contraindications to air travel

Last edited 08/2019

There is little hard data regarding contraindications to flying. Recommendations must be based largely on a common sense response to risks.

Contraindications include:

• severe respiratory disease where the patient is breathless at rest
  
  
• unstable angina
  
  
• uncontrolled arrhythmia
  
  
• poorly controlled heart failure
  
  
• for a period following a myocardial infarction
  • Uncomplicated myocardial infarction within 7 days (2)
    
    
  • Complicated myocardial infarction within 4-6 weeks (2)
    
    
• a deep vein thrombosis - until adequately anticoagulated and in absence of pulmonary complications
  
  
• suspected pneumothorax, pneumomediastinum
  
  
• untreated communicable disease
  
  
• acute gastrointestinal bleeding
  
  
• severe anaemia - Hb less than 7.5 g/dL
  
  
• recent sickling crisis
  
  
• if the patient has disturbed or unpredictable behaviour that could endanger passengers and / or crew
  
  
• pregnancy - if after 36 weeks of pregnancy; also flight should be avoided during the third trimester if the woman has a history of premature delivery, cervical incompetence, bleeding, increased uterine activity or has a multiple pregnancy
  
  
• infants should be at least 2 days old before undertaking air travel. Preferably they should be 7 days old
  
  
• for a period of 10 days after surgery to a hollow viscus. If uncomplicated chest surgery has been undertaken then air travel must not be undertaken for 3 - 4 weeks. If there has been eye surgery involving the intraocular injection of gas then air travel should not be undertaken until an ophthalmologist has confirmed complete resorption of the gas.

Check with respective airline as criteria for "fitness to fly" may vary between airline.

For up to date advice then check current guidance (2,3).

Reference:

1. 'Medical guidelines for air travel', Aviation, Space and Environmental Medicine, October 1996, 67, 10, 11.
2. Civil Aviation Authority. Fitness to Fly (Accessed 1/8/19)
3. International Air Transport Association. Medical Manual 11th Edition (2018).