Is air travel safe for those with lung disease?

Abstract

Airlines commonly report respiratory in-flight emergencies; flight outcomes have not been examined prospectively in large numbers of respiratory patients. The current authors conducted a prospective, observational study of flight outcomes in this group.UK respiratory specialists were invited to recruit patients planning air travel. Centres undertook their usual pre-flight assessment. Within 2 weeks of returning, patients completed a questionnaire documenting symptoms, in-flight oxygen use and unscheduled healthcare use.In total, 616 patients were recruited. Of these, 500 (81%) returned questionnaires. The most common diagnoses were airway (54%) and diffuse parenchymal lung disease (23%). In total, 12 patients died, seven before flying and five within 1 month. Pre-flight assessment included oximetry (96%), spirometry (95%), hypoxic challenge (45%) and walk test (10%). Of the patients, 11% did not fly. In those who flew, unscheduled respiratory healthcare use increased from 9% in the 4 weeks prior to travel to 19% in the 4 weeks after travel. However, when compared with selfreported data during the preceding year, medical consultations increased by just 2%.In patients flying after careful respiratory specialist assessment, commercial air travel appears generally safe.

Air travel and hypoxaemia in real life: Fig. 1—

“…The greater desaturation during LFs in healthy subjects is consistent with the data of COKER et al [1], who reported worsening symptoms mainly in patients in whom average flight duration was 7.6 h. As intermittent hypoxia is an effective stimulus for evoking cardiorespiratory responses, repetitive 4% desaturations (an take-off, lunch, lavatory visit and landing. The baseline Sa,O2 was 98%; after take-off it dropped to 95% ( # ).…”

“…MCGRATH et al [1] recently reported the case of a middle-aged Caucasian female with a diagnosis of diffuse panbronchiolitis (DPB) and highlighted the difficulties of securing such a diagnosis in populations in which it is rarely described, i.e. those of Western/non-Asian origin.…”

COPD and air travel: does hypoxia-altitude simulation testing predict in-flight respiratory symptoms?

“…The decreased oxygen saturation may exacerbate coexisting medical conditions, such as coronary heart disease, and may also be related to the development of respiratory distress during or after the flight [1][2][3]11]. Respiratory symptoms during air travel are reported by approximately one out of five patients with COPD [8,17,18], and the development of severe hypoxaemia is well documented, both during real and simulated flights [1,3,15,[19][20][21]. The association between in-flight respiratory symptoms and hypoxaemia has, however, not been studied.…”

Respiratory medicine syposium 2011

“…She also discussed the UK Flight Outcomes Study, with particular reference to healthcare requirements following travel, including acute hospitalisation, antibiotic and corticosteroid usage as well as the under-appreciated deleterious effects of flight on patients with interstitial lung disease. 1 The forthcoming British Thoracic Society (BTS) recommendations on air travel and lung disease aim to update those from 2004, and are likely to include revisions such as a shortened, one-week timescale post-resolution of spontaneous pneumothorax before a commercial flight, as opposed to the previously widely accepted six-week interval.…”