Travelling with asthma
Having asthma shouldn't restrict you from travelling and enjoying holidays.
With the right preparations, you should be able to minimise any potential problems and have an enjoyable and safe trip.
There's always lots to prepare before you go on holiday. We've put together helpful checklists and other advice to get your holiday off to a flying start.
Planning ahead is the key to enjoying your holiday and ensuring that you stay on top of your asthma while you are away.
Things to think about when booking your holiday
Choosing the type of holiday you want to have, and the destination, may be a challenge if you have asthma, particularly if it is severe. The following points may help:
- If your asthma is severe, you might not be able to fly long distances. Be practical about your limitations. Ask your GP or asthma nurse what length of journey they think is safe for you. They may be required by the airline to declare you 'fit to fly'.
- The weather and climate of your destination might affect your asthma, so it would be helpful to find out what it will be like at the time of your holiday. For example, is it hot and humid, or cold and windy, or is the air of poor quality there? Are there any factories or motorways giving off high levels of pollution which might affect your airways?
- Think about the location and look into local healthcare. How far away is the nearest hospital and will there be a language barrier? Choosing a trustworthy tour company with a representative on location may be helpful.
- If you have difficulty walking long distances check there aren't too many stairs at your accommodation or ask to stay on the ground floor. You might want to consider the environment nearby; it could be hilly, and it might be a good idea to check that you will be able to access all the places you want to go without getting too breathless; for example there may be steps or a hill down to the beach or pool.
- Find out about the meal arrangements, eg some hotels have a buffet style service which requires you to walk around and may be difficult for you to cope with. You might find that self-catering is a better option.
If you are flying there may be some things that you need to consider.
Before you leave
Fitness to fly
Depending on the severity of your asthma, you might need a fitness to fly test to see if you are able to cope with reduced cabin pressure. As a rough guide, if you are unable to walk for 50 metres without feeling breathless or needing to stop, you may not be able to cope with reduced cabin pressure. Speak to your GP or asthma nurse, to see if they think that you should be assessed.
You may be referred for a 'hypoxic challenge' test. This will predict how well you would be able to cope with the conditions in an aircraft cabin, and advise whether you need in-flight oxygen. Your doctor or asthma nurse will know how to refer you. It is up to your GP as to whether they charge you for this service.
Nebulisers on planes
Most airlines will not permit medical equipment such as nebulisers to be used on board if they need a mains supply but will accept the use of battery operated ones. If you need to use a nebuliser during the flight it is important to contact the airline to get permission to do so. Some airlines will ask for printed information on the flight safety of the device, (you can get this from the manufacturer). You will not be able to use a nebuliser during take off and landing. Using an inhaler with a spacer could be an alternative for you, and has been shown to be as effective as a nebuliser - ask your GP or nurse about this.
If tests show that your usual blood oxygen levels are so low that air travel may be a problem for you, you may still be able to travel by air, if oxygen is provided for you. Airlines can arrange extra oxygen, but most will charge. Different airlines have different charges, so check with them before you arrange your flight.
Arrangements for oxygen must be made by you or your travel agent if possible when booking your ticket, but at least one month before your trip. Do not assume that planes will have oxygen on board. They carry emergency supplies but not enough for several hours.
Assistance at the airport
New European regulations guarantee rights for people who are disabled or have mobility difficulties. The airport authorities have a responsibility to provide assistance at the airport and the airline you are travelling with has responsibility when you are on board the aircraft. Even if you are fairly mobile, there can be long distances to walk within airports and you may wish to consider taking the help available to you. If you are unable to climb the stairs into the aircraft there are lifts available to assist you.
You need to inform the airline of your needs at least 48 hours before you fly to ensure you receive the help you require, and ideally try to let them know when you book your flight. Be sure to book assistance for both of you if you have a carer or someone travelling with you so you can stay together. Airports have help points in various locations where you can call for help even if you have not pre- arranged it. Help carrying reasonable amounts of luggage can be provided free of charge. You can check on each airport's website or telephone for details, but help points are usually located:
- in long and short stay car parks
- on departure drop off zones
- within the terminal itself, in stations, baggage reclaim halls and along some routes where there are long walking distances.
It is usually best to carry all your medicines with you in your hand luggage, in case your checked luggage goes missing or your medicines are damaged in the baggage hold.
However, during current tightening of security and hand baggage restrictions, the Department for Transport has advised that you can only take up to 100ml of liquid creams or gels, and up to 50g of powder or tablets. Most asthma inhalers do not specify how much liquid medicine is contained within them (they are often measured in puffs or doses), but as a guide most inhalers contain approximately 10-20ml of liquid.
You are allowed to carry essential prescription medicines (including inhalers) but you will need:
- prior agreement of the airline with which you are travelling and your departure airport.
- You must bring supporting documentation from your doctor or other healthcare professional.
Other things to remember when packing your luggage:
- Always carry your reliever inhaler (usually blue) with you.
