What happens to patients with respiratory disease when they fly?

Despite current concerns about terrorism, commercial air travel remains a common mode of travel for millions. It has been estimated that a single major UK airline carries over 30 million passengers each year. There are no data available to indicate how many passengers flying on commercial aircraft have respiratory disease, but as far back as 1974 it was estimated that around 5% of passengers were ambulatory patients. As the average age of western populations continues to rise, so does the propensity for passengers to have some form of medical condition. In addition, flights are getting longer and aircraft bigger. The new Airbus 380, for example, will carry around 600 passengers for up to and in some cases exceeding 20 hours.

Air travel is in general safe, even for those with medical conditions, and there are no established methods for determining morbidity associated with air travel. Nevertheless, available airline data consistently record around 10% of in-flight medical emergencies as being respiratory in nature, with approximately one third attributed to asthma. Medaire, a North American company offering radio link emergency medical assistance to commercial aircraft, has published figures for 2002 which show that respiratory problems are the third most common cause of in-flight medical emergency (A Hawkins, Medaire, personal communication). Respiratory problems are also the third most common cause of medical diversion after cardiac and neurological events (including syncope), accounting for 9% of diversions. In 2002 Medaire recorded 414 diversions, 206 advised by Medaire and 208 …