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 one in 10 Australian adults and one in 9 or 10 children have asthma. It is often associated with other allergic conditions like hay fever and eczema.
Asthma cannot be cured, 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.
The effect of the condition on aviation
An asthma attack in-flight can be acutely incapacitating. A number of elements of the aviation environment 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 - a condition in which the body or a region of the body is deprived of adequate oxygen supply) may occur at lower altitudes than normal in asthmatics.
Asthma symptoms and asthma treatments can also cause more subtle impairment during aviation. Both treatment and symptoms of asthma can cause operator distraction.
The effect of treatment on aviation
Applicants prescribed doses of prednisolone or equivalent higher than 10mg cannot be issued a medical certificate because of potential side effects.
Implications for pilots and controllers
When renewing you will need to provide the following information to CASA:
- clinical status
- 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 CASA:
- confirmed diagnosis
- previous specialist reports if available.
In addition, any flare up of your asthma must be reported to your Designated Aviation Medical Examiner (DAME). A reliever inhaler such as salbutamol must be kept 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) will need to individually consider the circumstances of those with unstable asthma or whose condition tends to be triggered in an aviation environment.
More likely to be certified
You are more likely to be re-certified if:
- your asthma is stable
- a spirometry test shows good lung function
- you are taking inhaled preventers or bronchodilators.
Less likely to be certified
You are less likely to be re-certified if:
- dry air tends to make your asthma worse
- your condition or treatment have been declared unstable
- you have been prescribed oral steroids.
You are unique
Every case of asthma is different. How you are affected by asthma will depend on a range of circumstances. CASA makes aeromedical decisions on a case by case basis. A particular assessment decision is based on the individual circumstances of the applicant under consideration.
For further information see: