Asthma

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Aeromedical Implications (partial / total incapacitating features / hypoxia / hypobaria)

Effect of aviation on condition

Hypoxia
Cold triggers
Chemicals
Use of breathing apparatus

Effect of condition on aviation

Overt incapacitation with acute attack
Subtle with uncontrolled poorly controlled
Distraction due to treatment & symptoms

Approach to medical certification

Based on the condition

Respiratory function [FER>70%; Reversibility post bronchodilator FVC & FEV1 less than 12%; PaO2 on air >95%]

Based on Treatment

Not oral steroids / theophylline

Demonstrated Stability

Absence of symptoms
No hospital admissions - 12M
No requirement for prednisone or other oral/IV steroids in 12M

Risk assessment protocol - Information required

New cases

Confirmed diagnosis
Clinical status
- progress
- reliever use
- preventative therapy
- exacerbations (precipitating factors / frequency / severity / steroid use / hospitalisation)
Investigations conducted
Spirometry pre and post bronchodilator (mandatory within past 3M)
Challenge test (if undertaken)
Other tests and interventions previously undertaken
Management
- treatment
- side-effects
- monitoring /peak flow diary
Follow-up plan
Previous specialist reports if available

Renewal

Clinical status
- progress
- reliever use
- preventative therapy
- exacerbations (precipitating factors / frequency / severity / steroid use / hospitalisation)
Investigations conducted
Spirometry pre and post bronchodilator (mandatory within past 3M)
Management
- treatment
- side-effects
- monitoring /peak flow diary
Follow-up plan

Indicative outcomes

Asthma which is well-controlled (including using inhaled preventer therapy) may be eligible for any class of medical certificate. Unstable asthma and relevant triggers will need individual consideration.

Favourable

Stable asthma
Inhaled preventers
Inhaled bronchodilators

Unfavourable

Exacerbation in dry air
Unstable
Steroid requirement (oral)

Pilot & Controller Information

Any flare-up must be reported to the DAME
Doses of prednisolone over 10mg (or equivalent) are safety relevant and not acceptable
A reliever inhaler (eg Salbutamol) must be kept readily available for use when flying

Disclaimer

The Clinical Practice Guideline is provided by way of guidance only and subject to the Clinical practice guidelines disclaimer