Flying with Lung Disease

Recent airline statistics in the United States indicate that up to 10% of in-flight medical emergencies involve lung disease, and that these emergencies involving lung disease are the third most common medical reason for emergency landings.

Lung disease sufferers have special needs as a result of the drop in air pressure in aircraft cabins. Commercial aircraft flying at high altitudes are designed to have cabin pressure equivalent to an altitude of 2438 meters (8,000ft.). However, it is not uncommon to find a variation in his altitude equivalent of 2700 meters (8,860ft.). While in flight, the partial pressure of oxygen (PaO2), which reflects the quantity of oxygen transported in the blood, can fall from the 80 to 100 mmHg normal for healthy people at sea level, to 53-64 mmHg. This drop is easily tolerated by people with healthy lungs. However, for those with lung disease, it can have a significant impact.

In the December issue of the EUROPEAN RESPIRATORY JOURNAL, Dr.Robina K. Coker and her team at the Department of Respiratory Medicine, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK report the following:

Total Study:3 months before their scheduled flight, 616 patients with various lung diseases were recruited from 37 different clinics

• 54% had asthma or COPD
• 23% had interstitial lung disease
• 275 had hypoxia tests with half of them then recommended for in-flight oxygen therapy
• Just over 10% of the 617 did not fly for various reasons.

431 patients returned questionnaires after their trip. Of these:

• 18% suffered respiratory symptoms on one or both legs of their trip
  • 77% - breathlessness
  • 44% - cough
  • 23% - chest pain
    In most reports, these were usually moderate
     
  • 5 did require in flight medical attention,
    but only one for an exacerbation and none required emergency landings

Post flight results.

• 5 patients died within 30 days of the flight.
  This was considered a low death rate at under 1%
   
• Most notable, 81 patients visited their Doctor within 4 weeks - 65% of these were prescribed antibiotics

The EUROPEAN RESPIRATORY JOURNAL article states: This major multicentre prospective study thus proves that even a severe lung condition is not a contra-indication for flying, as long as the patient undergoes a thorough medical examination beforehand.

Dr Coker is quoted as saying: "Patients should also check before flying that they have insurance cover(age) and, if necessary, obtain extra cover(age) for oxygen," She adds: "But even if all precautions are taken, there can be no absolute guarantee that everything will go well."

We can see from the above that COPD should not stop us from flying. With good preplanning, including medical evaluations, good in flight procedures including supplemental O2 as needed, and post fight attentiveness to such things as infections etc. we can and should continue to be active.