Allergic rhinitis and aviation

Allergic rhinitis, or hay fever, is a combination of symptoms that affects approximately 20% of the U.S. population. Symptoms include nasal congestion, sneezing, rhinorrhea, and sleep aberrations. Patients with mild or seasonal cases of allergic rhinitis are perfectly capable of performing adequately in the aviation field. At present, these people are grounded during symptomatic periods. This grounding is due to both Federal Air Regulations and Navy regulations which preclude flying with nasal congestion or with the use of medications. Current therapy of allergic rhinitis is based on the use of three different basic modalities. The first modality is immunotherapy which requires usually weekly injections, and the patient is grounded for 24 h after the injection. The second and most commonly used modality is the use of antihistamine-decongestant preparations. The third group of medications is the topical steroids and cromolyn sodium, which are reviewed in detail because of their improved efficacy and safety. Recommendations are proposed for allowing those persons with allergic rhinitis symptoms that are easily controlled with the topical steroids or cromolyn sodium to continue flying.