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Advocating change for all people with allergy and airways diseases for 30 years




Medical oxygen is a common therapy among chronic obstructive pulmonary disease (COPD), severe asthma, cystic fibrosis, pulmonary fibrosis and lung cancer patients that have attained a severe degree of the disease. More than 3.5 million people in Europe people need this treatment permanently.

EFA, together with the European Lung Foundation, have documented that air travelling with oxygen is in many cases unaffordable and too complicated for individual patients to try. The current EU regulation allows air travel with medical oxygen equipment but the oxygen itself is currently provided by airlines as a complementary service for passengers.

The burden for COPD patients is not just economic. Severe respiratory patients requiring oxygen therapy, have to deal with unnecessary stress when travelling. For example, there is no single European Medical Information for Fitness to Travel (MEDIF) form to request airlines for medical oxygen and their connection between the airport entrances, safety check. Flight gates can be long and complicated without propertrained staff and specialized assistance. The possibility to find medical oxygen in airports is something patients cannot rely on in a case of an emergency providing no guarantee for patients to enable no oxygen gap from airport check-in to aircraft cabin and back.

Main findings of EFA’s Booklet on air travel with oxygen

  • Discriminatory practices are persistent among many of the major European commercial airlines which opt to charge for the use of oxygen.
  • People requiring oxygen when air travelling can be charged up to 7 times the price of the same round airfare trip for a normal passenger.
  • Each European airline have different Medical Information for Fitness to Travel (MEDIF) forms that require different approval periods making it difficult for people requiring oxygen to confidently arrange e travel reservations.
  • Some European airline cabin crews are inadequately trained on how to assist passengers requiring the use of oxygen.

EFA calls on airlines and airport authorities to assimilate their policies to enable patients requiring oxygen to travel safely and to stop overcharging patients for oxygen bottles on board. As a long term objective, EFA envisions the creation of oxygen tank refill stations at major airports, much like those already existing in the Zurich Train Station.

EFA’s booklet findings refer to an airline survey conducted in 2012 together with the European Lung Foundation and under its COPD project. Several airline companies featured in the booklet (KLM, Iberia, Vueling) have confirmed to EFA a change in these policies aiming to respond to COPD patient needs. An update of airline practices towards passengers requiring medical oxygen during air travel will be published soon.

For World COPD Day 2015, EFA launched a revision of this booklet.  This revision updated the information regarding the policies and practices of European commercial airlines and the steps to take to ensure travel with oxygen is as stress free as possible.  

Advocacy activities to enable to air travel with oxygen

After first publishing the booklet in 2013, endorsed by MEP Taylor, we started to raise awareness on the findings of the book to make tangible changes for patients on the ground:

  • We launched an updated version in November 2015, 'Enabling Air Travel with Oxygen in Europe'
  • We launched the leaflet 'Steps for passengers flying with medical oxygen' at European Respiratory Society Congress 2015, a patient-friendly tool to guide passengers travelling with oxygen in Europe. 
  • We requested to participate in the European Civil Aviation Conference (ECAC) body representing patient rights to discuss the obstacles patients encounter, and presented the booklet findings in a meeting - January 2015
  • The discrimination suffered by patients was our theme for the 2014 World COPD Day where we published the press release Air travel for patients requiring Oxygen Air travel for patients requiring oxygen should be facilitated, not hindered in seven languages - November 2014
  • We met with European airlines representatives and regulatory airport bodies to find ways to harmonise policies associated with the use of oxygen during air travel in Europe - October 2014.
  • We reached to other EU umbrella patients organisations such as the European Disability Forum (EDF) and Rare Diseases Europe (EURORDIS) to join forces to have a stronger voice on the discrimination of patients needing oxygen – September 2014
  • scientific abstract on our findings was accepted at the European Respiratory Society Congress 2014, we presented the results during a poster discussion on COPD.
  • We presented the booklet to the European Commission, the International Civil Aviation Organization (ICAO)the European Aviation Safety Agency (EASA) and most importantly to the EU Health Commissioner Tonio Borg at the European Health Forum 2014 Gastein. EFA received his support and the acknowledgement that these discriminatory practices are unacceptable.
  • We supported MEP Keith Taylor at the European Parliament, who requested an own-initiative report (OIR) in the Transportation and Tourism (TRAN) Committee of the European Parliament on “The functioning and application of established rights of people traveling by air” in 2012. The report was adopted.