What are the medical conditions that make a person unfit to fly?

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Last updated: May 21, 2025View editorial policy

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From the Guidelines

Conditions that are not fit to fly include active cardiac conditions, recent surgeries, uncontrolled psychiatric disorders, pregnancy beyond certain gestational ages, infectious diseases, severe anemia, recent stroke or TIA, ear or sinus infections, and decompression sickness. These conditions can worsen during flight due to hypoxia, gas expansion in body cavities, immobility leading to blood clots, and potential for disease transmission 1. Some specific conditions that are not fit to fly include:

  • Active cardiac conditions like recent heart attack or unstable angina
  • Respiratory issues such as severe COPD or pneumothorax
  • Recent surgeries (especially abdominal, thoracic, or neurological procedures within 10-14 days)
  • Uncontrolled psychiatric disorders
  • Pregnancy beyond 36 weeks for domestic flights or 32 weeks for international flights
  • Infectious diseases like tuberculosis or COVID-19
  • Severe anemia with hemoglobin below 8.5 g/dL
  • Recent stroke or TIA
  • Ear or sinus infections
  • Decompression sickness It is essential to consult with a healthcare provider before flying if you have any medical concerns, as some conditions may be permitted with medical clearance or supplemental oxygen 1.

From the Research

Conditions Not Fit to Fly

The following conditions may not be fit to fly due to the unique physiologic challenges posed by air travel:

  • Pulmonary conditions where the patient is unable to walk 50 m or has oxygen requirements exceeding 4 L per minute 2
  • Recent surgery, casting, ear, nose, and throat issues, or dental issues due to the risk of trapped gases expanding at high altitude 2
  • Pneumothorax, bronchogenic cyst, and severe pulmonary hypertension 3
  • Chronic lung disease with very poor performance status or severe lung disease 4
  • Recent thoracic surgery or unresolved pneumothorax, with recommended delay of air travel for 1 to 3 weeks 5

Additional Considerations

Patients with the following conditions may require special consideration or evaluation before flying:

  • Respiratory diseases, which may require a hypoxia altitude simulation test to assess fitness to fly 3
  • Cardiovascular disease, which may be affected by the hypoxic environment of air travel 2, 6
  • Diabetes, which may require adjustments to insulin requirements based on travel duration and direction 2

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Medical Advice for Commercial Air Travel.

American family physician, 2021

Research

Flying with respiratory disease.

Respiration; international review of thoracic diseases, 2010

Research

Patients with lung disease - Fit to fly?

Australian family physician, 2010

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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