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Fit to fly?

If you have a lung disease and decide to travel by air, you may experience a shortage of oxygen (hypoxia) during your flight, which may or may not worsen your disease symptoms.

Doctors are unable to predict how a patient may feel at altitude so methods have been devised to recreate this environment in a surgery. Lung patients should see their doctor to find out whether they are fit to fly.

The environment inside an aircraft is hypoxic (limited oxygen) because it has the same amount of oxygen available as if you were 8,000 ft (2,438m) above sea level.

Healthy patients can cope with the alteration in oxygen availability however, people with lung diseases may find it difficult to breathe and may need extra oxygen to breathe easily in this environment.

Are you fit to fly?

The ‘hypoxic challenge’ is the easiest way for doctors to recreate an aircraft environment to assess how a person’s breathing may be affected and how effective they may find a supply of extra oxygen. The patient is asked to breathe a mixture of gas resembling the oxygen pressure present in an aircraft for up to 30 minutes. This is thought to be enough time to notice any changes. If a patient shows symptoms of not having enough oxygen, their breathing should return to normal once they are given extra oxygen.

Oxygen supplementation

Patients are not allowed to take their own pressurised oxygen cylinders on board so they must rely on the airline. Policies for oxygen supplementation vary between airlines. Passengers with lung problems are advised to check before booking and travelling. Oxygen may not be available during take-off and landing.

Some airlines allow passengers to use portable oxygen concentrators (POC), although only specific models might be allowed. These devices can provide 1-5 litres of 90% oxygen per minute and need an external power supply for long haul flights but are not yet widely available to all passengers. Airlines often carry a limited supply of oxygen to be used in a medical emergency. If a patient is seriously ill during a flight, cabin crew can contact emergency medical support and if needed, they can make a diversion before their final destination.

Contact the airline in advance


The following is a list of approved POCs by the Federal Aviation Authority (FAA):

The European Federation of Allergy and Airways Diseases Patients’ Association (EFA, has launched in 2017 a new website for air passengers with a lung condition:

The website focuses on how the mobility rights of EU citizens are applied when the citizen needs medical oxygen on board a flight, and also summarises some of the findings from the initiative EFA and ELF have conducted jointly on the topic.

The website explains the steps patients needing oxygen should take, depending on their treatment and travelling preferences:

-        transport

-        mobility

-        access

-        anti-discrimination regulations