Supervisors info:
Κουσούλης Παναγιώτης, Επιστημονικός Συνεργάτης, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Δελίδης Αλέξανδρος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Μαραγκουδάκης Παύλος, Ομότιμος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Summary:
Introduction: Aircraft pilots are exposed to special working conditions that predispose them to two different and independent pathological entities, ΝIHL and barotrauma. The purpose of this study is to refer to the literature that has been published in recent years and can provide us with information about these diseases, in order to understand them clearly, to calculate the real risk of workers, to discover ways and tools of prevention and to improve monitoring programs and personal protection measures.
Method: In the present study, a descriptive literature review was conducted through the use of PubMed and Google Scholar databases. Based on this search and limitation in the last decade, English-language texts and full-text, emerged 1495 articles. Then, based on further filtering based on the content, emerged 25 articles which were used to extract the results and write the paper. The structure of the text was checked against the PRISMA Systematic Reviews Checklist.
Results: Studies focusing on airline pilots and the above diseases are not numerous in number or homogeneous among them. For this reason, each country presents different results in terms of incidence, clinical picture, risk factors and prevention. In our results, we also found some special characteristics of these diseases, such as the late-onset barotrauma and in terms of NIHL, the difference in the hearing threshold between the two ears and the synergistic effect of noise with other ototoxic factors.
Discussion: Barotrauma is the most common medical condition during air travel, with an incidence of no more than 20%. It has been associated with respiratory infections, a history of allergies, or other conditions that prevent the Eustachian tube from opening properly. Clinically it appears with or without otoscopic findings accompanied by otalgia, a feeling of fullness and sometimes, dizziness. Prevention of an episode can be achieved by using 120mg of pseudoephedrine orally before the flight. Barotrauma can also occur during exercise in a low-pressure chamber and in the form of "delayed barotrauma", under conditions of breathing pure 100% oxygen for a prolonged period of time. Regarding NIHL, data from the literature do not unanimously support that pilots show increased hearing thresholds compared to a reference group of the same sex and age. Age and total number of flight hours appear to be risk factors. Jet fuel emissions appear to contain ototoxic agents that can have additive effects with noise on the auditory system. DPOAEs and EHFA are helpful tests to detect an early damage to the cochlea.
Conclusions: Conditions under which Eustachian tube dysfunction and inability to open predispose to barotrauma and so pilots should seek medical attention when under such a condition. Also, they should apply the appropriate personal protection measures against noise and when they show symptoms compatible with hearing loss, they should refer to the medical units for diagnosis and consultation.
Keywords:
Middle ear barotrauma, Aircraft pilots, Aviation, Noise-induced hearing loss, Occupational noise exposure
