Colour Assessment and Diagnosis (CAD) Test. Sally Evans Chief Medical Officer UK CAA

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1 Colour Assessment and Diagnosis (CAD) Test Sally Evans Chief Medical Officer UK CAA

2 Joint Project UK CAA City University FAA (Part 3)

3 Colour Assessment and Diagnosis (CAD) Test Safety Human rights Applications

4 Scope Background Current tests of colour vision Visual Task Analysis The CAD test Safety critical colour discrimination

5 Background Requirements based on ability to perceive maritime coloured signal lights Absence of information about the specific colour vision needs of flight crew Lack of reliable, standardised tests

6 Colour Vision in Aviation CAA Paper 2006/04 Part 1: The Use of Colour Signals and the Assessment of Colour Vision Requirements in Aviation. click search for publication enter colour vision in search box

7 Current Colour Vision Primary Test Ishihara Plates

8 Current Colour Vision Secondary Tests Nagel Holmes Wright Beyne Spectrolux

9 Problems with Current Tests No test, including Ishihara 1 and anomaloscope, 2 assesses severity of colour vision loss Pass/fail variability (within-subject and inter-subject) is high 1 Lack of standardisation Correlation between outcomes of different tests is poor 1 Do not give reliable information about safe, minimum colour vision for flying 1 Squire TJ, Rodriguez-Carmona M et al (2005). Color vision tests for aviation: comparison of the anomaloscope and three lantern types. Aviat. Space Environ. Med. 76, Barbur JL, Rodriguez-Carmona M et al (2008). A study of unusual Rayleigh matches in deutan deficiency. Visual Neuroscience 25,

10 Terminology Normal trichromat Normal colour vision Deutan Abnormal R/G discrimination M -cone (green) abnormal Protan Abnormal R/G discrimination L -cone (red) abnormal

11 JAR Standard: Ishihara 15 plate Ishihara, no errors No protanope or deuteranope will pass Very small no of deutans will pass Some may be colour unsafe 15% of normal trichromats will fail

12 Secondary Tests: HW Lantern Normal trichromats who failed Ishihara will all pass HW lantern So a mixture of deutans and normal trichromats will pass HW lantern some of deutans may be colour unsafe All protans and some deutans will fail HW, though some may have sufficient chromatic sensitivity to be colour safe

13 Nagel Anomaloscope Does not quantify well the degree of loss of colour sensitivity May not always detect colour deficiency

14 Task Analysis CAA Paper 2006/04 Part 2: Task Analysis. Airbus A321 and Boeing click search for publication enter colour vision in search box

15 Internal Tasks

16 External Tasks

17 Safety Critical Colour Discrimination Tasks Tasks with no redundancy (other cues): PAPI Parking lights (much less hazard) Tasks with more redundancy or that are less demanding in terms of colour perception: Runway threshold, centre-line, lead-off, taxiway, stopway lights Navigation lights Rotating beacons on ground vehicles EFIS, maps, VASIS

18 PAPI Colour perception has to be accurate and fast. Too high Slightly high On slope Slightly low Too low

19 Perception of Colour: the CIE* diagram Yellow-Blue axis Red-Green axis = Normal threshold *CIE (Commission Internationale de L Eclairage) 1931 x,y chromaticity diagram

20 The CAD Test Determines threshold for perception of R/G and Y/B colour signals CAD has 100% specificity and 100% sensitivity for assessing whether an individual has normal colour vision (ie is a normal trichromat or not) CAD can quantify the severity of colour vision loss Cannot be learnt

21 Basis of the CAD Test Uses data that describe statistical limits of colour discrimination in normal trichromats 0.35 Deuteranope Protanope Tritanope 2.5% < P <97.5% "Standard Observer" 0.34 y x

22 Measures Threshold for Colour Perception Uses Dynamic Luminance Contrast Noise ie background contrast changes continuously to mask luminance cues. Can determine threshold for perception of pure colour signal.

23 Methods 1. PAPI 2. PAPI Signal Lights test 3. CAD test 4. Ishihara 5. Dvorine 6. Aviation Lights Test 7. Nagel Anomaloscope Total of 182 participants: color deficient (77 deutan + 40 protan) - 65 normal trichromats - age ranging from yrs G/R W/G G/W G/G R/G W/R W/W R/W R/R Green 546 nm Yellow 589 nm Red 670 nm 2 degrees

24 Laboratory Simulation Schematic representation of optical set-up Four stimulus channels derived from one light source Random luminance variation Viewing distance 4m Visual angle ~1.4 min arc Corresponds to approach distance ~5.54km PAPI test

25 Safety Critical Colour Discrimination CAA Paper 2009/04 Part 3: Minimum Colour Vision requirements for Professional Flight Crew. click search for publication enter colour vision in search box Gives evidence base for new colour vision test and standards for flight crew.

26 Results Normals (n=65) Deutans (n=77) Protans (n=40) PAPI % correct PAPI % correct CAD RG threshold units CAD RG threshold units RG threshold (CAD units) CAD RG threshold units

27 Results effect of using a colour-corrected PAPI white Standard WHITE PAPI test Normals Deutans Protans PAPI % correct CC WHITE PAPI (% correct) PAPI test RG thresholds (CAD units)

28 High Levels of Colour Deficiency A few individuals with high level of protanomaly or deuteranomaly passed PAPIs. Not considered colour safe due to very poor chromatic sensitivity likely to affect colour discrimination in other colour related tasks.

29 Minimum Colour Vision Requirements Based on level of colour vision loss below which an individual cannot perform safety critical colour perception tasks with the same accuracy as a normal trichromat = CAD threshold of <6 SN (CAD Units) for Deutans = CAD threshold of <12 SN (CAD Units) for Protans Ie If below these limits the applicant can perform the PAPI test as fast and accurately as a normal trichromat SN = Standard Normal

30 Using the CAD Test Fast-CAD for screening (to replace Ishihara) takes 30 seconds 94% of all applicants will pass and no further testing needed Full-CAD establishes class of colour vision loss and whether pass (colour safe) or fail (colour unsafe). Approx 35% of all colour deficient applicants will pass.

31 CAD Assessment

32 Further Information City Occupational Ltd, Tait Building, C249, Northampton Square, London EC1V 0HB

33 Acknowledgements UK CAA City University, London Qinetiq FAA Federal Aviation Administration

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