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Fit to Fly Assessments

Checked: 23-09-2022 by Rob Adams Next Review: 23-09-2023

Overview

The air we normally breathe is made up of about 21% oxygen. To make sure that there is enough oxygen for the people on board an aeroplane to breathe in, aeroplanes are designed to keep the oxygen levels inside the plane at the right level artificially (pressurised).

However, oxygen levels are only kept at this level up to 8,000ft in the air. Above this, the amount of oxygen in the air drops to about 15%. Patients with a lung condition, may already have low oxygen levels, or their lungs may not be able to work properly to keep the amount of oxygen in their blood at a safe level. Lower levels of oxygen may make a patient feel unwell or could even be harmful during or after a flight. Additional oxygen can be provided to keep the oxygen levels in the blood at a comfortable level and keep patients safe. (1)

The Hypoxic Challenge or Fit for Flight Test

The hypoxic challenge test, also known as a fit for flight test, recreates the oxygen levels on an aeroplane and measures how the body responds. Results of the test will show if a patient needs additional oxygen when they fly.

Who needs a Test

The Civil Aviation Authority has produced a guide for physicians on assessing fitness to fly:

Respiratory Disease - Information for Health Professionals on Assessing Fitness to Fly

Referral

Please note that although FIt for Flight tests are available on the NHS, there may be limited availability or long waits.

NBT

Referrals for Fit for Flight tests can be made via eRS to Respiratory Medicine at NBT (Southmead or Cossham).

If no appointment has been confirmed within 2 weeks of the referral, this means there has not been direct access spirometry capacity, or they have been unable to contact the patient to arrange the appointment. In this case, the responsibility will sit with primary care to deliver the spirometry test. If this is not possible, you can re-refer.

UHBW

Referrals for Fit for Flight tests can be made via eRS to Respiratory Medicine RAS at the BRI or SBCH.

Resources

(1) European Lung Foundation - Are you fit to fly?

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