Hearing Loss and Military Personnel

January 2006 – Hearing Loss is a Growing Problem for Veterans

January 2006 – Deafness Soaring Among Soldiers.

March 2006 – Hearing Loss on rise among troops

March 2006 – Seeking the right amount of sound in the fury of combat

March 2006 – Hearing Loss Rises Among U.S. Soldiers in Iraq

April 2006 – Military alarmed over skyrocketing hearing loss

July 2006 – Blast-Related Ear Injury in Current U.S. Military Operations

August 2006 – Army pipers can’t believe their ears

October 2006 – Military Vets Suffer Dramatic Increase in Tinnitus and Other Hearing Damage

October 2006 – ATA Promotes More Research to Benefit Veterans with Tinnitus

December 2006 – Soldiers Exposed To Gunshot Noise Need Better Hearing Protection

Mar 2007 – Communication and Hearing Protector System Helps Warfighters

Mar 2007 – Who listens to a deaf old Marine?

Mar 2007 – Asymmetric Hearing Loss from “Shooter’s Ear”

April 2007 – Noise Levels of Common Army Equipment

June 2007 – Many soldiers are returning from combat with hearing problems

November 2007 – Iraq & Afghanistan war vets suffer from hearing loss, tinnitus

March 2008 – Marines Ramp up Hearing Protection

March 2008 – Hearing loss is silent epidemic in U.S. troops

March 2008 – Hearing Pill to Undergo More Clinical Trials

March 2008 – Military Examines Effects of Too Much Noise

June 2008 – The Blast in the Ears: Good Hearing Among War’s Casualties

August 2008 – Hearing Loss can be Fatal for Soldier

October 2008 – Deafness is the new scourge of British troops in Afghanistan

November 2008 – Military Equipment Noise is Accelerating Hearing Loss

January 2009 – Army makes deployment hearing test mandatory

February 2009 – Is the Army FINALLY Doing Something About Soldiers’ Hearing Loss?

February 2009 – Army works to repair, prevent hearing loss

February 2009 – HLAA Supports Vets with Hearing Loss

March 2009 – Audit: Super Hornet a noise risk for sailors

September 2009 – Army says new earplugs will save your hearing

October 2009 – HLAA Convention: Military Veterans with Hearing Loss Project

December 2009 – Two-thirds of Afghan war veterans are suffering from hearing damage

January 2010 – Hearing Loss No. 1 Diagnosis for U.S. Soldiers in Afghanistan

January 2011 – Military, VA audiologists are confronting a wave of IED-related hearing damage

February 2011 – GAO Recommends Defense Department Improve Hearing Conservation Programs

August 2011 – The Military Paradox

January 2012 – Marine Corps mandates yearly hearing test for all

More on this and related topics

Hearing loss is a growing problem for veterans

January 2006

Now that his world is quieter, what Vietnam War veteran Romeo Rasing remembers about Navy life is the noise. “My battle station was right above the turret. We had to keep bombing day and night,” said Rasing, 56, who served on the cruiser Oklahoma City early in a 22-year Navy career that included 13 years of sea duty. “When the ship was in the yard, there were all kinds of noises – grinding, chipping, banging, pounding, welding.”  Full Story

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Deafness Soaring Among Soldiers

January 2006

The ranks of current and former military personnel receiving disability pensions for deafness has soared in recent years to almost 80,000, more than the number of active service members. A newly published Department of National Defence study says a lack of training and uncomfortable, incompatible ear-protection gear are partly to blame. The review also confirmed that middle-aged service members are more than twice as likely as the average Canadian to have moderate to severe hearing loss.  Full Story

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Hearing loss on rise among troops

March 2006

The Army’s chief of staff, Gen. Peter Schoomaker, wears hearing aids. Asked why once, the crusty special operations veteran grinned and said: “Guns, helicopters, demolition – 36 years of it.” Gen. Schoomaker’s faulty hearing is far from rare in the military. And experts say the war in Iraq has led to epidemic rates of hearing loss among troops. Yet while all the armed services are scrambling to come up with better hearing protection, the Army is slashing its staff of military audiologists – the specialists who combat hearing loss – to make room for more “trigger pullers” at the front. Only two military audiologists, for example, are at Fort Hood, home base for more than 40,000 soldiers.  Full Story  

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Seeking the right amount of sound in the fury of combat

