Pilot careers are lasting much longer, and pilots are retiring later than they retired in the past. Annual flying hours and work-related demands are constantly increasing. It is crucial, now more than ever, that professional pilots maintain not only their Medical Certificates , but also optimal physical and mental health both during, and after their flying careers. ICAO`s historic approach to Medical Fitness in licence holders has been based on detecting increased medical incapacitation risk (from ill health) once it has occurred, and by taking action to reduce the impact on aviation safety, such as restricting a licence or removing the licence holder from operations.