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Hearing impairment

Considerations

Reliable communications within the cockpit and between crew and Air Traffic Control are essential to flight safety. This is achieved via standard phraseology, adequate working knowledge of English, sufficient hearing and clear speech, as well as reliable communication technology.

Pilots’ communications take place in a noisy environment that may affect communication. Headsets are widely used by crews. They have the capability of delivering a sound level chosen by each individual. Some have a separate volume control for each ear and may have active environmental noise reduction (ANR headsets). Many applicants with clinically and socially noticeable hearing loss still have the functional hearing capacity to communicate safely in the aviation environment. However this needs to be demonstrated.

The less sophisticated hearing aids amplify environmental noise, thus compromising speech intelligibility. These aids are not recommended for use in aircraft.

Air traffic controllers (ATC) work in relatively quiet rooms. Interference occurs from overhearing other controllers speak. ATCs often use headsets when not working alone. These devices can be volume adjusted.

The hearing examination has two components: examination of the hearing function, and examination of the Eustachian tube function, the ear and vestibular apparatus.

The hearing function examination includes: Conversation voice test; to be done at each examination; pure tone audiometry, to be done in accordance with the GD Examination Procedures and as clinically indicated. Clinical examination of the Eustachian tube function, the ear and the vestibular apparatus should be done in accordance with best practice.

The clinical examination of the ear may identify the cause for any hearing impairment. It must be remembered that a hearing acuity that meets the standards may be accompanied by ear disease of aeromedical significance. Thus it is not sufficient for an applicant to have adequate hearing to be considered as meeting the Part 67 ENT standards.

Information to be provided

  • Bone audiometry on the first occasion that a hearing impairment beyond the thresholds outlined in the rules is identified. This is to classify the impairment as either conductive, sensorineural or mixed;
  • Impedance audiometry when conductive hearing loss is present. This is to identify middle ear effusion, perforation or Eustachian tube dysfunction;
  • Speech discrimination test on the first occasion that a hearing impairment, beyond the thresholds outlined in the rules, is identified in both ears. The test should be repeated when a further impairment is identified i.e. 10 dB or more at one frequency of 5 dBs or more at three frequencies;
  • A specialist otolaryngologist report on the first occasion that an asymmetrical hearing loss is identified i.e. asymmetry of 20 dB or more at one frequency or 15 dB at three or more frequencies;
  • A specialist otolaryngologist report on the first occasion that middle ear disease is identified by audiometry or by clinical examination;
  • An MRI report as may be advised by an ENT specialist;
  • An in-flight or ATC work hearing assessment report [PDF 23 KB] should be provided  or an ATC workplace assessment as relevant:
    • On the first occasion that the maximum speech discrimination does not reach 90%, in at least one ear;
    • On subsequent occasions if further deterioration is identified or suspected.
    • If the applicant intends using hearing aid during flights or ATC work; or
    • If there has been a report suggesting poor hearing performance.

Disposition

Class 1 and 2 - IFR

The hearing impairment may be considered as not being of aeromedical significance if the applicant has:

  • A normal conversation voice test; and
  • A maximum speech discrimination test reaching 90% in at least one ear; and
  • No middle ear disease other than otosclerosis as diagnosed by an ENT specialist; and
  • No asymmetrical sensori-neural hearing loss, other than noise induced; and
  • No intention to use, or is not using, hearing aids during flight.

Class 2 - No IFR

The hearing impairment may be considered as not being of aeromedical significance if the applicant has:

  • A normal conversation voice test; and
  • No middle ear disease, other than otosclerosis as diagnosed by an ENT specialist; and
  • No asymmetrical sensorineural hearing loss, other than noise induced; and
  • No intention to use, or is not using, hearing aids during flight; or
  • If the applicant intends to use hearing aids, an in-flight hearing assessment report has been obtained and found to be satisfactory.

Class 3

A Class 3 applicant with hearing impairment may be considered as having a hearing impairment that is not of aeromedical significance if the applicant has:

  • A normal conversation voice test; and
  • A maximum speech discrimination test reaching 90% in at least one ear; and
  • No middle ear disease, other than otosclerosis as diagnosed by an ENT specialist; and
  • No asymmetrical sensorineural hearing loss, other than noise induced; and
  • No intention to use, or is not using, hearing aids during air traffic control; or
  • If the applicant intends to use hearing aids, a functional hearing test has been undertaken and the report found to be satisfactory.

Note: If a condition causing a hearing loss has been diagnosed once by an ENT specialist, there may not be a need for another specialist report if the condition is stable, unless the ME suspects a deterioration to have occurred or the ME suspects another diagnosis.

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