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Allergies—Nothing to Sneeze At
by Charlie Spence, Aviation Writer and IFA Member

Watery eyes, sneezing, coughing—is it just a cold or an allergy? To pilots, it makes a great deal of difference.

According to the U.S. Federal Air Surgeon’s Bulletin: “Aside from being uncomfortable, the pilot with allergic rhinitis [clear watery nasal discharge] is more prone to barotraumas [pain or discomfort in the ear because of differences in air pressure inside the eardrum and outside the eardrum], changes in vision and cockpit distractions.”

To control allergies, pilots may use certain approved medications. However, any approved medication a pilot uses must be reported to the examining physician at the next routine medical examination.

According to estimates, about one out of five persons in the western hemisphere suffer from some form of allergy. Why some develop them and others do not is not yet known. Some medical persons believe heredity plays a big role in their development but what causes reaction in children is not always the same as that which affects parents. Most reactions are not serious but cause discomfort and possibly flight distractions. Some that can cause an inability to breath, or a severe drop in blood pressure.

Allergies are grouped in general categories according to the type of substance that causes them: skin, respiratory, food, drug, and insect stings. Symptoms vary. Sneezing, nasal congestion, and coughing could indicate a respiratory allergy. Wheezing might indicate asthma.

How do you tell the difference between a cold and an allergy? With an allergy, most of the symptoms—sneezing, congestion, runny nose, headaches, fatigue—occur at the same time. With a cold, symptoms occur in sequence, usually beginning with sneezing, then a runny nose, followed by congestion. The length of time for the symptoms also differs. Duration for a cold usually is a week to ten days; allergy symptoms remain as long as the irritant that cause the allergy is present.

Writing for the Flight Safety Foundation, Stanley R. Mohler, M.D. says there are basically three general methods to help persons with allergies. First, avoid the substances causing the reactions. This cannot easily be done for most persons, but dehumidifiers can help. Injections and antihistamines or other medications are the other two treatments. If taking an injection, a pilot should wait a sufficient time to be sure there is no reaction.

Medications are the more common method of treatment. Some medicines are available over the counter and others require a prescription. Antihistamines have been in use for more than a half-century. Some of the earlier ones often caused drowsiness, loss of coordination, loss of alertness, or other side effects. Newer types of medicines have fewer side effects. However, pilots should wait a period of time after taking the medication before operating an aircraft. Doctors prescribing the medication can give an indication about how long to wait to test for reactions.

The National Transportation Safety Board has cited anti-allergy drugs as the probable cause or contributing factor to at least 15 accidents that occurred between 1996 and 2000.

Different nations have different regulations concerning use of antihistamines by pilots. Some restrict the time between taking the medication and flying and these times often differ, some limit the kinds of medication that can be taken and still pilot an aircraft. Pilots taking anti-allergy medications should check with their medical examiners.

Information for this article came from several sources:
● Several items on WebMD by Paul Enright. M.D.
● Stanley R. Mohler, M.D. writing for Flight Safety Foundation. Dr. Mohler, professor and vice chairman and director of aerospace medicine at the Wright State University, Dayton, Ohio, holds an ATP rating and for 13 years was chief of the FAA’s Aeromedical Application Division.