Self-Perceived Vocal Status in Airline Crew Before and After Flights of Different Routes

To examine flight-related and aviation environmental changes in self-perceived vocal status among airline crew and to determine whether these differ between short-, medium-, and long-haul routes.

Thirty-three airline crew members (n = 11 short-, n = 11 medium-, and n = 11 long-haul) participated in this observational study. Self-evaluation was conducted before and after flight routine using the validated versions of the voice handicap index (VHI), vocal fatigue index (VFI) of cluster 1 (tiredness and avoidance plus physical discomfort), and vocal tract discomfort (VTD) scale. The study followed defined inclusion and exclusion criteria. Data were analyzed using the Shapiro-Wilk test to verify normal distribution, and depending on data characteristics, paired-sample t tests and Wilcoxon signed-rank tests compared pre and postflight results. Repeated-measures analysis of variance and Kruskal-Wallis tests examined differences among flight-route groups. Finally, effect size measures of Cohen's d and Cohen's f were used.

Overall, airline crew members reported a significant increase with small to medium effect sizes in voice-related complaints after flight operations across VHI, VFI, and VTD (P values < 0.01; d values ≥ 0.41). The general perception of voice-related complaints, as measured by the VHI, was observed among the airline crew on medium- and long-haul flights (P values < 0.05), with large effect sizes (f > 0.82). Although perceived vocal problems did not consistently manifest as vocal fatigue (VFI-cluster 1) or laryngeal discomfort (VTD) across all flight distances, postflight measurements still showed a significant overall rise in these parameters (P values = 0.002). Specifically, medium-haul flights were associated with marked vocal fatigue of cluster 1 (P = 0.008), while long-haul flights showed significantly increased laryngeal discomfort (P = 0.014). Airline crew members on long-haul routes were the most affected group, already exhibiting beginning pathological scores across all three preflight questionnaires compared with their short- and medium-haul counterparts.

Flight operations are associated with increased self-reported vocal complaints, particularly in long-haul crew. These outcomes point to the impact of occupational vocal loading in aviation and highlight the importance of further investigation to obtain vocal health in aviation.