March 2006

Modern combat is almost always noisy, but it was especially so in the Iraqi city of Fallujah in November 2004, when U.S. forces engaged insurgents in vicious house-to-house – often room-to-room – fighting. The reverberation of gunfire and explosions within concrete walls was so loud at times that “someone screaming in your ear could barely reach you,” said Jesse Grapes . . . Alarmed by the Fallujah experience, the corps revised its regulations last November to require that every Marine – “especially forward-deployed Marines in combat environments” – be issued Combat Arms Earplugs, trained in how to use them and required to carry them.  Full Story

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Hearing Loss Rises Among U.S. Soldiers in Iraq

March 2006

Soldiers sent to battle zones are over 50 times more likely to suffer noise-induced hearing loss (NIHL) than soldiers who do not deploy, according to research published in the December 2005 issue of American Journal of Audiology (AJA). The study, led by Thomas M. Helfer, Nikki N. Jordan, and Robyn B Lee of the U.S. Army Center for Health Promotion and Preventive Medicine, examined the cases of 806 U.S. soldiers diagnosed with NIHL. Full Story  

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Military alarmed over skyrocketing hearing loss

April 2006

As disability payments for hearing loss skyrocket,  the military is becoming much more aware of the dangers of loud noises and their impact on people’s hearing – and they’re taking steps to reverse the alarming trend. Here’s a Navy website that does a great job of treating the entire subject of noise induced hearing loss (NIHL), and also talks about the Navy’s noise-related programs.  Full Story

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Blast-Related Ear Injury in Current U.S. Military Operations

July 2006

In the 16th century, the French surgeon Ambroise Paré reported “… a great thunderous noise, large bells or artillery, and thus one often sees gunners losing their hearing whilst drawing the machinery because of the great agitation of the air inside the ear which breaks the aforementioned membrane and moves to the bones known as ossicles out of their natural position: so that the air is implanted or absorbed within the sinuses of the mastoid cavity and the patient has a continuous noise and air within the ear.” (Mudry, 1999). Five centuries later, noise-induced hearing loss and ear injury continues to be inextricably linked to military service, particularly in time of war.  Full Story

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Army pipers can’t believe their ears

August 2006

THEY have led soldiers into battle and frightened the enemy with their noise, while becoming one of Scotland’s most enduring musical icons. But the skirl of the traditional Scottish bagpipes is now under threat – from health and safety inspectors. Soldiers learning to play the revered instrument have been issued with strict new guidelines aimed at preventing servicemen suffering hearing problems. As well as wearing ear protectors, the guidelines insist that pipers should only play for a maximum of 24 minutes a day outside, and only 15 in practice rooms.  Full Story

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Military Vets Suffer Dramatic Increase in Tinnitus and Other Hearing Damage

October 2006

Veterans Administration figures showed 339,573 veterans with tinnitus-related disabilities in 2005, up from 144,243 in 2000. The amount paid to veterans with tinnitus climbed to $418 million in 2005 from $150 million in 2000. This indicates that military veterans are suffering a dramatic increase in tinnitus and other hearing damage, and deserve much more research funding to find a cure, according to the American Tinnitus Association (ATA), Portland, Ore. “We will have to spend more on veterans’ disability compensation for tinnitus and other hearing damage over the coming years than for any other medical injuries from the Iraq and Afghan wars,” says David Fagerlie, the association’s CEO. Full Story

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Communication and Hearing Protector System Helps Warfighters

March 2007

Developmental testing involving two Air Force Research Lab technical directorates has helped the Army’s Rapid Equipping Force equip and assess improved communication and hearing protection systems for deployed forces. Known as QuietPro(tm), the lightweight technology protects against acoustic trauma — injury to the hearing mechanisms within the inner ear caused by excessively loud noises (such as explosions). The system will enhance military operations and make hostile environments less dangerous for U.S. ground forces.  Full Story

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Asymmetric Hearing Loss from “Shooter’s Ear”

March 2007

Damage can accumulate quickly from impact/impulse noise exposure at these levels. Permanent hearing loss can occur with just a few unprotected shots, so firearm users should always be counseled to use appropriate hearing protection when using guns. Specialized hearing protection is available for shooters, with some technologies permitting ambient or environmental sounds to pass through, with special electronics shutting down the noise before it reaches damaging levels. Hearing protection is absolutely essential for shooters.  Full Story

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Noise Levels of Common Army Equipment

