Mobile technology is changing the way hearing tests are conducted,, increasing access to hearing care and improving readiness because they can now be conducted anywhere.

The automated, wireless equipment enables clinicians to perform hearing exams using just a headset outside a traditional sound-treated booth.

For 1,200 U.S. Army soldiers in an armored brigade combat team, mobile hearing tests "improved the unit's hearing readiness beyond 95%," said audiologist Lt. Col. Michael Murphy, U.S. Army liaison with the Defense Health Agency's Hearing Center of Excellence at Joint Base San Antonio-Lackland in San Antonio, Texas. The soldiers were training in an austere environment at the National Training Center, at Fort Irwin, California.

In preparation for the brigade's imminent mobilization, the Army identified soldiers who were overdue or would become overdue for a hearing exam within 60 days, jeopardizing their readiness to deploy. The solution was so-called "boothless" audiometry, which was successfully conducted in an empty building with cots and makeshift tables.

"The testing was a true success, showcasing that this advancement is a combat multiplier that can be utilized anywhere, at any time," said audiologist Dr. Theresa Schulz, who holds a doctorate and is HCE's prevention and surveillance section chief. In 2020, the Army purchased 169 automated, mobile audiometers for 16 installations, military hospitals, and clinics that have a hearing conservation program. "

"Since March 2021, boothless audiometry equipment has been used to obtain hearing readiness exams on 9,000 soldiers across the Army," Schulz added.

Technological Advances for Hearing Conservation

The boothless equipment was developed using small business innovative research funding and tested out by the military services in a variety of remote environments to determine viability of the technology. It is now available to service members in multiple settings, including spaces that don't typically have sound booth facilities, such as:

• Point-of-injury care in remote locations and military operational environments
• Pharmacy waiting areas
• In-patient care settings
• Primary care clinics
• Long-term care facilities
• Schools

Having testing options both at home and in-theater is a key benefit to warfighters. The mobile hearing tests can be used in a battlefield setting, so hearing-related injuries for deployed warfighters can be caught early.

"In-theater, boothless audiometry would enable combat medics and other frontline medical personnel to provide service members timely and onsite hearing health care," Schulz explained. "A combat medic trained to use mobile audiometry would be able to provide hearing care at the lowest level of care, the point of injury—to the highest levels of care, advanced trauma. Providing hearing health services at the point of injury allows for immediate hearing assessment and treatment, as well as the accurate identification and triage of service members requiring more comprehensive hearing care."

DOD policy requires the military services to each manage a comprehensive hearing conservation program to reduce hazardous occupational and operational noise exposures.

The U.S. Army and U.S. Marine Corps provide annual hearing tests to all service members, while the U.S. Air Force and U.S. Navy conduct annual testing on service members who are routinely exposed to hazardous noise.

With the goal to increase awareness and use of boothless audiometry, HCE established the joint DOD and Department of Veterans Affairs Boothless Audiometry Networking Group, or BANG, in September 2020. The group serves as a way for many potential DOD and government users of mobile audiometry "to learn with and from each other," Schulz noted. For example, the group quickly identified an issue with the calibration of test equipment and worked with the manufacturer to solve the issue, she explained.