Upper Respiratory Infections and Barotraumas in Commercial Pilots: A Retrospective Survey

Abstract

One of the most common causes of acute incapacitation among aircrew is barotrauma induced by pressure changes during descent in aviation. However, the incidence of ENT barotrauma during flight among commercial pilots with or without upper respiratory infections (URI) has not been described in detail. There were 948 commercial pilots--equivalent to one-third of all commercial pilots in Denmark--visiting the Danish Aero Medical Centre during a 6-mo period who answered a questionnaire regarding signs and symptoms of URI and barotrauma incidence in relation to flying with a common cold. On average, every commercial pilot experienced one to two URI per year. About two-thirds of the pilots (57.2%) reported themselves unfit, while 42.8% continued with their flying duties despite signs and symptoms of a URI. Of the latter group the 78.0% reported taking decongestant medication. More than one-third of all pilots (37.6%) reported having experienced one or more episodes of ear barotrauma, mainly during descent (90%), whereas 19.5% reported one or more sinus barotrauma incidents during their flying career. Less than 2% of these had felt incapacitated prior to the flight. The results suggest that not all pilots and airline companies consider URI a valid reason for unfitness to fly despite the risk for acute incapacitation. Urgent attention to this fact and to the risk factors caused by URI are strongly recommended.