PARIS — Europe’s top air safety regulator on Friday called for a series of measures aimed at strengthening the medical and psychological oversight of the region’s commercial airline pilots, including random drug and alcohol testing of flight crews.
The report with the recommendations, which has been presented to the European transportation commissioner, Violeta Bulc, for review, follows more than two months of discussions led by the regulator, the European Aviation Safety Agency, after the March 24 crash of a Germanwings airliner. The flight’s co-pilot had a history of severe depression and had shown suicidal tendencies.
If accepted by the European Commission officials, the changes could take effect within the next year. But officials said they were prepared for delicate negotiations over the coming months with European pilots’ unions, which have until now resisted such monitoring as overly intrusive and only minimally effective in improving safety.
“If improvements are to be made in the European safety and security rules or in their implementation, in order to help prevent future accidents or incidents, we will take the necessary action at E.U. level,” Ms. Bulc said in a statement.
Aside from its new medical oversight proposals, the task force said it would maintain its recommendation that two crew members be present in the cockpit at all times. The so-called two-person rule, which was standard in the United States and other parts of the world after the Sept. 11 terrorist attacks, was not widely adopted in Europe before the Germanwings crash.
The Federal Aviation Administration in the United States is also conducting its own review of existing standards and procedures for pilot medical oversight and cockpit door security. Its findings are expected to be published by the end of this year.
Patrick Ky, the European Aviation Safety Agency’s executive director and chairman of the task force that issued the report, said in a telephone interview from Brussels that most of the recommendations were “common sense.”
“We will never find a magic set of tools or solutions that can prevent every kind of accident,” he said, “but let’s try to do our best to maximize our chances of preventing this kind of thing from happening again.”
French investigators say that the 27-year-old co-pilot of the Germanwings flight, Andreas Lubitz, deliberately crashed the Airbus A320 after locking the captain out of the cockpit on a flight to Düsseldorf, Germany, from Barcelona, Spain. Mr. Lubitz and the 149 other people on board were killed.
Investigators have not uncovered any evidence that Mr. Lubitz used illegal drugs or alcohol, but members of the task force identified drug and alcohol abuse as “one of the disorders potentially affecting the mental health of pilots for which screening tests are readily available,” the agency said in a statement.
The task force included a dozen representatives from airlines, pilots unions, medical advisers and regulators.
Although Mr. Lubitz was a high-profile example of pilot suicide, his was not an isolated case. Over the past two decades, at least a half-dozen fatal airline crashes have been attributed to deliberate actions by the pilot. Other episodes and close calls have been quietly played down by investigators. Until now, none have led to significant changes in the regulation of the psychological health of pilots.
The task force cited a 2013 report by the Civil Aviation Authority of Britain that found that of the 31 air accidents caused by a pilot medical issue between 1980 and 2011, 20 were “of psychiatric cause.” The highest proportion of the psychiatric causes — 60 percent — was linked to drug or alcohol use.
A number of countries, including the United States and Australia, require airline pilots to submit to random tests for the use of alcohol and certain controlled substances, including amphetamines, cocaine, marijuana and opiates. Flight attendants, aircraft mechanics, air traffic controllers and others in “safety sensitive” roles are also subject to drug testing.
Some European countries, notably in Scandinavia, routinely test pilots, but there is no uniform standard that applies to the roughly 65,000 commercial pilots based in the 28-member European Union.
“We need to have a European mandate on this, because it doesn’t make a lot of sense to have individual national laws,” Mr. Ky said.
Mr. Ky said the European requirements would be modeled on the current policy of the F.A.A., which randomly selects 25 percent of aviation industry personnel for drug testing and 10 percent for alcohol testing every year. Initially, such testing would only apply to pilots, although it could eventually be extended to other employees who are critical to maintaining safety, he said.
In the weeks after the Germanwings crash, Carsten Spohr, the chief executive of Lufthansa, the parent company of Germanwings, proposed that regulators also consider screening pilots for the presence of antidepressants or other psychiatric drugs.
That idea was rejected, and Mr. Ky said that there were no plans to test for prescription medications. “If we extend the scope, we run the risk of too many false alarms,” he said.
Random drug and alcohol testing has long been opposed by pilots’ unions, who have tended to view such policies as inefficient: less than 0.49 percent of the roughly 50,000 American airline pilots who were screened tested positive for drugs or alcohol in 2013, the most recent year for which F.A.A. statistics were available.
“It produces very few positive outcomes,” Capt. Martin Chalk, the president of the International Federation of Air Line Pilots’ Associations, said in a recent interview. “Those who want to stay below the radar can do so.”
He added: “In the case of alcohol and drugs, it is quite clear that if you look around the world, peer-support or intervention are both cheaper and more effective.”
Many pilots’ unions and large airline groups, including Lufthansa, already have programs in place where pilots with drug, alcohol or other mental health problems can confide in specially trained colleagues, who can steer them toward professional help without risking their jobs. Pilots can also confidentially report others who they suspect may have a problem, in order to encourage them to seek treatment.
The task force’s report urges airlines to augment drug testing with such “nonpunitive” support and peer-reporting programs for pilots with substance abuse or mental health problems. Mr. Ky said regulators would regularly review such programs as part of their mandatory periodic inspections of airline operations.
“We want to be given evidence that this exists and is not facing any undue constraints that make it unworkable,” Mr. Ky said.
The report also calls for the creation of a central European Union database, which would be maintained by the European Aviation Safety Agency, containing basic information about pilots’ medical certification status and contact details for the flight doctor who conducted their most recent exam.
Airline pilots are generally free to choose their own flight doctors, in the same way that most people choose their own personal physicians. The lack of a central repository for pilots’ records creates a loophole, medical experts say, and could allow a pilot to hide a previous diagnosis of a physical or mental health condition.
But bowing to the concerns from some member states with strict laws governing medical privacy, notably Germany, the task stopped short of requiring that the full details of a pilot’s medical records be included in the database.
In the case of Mr. Lubitz, who had an episode of depression in 2009, there was a note in his German medical file that required flight doctors to check for any signs of a recurrence during his regular annual exam. Under the task force’s proposal, such information would not appear in the new database.
In its report, the task force acknowledged the “limitations” of the database as a tool for flight doctors, but called it a “first step” toward what could eventually develop into a “full aeromedical records system.”
The task force’s report also calls for mandatory and comprehensive psychological screening by a qualified specialist of all prospective pilots either during their initial training or before they are hired. While such comprehensive tests are standard at many European flight schools and airlines — including Lufthansa, where Mr. Lubitz was trained and eventually hired — this is not a legal requirement across the European Union.
The result of that exam would form part of a pilot’s permanent medical record, Mr. Ky said.
Most airline pilots today receive only cursory mental health screening when they apply for their license, annual medical exams that are often conducted by general practitioners with no psychiatric expertise. Even in the United States, more extensive psychological checks are normally ordered at the discretion of a flight doctor.
The European task force urged national regulators to improve psychological training programs for flight doctors and to encourage the development of peer networks that would allow doctors to learn from one another.
“We want to enable medical examiners to share information — not about individual cases, but best practices and experiences,” Mr. Ky said.