The roar of a howitzer. The piercing scream of a jet engine. These are just a couple of the deafening sounds people have to deal with during battle. It’s just the nature of the business for the military, and no wonder why noise-induced hearing loss can be so prevalent among service members. It’s also why the Military Health System works with other federal agencies, colleges and universities and public and private entities to prevent and treat those types of injuries.
“Noise-induced hearing loss and tinnitus, the ringing in the ears, are highly prevalent in the Department of Defense (DOD),” said Lynn Henselman, interim executive director of the Hearing Center of Excellence (HCE), a joint effort between the DOD and Department of Veterans Affairs (VA). “Hearing is a critical sense, especially for our service members conducting their missions, to have situational awareness. When they don’t have good hearing, it can potentially affect their ability to do the mission.”
Henselman is a VA employee assigned to the DOD for this collaboration. The center comes under formal control of the Defense Health Agency Dec. 11, 2016. But the collaboration between the military and VA on hearing loss issues goes back decades before the 2009 law that created the HCE.
“There’s always been a great partnership between hearing health providers in the VA and DOD,” said Henselman. “So it made sense for us to have this platform with the center to accomplish several strategic initiatives to improve the hearing health of service members and veterans. These initiatives focus on the prevention, diagnosis, mitigation, treatment, rehabilitation and research of hearing loss and injuries to the auditory system and sense of balance functions of the ear.”
Most of the DOD’s primary focus, according to Henselman, has been on prevention of noise-induced hearing loss, even if the nature of warfare sometimes makes preventing it difficult. That’s where the military can draw on the experience the VA brings in treatment, including rehabilitation.
“People are in the VA because they already have the injuries, so we’re used to treating them,” said Henselman. “That’s why we’re educating the military health care providers about best practices in certain hearing loss treatments and approaches to managing tinnitus.”
The VA’s research arm has done extensive work in tinnitus assessment and management. The VA’s partnership with other research laboratories continues to update VA and military clinics about the best practices and latest equipment.
Meanwhile, the VA is learning from the military how to help people prevent noise-induced hearing loss. Henselman pointed to the HCE’s Comprehensive Hearing Health Program, an approach using three basic concepts:
- Protection – promoting the proper use of the right kinds of protective equipment, such as earplugs and earmuffs
- Education – teaching service members and veterans about the effects of noise and how important hearing protection is to this vital sense
- Monitoring – testing the hearing of service members in traditionally noisy jobs, as well as getting all service members checked annually or periodically (the Army and Marine Corps test all their members every year; the Navy and Air Force do it for those exposed as part of their jobs) to ensure a ready and fit-to-fight military
“Even though our veterans come into our clinics with hearing loss, it can get worse,” said Henselman. “Since they might work in industrial areas or shoot recreationally or attend loud events, such as a NASCAR race, our patients need to be able to know what to do to protect their hearing from hazardous noise levels.”
HCE is a small organization, only about three dozen people. That’s not a lot of hands to help the millions affected by some type of hearing loss. Henselman said they leverage their support from the military services, public health offices, Veterans Health Administration and civilian hearing health organizations. “They’re the ones to help guide us to fill any gaps in care.”