Asthma Action Plan

Source: FAA Safety Briefing November/December 2018
By Leo M. Hattrup, M.D.

Asthma is a chronic lung disease that affects more than 25 million Americans. It inflames and narrows the airways causing recurring episodes of wheezing, chest tightness, shortness of breath, and coughing. The narrowing of the airways reduces airflow into the lungs and severe cases can be life threatening, even at sea level. Obviously, this is of greater concern in the low oxygen and low humidity environments that are typical in aviation.

Asthma can be provoked by exercise as well as by irritants (which vary with the person), but some individuals can suffer an asthma attack without an identifiable provocative agent. It should go without saying that smoking, both legal and illegal substances, is bad for your health. This is especially true for the asthmatic, even if exposure is secondhand.Asthma has no cure. Many who have had childhood asthma believe that they have “grown out of it.” This is a misconception. As we grow, our airways get larger and the resistance to airflow decreases dramatically. However, the tendency for hyper-reactivity of the airways remains, and there is a risk of recurrence. You may experience flare-ups at any time, even years apart. But with modern knowledge and treatments, asthma can be effectively managed in a manner safe for continued flying. In fact, most people who have properly treated asthma can live normal, active lives.

Asthma treatment focuses on long-term control and quick relief of any flare-ups. Long-term control involves both medication (to treat the underlying mechanisms in asthma, e.g., airway constriction and thickening, mucus production, and inflammation) and lifestyle changes that improve your general lung health and help you avoid asthma triggers to reduce your need for quick-relief treatments. Quick-relief medicines (such as albuterol) are used to rapidly relieve the symptoms of flare-ups. The actual methods of both long-term control and quick-relief should be determined in consultation with your doctor as part of your Asthma Action Plan.

Frequently Asked Questions

Can I get a medical certificate if I have asthma?

Yes, if you have mild or seasonal asthmatic symptoms, you may qualify for our Conditions AMEs Can Issue (CACI) program. Under this program, the Aviation Medical Examiners (AME) can issue an unrestricted medical certificate during your visit if you meet specific criteria. To qualify for this program you MUST bring the required documentation to your AME at the time of your exam. You can find those criteria and what information to bring to your AME appointment at go.usa.gov/xP8t2, or go to faa.gov/go/caci for information on all the CACI conditions.

What if I don’t meet the CACI criteria?

If you do not meet the CACI criteria, you may still be able to get a medical certificate through the Special Issuance (SI) process. You should bring the same information as required above to your AME at the time of your exam. Your AME must defer to the FAA for the initial decision. If the SI is approved, the AME may issue follow up certificates under the AASI (AME Assisted Special Issuance program) without deferring to the FAA so long as certain criteria are met. Specific requirements on what information to bring during a follow up will be spelled out in your Authorization Letter. This allows for much faster turnaround in certification and therefore, a shorter delay for you.

Are there any medications or symptoms associated with asthma that would disqualify me?

Ongoing use of oral steroids or poorly controlled asthma present additional risks and are handled on a case-by-case basis. Most airmen with asthma can safely be allowed to continue to fly.

Leo M. Hattrup, M.D., received bachelor’s degrees from Wichita State University, a Master’s in Public Health from Harvard University, and a doctor-ate from Vanderbilt University. He is retired from the USAF in which he spent the majority of his career in aerospace medicine. He is board certified in aerospace and occupational medicine. He is a certified flight instructor and enjoys flying airplanes, helicopters, and gliders.But with modern knowledge and treatments, asthma can be effectively managed in a manner safe for continued flying.