Evaluating the climate impact of aviation emission scenarios towards the Paris agreement including COVID-19 effects.

Aviation is an important contributor to the global economy, satisfying society's mobility needs. It contributes to climate change through CO2 and non-CO2 effects, including contrail-cirrus and ozone formation. There is currently significant interest in policies, regulations and research aiming to reduce aviation's climate impact. Here we model the effect of these measures on global warming and perform a bottom-up analysis of potential technical improvements, challenging the assumptions of the targets for the sector with a number of scenarios up to 2100. We show that although the emissions targets for aviation are in line with the overall goals of the Paris Agreement, there is a high likelihood that the climate impact of aviation will not meet these goals. Our assessment includes feasible technological advancements and the availability of sustainable aviation fuels. This conclusion is robust for several COVID-19 recovery scenarios, including changes in travel behaviour.

Emergency drug usage during flight and airline safety management for passengers.

During flight, passengers may experience aviation-related symptoms such as headache, nausea, respiratory failure, and panic disorders. To treat patients with these symptoms, emergency drugs are prepared in the cabin and crews treat patients according taking into account usage and dose guidelines described on the drug containers. However, certain types of drugs are limited and not adequately prepared in the cabin. The aim of this study was to examine (1) emergency drugs used during flight and frequency of symptoms experienced in passengers and (2) cognizance of drug usage among crews was also determined in low-cost carriers. Most frequent symptoms recorded were headache (74.1%), abdominal pain (72.3%), nausea (70.5%), and ear pain (60.7%). Panic disorder (50.9%) is the fifth frequent syndrome in passengers, but emergency drugs are not available for this condition in the cabin. The cognizance survey showed that 21% of crews out of 112 who responded were not interested in usage guidelines of emergency drugs or simply ignored. Thirty-seven percent of crews failed to pay attention to drug expiration dates. Our findings suggest that crews need to be better trained for preparation and usage of emergency drugs in the cabin for passengers suffering from various symptoms. Further, it is recommended that airline companies need to consider to improve the emergency drug management system by requesting training from pharmacists and doctors for safe drug usage.

A comparison of general aviation accidents involving airline pilots and instrument-rated private pilots.

INTRODUCTION: The extremely low accident rate for U.S air carriers relative to that of general aviation (∼1 and ∼60/million flight hours respectively) partly reflects advanced airman certification, more demanding recurrency training and stringent operational regulations. However, whether such skillset/training/regulations translate into improved safety for airline pilots operating in the general aviation environment is unknown and the aim of this study. METHODS: Accidents (1998-2017) involving airline pilots and instrument-rated private pilots (PPL-IFR) operating non-revenue light aircraft were identified from the NTSB accident database. An online survey informed general aviation flight exposure for both pilot cohorts. Statistics used proportion testing and Mann-Whitney U tests. RESULTS: In degraded visibility, 0 and 40% (χ2p = 0.043) of fatal accidents involving airline and PPL-IFR airmen were due to in-flight loss-of-control, respectively. For landing accidents, airline pilots were under-represented for mishaps related to airspeed mismanagement (p = 0.036) relative to PPL-IFR but showed a dis-proportionate count (2X) of ground loss-of-directional control accidents (p = 0.009) the latter likely reflecting a preference for tail-wheel aircraft. The proportion of FAA rule violation-related mishaps by airline pilots was >2X (7 vs. 3%) that for PPL-IFR airmen. Moreover, airline pilots showed a disproportionate (χ2p = 0.021) count of flights below legal minimum altitudes. Not performing an official preflight weather briefing or intentionally operating in instrument conditions without an IFR flight plan represented 43% of airline pilot accidents involving FAA rule infractions. CONCLUSIONS: These findings inform safety deficiencies for: (a) airline pilots, landing/ground operations in tail-wheel aircraft and lack of 14CFR 91 familiarization regulations regarding minimum operating altitudes and (b) PPL-IFR airmen in-flight loss-of-control and poor landing speed management. Practical Applications: For PPL-IFR airmen, training/recurrency should focus on unusual attitude recovery and managing approach speeds. Airline pilots should seek additional instructional time regarding landing tail-wheel aircraft and become familiar with 14CFR 91 rules covering minimum altitudes.

