Michael Turner
Regulators and most carriers treat compressed medical-gas containers as dangerous goods: IATA Dangerous Goods Regulations and civil aviation authorities commonly prohibit placing pressurised medical cylinders in the aircraft hold for passenger flights. Battery-powered portable concentrators are normally permitted only in the cabin when the carrier lists the device as approved; consigning such equipment to the hold is typically refused.
Pre-flight actions: Contact the airline at least 48–72 hours before departure and obtain written permission. Carry a physician’s letter that specifies diagnosis, required continuous or PRN flow (litres per minute), and expected duration of use. Bring the device manual, manufacturer declaration or FAA/TSA approval documentation for battery-powered units, and a clear statement of cylinder volume and service pressure if applicable.
Handling and security: Keep the valve closed and the protective cap fitted; transport cylinders in an upright, secured position inside the cabin and present the device and paperwork at the ticket counter, security checkpoint and gate. Spare batteries for concentrators must be carried onboard, with terminals insulated and capacity (Wh) documented when requested; do not place spare cells in stowed bags.
Alternatives and non-compliance consequences: If the carrier refuses cabin carriage, arrange shipment via airline cargo under dangerous-goods procedures, rent or source a device at the destination, or request onboard medical-gas service from the airline. Failure to follow carrier or regulator rules can result in refusal of carriage or removal of the device at the gate.
Which airlines permit respiratory gas cylinders in the aircraft hold?
Do not place compressed respiratory-gas cylinders in passenger baggage stored in the aircraft hold; virtually every major scheduled carrier prohibits compressed therapy gas cylinders from being stowed as passenger-checked items. Carriers will accept respiratory gas only through their cargo/dangerous-goods channels under strict documentation (UN1072 for compressed gas) or as approved in-cabin medical equipment when that option exists.
Major passenger carriers – policy snapshot
American Airlines: compressed medical gas cylinders are prohibited from the aircraft hold; portable concentrators (POCs) for respiratory therapy are allowed in the cabin with advance medical clearance and battery compliance.
Delta Air Lines: compressed cylinders not permitted in passenger baggage held in the hold; POCs allowed in cabin after approval from Delta Medical.
United Airlines: forbids passenger carriage of compressed respiratory gas in the hold; permits POCs in cabin with medical documentation and prior approval.
British Airways: compressed therapy gas cylinders must not be placed in hold baggage; small, airline‑approved POCs are allowed in the cabin with paperwork.
Lufthansa / Air France – KLM: passenger hold carriage of compressed respiratory gas is not allowed; their cargo divisions accept compressed gas as dangerous goods under IATA DGR with correct UN/ID numbers and shippers’ declarations.
Emirates, Qantas, Air Canada, Ryanair and most large scheduled carriers: compressed respiratory-gas cylinders in passenger hold baggage are prohibited; check each carrier’s medical/disabled-traveller desk for cabin options or cargo routing.
Cargo departments and practical alternatives
If a cylinder must travel by air, arrange acceptance through the airline’s cargo or dangerous-goods office: carriers that commonly accept compressed respiratory gas shipments (with appropriate DGR paperwork, packaging, valve protection and UN1072 labelling) include Lufthansa Cargo, Air France KLM Cargo, Singapore Airlines Cargo, Emirates SkyCargo, Qatar Airways Cargo and Cargolux. Shipment requires a trained dangerous‑goods shipper and prior airline approval.
Practical steps:
1) Contact the airline’s medical/disabled-traveller desk and cargo dangerous-goods office before booking.
2) If carrying therapy via passenger cabin, request formal medical clearance and confirm device type, battery runtime and spare battery limits (POCs are commonly accepted; compressed cylinders rarely are).
3) For cargo movement, secure a shipper’s declaration for dangerous goods, include the correct UN number (UN1072 for compressed gaseous breathing gas), use DOT/TPED‑approved cylinders, protect valves, and arrange pick-up through the airline’s cargo terminal.
4) Consider renting or sourcing medical gas at destination to avoid air transport of pressurised cylinders whenever possible.
How do FAA, EASA and IATA regulations differ for medical gas cylinders stowed in the aircraft hold?
Do not place a medical gas cylinder in the aircraft hold unless you have the carrier’s written acceptance and the cylinder meets DOT/UN/IATA technical requirements: valid hydrostatic test date, pressure‑relief device, valve protection and correct markings.
FAA (United States): regulated under U.S. hazardous‑materials rules (49 CFR) with airline acceptance required for passenger carriage. U.S. carriers usually treat serviceable medical gas cylinders as hazardous items subject to operator approval, mandatory documentation and limits on quantity and packaging; many carriers restrict these devices to cabin use and require advance notification and a physician’s statement.
