A Cross-Sectional Audiometric Analysis of Noise-Induced Hearing Loss in Military Aviators

The objective of this study was to establish a quantitative relationship between the occurrence of certain auditory impairments in Chinese military pilots and their flight hours. The investigation will determine whether the prevalence of left-ear vulnerability necessitates the implementation of cockpit noise control measures.

Cross-sectional pure-tone audiometry (0.125-8 kHz) was performed in 155 active-duty aviators with an average time of 2241 h in 2024. Hearing loss (HL) was defined as pure tone average (4, 6, 8 kHz) ≥25 dB. Asymmetry was tested with paired t-tests.

Prevalence of high-frequency HL rate was 14.2% unilateral and 12.9% bilateral. Aircraft type correlated with threshold differences at 0.125, 2, and 6 kHz in the left ear and at 8 kHz in the right ear. Flight hours showed strong associations with elevated thresholds at 4, 6, and 8 kHz in both ears. A two-way analysis of variance indicated no significant interaction between flight hours and aircraft type on hearing thresholds. An asymmetry existed between the two ears, with left-ear thresholds exceeding the right by 2.9 ± 0.73 dB at 0.25-4 kHz.

This study found that age and flight time were statistically significant risk factors for noise-induced HL in military pilots. Early detection strategies are of critical importance for hearing protection. The consistent inferiority of the left ear indicates the necessity of optimizing active noise reduction for the left helmet cup. Hao M, Zheng X, Chen D, Ma X, Yu W, Liu L, Bai Y. A cross-sectional audiometric analysis of noise-induced hearing loss in military aviators. Aerosp Med Hum Perform. 2026; 97(8):618-626.