Can You Be a Pilot with Tinnitus?: Hearing Tests and Tinnitus in Pilots

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Tinnitus can be a debilitating condition, causing ringing or buzzing in the ears. For some people, it can be so severe that it disrupts their daily lives. But can you still be a pilot with tinnitus?

In this blog post, we will take a look at the hearing tests pilots undergo, and whether having tinnitus disqualifies you from being a commercial airline pilot. We will also explore if flying can give you tinnitus — or make an existing condition worse.

Disclaimer

The author is a holder of a Class 1 Medical and current airline Captain. This information is sourced directly from personal experience, alongside relevant aviation authority rulesets. However, for specialist advice, always consult an AME.

Does tinnitus automatically disqualify you from being a pilot?

No. There are many pilots who have tinnitus and fly commercially without problems. In addition, while a pilot’s hearing is important, it doesn’t have to be flawless. Most aviation authorities allow hearing aids to complete aviation medical exams.

However, medical examinations typically check for stable hearing, so a sudden degradation or new onset of tinnitus will likely be disqualifying until the underlying cause has been found.

If your tinnitus is severe, it could affect your ability to hear radio communications or other important sounds while flying. Sufferers with very severe tinnitus are unlikely to pass an initial class 1 medical exam in some regions — required for all commercial airline pilots — as it can involve distinguishing tones in a silent booth.

What hearing tests do pilots have to take?

Pilots require a first-class medical certificate to fly commercially, including hearing checks.

All aviation authorities require an initial ear checkup by a specialist, before deviating in their specific testing requirements.

Full medical ear exams are performed before pilots are awarded an initial class 1

Commercial pilots in the USA have to undertake a simple conversational test

The applicant must demonstrate an ability to hear an average conversational voice in a quiet room, using both ears, at a distance of 6 feet (1.83 m) from the Examiner, with the back turned to the Examiner.
Hearing tests — FAA

Commercial pilots in Europe have slightly more stringent hearing tests, with initial medicals requiring testing in a soundproof booth using pure-tone audiometry.

A pure tone audiometry test will evaluate your hearing. Applicants may not have a hearing loss of more than 35dB at any of the frequencies 500Hz, 1000Hz or 2000Hz, or more than 50dB at 3000Hz, in either ear separately.
Class 1 hearing tests — CAA

When are the checks performed?

After attaining an initial medical certificate, pilots must renew their medical certificate every year until the age of 60.
Any changes in a pilot’s hearing must be reported at the annual medical check; however, specific hearing tests are not performed annually.
Class one medical certificate hearing tests are normally repeated at 5-year intervals until the age of 40.
Over the age of 40, hearing tests are required to be repeated every 2 years.

Can flying give you tinnitus?

Some studies, such as this 1998 review into tinnitus in commercial airline pilots, suggest pilots do have a higher prevalence of tinnitus than the general population.

Traditionally, aircraft — in particular military aircraft — have been a very loud working environment. Working in a very noisy environment, or very loud noise exposures, can cause hearing loss and tinnitus.

Pilots with tinnitus may struggle to pass the audiometry test

However, this viewpoint isn’t universally accepted, with more recent studies refuting the claim that airline pilots suffer disproportionately from tinnitus.

The frequency of tinnitus is most closely related to age, gender, exposure to high impulse noise during leisure time, and hearing impairment. There was no association with aircraft type or work as a military pilot.
Tinnitus among airline pilots

More recently, virtually all commercial pilots benefit from advances in noise-cancelling headphones. There is also focus on using hearing protection whenever pilots are on the airfield apron — experiencing very loud noise exposure from jet engines.
As a result, more recent studies, like this 2009 Swedish review into pilots hearing, have shown that there is little correlation between the profession and tinnitus. It is unlikely that you would develop tinnitus from flying alone.
In reality, as tinnitus becomes more acute with silence, many find the background noise in an aircraft to be beneficial for sufferers.

If you are a pilot with tinnitus, there are some things you can do to help manage your condition. For example, you can wear earplugs or noise-cancelling headphones while flying.

Some airlines allow pilots to bring personal headsets, which can be fitted with custom earplugs or personalised background noise set-ups to minimise their tinnitus. You can also try to avoid flying during times when your tinnitus is worse.

Many people actually find flying to be one of the times when they are completely free of their tinnitus because of the background noise of the engines.
Flying And The Ear — Tinnitus UK

Summary

If you have tinnitus and are interested in becoming a pilot, you should consult an ENT specialist or audiologist. They can help you determine if your tinnitus will affect your ability to fly and whether you will need to undergo special testing. They can also provide advice on how to manage your tinnitus while flying.

For any prospective pilots with tinnitus — like any health issue — the best advice for is it to book a Class 1 medical before embarking on any flying training. Pilot training is hugely expensive, it’s better to know from the outset, if any medical concerns could potentially ground your dream of becoming a pilot.

Tinnitus does not automatically disqualify you from being a pilot, but if it is severe, it could impact your ability to hear radio communications or other important sounds while flying.
Pilots are required to have a first-class medical certificate to fly commercially. To get this certificate, they must undergo a series of hearing tests, which may include pure tone audiometry, speech reception threshold testing, and ear examinations.
If tinnitus is severe, it could affect the ability to hear the required frequencies on the pure tone audiometry test, applicable to European-based pilots.
It is unlikely that you would develop tinnitus from flying alone. More recent studies have shown pilots exposure to loud noise in their leisure times having a more significant impact than their profession.