Delta: The Value That Matters in Fatigue Risk Management.

INTRODUCTION: Noninferiority or equivalence testing are often used when comparing a novel pharmaceutical, operation, or procedure to the current standard designated as safe. Noninferiority and equivalence testing require estimates of a metric called delta: the margin of meaningful difference. Inappropriate delta margins can lead to invalid conclusions, thereby creating uncertainty about a studys scientific credibility. We recommend that a working group be convened with the following goals: 1) to evaluate delta values currently in use in aviation; 2) to determine if it is possible to develop a systematic, evidence-based, and replicable process to derive delta values based on statistical properties from population data, rather than a mixture of evidence- and opinion-based processes; and 3) based on the findings of the second goal, update the current delta values in use in aviation. This working group should include, at a minimum, government agencies and other key stakeholders using these values within operational settings.Lamp ACM, Rempe MJ, Belenky GL. Delta: the value that matters in fatigue risk management. Aerosp Med Hum Perform. 2021; 92(2):127128.

Epidemiology of skydiving-related deaths and injuries: A 10-years prospective study of 6.2 million jumps between 2010 and 2019 in France.

OBJECTIVES: To analyse the data on skydiving deaths and injuries collected prospectively by the French Parachuting Federation (FFP) between 2010 and 2019. DESIGN: Prospective cohort study. METHODS: Data on number of skydiving deaths and injuries were collected prospectively between January 2010 and December 2019, among all skydivers licensed to the FFP, via a standardised report form that included the skydiver's sex and level of experience (classified as tandem, student, or experienced), deaths, injuries, and injury location. The number of licensees, jumps, skydiving deaths and injuries were analysed descriptively and expressed as rates per 100,000 jumps and per 1000 skydivers with 95% confidence intervals (95%CI). RESULTS: Among the almost 6.2 million jumps performed by 519,620 skydivers over 10 years between 2010 and 2019, 35 deaths and 3015 injuries were reported, corresponding to 0.57 deaths (95%CI 0.38 to 0.75) and 49 injuries (95%CI 47.0 to 50.1) per 100,000 jumps. Male skydivers had a five times higher deaths rate than women (RR=4.8, 95%CI 1.5 to 15.6). There was no death in tandem skydivers. Student skydivers had a six times higher risk of injuries than experienced skydivers (RR=6.1, 95%CI 5.7 to 6.6) and tandem skydivers had a significant lower risk of injuries than experienced skydivers (RR=0.07, 95%CI 0.06 to 0.08). 83.3% of the injuries occurred during the landing phase and 64.3% concerned the lower limb. CONCLUSIONS: This large survey shows that the highest risk of death concerned experienced and male skydivers, and the highest risk of injuries concerned student skydivers. It also shows the safety of tandem skydiving. These results can be of help to develop skydiving-related deaths and injuries risk reduction strategies, and thus improve the global skydiving safety and the skydivers' health.

A survey of spatial disorientation incidence in Polish military pilots.