EASA (European Union): implements ICAO Technical Instructions through EU rules; enforcement is at Member State and operator level. EU carriers apply the ICAO acceptance process and commonly require prior written permission for carriage in the hold, proof of conformity to UN/DOT specifications, current test dates and appropriate stowage (valve protection, securing in baggage hold), with additional national paperwork possible.
IATA (industry standard): IATA Dangerous Goods Regulations define the detailed packing, labeling, quantity limits and operator acceptance procedures that most airlines adopt. IATA focuses on UN numbers, permitted cylinder types, labeling and packing instructions; many airlines referencing IATA will prohibit placement in the hold unless packing and documentation meet the DGR and the operator has issued explicit acceptance.
Practical checklist before attempting to stow any medical gas cylinder in the hold: obtain written carrier approval; confirm cylinder is UN/DOT/EU‑approved and within hydrostatic test date; ensure a functioning pressure‑relief device and protective valve cap; declare the item to the carrier’s dangerous goods office at least 48 hours in advance if required; carry a physician’s letter and the cylinder’s technical documentation; consider using airline‑provided or on‑board oxygen services as an alternative.
Allowable cylinder size, pressure and gas content limits for hold baggage
Do not carry pressurised O2 cylinders in the aircraft hold without written airline approval; normally only completely empty, depressurised cylinders that are clearly marked EMPTY and have valves removed or locked open are accepted for stowage in hold baggage.
- Typical permitted state
- Empty only: cylinder pressure at atmospheric (no residual pressure), valve removed or permanently locked open, valve protection cap fitted, label or tag reading “EMPTY”.
- Pressurised cylinders: normally forbidden in passenger baggage compartments and must be shipped only as Dangerous Goods through cargo channels with a shipper’s declaration and carrier acceptance.
- What to check on the cylinder before requesting airline approval or cargo shipment
- Manufacturer stamping: water capacity (L), service/test pressure (bar or psi) and UN marking – these determine whether the receptacle meets transport regulations.
- Hydrostatic test date and validity – expired test dates typically disqualify a cylinder for transport.
- Valve protection: threaded valve cap or bolted valve guard must be fitted for any movement of the cylinder.
- Common physical ranges (use for identification, not as a permission list)
- Water capacity (WC): small portable bottles typically 0.5–5.0 L; standard medical steel cylinders often 2–5 L WC.
- Service/test pressure: commonly 150–300 bar (≈2,175–4,350 psi) depending on cylinder design; marking on the cylinder gives exact rating.
- Gas content (nominal free volume at STP): small travel bottles often contain ~100–700 litres of gas expressed at atmospheric pressure (manufacturer label will state the exact litre capacity).
- When pressurised carriage is pursued via cargo (Dangerous Goods)
- Only UN-certified cylinders accepted; carrier will require correct UN number, proper shipping name, correct packing instruction and a valid shipper’s declaration.
- Valve guards, outlets capped, no leakage, valid hydrostatic test, and quantity limits per package per the applicable Dangerous Goods Regulations.
- Many airlines impose additional maximums per package (example: limited aggregate gas volume or maximum cylinder WC per shipment) – obtain written cargo acceptance terms before presenting the item.
- Practical actions before travel or shipment
- Read the cylinder stamping: water capacity (L) and service pressure (bar/psi) – forward those values to the airline or cargo agent.
- Request written approval from the airline for hold stowage or arrange dangerous-goods cargo shipment; do not assume acceptance.
- If the cylinder will be carried empty, tag it EMPTY, remove or lock the valve, fit the protection cap, and carry proof (manufacturer spec sheet or service record) to show compliance.
- Consider renting airline-approved equipment or using an approved portable concentrator for in-flight needs instead of transporting pressurised cylinders.
If in doubt, obtain a written statement from the carrier or a DG specialist that references the cylinder markings (WC and service pressure), the intended state (empty or filled) and the mode of transport (passenger hold versus air cargo).
Documentation, medical certificates and airline approvals required for stowing medical gas cylinders in the aircraft hold
Obtain a signed physician’s prescription and medical clearance that lists diagnosis, prescribed flow rate (L/min), expected duration during travel, cylinder size (litres or capacity), maximum working pressure (bar/psi), and explicit statement that the patient can operate the device independently or with an attendant.
Required medical documents
Physician’s prescription – full clinic letter on practice letterhead with physician name, license/registration number, contact phone/email, and signature; date within the airline’s window (commonly 7–14 days before departure). Fit-to-fly / medical fitness form – where requested by carrier; include oxygen therapy parameters, mobility limitations, and whether supplemental in‑flight assistance is needed. Emergency care plan – short instructions for cabin crew and first responders (what to do if the patient becomes hypoxic or device fails), emergency contact at destination.
