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For most passengers, even those with respiratory disease, air travel is safe and comfortable. Some patients with COPD may be at risk but, with screening, these patients can be identified and most can travel safely with supplemental oxygen.
A House of Lords Select Committee on Science and Technology published a report entitled “Air Travel and Health” in November 2000.1 They concluded that air travel was safe for the vast majority of passengers but that a few were at risk, and the Government, regulators and the airline industry were open to criticism for failing to give “sufficient active attention to health”. One of the key recommendations of the report was that more information should be available to intending air travellers so that they could make informed choices about the risks (even though these may be minor) of air travel. Another recommendation was that intending air travellers should be urged to consult their doctor if they had any doubt regarding their fitness to fly.
A recent survey of chest physicians providing advice to patients with respiratory disease who wished to travel by air concluded that “the risk of hypoxia at altitude is recognised by most respiratory physicians in England and Wales, but assessment methods and criteria for recommending oxygen vary widely”.2 The article suggested that evidence based guidelines were required.
The British Thoracic Society has recently produced guidelines on fitness to fly in patients with respiratory disease which concentrates on intending air travellers with chronic obstructive pulmonary disease (COPD).3 It provides a concise summary of the field with an extensive literature list.
ALTITUDE AND HYPOXIA
Commercial aircraft are pressurised during flight because passengers could not survive exposure to the low atmospheric pressure at the usual cruising altitude (10 000–13 500 m). For reasons of aircraft weight and fuel economy, it is impractical …