title: Noise exposure during ambulance flights and repatriation operations.
abstract: OBJECTIVE
  Although ambulance flights are routine work and thousands of employees work in repatriation organizations, there is no data on noise exposure which may be used for preventive advice. We investigated the noise exposure of crews working in ambulance flight organizations for international patient repatriation to get the data for specific guidelines concerning noise protection.
  
  
  METHODS
  Noise levels inside Learjet 35A, the aircraft type which is most often used for repatriation operations, were collected from locations where flight crews typically spend their time. A sound level meter class 1 meeting the DIN IEC 651 requirements was used for noise measurements, but several factors during the real flight situations caused a measurement error of ~3%. Therefore, the results fulfill the specifications for class 2. The data was collected during several real repatriation operations and was combined with the flight data (hours per day) regarding the personnel to evaluate the occupationally encountered equivalent noise level according to DIN 45645-2.
  
  
  CONCLUSIONS
  The measured noise levels were safely just below the 85 dB(A) threshold and should not induce permanent threshold shifts, provided that additional high noise exposure by non-occupational or private activities was avoided. As the levels of the noise produced by the engines outside the cabin are significantly above the 85 dB(A) threshold, the doors of the aircraft must be kept closed while the engines are running, and any activity performed outside the aircraft - or with the doors opened while the engines are running - must be done with adequate noise protection. The new EU noise directive (2003/10/EG) states that protective equipment must be made available to the aircrew to protect their hearing, though its use is not mandatory.
authors.affiliation: Institute of Occupational and Social Medicine, RWTH Aachen University, Aachen, Germany. tkuepper@ukaachen.de
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Küpper
authors.forename: Bernd
authors.initials: B
authors.lastname: Zimmer
authors.forename: Gerson
authors.initials: G
authors.lastname: Conrad
authors.forename: Paul
authors.initials: P
authors.lastname: Jansing
authors.forename: Aline
authors.initials: A
authors.lastname: Hardt
mesh_terms: D017732:Air Ambulances; D004784:Environmental Monitoring / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D009622:Noise / Q000517:prevention & control*; D016273:Occupational Exposure; D009787:Occupational Medicine