April 2007

I just read that as many of 60% of our returning soldiers suffer from hearing loss! That’s an amazing statistic! But if you take a look at the noise levels produced by some of their equipment it becomes a bit more understandable. Take a look at the following site, and be sure to scroll down to see noise levels in tanks, and even farther to see the kind of noise levels produced by the weapons our soldiers fire. Here’s the story

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Many soldiers are returning from combat with hearing problems  

June 2007

When Robert Conley, 22, left his New Hampshire home in 2004 to join the Army, he never thought flying home for a visit would cause him physical pain, he said. But it did because of the damage to his ears he suffered as a result of his combat experience in Iraq.   He is one of many soldiers suffering from noise-induced hearing loss, a condition specialists now consider an “epidemic” within the military.   Sixty percent of soldiers who return from Iraq or Afghanistan suffer from noise-induced hearing loss, and 49 percent also suffer from tinnitus, a potentially debilitating ringing of the ears, according to military audiology reports.   While troops are educated in the proper use of special noise-blocking devices, many audiologists and soldiers say any kind of earplug is impractical.  Full Story

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Iraq & Afghanistan war vets suffer from hearing loss, tinnitus

November 2007

As a gunner in Iraq, Steve Kraft spent more time ducking for cover than covering his ears.  But after he returned to New York from a year-long deployment, the echoes of war still resonated.  “Is there something buzzing?” he asked the Veterans Administration audiologist who examined him before he wrapped up his service. “There’s never any silence.”  Kraft, 34, was told he had tinnitus, a maddening condition that has skyrocketed among vets since the start of the wars in Iraq and Afghanistan.  Thirty percent of soldiers deployed in Iraq return with tinnitus, Army doctors reported in a study published last year. Among those exposed to roadside bomb blasts, 50% have it.  Triggered by hearing loss, head injuries and loud noises, tinnitus causes phantom sounds sufferers describe as ringing, roaring or hissing in one or both ears. It can be intermittent or constant – and distracting enough to be crippling.  There is no cure, and treatment is by trial and error.    Full Story

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Marines Ramp up Hearing Protection

March 2008

The new device consists of a foam earplug that sits deep inside the ear canal and connects with a wire to an electronic box strapped to a Marine’s vest, like an iPod. It moderates the sound entering the ear, allowing conversation and most background noises to flow in, but clipping out large sound waves from gunshots and explosions, as well as low-frequency noises such as the steady rumble of a moving vehicle. “It’s like having a bionic ear,” said Ron Oyler, director of technical support with the North Carolina office of Nacre, the Norway-based company that makes the device, known as QuietPro. Integrated with the radio communications systems, the device allows troops to hear their radios and maintain complete situational awareness. A digital processor locks up at any sign of a blast that could damage the inner ear, company officials said, and opens up again immediately after a blast to permit normal sound. This sort of advanced and costly technology has been used before, mainly among high-ranking senior leaders and elite special-operations units, but the new contract shipping to Marines and soldiers marks the first time junior troops will have such protection, company officials said.  Full Story

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Hearing loss is silent epidemic in U.S. troops

March 2008

Soldiers coming home with permanent hearing damage and ringing in ears. Large numbers of soldiers and Marines caught in roadside bombings and firefights in Iraq and Afghanistan are coming home with permanent hearing loss and ringing in their ears, prompting the military to redouble its efforts to protect the troops from noise. Hearing damage is the No. 1 disability in the war on terror, according to the Department of Veterans Affairs, and some experts say the true toll could take decades to become clear. Nearly 70,000 of the more than 1.3 million troops who have served in the two war zones are collecting disability for tinnitus, a potentially debilitating ringing in the ears, and more than 58,000 are on disability for hearing loss, the VA said.  Full Story

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Hearing Pill to Undergo More Clinical Trials

March 2008

In the not-too-distant future, medication may reverse the effects of hearing loss from acoustic trauma, according to Ben J. Balough, a Navy captain and otolaryngologist at the Naval Medical Center San Diego. Balough is leading research on a “hearing pill”-a special formulation of N-acetylcysteine (NAC) on which the Navy conducted a double-blind, placebo-controlled clinical trial in 2004 (“A Magic Pill?”, The ASHA Leader, June 14, 2005). The clinical trial found that when compared to the placebo, NAC reduced permanent hearing loss in the ear closest to the source of acoustic trauma. NAC has also shown potential in reversing other symptoms of acoustic trauma, such as tinnitus and balance disorders. The U.S. Department of Defense is providing $2.5 million for more clinical trials, according to Balough, who was involved in the earlier study. The trials will include higher dosing of NAC in search of a more beneficial effect, he said. The Navy also is seeking to package the supplement in an actual pill form instead of previous formulation of an effervescent tablet mixed with water.   Full Story