Technical and airline approvals
Cylinder technical dossier – manufacturer name, serial number, UN marking (e.g. UN1072 for compressed breathing gas), DOT/TC/EN stamp, hydrostatic test date and interval (provide current test certificate; regulatory intervals vary by cylinder material). Regulator and valve paperwork – make/model, proof of maintenance or inspection, statement that the equipment is certified for aircraft use. Advance airline approval – written acceptance from the airline’s Medical Clearance or Dangerous Goods office (email or PDF) that explicitly authorises carriage in the aircraft hold and lists any operating or stowage conditions; obtain this at least 48–72 hours before departure. Dangerous Goods declaration – if required by the carrier, a completed DG acceptance form or reference number provided by the airline. Battery documentation – if the regulator or monitoring device contains batteries, supply battery type, watt‑hours or lithium content, and manufacturer guidance; airlines may impose additional packing rules.
Operational checklist to present at the airport: printed originals of physician’s prescription and fit‑to‑fly, airline approval email/letter, cylinder test certificate, regulator documentation, passenger ID, and a signed declaration by the patient confirming no leaks and proper valve closure. Keep electronic copies and give the airline at check‑in or to the ground Dangerous Goods officer; refusal to present required paperwork can result in denial of carriage. For alternate options and travel gear unrelated to medical transport see best green solar patio umbrella.
Packing, labeling and securing portable O₂ cylinders for airline hold transport
Close the cylinder valve fully, fit the manufacturer-supplied metal valve protection cap and remove the regulator before packing; secure the empty regulator in a separate padded pouch inside the case.
Use a rigid, hard-sided case (ABS or composite) sized so the cylinder cannot shift; surround the bottle with at least 2 in (5 cm) of closed-cell foam on all sides and add two webbing straps rated ≥200 lb (≈90 kg) to immobilize the cylinder inside the case.
Install a tamper-evident seal or padlock on the case and attach a clear weatherproof pouch to the outside with: patient name, prescribing physician and phone number, airline approval tag, and a durable hazard label showing UN 1072 and the technical name “O₂, compressed.” Affix a directional arrow label for upright orientation and a “Do not stack / keep clear of heavy items” note.
Leave the cylinder’s pressure-relief device exposed and unobstructed; do not tape over relief ports or place soft materials directly over the relief valve. Position the bottle so the valve faces upward and the relief device is not against hard case walls.
Perform a leak check after packing: with the valve closed, spray or brush mild soap-and-water around the valve and fittings and watch for bubbles for 60 seconds; if bubbles appear, do not transport and contact the gas supplier. Avoid petroleum-based cleaners and foaming products such as best car foam soap for pressure washer for diagnostic checks.
Mark the case with the cylinder’s test/hydrostatic date; refuse carriage if test date is out of tolerance per the cylinder stamping. Use only DOT/ISO-stamped cylinders that meet carrier and authority standards and ensure serial number and test stamp remain visible.
| Item | Minimum specification / instruction |
|---|---|
| Case | Hard-sided (ABS/composite), lockable, internal foam ≥2 in (5 cm) |
| Internal securing | Two webbing straps ≥200 lb (≈90 kg); cylinder immobilized, valve up |
| Valve protection | Manufacturer metal protection cap installed; regulator removed and stowed |
| Labels & markings | Weatherproof: UN 1072, “O₂, compressed”, patient + physician contact, upright arrow, “Do not stack” |
| Leak verification | Soap-and-water test 60 s after packing; no bubbles permitted |
| Relief device | Unobstructed, not taped, not pressed against hard surfaces |
| Test status | Legible hydrostatic/test stamp within authority interval |
| Documentation attachment | Airline approval tag and medical note in exterior pouch; hazard label ≥100×100 mm where required |
If a carrier requests access for inspection, unlock or provide the key/code; do not attempt makeshift repairs or jury-rig valve covers at the airport. For suspected damage or leak discovered at any point, isolate the case in a ventilated area and notify airline ground staff and the gas supplier immediately.
Practical alternatives when pressurized medical cylinders are not allowed
Primary recommendation: use an approved portable concentrator (POC) as the first option; if a POC is not feasible, pre-arrange airline-provided supplemental gas or transport pressurized cylinders as cargo through a certified hazardous‑goods forwarder.
Portable concentrators (POCs)
- Device selection: choose a model with FAA/TCAA/IATA acceptance listed in the airline’s approved device list (examples in common use: Inogen One series, Philips Respironics SimplyGo, AirSep FreeStyle). Confirm the unit supports your prescribed mode (pulse-dose vs continuous) and the required flow settings.
