A new Department of Transportation (DOT) regulation, which went into effect May 16, requires all U.S. and foreign airlines serving the United States to accept portable oxygen concentrators (POCs) on aircraft.

While new federal rules often times add increased costs to air carriers, this new regulation benefits both passengers with breathing problems (an estimated 50,000 people who annually travel with oxygen on civil transports) and cash-strapped airlines.

OxygenToGo, based in Jackson, Wyoming, hopes to cash in on traveler oxygen services, allowing oxygen-dependent individuals the freedom to move about the country and world while also helping air carriers to comply with the new DOT regulation requiring all commercial flights originating or departing from a U.S. airport to allow passengers to bring and operate portable POCs on their aircraft.

Individuals with breathing issues, including chronic lung disease patients, asthmatics, and heart disease patients, are dependent on either tanks of purified oxygen or POCs. The smallest, portable oxygen tank is 2.5 feet tall, providing about two hours of life-saving pure oxygen. Heavier five-foot long tanks might provide as much as six hours of oxygen, but they must be stowed in a jetliner cabin’s overhead storage bin with the lifeline running down to the passenger seat.

The majority of ambient air is composed of nitrogen. A POC filters nitrogen out of the surrounding air, providing a concentrated flow of oxygen to the user. POCs weighing 75-80 pounds that plug into wall AC outlets have been around for a number of years in patient’s homes. On the other hand, a battery-operated portable POC is about the size of a toaster oven, weighs 9-10 pounds, is carried in a shoulder bag or mounted in a wheeled cart, much like a luggage trolley, and can be stowed under a passenger seat. It runs as long as lithium battery power is available. A portable POC costs about $5,000, so most users simply rent them for trips, as the Federal Aviation Administration (FAA) and the Transportation Security Administration (TSA) have approved several models for use onboard commercial aircraft.

After the 9/11 terrorist attacks, the FAA and TSA no longer permitted passengers to bring their personal portable oxygen tanks onboard commercial transport, a ban that remains today. Screeners had no means to verify that they only contained oxygen. Airlines were then required to provide oxygen for passengers with breathing problems for a fee, of course, about $100 per flight leg. But the airlines had to provide oxygen from the passenger’s home to the traveler’s destination and points in between, including originating, hub and destination airports. Invariably, snafus ensued; oxygen tanks arrived late or not at all, said Dr. Brent Blue, M.D., medical director for OxygenToGo. “It was a huge logistics nightmare for the airlines,” he said.

“Portable oxygen concentrators are no longer just something for airlines to talk about. Government regulations are forcing airlines to accept POCs and in the end, provide a safer and more user-friendly solution for oxygen-dependent travelers, says Dr. Blue.

Some air carriers had previously approved use of POCs, but the new DOT regulation requires all U.S. air carriers, including regional airlines, which had banned POCs, and foreign airlines flying to/from U.S. gateways, to allow operation of personal POCs aboard their civil transports. United Airlines, for example, had banned personal POCs, forcing passengers to use the airline’s equipment. Delta Air Lines, on the other hand, gave passengers a choice: either use POCs or oxygen tanks.

“By using our complete medical oxygen service, OxygenToGo removes airlines from the hassles, costs and dangers of carrying heavy tanks filled with pressurized oxygen,” Blue said. “POCs are lighter than traditional tanks, plus passengers receive consistent oxygen through all of the segments of their trip – on the ground, during airport layovers and delays, in the air and at the destination.”

The family and emergency medicine clinician, who is also a senior aviation medical examiner and rated private pilot, founded OxygenToGo nearly four years ago to offer “door-to-door oxygen equipment to people who are oxygen dependent for travel on airlines, cruise ships and the like. “We do not just rent medical equipment. We are a medical services provider with licensed respiratory therapists and board-certified physicians who work with our patients and the airlines, taking care of any issues on a 24/7 basis,” said Dr. Blue.

Here’s how it works: OxygenToGo personnel obtain a prescription for a POC from a doctor. The company selects the appropriate POC from the list of TSA/FAA-approved units. The firm contacts the traveler’s doctor to resolve any medical questions. The portable oxygen concentrator rental unit is delivered to the passenger’s home 24 hours prior to departure and picked up upon the passenger’s return. OxygenToGo bills the fees directly to the passenger, removing the airline from all financial or logistical burdens. During travel, the patient/passenger uses the provided pulse oximeter attached to a finger to check the oxygen level.

“We provide our customers with the right POC, assure its safety and explain how to use it. We also guarantee that the paperwork is done properly so there is no hitch at airport check-in,” said Dr. Blue. The company also determines how many batteries are needed for the flight since the DOT requires 150 percent battery time as a safety margin For example, if the flight is estimated to last two hours, OxygenToGo will provide enough batteries to run the POC for no less than three hours.

‘We assure our customers that they won’t run out of battery power over the Atlantic Ocean. We assure the airlines that they won’t have to divert a flight due to a medical emergency involving our service. We’ve never caused an aircraft diversion in the three plus years that we’ve been in business,” Dr. Blue noted.

Currently, OxygenToGo works with more than a dozen airlines, including Delta Air Lines and Frontier Airlines, to provide a short-term POC rental program. Travelers in need of a POC or medical oxygen are directed to OxygenToGo via an airline’s Web site or customer service staff. And OxygenToGo pays a commission to participating air carriers for the referral. “We take a bottom line loss and turn it into a bottom line profit for a partner air carrier,” said Dr. Blue.

Airlines may actually benefit from the transition from tanks to POCs. According to calculations by OxygenToGo, POCs reduce the weight of an oxygen-dependent passenger’s medical equipment by over one hundred pounds on long-haul flights. Since the passenger carries the POC on and off the plane, airlines will no longer need an expensive, error-prone infrastructure to deliver tanks to the cabin.

“Our role is to provide good medical care so people can travel safely but we also provide savings for the airlines,” he added.

Most rentals occur during holiday seasons. Dr. Blue said business picked up in June because of student graduations and despite the overall slump in leisure travel because of the recession. Business has consistently grown over the past four years, but Dr. Blue said it is too early to tell what impact the DOT regulation will have on his future bookings.

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