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Military Examines Effects of Too Much Noise

March 2008

In September 2005, the Institute of Medicine (IOM) of the National Academies released Noise and Military Service: Implications for Hearing Loss and Tinnitus. Hearing loss and tinnitus are among the most common forms of disability among military veterans. The Department of Veterans Affairs (VA) reported that at the end of fiscal year 2003, disabilities of the auditory system, including tinnitus and hearing loss, were the third most common type of disability among compensated veterans. At the end of 2004, the monthly compensation payments to veterans with hearing loss as their major form of disability represented an annualized cost of some $660 million. The corresponding compensation payments to veterans with tinnitus as their major disability were close to $190 million on an annualized basis. However, determining whether a veteran’s hearing loss or tinnitus is attributable to prior military service can pose a challenge for the VA if documentation of hearing thresholds or tinnitus during military service is not available. After the fact, hearing loss or tinnitus incurred during military service is difficult to distinguish from the effects of subsequent work in a noisy industry or participation in noisy recreational activities, such as hunting. Furthermore, high-frequency hearing losses, which are typical of noise exposure, are also seen at older ages, although the patterns of age- and noise-related hearing loss are generally indistinguishable until 60 to 70 years of age. Tinnitus, too, may develop in response to factors other than noise exposure (e.g., head injury, middle ear diseases, exposure to certain medications).  Full Story

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The Blast in the Ears: Good Hearing Among War’s Casualties

June 2008

No matter which side of the political spectrum you sit on, the undeniable fact is that war is very bad for the soldiers’ hearing. Research carried out by the U.S Army Center for Health Promotion and Preventive Medicine shows that troops in combat zones are over 50 times more likely to suffer noise-induced hearing loss (NIHL) than soldiers who don’t deploy. Do you think your vacuum cleaner is loud? Consider this: a typical vacuum cleaner emits, according to the Noise Pollution Clearinghouse, an anti-noise organization, between 84 and 85 decibels. An M-16 rifle, on the other hand, registers at 157 decibels, and other weapons can be even louder. The explosion of roadside bombs, for example, is so powerful, it can rupture the eardrum and break bones inside the ear. Sadly, the full extent of the hearing damage to the troops may not be known for years. What is evident right now from the figures released by the Department of Veterans Affairs (DVA), is that of the 1.3 million U.S. soldiers who served in Iraq since the war started in 2003, nearly 70,000 are currently collecting disability for tinnitus, and more than 58,000 are on disability for hearing loss, making hearing damage the number one disability produced by this war.  Full Story

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Hearing Loss can be Fatal for Soldier

August 2008

The bombs along the Baghdad road exploded one after the other, leaving one soldier unconscious and another screaming from his wounds. Staff Sgt. Kevin Dunne’s squad was under attack. Rifle and machine gun fire pinned them down. Then shots from a sniper. Dunne yelled orders, but he and his squad were at a disadvantage. Dunne says he couldn’t hear well enough to tell where the sniper fire was coming from. “I had no idea,” he wrote in an e-mail to USA TODAY. In the four months before the April 7 attack, the chief physician at Fort Hood, Texas, had warned that Dunne’s hearing was so bad that he should be removed from combat duties. Others in the Army overruled him and sent Dunne back to Iraq for his third combat tour. Now, a member of Dunne’s squad – Sgt. Richard Vaughn, 22, of San Diego – lay dead from a sniper’s bullet. “He was lying in the middle of the street motionless,” Dunne wrote. “I blame myself a lot for not being able to identify the threat simply because of the way I heard the shots.”  Full Story

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Deafness is the new scourge of British troops in Afghanistan