OBJECTIVES: The study aimed to establish the current incidence and severity of spatial disorientation (SD) in Polish military pilots when flying different aircraft types over their entire careers, and to determine how SD training and pilots' flight experience might benefit their recognition of situations that may cause SD. MATERIAL AND METHODS: Overall, 176 military Polish pilots (aged 33.8±7.72 years, the number of flying hours: 1194±941) flying different aircraft types, who attended the aviation medicine course, were surveyed and asked to report their episodes of SD. To collect anonymous data, a postal SD questionnaire (INFO PUB 61/117/5) was used. RESULTS: In the overall incidence rate of SD (96%), the most commonly experienced SD illusion was "loss of horizon due to atmospheric conditions" (81%). More SD incidents were reported by pilots who had received SD training. Some differences in the categories of the most commonly experienced SD illusion episodes between aircraft types were found. A severe episode adversely affecting flight safety was categorized by 10% of the respondents. CONCLUSIONS: In Polish military aviation, episodes of SD are a significant threat to aviation safety. There is evidence for the beneficial effects of SD training in the improvement of pilots' ability to recognize those factors that lead to SD. Int J Occup Med Environ Health. 2020;33(6):791-810.

Workers' compensation injury claims of aviation industry worker injuries in Alaska, 2014-2015.

Aviation operations in Alaska often occur in remote locations and during inclement weather. Limited infrastructure and staff in some locations often requires aviation workers to perform tasks outside of their specific job descriptions. Researchers identified workers' compensation claims as a valuable data source to characterise nonfatal injuries among Alaskan aviation workers. Keyword searches of injury claim narrative fields and industry codes were used to identify potentially aviation-related workers' compensation claims during 2014-2015. These claims were manually reviewed to verify whether aviation related and manually coded according to the US Bureau of Labour Statistics' Occupational Injury and Illness Classification System. There were 875 aviation-related injury claims accepted during 2014-2015. Ramp/baggage/cargo agents incurred the most injuries (35%), followed by mechanics/maintenance workers (15%). Among all workers, Overexertion and Bodily Reaction (40%) was most often cited as the injury event, followed by Contact with Objects and Equipment (28%), and Falls, Slips, Trips (22%). Sprains, strains, tears were the most frequent nature of injury (55%). Cargo/freight/luggage was the most frequent source of injury (24%). The 3 most frequently identified injury event types were responsible for over 90% of all injuries, which indicates that preventive interventions should be directed towards tasks rather than occupational groups.

The Episode of National Lockdown in the Pandemic: Air Traffic Restriction as the Control Strategy and Its Impact on Existing Cases and Recovery Rate of Novel Coronavirus Disease in Megacities of China.

OBJECTIVE: The effectiveness of air traffic restriction in containing the spread of infectious diseases is full of controversy in prior literature. In January 2020, the Civil Aviation Administration of China (CAAC) announced air traffic restriction in response to the coronavirus disease (COVID-19) pandemic. This study's aim is to empirically examine the policy effectiveness. METHOD: The data from 2 third-party platforms are used in this investigation. The COVID-19 data from the platform DXY and the air traffic data from Airsavvi are matched to each other. The robust panel regression with controlling city effect and time effect is conducted. RESULTS: The curvilinear relations are found between the air traffic restriction and the existing cases, and the recovery rate (quadratic term = 9.006 and -0.967, respectively). As the strength of air traffic restriction is growing, the negative effect (-8.146) of air traffic restriction on the existing cases and the positive effect (0.961) of air traffic restriction on the recovery rate, respectively, begin decreasing. CONCLUSION: On the macro level, the air traffic restriction may help alleviate the growth of existing cases and help raise the recovery rate of COVID-19 in megacities of China, but both these effects will marginally recede as the restriction strength is intensifying.

Incidence and risk factors associated with injuries during static line parachute training in Royal Thai Army.

