Qiang Y, Rebok GW, Baker SP, Li G. Hearing deficit in a birth cohort of U.S. male commuter air carrier and air taxi pilots. Aviat Space Environ Med 2008; 79:1051–5.Purpose: Long-term exposure to multiple risk factors in aviation may place pilots at excess risk of developing hearing deficits. We examined the incidence and risk factors for hearing deficit in a birth cohort of male commuter and air taxi pilots. Methods: The subjects (N = 3019), who were 45-54 yr of age and held Class I medical certificates in 1987, were followed up from 1987 to 1997 through the medical certification system of the Federal Aviation Administration (FAA). In this study, hearing deficit refers to the FAA pathology code 220 (defective hearing, deafness, not elsewhere classified). Poisson regression modeling based on generalized estimation equations was used to assess the associations between pilot characteristics and the risk of developing hearing deficit. Results: The 10-yr follow-up accumulated a total of 20,671 person-years and 574 incident cases of hearing deficit, yielding an incidence rate of 27.8 per 1000 person-years. Compared with age 45-49 yr, the risk of developing hearing deficit at age 50-54 yr, 55-59 yr, and 60-64 yr increased by 12% [adjusted relative risk (RR) 1.12, 95% confidence interval (CI) 0.98-1.30], 34% (RR 1.34, 95% CI 1.13-1.59), and 79% (RR 1.79, 95% CI 1.20-2.67), respectively. Conclusions: Hearing deficit is prevalent among commuter air carrier and air taxi pilots and the risk of hearing deficit increases progressively with pilot age. Effective programs for preventing excess hearing loss in the pilot population are warranted.