{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T14:38:36Z","timestamp":1787236716440,"version":"build-2736575974"},"reference-count":33,"publisher":"Aerospace Medical Association","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["aerosp med hum perform"],"published-print":{"date-parts":[[2021,3,1]]},"abstract":"<jats:p><jats:bold>BACKGROUND:<\/jats:bold> 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.<jats:bold>METHODS:<\/jats:bold> In this survey\n study, an anonymous, electronic questionnaire was distributed to commercial aircrew of the three major commercial airlines operating in Finland (<jats:italic>N<\/jats:italic> 3799), covering 93% of the target population (i.e., all commercial aircrew operating in Finland, <jats:italic>N<\/jats:italic> 4083). Primary outcomes were self-reported\n 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.<jats:bold>RESULTS:<\/jats:bold> Response rate was 47% (<jats:italic>N<\/jats:italic> 1789\/3799), with\n 85% (<jats:italic>N<\/jats:italic> 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\n 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\n 2.6730.78) maneuvers.<jats:bold>CONCLUSION:<\/jats:bold> 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\n and poor performance in pressure equalization maneuvers.<jats:bold>Lindfors OH, Ketola KS, Klockars TK, Leino TK, Sinkkonen ST. <jats:italic>Middle ear barotraumas in commercial aircrew.<\/jats:italic> Aerosp Med Hum Perform. 2021; 92(3):182189.<\/jats:bold><\/jats:p>","DOI":"10.3357\/amhp.5738.2021","type":"journal-article","created":{"date-parts":[[2021,3,23]],"date-time":"2021-03-23T15:08:36Z","timestamp":1616512116000},"page":"182-189","source":"Crossref","is-referenced-by-count":7,"title":["Middle Ear Barotraumas in Commercial Aircrew"],"prefix":"10.3357","volume":"92","author":[{"given":"Oskari H.","family":"Lindfors","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimmo S.","family":"Ketola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuomas 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