BACKGROUND: Incidence and risk factors of parachute injuries has been studied in developed countries, but not in trainees of the airborne forces in the Royal Thailand Army. METHODS: A prospective cohort study was conducted among 992 military personnel who attended the basic airborne training program from February to July 2018. Information sheets were used to collect data about (a) personal demographics; (b) environmental conditions surrounding the parachute practice; and (c) parachute-related injuries. The incidence rate of injury was then calculated. Risk factors were examined using multilevel Poisson regression analysis and presented as incidence rate ratio (IRR) and 95% confidence interval (95% CI). RESULTS: A total of 166 parachute-related injuries occurred in 4677 jumps. The incidence rate of injury was 35.50 per 1000 jumps (95%CI: 30.04-41.21). Factors significantly related to parachute injury included: jumping with equipment versus without equipment [adjusted IRR (95% CI): 1.28 (0.88-1.87)], higher wind speed [1.54 (1.27-1.87) per knot], airplane versus helicopter exit [1.75(0.68-4.55)], side versus rear exit [2.13 (1.43-3.23)], night versus day jumping [2.19 (0.81-5.90)], and presence of motion sickness [3.43 (1.93-6.92)]. CONCLUSIONS: To prevent military static line parachute injuries, the following factors should be taken into consideration: type of aircraft, aircraft exit, time of the day, equipment, motion sickness and wind speed. TRIAL REGISTRATION: The project was certified by the Research Ethics Committee, Faculty of Medicine, Chulalongkorn University (IRB No. 697/60).

The Predictive Capacity of Air Travel Patterns During the Global Spread of the COVID-19 Pandemic: Risk, Uncertainty and Randomness.

Air travel has a decisive role in the spread of infectious diseases at the global level. We present a methodology applied during the early stages of the COVID-19 pandemic that uses detailed aviation data at the final destination level in order to measure the risk of the disease spreading outside China. The approach proved to be successful in terms of identifying countries with a high risk of infected travellers and as a tool to monitor the evolution of the pandemic in different countries. The high number of undetected or asymptomatic cases of COVID-19, however, limits the capacity of the approach to model the full dynamics. As a result, the risk for countries with a low number of passengers from Hubei province appeared as low. Globalization and international aviation connectivity allow travel times that are much shorter than the incubation period of infectious diseases, a fact that raises the question of how to react in a potential new pandemic.

Skyborn: in-flight emergency births on commercial airlines.

BACKGROUND: This study reports the global occurrence of in-flight emergency births on commercial airlines. To date, no existing research investigating in-flight emergency births has been published. METHODS: A retrospective study was conducted of all known in-flight births on commercial airlines between 1929 and 2018. RESULTS: Between 1929 and 2018, there were 74 infants born on 73 commercial flights. Seventy-one of the infants survived delivery, two died shortly after delivery and the status of one is unknown. Seventy-seven percent of the flights were designated international flights, and 26% of all flights were diverted due to the in-flight emergency births. The gestational age at delivery ranged from 25 to 38 weeks with 10% of the infants born at 37-38 weeks, 16% born at 34-36 weeks, 19% born at 31-33 weeks and 12% born prior to 32 weeks. Physicians, nurses, the flight crew and other medical personnel provided medical assistance in 45% of the births. CONCLUSION: In-flight emergency births are infrequent but not trivial. Commercial airlines are dependent on physicians and other medically trained passengers to help with in-flight deliveries.Despite US Federal Aviation Authority and Joint Aviation Authority standards, on-board medical and first aid kits are depleted and inadequate for in-flight deliveries.

A global model for predicting the arrival of imported dengue infections.

With approximately half of the world's population at risk of contracting dengue, this mosquito-borne disease is of global concern. International travellers significantly contribute to dengue's rapid and large-scale spread by importing the disease from endemic into non-endemic countries. To prevent future outbreaks and dengue from establishing in non-endemic countries, knowledge about the arrival time and location of infected travellers is crucial. We propose a network model that predicts the monthly number of dengue-infected air passengers arriving at any given airport. We consider international air travel volumes to construct weighted networks, representing passenger flows between airports. We further calculate the probability of passengers, who travel through the international air transport network, being infected with dengue. The probability of being infected depends on the destination, duration and timing of travel. Our findings shed light onto dengue importation routes and reveal country-specific reporting rates that have been until now largely unknown. This paper provides important new knowledge about the spreading dynamics of dengue that is highly beneficial for public health authorities to strategically allocate the often limited resources to more efficiently prevent the spread of dengue.

