2.2 The origin and development of the CASA DAME Handbook

CASA and its antecedent organizations have published advice for DAMEs concerning practical and administrative aspects of their duties for many years. The most comprehensive and semi-permanent repository of such advice has been CASA's DAME Handbook, which originated in the late 1980s. The original hard copy publication was an amalgam of advice derived from many sources. Some of the material can be traced back to directives produced by the Aviation Medicine Branch within the Australian Department of Civil Aviation during the 1950s. A considerable debt is due also to earlier published advice from other Regulators, particularly CAA (New Zealand) and the US FAA.

The DAME Handbook was never intended to be completely prescriptive or authoritative, particularly in its more clinically oriented sections. The principal purpose of creating (and maintaining) such a publication is to provide a compact ready reference for DAMEs and anyone else in CASA's procedures related to aeromedical certification. Soon after The DAME Handbook was first published, a need for further explanation and elaboration of its contents became obvious, leading to creation of periodic DAME Newsletters issued by the Director of Aviation Medicine. Jointly, these publications aspired to answer DAMEs' FAQs and to provide guidance that would reduce errors and facilitate expeditious handling of the medical examinations and reports concerning applicants prepared for CASA.

By 1998, The DAME Handbook was showing distinct signs of nearing the end of its useful life. Parts of the Handbook had been so qualified and specifically interpreted that it was sometimes difficult for DAMEs and even for staff of CASA Aviation Medicine Section to understand all requirements. Thereafter, an interim revision was produced to remove the more glaring inconsistencies and contradictions that existed between it and some DAME Newsletters. At the same time, CASA had determined that all its future public documents should be created and maintained in electronic format, available on-line, rather than as hard copy. This decision had other major implications, particularly the accessibility of all such documents to unrestricted public scrutiny.

The first on-line version of The DAME Handbook was posted on CASA's website in May 1999. It represented only an interim answer to a continuing need to provide succinct, accessible, relevant advice to DAMEs and other interested persons. At that stage, much of its contents still derived from the reverence accorded to our authoritative forebears, who had not been constrained to reach decisions on evidence-based medicine principles. At least the style was brought into line with modern CASA standards.

The next priority was to review the contents of the system-based chapters. This task has continued ever since. CASA intended that this process would continue indefinitely, to ensure relevance and currency of guidance provided. However, with rapid advances in medicine and increased and continuous need to update the Handbook, a decision was made in 2012 to re-create the Handbook in a manner that aimed at providing critically focused information - in the process changing from a primer in aviation medicine to a guidance document for DAMEs.

The new Handbook provides little if any information about medical conditions. This omission is deliberate and based on the awareness of several sites that are dedicated to medical information - sites that are maintained and updated almost weekly. What the Handbook provides is information about what is CASA's approach to medical certification, and what information is required for an appropriate risk assessment to be carried out.

CASA is committed to procedural transparency and to meeting best-practice standards in all of its activities. Aviation Medicine Section's accelerating, continuous review of The DAME Handbook reflects that commitment and will result in the availability of a better, cross- referenced and more practically useful guide.

Updated: 11 April 2022
Online version available at: https://www.casa.gov.au//search-centre/manuals-and-handbooks/designated-aviation-medical-examiners-handbook/22-origin-and-development-casa-dame-handbook
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