical practitioner, veterinarian, dentist, practitioner, nurse, Midwife, nursing assistant, pharmacist, veterinary assistant, veterinary nurse, manufacturer of, or wholesale dealer in, pharmaceutical products, importer or exporter, or any other person contemplated in the Medicines Act or any regulation made thereunder, who or which has acquired, bought, imported, cultivated, collected or manufactured, or uses or is in possession of, or intends to administer, supply, sell, transmit or export any such substance in accordance with the requirements or conditions of the said Act or regulation, or any permit issued to him, her or it under the said Act or regulation; (v) He is an employee of a pharmacist, manufacturer of, or wholesale dealer in, pharmaceutical products, importer or exporter who has acquired, bought, imported, cultivated, collected or manufactured, or uses or is in possession of, or intends to supply, sell, transmit or export any such substance in the course of his employment and in accordance with the requirements. Or conditions of the Medicines Act or any regulation made thereunder, or any permit issued to such pharmacist, manufacturer of, or wholesale dealer in, pharmaceutical products, importer or exporter; and (vi) He has otherwise come into possession of any such substance in a lawful manner. Presumptions and liability of employers and principals-interpretation 8.5. Presumption relating to samples of substances If in any prosecution for an offence under this Act it is proved that a sample which was taken from any substance by means or in respect of which the offence allegedly was committed possesses particular properties, it shall be presumed, until the contrary is proved, that any such substance possesses the same properties Presumption relating to possession of drugs If in the prosecution of any person for an offence under this Act it is proved that any drug was found in the immediate vicinity of the accused, it shall be presumed, until the contrary is proved, that the accused was found in possession of such drug. New Version 1 of 2017 Page 26 of 72

27 8.7. Liability of employers and principals. (1) An act or omission of an employee or agent which constitutes an offence under this Act shall be deemed to be the act or omission of his employer or principal, and that employer or Principal may be convicted and sentenced in respect of it, unless it appears from the evidence (a) That he did not permit or connive at such act or omission; and (b) that he took all reasonable steps to prevent an act or omission of the kind in question; and (c) That an act or omission, whether legal or illegal, of the character of the act or omission charged Did not under any condition or in any circumstance fall within the course of the employment or the scope of the authority of the employee or agent concerned. (2) For the purposes of subsection (1) (b) the fact that an employer or principal forbade an act or Omission of the kind in question shall not by itself be regarded as sufficient that he took all reasonable steps to prevent such an act or omission. (3) The provisions of subsection (1) shall not relieve the employee or agent concerned from liability to be convicted and sentenced in respect of the act or omission in question. 9. PROPOSED LEGISLATION BE INCORPORATED INTO PART 145 OF THE SACAA REGULATIONS It is proposed that the areas below be incorporated in the SACAA DAMPSA legislation in order to provide guidance to the employers, employees, contractors, subcontractors and all the safety sensitive employees affected by the legislation a) Introduction to the Drug and alcohol management plans and testing b) Drug and Substance Abuse management plans (Persons required to have a DASAMP c) and Implementation of the Programme); d) Content and implementation of DASAMP; e) Drug and Substance Abuse Testing Program and DASAMP Medical Review Programme; New Version 1 of 2017 Page 27 of 72

28 f) Drug and Substance Abuse response program (Identified employees using substance and alcohol, process to be followed as part of the requirements to return to duty and intervention programme; g) Review and audit of DASAMP (Review of DASAMP by DASAMP organisation and Audit of DASAMP Organisation by the SACAA h) SACAA may direct changes to DASAMP i) Provision of Information (DASAMP Organization or DASAMP contractor and subcontractors and DAMP Record Keeping; j) Drug and Substance Abuse testing by SACAA k) Who may be drug or Substance Abuse tested (procedure such as body samples may only be taken if person consents l) Powers of approved testers m) SACAA to approve testing devices (Approved drug and Substance Abuse testing Devices) n) Drug testing (which body samples may be drug tested, how samples are taken and o) Tested, method for determining sample identifiers and others; p) Initial drug tests (if initial drug test result is not positive, if initial drug test result is positive; q) Notices of initial drug test, dealing with samples for confirmatory drug test and r) Transporting samples s) Receipt and storage of samples by approved laboratories (Receipt of samples and storage of samples) t) Conduct of drug tests by approved laboratories (Testing Sample A and Testing Sample B) Samples to be tested in accordance with National Association of Testing Authorities accreditation. u) Record-keeping- Approved laboratory to keep records v) Alcohol testing (Which body samples may be alcohol tested, how samples are taken and tested and approved breathalyses to be used in alcohol tests and how to address and Results. w) Evidentiary certificates and prescribed proceedings (Certificates by approved tester, Certificates by approved Laboratory, CAA may ask for full certificate and other issues). x) Offences (Refusing or failing to give a body sample, continuing to perform applicable SSAA after refusing a drug or alcohol test or failing to give a body sample and others). New Version 1 of 2017 Page 28 of 72