Asthma

Asthma and its implications on flying

JAA Class 1 and Class 2 certification

 

Asthma affects approximately 5% of the adult population.  An attack is caused by narrowing of the small airways in the lung, leading to symptoms of cough, breathlessness and tightness of the chest. It can be associated with an allergy. Childhood symptoms often improve in early adult life, but up to 75% may recur in middle age.  Asthma can range from a single episode which does not require any treatment, to a constant disabling condition requiring intensive medication and sometimes hospital admission.  Its course and severity are unpredictable, and sudden incapacitation is an uncommon but potential hazard for all asthmatics.

 

The implications of asthma in a pilot are several:

 

Distraction or incapacitation due to an acute attack

  • The presence on the flight deck of ‘triggers’ to an acute attack (dust, cold, smoke and fumes)
  • An attack may be caused by anxiety (operational delays and difficult flying conditions)
  • Attacks may be precipitated by emergencies such as the sudden hypoxia (lack of oxygen)and cold air following cabin decompression

Class 1 Requirements

 

Initial Class 1 certification may be possible provided that:

  • There is a minimum period of 5 years since the last acute attack, and no significant hospital admissions
  • Lung function tests are acceptable (the FEV1/FVC ratio should be greater than 70% with no appreciable drop after exercise)
  • The asthma is well controlled on treatment with an inhaled steroid (“preventer”), with or without an inhaled bronchodilator (“releiver”).  Treatment with steroid tablets is disqualifying.
  • There is no bronchospasm (wheeze) on examination
  • There is no bronchospasm with a mild respiratory infection (eg common cold)
  • A comprehensive report detailing the above is provided from a Consultant Chest Physician

Existing Class 1 certificate holders who develop asthma require similar evaluation and may be restricted to multi-crew duties.

 

Class 2 Requirements

 

Initial Class 2 certification may be possible provided that:

  • There is a minimum period of 2 years since the last acute attack, and no significant hospital admissions
  • Lung function tests are acceptable (the peak flow rate, a simple test that can be carried out by your GP, should be more than 80% of the predicted normal)
  • The asthma is well controlled on treatment with an inhaled steroid (“preventer”), with or without an inhaled bronchodilator (“releiver”).  Treatment with steroid tablets is disqualifying.
  • There is no bronchospasm (wheeze) on examination
  • Bronchospasm with mild respiratory infection (eg common cold) is easily controlled
  • A comprehensive medical report from your General Practitioner or Consultant Chest Physician is provided for your AME detailing the above.

Existing Class 2 certificate holders who develop asthma require similar evaluation and may need a safety pilot limitation.

 

 

European Class 3 Requirements (ATCOs)

 

Assessment of asthma is on an individual basis.

 

 

 

 

September 2009