- Battery planning: carry batteries that provide at least 150% of expected use time (example: 6‑hour scheduled flight → batteries for 9 hours). Rule of thumb for air travel: spare lithium‑ion batteries must travel in the cabin; 0–100 Wh: airline approval generally not required; 100–160 Wh: airline approval required and typically limited to two spare batteries per passenger; >160 Wh: usually prohibited.
- Aircraft power: verify whether the aircraft offers a compatible 15V DC/110V AC outlet and the manufacturer’s approved in‑flight power cable; do not rely on gate power or seat outlets without confirmation.
- Pre‑flight steps: register the POC with the carrier at booking, obtain written approval, carry the manufacturer’s approval statement and the clinician’s prescription, and label batteries with Wh rating.
- Security screening: POCs remain powered on for screening unless instructed otherwise; spares must be removed from equipment and screened separately.
Airline‑provided supplemental gas and cargo shipment
- Airline‑supplied service:
- Arrange through the airline’s medical department well in advance – typical lead time 48–72 hours (some carriers require 5–7 days).
- Common continuous‑flow limits range from 2–6 L/min depending on carrier and aircraft; verify exact maximum and available connectors.
- Documentation usually required: medical form (MEDIF or equivalent), physician letter specifying flow rate and duration, passenger DOB and booking reference. Obtain written confirmation of provision and any service fee (fees vary widely: $0–$250).
- Onboard supply availability varies by route and aircraft type; request confirmation for both outbound and return sectors.
- Cargo shipment of pressurized cylinders:
- Use an IATA‑trained hazardous‑goods forwarder; do not attempt to ship cylinders without a specialist. Forwarder verifies carrier acceptance, packaging, markings and paperwork.
- Ensure cylinders meet transport standards: current hydrostatic test date, intact pressure‑relief devices, protective valve caps, and serviceable valves. Forwarder will advise if empty vs filled shipment is required for the chosen routing.
- Required documentation includes a shipper’s declaration for dangerous goods, UN number and class labels as specified by IATA/ICAO, and customs paperwork for international moves.
- Timing and cost: allow additional transit time (often 3–7 business days) and expect meaningful handling fees plus hazardous‑goods surcharges. Verify destination handling for collection or last‑mile delivery.
- Regulatory constraints: some carriers and countries prohibit shipment of medical pressurized gas; obtain written acceptance before relinquishing the item to the forwarder.
Fast operational checklist: 1) select a POC that meets prescribed flow and airline acceptance; 2) pack batteries for 150% runtime and secure airline approval if any battery is 100–160 Wh; 3) obtain written confirmation from the carrier for onboard supplemental gas if POC is unavailable; 4) if shipping as cargo, engage an IATA dangerous‑goods specialist and secure written acceptance and timelines before travel.
FAQ:
Can oxygen canisters be placed in checked baggage for a flight?
No. Most airlines and aviation authorities prohibit compressed oxygen cylinders and refillable gas canisters in checked luggage because pressure and temperature changes create a leak and hazard risk. Some forms of oxygen for medical use are allowed in the cabin with prior airline approval and proper documentation. Before traveling, contact your carrier to confirm what is permitted and how to proceed.
What paperwork or approvals are required if I need to carry medical oxygen on a plane?
Airlines typically require advance approval and medical documentation. Expect to provide a letter from your treating clinician stating your diagnosis, oxygen flow rate or device settings, and anticipated oxygen requirements during travel. The carrier may ask for details about the cylinder or device model, tank size, and fittings. A separate airline form for medical equipment is often required; submit these materials well ahead of departure so the airline can arrange any necessary handling and seating accommodations.
Are small consumer “canned oxygen” products treated the same as medical cylinders?
Policies vary. Retail canned oxygen items are usually compressed gas in small containers; some airlines classify them as hazardous goods and ban them from checked baggage. Others may allow them only in carry-on and only with clear manufacturer labeling and a safety data sheet (SDS). To avoid problems at the airport, check the airline’s hazardous goods rules, have the product label and SDS available, and ask for explicit confirmation before packing or carrying the item.
Which practical steps should I take before flying if I rely on oxygen or an oxygen device?
Plan ahead and follow a checklist: contact the airline as early as possible and request written confirmation of their policy; obtain a medical letter specifying flow rates and device needs; confirm whether your device is a portable oxygen concentrator (POC), an approved cylinder, or another type, because rules differ; if you use batteries, verify airline and security rules for spare cells and plan to carry them in the cabin; secure any cylinders with valve protection caps and pack regulators and tubing in carry-on so they are not lost; arrange for an oxygen supply to last beyond the scheduled flight time to cover delays; bring manufacturer literature and an SDS for the device or canister; arrive at the airport early so staff can verify paperwork and equipment. If you are traveling internationally, check both airlines’ and destination-country rules for transport of medical gases to avoid unexpected refusals.
