Considerations

This is a very common condition with predominance of seasonal allergic rhinitis. The commonest allergen is grass pollen. Bouts of sneezing, watery eyes and nasal obstruction with their potential complications, including distraction, are of concern to aviation safety. Pollens are few at altitude, and negligible or absent in pressurised cabins because of filtration systems.

From an aeromedical perspective, steroid nasal sprays are preferable for treatment because they do not cause sedation and they act as a preventer. They may however cause nose bleed and the spray should not be directed towards the Little area. They require regular use and take several days to be effective. The use of IM steroids is generally not acceptable and would be a reason to consider the application under the flexibility process.

If oral medication is needed, alone or in addition with nasal steroids (i.e. in the first few days of nasal spray use or if a nasal spray does not sufficiently control the symptoms) the following are acceptable: Loratadine, Desloratadine and Fexofenadine following a ground trial. Other antihistamines must not be used within 48 h prior to flying.

Information to be provided

  • An applicant with allergic rhinitis should provide copy of the GP notes for the past two years if the ME is uncertain about the allergy severity, its control or the treatment used;
  • An ENT specialist report if there is nasal obstruction, or if polyps are present or suspected.

Disposition

An applicant with allergic rhinitis may be considered as having a condition that is not of aeromedical significance if:

  • The condition is successfully treated; and
  • The treatment is acceptable. [See above for recommendations], or
  • The condition is very mild, i.e. when suffering from the condition there should be adequate respiratory function, adequate ventilation of the sinuses and the middle ears and no disabling or distracting sneezing or other symptoms.