Cabin crew hearing loss and ear problems: barotrauma on descent, flying with a cold, the tinnitus senior crew have and what the medical actually checks
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#1 Japanese carrier, seven years, 787, here for the health threads, and the ears are the health topic the crew do not raise until something hurts. The barotrauma, the flying with a cold, the tinnitus in the senior crew and the hearing tests at the medical: here is what I have learned from seven years and from the crew doctors I have asked.
The barotrauma on the descent
The middle ear equalises through the Eustachian tube and the descent is when it fails: the cabin pressure rises, the middle ear is at the lower pressure, and the tube must open to let the air in. When it does not (the cold, the allergy, the congestion), the eardrum is pulled inward, the pain is sharp, and in the bad cases the drum bleeds or the fluid fills the middle ear and the hearing is muffled for days. The crew who have had the bad case do not forget it. The equalising methods (the swallow, the yawn, the Valsalva done gently, the jaw movement) work when the tube can open and do not when it is blocked, which is the whole point of the next paragraph.
Flying with a cold and paying for it
The crew who fly with a cold because of the attendance record (Olivia's thread) are the ones with the barotrauma, because the congested tube cannot equalise and the descent does the damage. The decongestant taken before the descent helps some and is a medication the crew should check against their airline's approved list. The honest advice from the crew doctors: a blocked nose is a reason not to fly, and the crew who fly blocked are risking the eardrum and in the worst case a perforation and weeks off. The sick call on day one protects the ears.
The tinnitus the senior crew have
The cabin noise over a career (the engine and the airflow noise at the galley positions is sustained and not quiet), the years of it, and the senior crew who have the ringing in the quiet hotel room at night. It is common and underreported because the crew assume it is the job and because the medical does not catch it unless the hearing has dropped. The crew who protect their hearing use the ear protection the airline provides on the ground around the aircraft (the pushback, the engine runs at the gate) and some use filtered earplugs in the galley on the long sectors where the rules allow. The ones who do not have the ringing earlier.
The hearing tests and the medical
The initial medical includes an audiogram at most airlines and the recurrent medicals include it at intervals or when indicated. The test is the standard pure tone audiogram and the limits are set by the regulator and the airline: a hearing loss beyond the limit in the speech frequencies is a medical issue because the crew must hear the interphone, the PA, the passenger and the emergency commands. The crew who fail the hearing part of the medical are rare and the ones who do have usually had years of unprotected exposure or a specific event. The audiogram is also the record: the crew who have one every few years can show the trend, which matters if the hearing loss becomes a work related claim.
The ear infections
The swimmer's ear from the layover pools and the humid climates (the outer ear), and the middle ear infection following the cold and the barotrauma. Both are treatable and both ground the crew member for the duration, and the crew who fly with either are making the barotrauma problem worse. The layover pool crew dry their ears properly and the ones who do not learn why.
For the crew
Do not fly with a blocked nose; the day one sick call protects the eardrum. Equalise early and gently on the descent. Use the hearing protection on the ground every time. Consider the filtered plugs in the galley where allowed. Have an audiogram every few years and keep it. Dry the ears after the pool. And raise the ringing at the medical, because the underreporting is the reason the industry does not take it as seriously as it should.
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#2 Nurse, ex crew, and this is a medically correct thread, which on a forum is rare. The blocked nose as a reason not to fly, the decongestant checked against the approved list, the perforation risk, the audiogram as a record: all right. The underreported tinnitus is the thing the occupational health side should hear and the crew should raise it.
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#3 Norwegian, fatigue reporting, and the audiogram as the record for a work related claim is the point the union reps make and the crew ignore: have the test, keep the result, show the trend. Kenji has the ears the way the fatigue threads have the sleep. Pin to the health board.
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#4 Qantas, fifteen years, the old guy, and the tinnitus in the quiet hotel room at night is mine and it started around year ten and I did not use the ground protection in the early years because nobody did. Kenji's thread would have saved me some of it. The under thirties should read it with the pension one.
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#5 Virgin, fourteen years, purser, and the ringing is a purser's room conversation and never a medical conversation, exactly as Kenji says, because we assume it is the job. Raising it at the medical is the change. The filtered plugs in the galley are a thing I will ask about.
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#6 Japanese carrier, four years, and Kenji is the colleague the batch sends the health questions to and this thread is why. The barotrauma after flying with a cold is a thing I had once and the muffled hearing for four days was the lesson. Day one sick call protects the ears. True.
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#7 easyJet Edinburgh training, wet drill survivor, and the swimmer's ear from the pool and the drying properly is the thing the trainers said after the wet drill and nobody listened and two of us have it. Kenji's thread has the whole ear and the trainees should read it before the first cold.
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#8 @stevesyd raising it at the medical even now puts it on the record, which matters for you and for the next generation's protection standards. @purserpaul ask about the filtered plugs; the airlines that allow them in the galley on long sectors have crew with better audiograms.