- When you are travelling always carry a spare reliever inhaler (usually blue) in your hand luggage, in case you run out or your checked-in baggage goes missing.
- All asthma medicines taken on board an aircraft should have the prescription label and contact details of the pharmacy clearly shown.
- All medicines in your hand luggage should be placed in a clear plastic bag.
- When checking in, and at the security check, inform staff of your need to carry your asthma medicines with you and in your hand luggage.
- You may be asked to taste your asthma medicines in front of airport staff in order to verify that they are genuine. Taking a one-off extra dose of any of your asthma medicines is not a problem. However, this does not replace your next dose and you should continue to take your asthma medicines when you normally would.
- If you can, carry a note from your doctor explaining why you need to take the medicines on board or, if this is not possible, carry a prescription of each of your medicines with your name on it.
Checked in luggag
Ideally you should carry all your asthma medicines in your hand luggage. However, if you do need to pack some of your asthma medicines in your checked-in luggage, inform check-in staff that your luggage contains asthma medicines that can freeze at altitude and become less effective. Ask check-in staff for your luggage to be placed in the heated area of the hold.
Travel insurance for people with asthma
Here is some information which may assist you in finding right insurance provider for you.
Insurance for people with long-term medical conditions can be expensive. In order to get the best price for you it is important that you shop around. Travel insurance quotes will vary from person to person and will depend on a range of things such as:
- your age
- the medicines you use
- the number of emergency admissions you have had
- where you are travelling to
- any other conditions you might have - all travel insurance policies require you to disclose any information about all existing or pre-existing conditions. If you do not do this, the insurance company can rightly claim it was misinformed and may not pay out if you make a claim.
There are many mountainous places in the world where you can be at high altitude. A high altitude is anywhere over 1,500 metres above sea level. When you plan to go on a trekking or climbing holiday you may expect to be at high altitude and take precautions, but you may also find yourself unexpectedly at high altitude when for example skiing on high runs, driving or cycling over passes or even flying into towns and cities.
Travelling at high altitude can lead to serious health risks and is something that should be taken seriously. Theinformation provided here will help you prepare and minimise the risks to your health.
What is altitude sickness?
If you're not used to living at high altitudes you may become unwell at 1,500 metres above sea level. This is known as altitude sickness. As you go higher the the air gets thinner (as the air pressure gets lower) which means that there's less oxygen for your body. While your body acclimatises to the shortage of oxygen you can suffer symptoms, including:
- loss of appetite
- abdominal pain.
If you adjust to altitude by slowly climbing higher your body has the chance to adapt, but if you go too quickly you're at risk of suffering from altitude related sickness and very rapid climbs may cause fluid to accumulate in the lungs, which can lead to difficulty in breathing.
Can people with asthma travel to high altitudes?
People with asthma can, and do, travel to high altitude regions of the world. However, everyone's asthma is different and they'll be affected by altitude in different ways. People who are fit and healthy with well-controlled asthma should have no problems, provided they climb slowly and are alert to changes in their asthma.
How else does high altitude affect people with asthma?
People whose asthma is triggered by the cold might find that the cold temperatures associated with high altitudes are a problem. People whose asthma is triggered by exercise may also find that climbing at high altitude is strenuous and might trigger their asthma. However, some people find that their asthma improves because their exposure to allergens like house-dust mite is much lower at higher altitudes.
Planning for high altitude trips
It's important to make sure your asthma is as well controlled as possible, so it's a good idea to see your doctor or nurse for an asthma review at least six months before your trip. You can discuss your travel plans with them, and find out if they recommend travelling to your chosen destination and what you need to do to look after you asthma while you're there. It's a good idea to get a personalised asthma action plan, so that you know what to do if your asthma gets worse while you're away. You can also ask your doctor or nurse to write a medicalinformation letter, which you should carry with you while you're away.
Make sure that you take out medical insurance that covers your asthma and the activities you're planning on doing. See our list of recommended insurance providers who cover people with asthma.
A good way to prepare for high altitude trips is by making sure you're physically fit. Slowly build up your fitness levels by starting with light exercise and then gradually building intensity. If possible, you could practise some hill walks. See our pages on exercise for moreinformation.
When you are at altitude
Make sure you keep your inhalers with you at all times. In freezing conditions aerosol inhalers may not work properly and should be gently warmed (eg in the hands) before use.
- Activities at high altitude can be strenuous and this may trigger asthma, so make sure you know what to do if you have an asthma attack. Discuss this with your doctor or nurse at your asthma review before you travel. You can also carry an asthma attack card, so that you can show it to others in your group.
- If you fly directly into a place that is at high altitude you will not have time to acclimatise and this may lead to problems. When you arrive spend a few hours resting, to get used to the altitude, before doing any activity.
- If you start to feel unwell when you are at altitude, tell someone, stop and have a rest. Take your reliever inhaler if you are having symptoms of asthma.
If your symptoms get worse, avoid climbing further and slowly descend. It would be safest to have someone come with you.