Asthma is a common disease of the airways and is the most widespread chronic health problem in Australia.
During an asthma attack, the airways narrow, reducing the flow of air in and out of the lungs. This may lead to wheezing and coughing. Pollen, cigarette smoke, colds and flu can trigger an asthma attack.
About 1 in 10 Australian adults and 1 in 9 children live with asthma. Asthma is often associated with other allergic conditions like hay fever and eczema.
There is no cure for asthma, but with good management, people with asthma can lead normal, active lives. A range of programs and services are available to support people with asthma.
Effects of asthma during a flight
An asthma attack in-flight can be acutely incapacitating. There are several things in-flight that can make asthma symptoms worse, including:
- low temperature
- humid environment and high pollen counts during low altitude flight, which can trigger severe asthma attacks
- inhalation of fumes from chemicals used in aircraft maintenance or those caused by engine or electrical fires
- breathing apparatus
- sudden decompression; this can lead to barotrauma in acute asthmatics (physical damage to body tissues caused by pressure differences), in high altitude flight.
In addition, hypoxia (also known as anoxemia) is a condition where the body or a region of the body is deprived of adequate oxygen supply. It may occur at lower altitudes than normal in asthmatics.
Asthma symptoms and asthma treatments can also cause subtle impairment during aviation. Both treatment and symptoms of asthma can cause operator distraction.
Effects of asthma treatment on operators
We cannot issue a medical certificate to anyone prescribed doses of prednisolone or equivalent higher than 10 mg. This is because of potential side effects from the treatment.
Implications for pilots and controllers
When renewing you will need to provide the following information to us:
- clinical status
- progress
- reliever use
- preventative therapy
- precipitating factors, frequency, severity, steroid use or hospitalisation
- investigations conducted
- results of spirometry pre and post-bronchodilator testing (mandatory within the past three months)
- management, treatment and side effects of any medication prescribed
- monitoring and peak flow diary
- follow-up plan.
In new cases of asthma, you will also need to provide the following to us:
- confirmed diagnosis
- previous specialist reports if available.
In addition, you must report any flare up of your asthma to your Designated Aviation Medical Examiner (DAME). You must keep a reliever inhaler, such as salbutamol, readily available for use when flying.
Approach to medical certification
People with well-controlled asthma, including those using inhaled preventer therapy, may be eligible for any class of medical certificate.
Aviation Medicine (AvMed) considers the circumstances of those with:
- unstable asthma
- a condition triggered in an aviation environment.
More likely to gain certification
You are more likely to gain certification if:
- your asthma is stable
- a spirometry test shows good lung function
- you are taking inhaled preventers or bronchodilators.
Less likely to gain certification
You are less likely to gain certification if:
- dry air tends to make your asthma worse
- your condition or treatment is unstable
- you are taking prescribed oral steroids.
You are unique
Every case of asthma is different. How asthma affects you depend on a range of circumstances. We make aeromedical decisions on a case-by-case basis. We base a particular assessment decision on the individual circumstances of the applicant under consideration.
Further information
For further information see the Better Health Channel.