Association of Medical Certification Factors with All-Cause Mortality in U.S. Aviators.

INTRODUCTION: The value of aeromedical certification in reducing adverse medical outcomes is an especially important question for this era of increasing flight operations that do not require an FAA medical certificate. The study of this question has previously been thwarted by a lack of information about pilots when their medical certificates are not renewed.METHODS: We matched airmen in the FAA medical certification database to the U.S. Social Security Death Index to identify date of death for deceased pilots. Logistic regression models were used to explore associations of certification data with odds of death while holding a medical certificate and within 4 yr of expiration of a medical certificate.RESULTS: FAA aeromedical waivers were associated with 33% lower odds of death while holding a medical certificate and 35% increased odds of death within 4 yr after expiration of a medical certificate. Denial was associated with 21% increased odds of death in the next 4 yr. Only 13 of 47 medical conditions having significant associations were associated with increased odds of death during certification.DISCUSSION: We found that FAA aeromedical certification reduces the odds of death while holding a medical certificate compared to the 4 yr after certificate expiration. We believe this helps provide a positive answer to the question of whether medical certification reduces medically related events.Mills WD, Greenhaw RM. Association of medical certification factors with all-cause mortality in U.S. aviators. Aerosp Med Hum Perform. 2019; 90(11):938-944.

Insomnia, Work-Related Burnout, and Eating Habits Affecting the Work Ability of Flight Attendants.

BACKGROUND: Work ability is an important component of occupational health assessments and reflects how a persons' physical and mental health affect their ability to perform their job. However, little is known about factors relating to the work ability status of flight attendants. The aim of this study was to investigate the physical, mental, and work-related factors that affect flight attendants' work ability.METHODS: A questionnaire-based cross-sectional study and simple random sampling was conducted with participants employed at a Taiwan-based airline for longer than 1 yr. Analysis of variance and Pearson correlation tests were carried out to analyze work ability according to the flight attendants' social demographics, physical and mental health, and work-related factors. Multiple regression analysis was used to predict the flight attendants' work abilities.RESULTS: A total of 472 flight attendants were recruited and the response rate was 78.67%. The work ability of the flight attendants ranged from 'moderate' to 'excellent' (WAI score, 34.1 ± 1.8 to 45.1 ± 1.5). In a regression analysis, work ability was positively associated with gender, age, and good eating habits; in contrast, insomnia and work-related burnout were negatively associated with work ability (R² = 32.4%).DISCUSSION: Insomnia, work-related burnout, and eating habits had a significant impact on flight attendants' work abilities. Hence, it is important to address insomnia and high workloads and maintain a healthy lifestyle in the workplace.Hu C-J, Hong R-M, Yeh G-L, Hsieh I-C. Insomnia, work-related burnout, and eating habits affecting the work ability of flight attendants. Aerosp Med Hum Perform. 2019; 90(7):601-605.

U.S. Army Parachute Mishap Fatalities: 2010-2015.

INTRODUCTION: Despite the large number of U.S. military members who conduct parachuting operations, its inherent safety risks, and the introduction of a new military parachute in 2010, little has been published in the last decade on U.S. military parachute fatalities.METHODS: Parachute fatality investigative records maintained by the U.S. Army Combat Readiness Center were reviewed for U.S. Army fatalities resulting from military parachuting operations from January 1, 2010, through December 31, 2015. De-identified data on cases were collected, including causes, lethal injuries, and demographic, environmental, and missional factors. A descriptive analysis was performed.RESULTS: There were 13 cases which met study inclusion criteria. Most occurred during static-line operations and were jumps from a C-17 aircraft using a T-11 parachute. The two most common assigned accident codes were "improper or abnormal exit" and "unstable or improper body position," which combined accounted for 33% of cases. Also noteworthy at 11% each were "entanglement," "parachute malfunction," and "dragged on the drop zone," and at 6% each were "static line injury," "lost or stolen air," and "drop zone hazard." In 69% of cases blunt force trauma was the cause of death.DISCUSSION: Incident factors included human actions, equipment failure, and the environment. Death from blunt force trauma upon impact with the ground as the most frequent lethal injury was expected for parachute operations. This descriptive study provides awareness to military leaders of circumstances in which fatalities occur. Future investigations should include data on the total number of jumps to provide a more comprehensive analysis of risk.Johnson ES, Gaydos SJ, Pavelites JJ, Kotwal RS, Houk JE. U.S. Army parachute mishap fatalities: 2010-2015. Aerosp Med Hum Perform. 2019; 90(7):637-642.

