Prolonged flight exposure and its effects on sinonasal health among aircrew members

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Figure 1
- The most important symptoms affecting health.

Table 1

- Demographic and clinical characteristics of aircrew members (N=184).

Study data	n (%)
Age groups
20-30 years	64 (34.8)
31-40 years	54 (29.3)
41-50 years	47 (25.5)
51-60 years	19 (10.3)
Gender
Male	149 (81.0)
Female	35 (19.0)
Job category
Pilot	64 (34.8)
Flight attendant	42 (22.8)
Other aircrew members	78 (42.4)
Do you have any nasal, sinus, or ear problems after or during flying?
Yes	108 (58.7)
No	76 (41.3)
How long do nose and ear problems last after a flight? (n=108)
<1 day	43 (39.8)
1-7 days	42 (38.9)
>7 days	23 (21.3)
Do these problems affect your job performance?
Yes	81 (44.0)
No	103 (56.0)
Do you have to cancel or change your trip due to recurring symptoms?
Yes	47 (25.5)
No	137 (74.5)
How many hours are you in the air per week?
<4 hours	63 (34.2)
4-8 hours	36 (19.6)
9-12 hours	24 (13.0)
>12 hours	61 (33.2)
Having allergy
Yes	48 (26.1)
No	33 (17.9)
I don’t know	103 (56.0)
Smoking
Yes	72 (39.1)
No	112 (60.9)
History of sinus, nasal, or ear surgery
Yes	33 (17.9)
No	151 (82.1)
Having medical condition
Yes	37 (20.1)
No	147 (79.9)
Taking medication
Yes	50 (27.2)
No	134 (72.8)
Previous accidents to the head, face, or nose
Yes	22 (12.0)
No	162 (88.0)

Values are presented as numbers and percentages (%).

Table 2

- Descriptive statistics of sinonasal symptoms using the sino-nasal outcome test-22 (N=184).

SNOT-22 variables	n (%)
SNOT-22 total score, mean±SD	30.1±28.9
Severity of symptoms
Normal (score <8)	58 (31.5)
Mild (score 8-20)	35 (19.0)
Moderate (score 21-50)	47 (25.5)
Severe (score >50)	44 (23.9)
Presence of sinonasal symptoms
Yes (score ≥8)	126 (68.5)
No (score <8)	58 (31.5)

Values are presented as numbers and percentages (%).

SNOT-22: sino-nasal outcome test-22, SD: standard deviation

Table 3

- Univariate analysis of the factors influencing the presence of sinonasal symptoms (N=184).

Factors	Presence of sinonasal symptoms		X²	P-values^{^§}
Factors	Yes (n=126)	No (n=58)	X²	P-values^{^§}
Age group
≤40 years	77 (61.1)	41 (70.7)	1.584	0.208
>40 years	49 (38.9)	17 (29.3)	1.584	0.208
Gender
Male	103 (81.7)	46 (79.3)	0.153	0.696
Female	23 (18.3)	12 (20.7)	0.153	0.696
Job category
Pilot	44 (34.9)	20 (34.5)	6.739	0.034^**
Flight attendant	35 (27.8)	7 (12.1)
Other aircrew members	47 (37.3)	31 (53.4)
Do you have any nasal, sinus, or ear problems after or during flying?
Yes	90 (71.4)	18 (31.0)	26.731	<0.001^**
No	36 (28.6)	40 (69.0)	26.731	<0.001^**
Do these problems affect your job performance?
Yes	73 (57.9)	8 (13.8)	31.407	<0.001^**
No	53 (42.1)	50 (86.2)	31.407	<0.001^**
Do you have to cancel or change your trip due to recurring symptoms?
Yes	43 (34.1)	4 (06.9)	15.485	<0.001^**
No	83 (65.9)	54 (93.1)	15.485	<0.001^**
Duration in hours in the air per week
≤8 hours	59 (46.8)	40 (69.0)	7.833	0.005^**
>8 hours	67 (53.2)	18 (31.0)	7.833	0.005^**
Having allergy^*
Yes	34 (61.8)	14 (53.8)	0.465	0.495
No	21 (38.2)	12 (46.2)	0.465	0.495
Smoking
Yes	53 (42.1)	19 (32.8)	1.444	0.230
No	73 (57.9)	39 (67.2)	1.444	0.230
History of sinus, nasal, or ear surgery
Yes	29 (23.0)	4 (06.9)	7.012	0.008^**
No	97 (77.0)	54 (93.1)	7.012	0.008^**
Having medical condition
Yes	27 (21.4)	10 (17.2)	0.433	0.510
No	99 (78.6)	48 (82.8)	0.433	0.510
Taking medication
Yes	40 (31.7)	10 (17.2)	4.222	0.040^**
No	86 (68.3)	48 (82.8)	4.222	0.040^**
Previous accidents to the head, face, or nose
Yes	19 (15.1)	3 (05.2)	3.703	0.054
No	107 (84.9)	55 (94.8)	3.703	0.054

Values are presented as numbers and percentages (%).

Table 4

- The multivariate regression analysis identifying significant independent predictors of sinonasal symptoms (N=184).

Factors	AOR	95% CI	P-values
Job category
Flight attendant	1.624	0.629-4.193	0.317
Pilot	0.502	0.162-1.550	0.231
Other air crew members	Ref
Do you have any nasal, sinus, or ear problems after or during flying?
Yes	2.973	1.323-6.679	0.008^**
No	Ref
Do these problems affect your job performance?
Yes	4.285	1.586-11.578	0.004^**
No	Ref
Do you have to cancel or change your trip due to recurring symptoms?
Yes	2.946	0.841-10.326	0.091
No	Ref
Duration in hours in the air per week
≤8 hours	Ref
>8 hours	1.095	0.434-2.763	0.848
History of sinus, nasal, or ear surgery
Yes	3.777	1.126-12.674	0.031^**
No	Ref
Taking medication
Yes	1.501	0.581-3.880	0.402
No	Ref