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.
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
- Most airlines need to view and approve a certificate from a doctor (i.e. fit to fly certificate or MEDIF). Most airlines advise passengers to get in touch and provide these documents at least 72 hours before travelling.
- Some airlines may only provide facemasks for oxygen delivery despite nasal tubes being more comfortable for many people. Oxygen is usually delivered at a rate of 2-4 litres per minute and patients that require a different flow rate must make arrangements in advance for their individual needs.Passengers' own Portable Oxygen Bottles (POB) are rarely allowed on board. Passengers need to ask the airline to provide medical oxygen. g
- Portable Oxygen Concentrars (POC) or oxygen service on-board need to be pre-oredered and pre-paid.
- Passengers are often required to provide information on the type of medical equipment they will be using.
- Patients who need permanent ventilation are usually only allowed to fly if they are accompanied by a medical escort..
- Patients should check to comply with requirements in terms of battery type (lithium restrictions) and duration (usually battery needs to cover 150% of flight time) as most of European airlines do not allow the use of electricity on-board.
The following is a list of approved POCs by the Federal Aviation Authority (FAA):
- AirSep FreeStyle
- AirSep LifeStyle
- AirSep Focus
- AirSep FreeStyle 5
- Delphi RS-00400
- DeVilbiss Healthcare iGo
- Inogen One
- Inogen One G2
- Inogen One G3
- Inova Labs LifeChoice
- Inova Labs LifeChoice Activox
- International Biophysics LifeChoice
- Invacare XPO
- Invacare Solo2
- Oxlife Independence Oxygen Concentrator
- Oxus RS-00400
- Precision Medical EasyPulse
- Respironics EverGo
- Respironics Simply Go
- SeQual Eclipse
- SeQual SAROS
- SeQual Technologies eQuinox (Model 4000)
- Oxywell (Model 4000)
- VBOX Inc. Trooper
The European Federation of Allergy and Airways Diseases Patients’ Association (EFA, http://www.efanet.org) 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:
- anti-discrimination regulations