Noise can be a prevalent hazardous exposure to service members, regardless of occupation or specialty.

Around 10% of service members are affected by hearing loss. “The two largest claims of disability in the Department of Veterans Affairs for the last several years have been tinnitus and hearing loss,” according to U.S. Navy Lt. Cmdr. Kyle Shepard, an occupational audiologist at the Naval Air Warfare Center Aircraft Division at Naval Air Station Patuxent River.

The Comprehensive Hearing Health Program was developed by the Defense Health Agency Hearing Center of Excellence as a collection of tools which can be used by the services’ Hearing Conservation Programs. These materials group the elements of an effective hearing conservation program in three components: education, protection, and monitoring to combat hearing loss. Focused on protecting military personnel and civilians from hearing loss caused by occupational and operational noise exposure, the program aims to make conserving hearing a life-long priority.

Educating our Forces on the Issue

First, the Hearing Conservation Programs inform service members about the risk of hearing loss.

U.S. Air Force Maj. Michael Hammerbacher, hearing conservation program manager at Robins Air Force Base in Georgia, noted that jobs like security forces, explosive ordinance disposal, firefighters, mechanics, and pilots are usually at higher risk than other occupations and need to be educated accordingly. Yet, he adds, it’s not just the presence of loud noise that can cause hearing loss. Research has shown that those who handle certain chemicals, like jet fuel or solvents, are at risk of developing hearing loss or balance problems, regardless of noise exposure.

The U.S. Air Force, like the other branches, holds annual trainings for those enrolled in programs, as well as lectures, town hall meetings, and community awareness programs “to educate not only the military components, but also civilians. We train on the use of proper hearing protection, effects of hazardous noise, and measures one can take to reduce their chance of hearing loss,” said Hammerbacher.

It's also important to know the signs and symptoms of hearing loss to get help if there’s an issue. According to the National Institutes of Health, signs of hearing loss include:

• A dullness in hearing.

• Ringing in the ears (tinnitus).

• Difficulty following conservations.

• Difficulty in understanding speech.

Enforcing Protection and New Technology to Prevent Loss

Shepard stressed the importance of protective equipment. “In the military, we're getting faster, stronger and more lethal, which often involves our aircrafts, weapon systems, or equipment becoming louder. We need to think about personal protective equipment and controls on the individual,” said Shepard.

He explained that sometimes sailors can get frustrated with their protection, because they may not understand commands, and will often remove it. “I empathize with them. We need to strike that balance between adequately protecting, but not over protecting, so we don't decrease performance, particularly from a communication and situational awareness standpoint.”

Innovations in hearing technology can further protect service members, including equipment that helps you communicate while conserving your hearing.

“The biggest advances currently being investigated are electronic hearing protectors. They have active noise-reduction technology, which include speakers and microphones in and outside of earmuffs, that when turned on, can digitally suppress noise inside of the hearing protector,” said Shepard.

Newer innovations like noise-attenuating helmet systems, tactical communications and protective systems, new materials for ear plugs, 3D scanning of ear canals, 3D printing of earplugs, equipment encasements, and much more are also being tested across the DOD.

Monitoring Exposure to Noise

Monitoring noise exposure is a critical part of military hearing conservation. As an example, the program monitors not only risks, but who is at risk. “Unlike the Marine Corps, where every Marine is a rifleman, and therefore everyone is automatically enrolled in the hearing conservation program, in the Navy we determine which personnel are routinely exposed to hazardous noise and meet the criteria to be enrolled,” said Shepard.

It's also important to know how sound intensity impacts hearing loss. “The hazard is noise. We need to determine what type of noise people are exposed to, whether it’s impulse, continuous, or a mixture. Then how intense that noise is and what is the average amount of time people may be around it,” said Shepard.

A newer technology that makes monitoring hearing loss easier and more accessible for the warfighter is “boothless” audiometry, which are portable tests. The capability increases access to hearing services because hearing tests can now be completed anywhere.

“It's a game changer,” said Dr. Victoria Bugtong, hearing program manager at Fort George G. Meade Medical Department Activity at Kimbrough Ambulatory Care Center, in Fort Meade, Maryland. “It's a wireless testing system. It uses noise cancellation technology in headsets and can be done outside of the conventional clinic setting like office spaces, conference rooms, in the field, or wherever needed.”

Successful hearing conservation and care also consider how service members are treated. “Our treatments are done with a multidisciplinary approach to determining causes of issues and how to appropriately intervene. A proper hearing conservation program is managed with specialists in multiple professions,” said Hammerbacher.

Shepard talked about the four “Ps” of hearing loss. The first “one is unfortunately, that it’s painless. I wish noise-induced hearing loss always caused pain, but it doesn’t. So, it’s harder to detect immediately. The second is that it’s progressive. The third ‘P’ is that it is permanent. There is no medication or surgery that can reverse that injury right now. The fourth ‘P’ is that is preventable.”

Education about prevention is ultimately the best solution against hearing loss. An increase in applying prevention methods is why the military has seen a decrease in hearing loss prevalence over time. “I would argue most of all, it’s just the culture that we’re trying to create around safety in the military,” Shepard said. “While I’m a big proponent of mental toughness, grit, and resilience, and that is obviously a very large virtue in the military, these are not attributes you can rely on to overcome hearing loss.”