A case of 43-year-old fighter pilot with bronchial asthma

A Japan Air Self-Defense Force (JASDF) fighter pilot with adult onset atopic bronchial asthma was successfully returned to flying status. This was against the common wisdom of most Japanese military flight surgeons. Bronchial asthma generally results in permanent disqualification from flying duties because of possible acute incapacitation during flight. This JASDF pilot was treated with inhaled medications, including beclomethasone, for 6 mo with suppression of all clinical symptoms. All medications were discontinued and the pilot was observed for another 7 mo before resumption of flying status. This aeromedical disposition was based on the thinking that his long asymptomatic period indicated bronchial inflammation was resolved, bronchial reactivity was improved, and thus the risk of exacerbation was reduced.