Asthma

Developed in collaboration with CASA Medical.

Asthma is a long-term lung disease affecting people of all ages. It is caused by inflammation and muscle tightness around the airways, which make it harder to breath. Symptoms can include coughing, wheezing, shortness of breath and chest tightness. These symptoms can be mild or severe and can come and go over time. It can be controlled but not cured.

In clinical practice, asthma is defined by the presence of both the following:

• excessive variation in lung function (‘variable airflow limitation’, i.e. variation in expiratory airflow that is greater than that seen in healthy people)
• respiratory symptoms (e.g. wheeze, shortness of breath, cough, chest tightness) that vary over time and may be present or absent at any point in time. 

Asthma is often under diagnosed and under treated. Untreated asthma is usually characterised by chronic inflammation involving many cells and cellular elements, airway hyperresponsiveness, and intermittent airway narrowing (due to bronchoconstriction, congestion or oedema of bronchial mucosa, mucus, or a combination of these).

Asthma, a severe and chronic condition, impacts 1 out of 9 Australians and New Zealanders. While there is presently no cure, effective management strategies enable most individuals with asthma to lead fulfilling lives. Asthma entails having sensitive airways, prone to inflammation or swelling upon exposure to certain triggers. Trigger-induced changes in the airways include thickening of airway walls, accumulation of mucus, and constriction due to muscle tightening around the airways, collectively impeding normal breathing. A diagnosis of asthma is typically made by a doctor through a comprehensive assessment of medical history, symptoms, and possibly lung function tests like spirometry. Asthma can be diagnosed at any stage of life, underscoring the importance of ongoing monitoring and management.

Asthma should be managed as outlined in the Australian Asthma Handbook or NZ Guidelines. Reliever medication (bronchodilator such as salbutamol) must always be readily accessible while flying or operating.

Pilot and controller information

Stop flying or operating and report to ME or CAA NZ for any of the following:

• With asthma symptoms
• An asthma attack requiring emergency treatment, hospitalisation or significant symptoms not responding to your inhaler medication
• Use of regular oral corticosteroid medication > 10mg/day
• You are advised by a health professional that you are not fit to fly or operate

For more information, see Medical Manual: Asthma.