Malaria Prophylaxis Adherence Among Aircrew Members.

INTRODUCTION: Joint Base Charleston's C-17 Globemaster III mission is executed by 400 active-duty members from three operational and support wings. Aircrew and mission-essential personnel travel to locations with endemic diseases which are mostly eradicated in the United States. Recently, two members contracted malaria after missions in Africa which required advanced hospital care. Personnel were provided chemoprophylaxis, but the members who contracted malaria were among several who chose not to take it. This preliminary survey assessed aircrew malaria prophylaxis adherence and examined potential factors contributing to nonadherence.METHODS: JB Charleston aircrew members who visited the Flight and Operational Medicine Clinic between January and April 2018 were administered a retrospective, online survey. Researchers performed descriptive statistics and Chi-squared analysis.RESULTS: Most respondents were pilots under 30 yr of age and were prescribed malaria chemoprophylaxis while on a mission. More than two-thirds of respondent aircrew members did not take the medication as prescribed or did not take it at all. Of those, over half of respondents stated too many pills/too many days and medication side effects as the main reasons for nonadherence. Furthermore, almost 70% of adherent members experienced negative medication side effects such as nausea and heightened dreams. There was no statistical relationship between crew position, age, side effects, and prophylaxis adherence.DISCUSSION: Numerous factors contribute to poor prophylaxis regimen compliance among aircrew members. This study highlighted the need for risk-based policy validation, improved patient education, prophylaxis enforcement, process improvements to facilitate adherence, and evaluation of perceived vs. actual risk.Rutherford AE, Yale RS, Finn MF. Malaria prophylaxis adherence among aircrew members. Aerosp Med Hum Perform. 2019; 90(7):643-646.

Hoarseness and vocal tract discomfort and associated risk factors in air traffic controllers / Rouquidão, desconforto do trato vocal e fatores de risco associados em controladores de tráfego aéreo

Abstract Introduction: An air traffic controller is a professional who performs air traffic control functions in air traffic control units and is responsible for controlling the various stages of a flight. Objective: To compare hoarseness and vocal tract discomfort and their risk factors among air traffic controllers in the approach control of São Paulo. Methods: In a cross-sectional survey, a voice self-evaluation adapted from to self-evaluation prepared by the Brazilian Ministry of Labor for teachers was administered to 76 air traffic controllers at approach control of São Paulo, Brazil. Results: The percentage of hoarseness and vocal tract discomfort was 19.7% and 38.2%, respectively. In relation to air pollution, the percentages of hoarseness and vocal tract discomfort were higher among those who consider their working environment to be intolerable than among those in a comfortable or disturbing environment. The percentage of hoarseness was higher among those who seek medical advice due to vocal complaints and among those who experience difficulty using their voice at work than among those who experience mild or no difficulty. The percentage of vocal tract discomfort was higher among those in a very tense and stressful environment than among those who consider their work environment to be mild or moderately tense and stressful. The percentage of vocal tract discomfort was higher among those who describe themselves as very tense and stressed or tense and stressed than among those who describe themselves as calm. Additionally, the percentage of vocal tract discomfort was higher among those who care about their health. Conclusion: Among air traffic controllers, the percentage of vocal tract discomfort was almost twice that of hoarseness. Both symptoms are prevalent among air traffic controllers who considered their workplace intolerable in terms of air pollution. Vocal tract discomfort was related to a tense and stressful environment, and hoarseness was related to difficulty using the voice at work.

