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As a pilot, you know the importance of performing a thorough preflight inspection to ensure the aircraft you’re about to fly is safe and airworthy. While you wouldn’t skip the preflight check of your aircraft, you might sometimes forget to do a self-assessment of your own fitness to fly.

When it comes to identifying risk and assessing one’s preparedness to fly, a pilot must be able to answer three questions before every flight: Am I healthy? Am I legal? Am I proficient? In this three-part series, we’ll provide tips for self-assessing risk in the areas of health, currency, and proficiency. This week, we’re focusing on identifying health risks before flight.

The FAA recommends using the acronym I’M SAFE as a personal checklist to assess your health before getting ready to fly. Here’s a breakdown of the checklist:

I – Illness

As a pilot, it’s your responsibility to ensure you’re healthy enough to take the controls. Anything from a cold to an upset stomach can affect your ability to focus on flying the aircraft. If you’re not feeling up to par, don’t fly. Always use your best judgment and stay on the ground if you feel unwell.

M – Medication

Some prescription and over-the-counter medications can make flying dangerous. A 2014 study revealed that the most common drug found in pilots’ systems after fatal aviation accidents was diphenhydramine, an active ingredient in many cold and allergy medications that may cause impairing side effects. If you’re taking medication, check the labels to see if there are potential side effects that may impair your flying abilities. Do your research and contact your Aviation Medical Examiner with any questions about your medications before flying.

S – Stress

Most people experience stress on a regular basis, but for pilots, stress can be particularly distracting and negatively impact performance. In general, there are three different kinds of stress that pilots can encounter: physiological, environmental, and psychological stress. Physiological stress is caused by a lack of sleep, illness, unhealthy eating, or another physical ailment. Environmental stress includes external factors such as temperature, loud noises, or inadequate oxygen levels. Psychological stress is caused by mental, emotional, and/or social pressures or anxieties. Before flying, evaluate your stress level. Are you feeling stressed or anxious? Practice positive habits to cope with stress, such as meditation, exercise, or breathing techniques.

A – Alcohol

Like drinking and driving, alcohol and flying just don’t mix. Most pilots are familiar with the FAA’s 8 hour rule directing pilots to leave a gap of 8 hours from “bottle to throttle.” The FAA also prohibits flying an aircraft with a blood alcohol concentration of 0.04% or higher, which is half of the legal limit for U.S. drivers. Even if you haven’t had a drink in over 8 hours, the effects of a hangover can also impair your ability to fly, causing nausea, headaches, dizziness, fatigue, and problems focusing. For this reason, the FAA recommends pilots wait 24 hours after drinking before flying.

F – Fatigue

Pilot fatigue is another threat to aviation safety. Sleep deprivation caused by time changes, jet lag, stress, or flying long hours can impact your ability to focus and hinder your decision-making skills. Caffeine and cold showers can’t replace a good night’s sleep; be sure you’re well-rested and refreshed before getting behind the controls.

E – Emotion

Ask yourself if you’re in an emotionally stable peace of mind before taking off. If you’re feeling upset, angry, or impatient, you should stay grounded. No matter how hard we try to hide them, negative emotions can get the best of us, especially in stressful situations.

Some pilots swap out Eating for the “E” in I’M SAFE to emphasize the importance of being well-nourished before flight. It’s always a good idea to bring some healthy snacks to keep your energy up during flight. Be sure you’re also drinking enough fluids to prevent dehydration, which can cause dizziness, fatigue, and confusion.

Remember, safety starts before you climb into the cockpit. Following the “I’M SAFE” checklist will help you determine if you’re fit for flying. It’s also wise to ask your passengers the questions on the checklist, too. The last thing you want is a sick passenger on board, as they could pose a health risk to others. If you have any doubts about an item on your checklist, don’t fly!