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Hearing threshold shifts among military pilots of the Israeli Air Force
  1. Liyona Kampel-Furman1,2,
  2. Z Joachims2,
  3. H Bar-Cohen2,
  4. A Grossman3,4,
  5. Y Frenkel-Nir1,2,
  6. Y Shapira5,
  7. E Alon5,
  8. E Carmon6 and
  9. B Gordon1,2
  1. 1Medical Corps, Israeli Defense Forces, Tel Hashomer, Israel
  2. 2Clinical Ward Aeromedical Center, Israeli Air Force, Tel Hashomer, Israel
  3. 3Unit of Endocrinology and Metabolism, Rabin Medical Center, Petah Tikva, Israel
  4. 4Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel
  5. 5Department of Otolaryngology-Head and Neck Surgery, Sheba Medical Center, Tel Hashomer, Israel
  6. 6Surgeon General Headquarters, Israeli Air Force, Tel Hashomer, Israel
  1. Correspondence to Dr Liyona Kampel-Furman, Clinical Ward Aeromedical Center, Israeli Air Force, Tel Hashomer 52620, Israel; liyonaka{at}


Background Military aviators are potentially at risk for developing noise-induced hearing loss. Whether ambient aircraft noise exposure causes hearing deficit beyond the changes attributed to natural ageing is debated. The aim of this research was to assess changes in hearing thresholds of Israeli Air Force (IAF) pilots over 20 years of military service and identify potential risk factors for hearing loss.

Methods A retrospective cohort analysis was conducted of pure-tone air conduction audiograms of pilots, from their recruitment at 18 years of age until the last documented medical check-up. Mean hearing thresholds were analysed in relation to age, total flight hours and aircraft platform. Comparisons were made to the hearing thresholds of air traffic controllers (ATCs) who were not exposed to the noise generated by aircraft while on duty.

Results One hundred and sixty-three pilots were included, with flying platforms ranging from fighter jets (n=54), combat helicopters (n=27), transport helicopters (n=52) and transport aircraft (n=30). These were compared with the results from 17 ATCs. A marked notch in the frequency range of 4–6 kHz was demonstrated in the mean audiograms of all platforms pilots, progressing with ageing. Hearing threshold shifts in relation to measurements at recruitment were first noted at the age of 30 years, particularly at 4 kHz (mean shift of 2.97 dB, p=0.001). There was no statistical association between flying variables and hearing thresholds adjusted for age by logistic regression analysis.

Conclusions The audiometric profile of IAF pilots has a pattern compatible with noise exposure, as reflected by characteristic noise notch. However, no flight variable was associated with deterioration of hearing thresholds, and no significant difference from non-flying controls (ATCs) was seen.

  • audiology
  • noise-induced hearing loss
  • aircraft
  • pilot
  • noise notch

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  • Contributors All authors have made a significant contribution. ZJ and AG conceived and designed the study. HB and LKF collected the data. YFN contributed the materials. LKF, BG, YS and EA analysed the data. LKF wrote the paper. All authors have approved the final draft of the manuscript.

  • Competing interests None declared.

  • Ethics approval The Israel Defense Forces Medical Corps institutional review board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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