Middle Ear Barotraumas in Commercial Aircrew

2021 ◽  
Vol 92 (3) ◽  
pp. 182-189
Author(s):  
Oskari H. Lindfors ◽  
Kimmo S. Ketola ◽  
Tuomas K. Klockars ◽  
Tuomo K. Leino ◽  
Saku T. Sinkkonen

BACKGROUND: Middle ear (ME) barotraumas are the most common condition in aviation medicine, sometimes seriously compromising flight safety. Considering this and the ever-increasing amount of commercial aviation, a detailed overview is warranted.METHODS: In this survey study, an anonymous, electronic questionnaire was distributed to commercial aircrew of the three major commercial airlines operating in Finland (N 3799), covering 93% of the target population (i.e., all commercial aircrew operating in Finland, N 4083). Primary outcomes were self-reported prevalence, clinical characteristics, and health and occupational effects of ME barotraumas in flight. Secondary outcomes were adjusted odds ratios (OR) for frequency of ME barotraumas with respect to possible risk factors.RESULTS: Response rate was 47% (N 1789/3799), with 85% (N 1516) having experienced ME barotraumas in flight. Of those affected, 60% had used medications, 5% had undergone surgical procedures, and 48% had been on sick leave due to ME barotraumas (40% during the last year). Factors associated with ME barotraumas included a high number of upper respiratory tract infections [3 URTIs/yr vs. 0 URTIs/yr: OR, 9.02; 95% confidence interval (CI) 3.9920.39] and poor subjective performance in Valsalva (occasionally vs. always successful: OR, 7.84; 95% CI 3.9715.51) and Toynbee (occasionally vs. always successful: OR, 9.06; 95% CI 2.6730.78) maneuvers.CONCLUSION: ME barotraumas were reported by 85% of commercial aircrew. They lead to an increased need for medications, otorhinolaryngology-related surgical procedures, and sickness absence from flight duty. Possible risk factors include a high number of URTIs and poor performance in pressure equalization maneuvers.Lindfors OH, Ketola KS, Klockars TK, Leino TK, Sinkkonen ST. Middle ear barotraumas in commercial aircrew. Aerosp Med Hum Perform. 2021; 92(3):182189.

2021 ◽  
Vol 92 (11) ◽  
pp. 857-863
Author(s):  
Oskari H. Lindfors ◽  
Kimmo S. Ketola ◽  
Tuomas K. Klockars ◽  
Tuomo K. Leino ◽  
Saku T. Sinkkonen

BACKGROUND: Sinus barotraumas are a common condition in aviation medicine, sometimes compromising flight safety and even permanently grounding aircrew. Considering this and the ever-increasing amount of commercial aviation, a thorough examination is required.METHODS: In this survey study, an anonymous, electronic questionnaire was distributed to commercial aircrew of the three major commercial airlines operating in Finland (N 3799), covering 93% of the target population (i.e., all commercial aircrew operating in Finland, N 4083). Primary outcomes were self-reported prevalence, clinical characteristics, and health and occupational effects of sinus barotraumas in flight. Secondary outcomes were adjusted odds ratios (OR) for frequency of sinus barotraumas with respect to possible risk factors.RESULTS: Response rate was 47% (N 1789/3799), with 61% (N 1088) of the respondents having experienced sinus barotraumas in flight. Of those affected, 59% had used medications, 18% had undergone surgical procedures, and 53% had been on sick leave due to sinus barotraumas (38% during the last year) in flight. Factors associated with sinus barotraumas were female sex [OR, 2.47; 95% confidence interval (CI) 1.354.50] and a high number of upper respiratory tract infections (3 vs. <3 URTIs/yr: OR, 3.61; 95% CI 2.654.93).CONCLUSION: Sinus barotraumas were reported by 61 of commercial aircrew. They caused an increased need for medications, otorhinolaryngology-related surgical procedures, and sickness absence from flight duty. The possible risk factors were female sex and a high number of URTIs/yr.Lindfors OH, Ketola KS, Klockars TK, Leino TK, Sinkkonen ST. Sinus barotraumas in commercial aircrew. Aerosp Med Hum Perform. 2021; 92(11):857-863.


2021 ◽  
Vol 51 (2) ◽  
pp. 182-189
Author(s):  
Oskari H Lindfors ◽  
◽  
Anne K Räisänen-Sokolowski ◽  
Jari Suvilehto ◽  
Saku T Sinkkonen ◽  
...  

Introduction: Sinus barotrauma is a common occurrence in diving and subaquatic medicine, potentially compromising dive safety. To gain a more thorough understanding of the condition, an in-depth investigation is justified. Methods: This was a survey study. An anonymous, electronic questionnaire was distributed to 7,060 recipients: professional divers of the Finnish Border Guard, the Finnish Rescue Services, and the Finnish Heritage agency, as well as recreational divers registered as members of the Finnish Divers’ Association reachable by email (roughly two-thirds of all members and recreational divers in Finland). Primary outcomes were self-reported prevalence, clinical characteristics, and health effects of sinus barotrauma while diving. Secondary outcomes were adjusted odds ratios (OR) for frequency of sinus barotrauma with respect to possible risk factors. Results: In total, 1,881 respondents participated in the study (response rate 27%). A total of 49% of the respondents had experienced sinus barotrauma while diving and of those affected, 32% had used medications to alleviate their symptoms. The factors associated with sinus barotrauma were pollen allergies (OR 1.59; 95% CI 1.10–2.29), regular smoking (OR 2.04; 95% CI 1.07–3.91) and a high number of upper respiratory tract infections per year (≥ 3 vs. < 3 infections per year: OR 2.76; 95% CI 1.79–4.24). Conclusions: Sinus barotrauma is the second most common condition encountered in diving medicine, having affected 49% of the respondents. Possible risk factors include allergies to pollen, regular smoking, and a high number of URTIs per year.


Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 138
Author(s):  
Anna Materna-Kiryluk ◽  
Katarzyna Wisniewska ◽  
Barbara Wieckowska ◽  
Jolanta Wierzba ◽  
Anna Jazdzewska ◽  
...  

Data from the Polish Registry of Congenital Malformations (PRCM) suggest that the prevalence of limb reduction defects (LRDs) in some Polish regions is significantly higher in comparison to that reported in the European Surveillance of Congenital Anomalies (EUROCAT) registry, but specific risk factors are still unknown. The objectives of this study were two-fold: to detect risk factors linked to isolated LRDs among Polish natives and to search for geospatial clusters of isolated LRDs to identify high-risk areas across the country. Among the 2,939,001 births accounted for in the PRCM, we determined that there were 852 children with distinct LRDs. Our data demonstrate that lower birth weight, prematurity, and maternal smoking history are strongly associated with isolated LRDs. Furthermore, our investigation pointed to various additional risk factors for isolated LRDs, including paternal education, gestational hypertension, upper respiratory tract infections, and exposure to anti-inflammatory drugs in the first trimester of pregnancy. We did not recognize statistically significant spatial or spatiotemporal clusters over the area of Poland using Kulldorff’s scan. Our study strengthens the hypothesis that maternal factors have an integral role in the etiology of isolated LRDs.


2020 ◽  
Vol 98 (6) ◽  
pp. 36-39
Author(s):  
G. T. Tаshmetovа ◽  
I. V. Liverko

The objective: to study the prevalence of chronic obstructive pulmonary disease (COPD) in adult organized groups, to assess the structure and risk factors of its development.Subjects and methods. 3,000 people of the organized population working at various enterprises in Tashkent aged 20 to 60 years (1,400 (46.7%) women and 1,600 (53.3%) men) underwent the contemporary pulmonological screening.Results. The active pulmonological screening aimed to detect COPD among organized groups has been justified; examination of 3,000 people allowed detecting 198 (6.6%) new patients additionally to 65 cases that were already known at the time of screening. The chances of developing COPD increase with the presence of risk factors such as smoking, exposure to toxic substances and chemicals, and recurrent upper respiratory tract infections.


2020 ◽  
Vol 11 (SPL4) ◽  
pp. 2527-2530
Author(s):  
Adhavan I ◽  
Indu Rajkumar ◽  
Raadhika Shree N

Adenoids and tonsils are pharyngeal lymphoid tissue aggregation. Adenotonsillar hypertrophy is usually seen in children. Enlarged adenoid and tonsillar tissue in children causes snoring, sleeping disorders, failure to thrive, frequent upper respiratory tract infections and abnormalities in maxillofacial development. Surgical treatment performed for their removal is termed as adenotonsillectomy. This is one of the most commonly performed surgical procedures in children. The present study was conducted to compare the voice change using the GRBAS scale before and after adenotonsillectomy. This is a prospective study conducted for three months at the Department of Otorhinolaryngology in our tertiary care center. Voice of 35 children with adenotonsillar hypertrophy is analyzed by GRBAS scale in three stages before the surgery, three weeks after surgery and six weeks after surgery. The resulting voice quality improvement is noted in these children after adenotonsillectomy. This study showed that surgical procedures of adenotonsillectomy do not induce drastic adjustments in sound quality and can be performed safely in children. Post-operative voice changes are a significant concern issue among the parents of the children.


2014 ◽  
Vol 143 (4) ◽  
pp. 821-830 ◽  
Author(s):  
I. KORONA-GLOWNIAK ◽  
A. NIEDZIELSKI ◽  
U. KOSIKOWSKA ◽  
A. GRZEGORCZYK ◽  
A. MALM

SUMMARYStreptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis and Staphylococcus aureus colonization of the adenoids and nasopharynx in 103 preschool children who underwent adenoidectomy for recurrent upper respiratory tract infections was examined. Bacterial interactions and risk factors for bacterial colonization of the nasopharynx and adenoids, separately, were analysed statistically. The prevalence of simultaneous isolation from both anatomical sites was 45·6% for S. pneumoniae, 29·1% for H. influenzae, 15·5% for M. catarrhalis and 18·4% for S. aureus. Three pathogens were significantly more frequent together from adenoid samples; nasopharyngeal swabs more often yielded a single organism, but without statistical significance. M. catarrhalis and S. aureus significantly more frequently co-existed with S. pneumoniae and H. influenzae than with each other and a positive association of S. pneumoniae and H. influenzae in adenoid samples was evident. Several differences between risk factors for nasopharyngeal and adenoid colonization by the individual pathogens were observed. We conclude that the adenoids and nasopharynx appear to differ substantially in colonization by pathogenic microbes but occurrence of H. influenzae and S. pneumoniae in the nasopharynx could be predictive of upper respiratory tract infections.


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