Resumo Introdução: O controlador de tráfego aéreo é um profissional que executa funções de controle de tráfego aéreo em unidades de controle de tráfego aéreo e são responsáveis por controlar as várias fases de um voo. Objetivo: Comparar a rouquidão e o desconforto no trato vocal e seus fatores de risco em controladores de tráfego aéreo no centro de controle de aproximação de São Paulo. Método: Em um estudo transversal, uma autoavaliação de voz adaptada da autoavaliação preparada pelo Ministério do Trabalho para professores foi administrada a 76 profissionais do centro de controle de aproximação de São Paulo, Brasil. Resultados: A porcentagem de rouquidão e desconforto no trato vocal foi de 19,7% e 38,2%, respectivamente. Em relação à poluição do ar, as porcentagens de rouquidão e desconforto no trato vocal foram maiores entre aqueles que consideram seu ambiente de trabalho como intolerável do que entre aqueles em um ambiente confortável ou incômodo. A porcentagem de rouquidão foi maior entre aqueles que procuram assistência médica devido a queixas vocais e entre aqueles que têm dificuldade de usar a voz no trabalho do que entre aqueles que experimentam dificuldade leve ou não apresentam dificuldades. A porcentagem de desconforto no trato vocal foi maior entre aqueles em um ambiente muito tenso e estressante do que entre aqueles que consideram seu ambiente de trabalho leve ou moderadamente tenso e estressante. A porcentagem de desconforto no trato vocal foi maior entre aqueles que se descrevem como muito tensos e estressados ou tensos e estressados do que entre aqueles que se descrevem como calmos. Além disso, a porcentagem de desconforto no trato vocal foi maior entre aqueles que se preocupam com sua saúde. Conclusão: Entre os controladores de tráfego aéreo, a porcentagem de desconforto no trato vocal foi quase o dobro da rouquidão. Ambos os sintomas são prevalentes entre os controladores de tráfego aéreo que consideram o seu local de trabalho intolerável em termos de poluição do ar. O desconforto no trato vocal foi associado a um ambiente tenso e estressante e a rouquidão foi associada à dificuldade de usar a voz no trabalho.

Otitis Media with Effusion in Aircrew Members.

BACKGROUND: Middle-ear barotrauma is a common problem reported by aircrew members and passengers. Studies have shown that 20-50% of passengers report ear complaints during the flight or after landing. The aim of this study is to determine the prevalence of otitis media with effusion in aircrew members and describe the time to resolution of the condition.METHODS: All aircrew members presenting at Civil Aviation Center at Congonhas Airport at São Paulo for annual flight medical examinations from September 2014 to May 2015 were reviewed retrospectively for the presence of otologic disorders. Eligible participants were all pilots, copilots, and flight attendants with a diagnosis of otitis media with effusion confirmed by immittance testing.RESULTS: Of 1607 aircrew members, 155 (9.65%) were diagnosed as having otitis media with effusion. Most participants were men (51.6%). Regarding aircrew position, 81.9% were flight attendants, 11.6% were copilots, and 6.5% were pilots. The mean time to resolution of the otitis media was 8.23 (± 3.02) days.DISCUSSION: Otolaryngologists must be aware of the effects of gas expansion in the middle ear at higher altitudes for the appropriate treatment of diseases related to pressure changes. The recommendation for an aircrew member to return to flying duties should occur only after the individual has been treated and complete resolution, confirmed by immittance testing, has been documented.Pinto JA, dos Santos Sobreira Nunes H, dos Santos RS, Cavallini A, Freitas G, Knoll D, Duarte C. Otitis media with effusion in aircrew members. Aerosp Med Hum Perform. 2019; 90(5):462-465.