October 2008

Hundreds of soldiers are returning from Afghanistan suffering from severe and permanent damage to their hearing because of the overwhelming noise of intense combat. Nearly one in ten soldiers serving with one regiment have hearing defects that could bar them from further frontline service and affect their civilian job prospects, The Times has learnt. The number of hearing injuries is one of the untold stories of Britain’s military campaigns, evoking comparisons with the thunder of battle in the two world wars and the Korean War. Many of the soldiers involved in the most violent clashes with Shia militias in Iraq in 2004 and 2005 also returned with permanent hearing impairment. But in Afghanistan roadside bombs, ferocious close-combat clashes with the Taleban and 500lb bombs dropped by coalition aircraft have burst eardrums, caused tinnitus and, in some cases, resulted in total deafness.   Full Story

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Military Equipment Noise is Accelerating Hearing Loss

November 2008

In September 2007, a U.S. Navy officer working with the Marines’ executive safety board issued a simple, stark warning. According to a presentation by Cdr. Stan Jossell, the Marines — and to some extent the services in general — are buying new equipment that is so loud that it’s not a matter of whether but when and how badly operators will suffer permanent hearing damage. Jossell noted, moreover, that the technology to protect users from damage does not yet exist. Jossell, who declined to be interviewed for this article, singled out the F-35 Joint Strike Fighter and the Expeditionary Fighting Vehicle (EFV) as particular problems. Noise levels for these systems “will result in permanent hearing loss,” he wrote. “We are not protecting our people . . . [Program Executive Office] Tacair has accepted the ‘serious risk’ for the F/A-18E/F and EA-18G engine noise. Yet we are actually accepting the probability of permanent injury, not the risk of the occurrence.”  Full Story

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Army makes deployment hearing test mandatory

January 2008

Bomb blasts, howling engines, growling generators and the deafening roar of military aircraft have made the war zones noisy enough to damage soldiers’ hearing. An estimated 25 percent of redeploying soldiers have reported experiencing some change in their hearing, or dizziness or ringing of the ears, according to Army audiologists whose data was gathered from hearing tests done at units and installations after deployments. The hearing tests are now mandatory in an effort to collect the data from all soldiers and make sure they are fit for duty and get follow-up care if needed. They must take the test as soon as practicable upon redeployment, or as part of their post-deployment health assessment. Active-duty soldiers are required to have the test no later than six months after redeployment. For National Guard and Reserve soldiers, the test must take place before they go off active duty.  Full Story

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Is the Army FINALLY Doing Something About Soldiers’ Hearing Loss?

February 2009

Staff Sgt. Chris Mountjoy couldn’t hear for three days after the mortar round screamed into his camp and exploded 15 feet away from him. The open door of a Humvee saved him from the shrapnel, but a shock wave blew him 30 feet into a wall, perforating his ear drums. His hearing came back, but only partially. Now, more than two years later, the 27-year-old who loved being in the infantry spends his days behind a desk at Fort Carson’s 10th Combat Support Hospital, where he was reassigned because of his hearing loss and a traumatic brain injury from the blast. Hearing aids help him, but they’re not perfect. He seldom lets his two young children play in a different room because he cannot hear if something were to happen. He avoids loud restaurants, where background noise blots out dinner conversation with his wife. Mountjoy isn’t alone in his quiet world. A cacophony of roadside bombs, machine guns and heavy equipment is wreaking havoc on the hearing of soldiers serving in Iraq and Afghanistan. An Army questionnaire of soldiers returning from Iraq found that as many as one in four returned from Iraq with some level of hearing damage.  Full Story

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Army works to repair, prevent hearing loss

February 2009

Staff Sgt. Chris Mountjoy couldn’t hear for three days after the mortar round screamed into his camp and exploded 15 feet from him. The open door of a Humvee saved him from the shrapnel, but a shock wave blew him 30 feet into a wall, perforating his ear drums. His hearing came back, but only partially. Now, more than two years later, the 27-year-old who loved being in the infantry spends his days behind a desk at the 10th Combat Support Hospital in Fort Carson, Colo., where he was reassigned because of his hearing loss and a traumatic brain injury from the blast. Hearing aids help him, but they’re not perfect. He seldom lets his two young children play in a different room because he cannot hear if something were to happen.   Full Story

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Audit: Super Hornet a noise risk for sailors

March 2009

Navy officials who helped design and purchase F/A-18E/F Super Hornets in the 1990s failed to initially consider ways to reduce the fighter jet’s deafening noise level, putting today’s flight-deck sailors at risk for hearing damage, according to a Naval Audit Service report. Even when flight deck crews wear earplugs and cranials, Super Hornets are dangerously loud. Noise levels are near 150 decibels, a sound blast far beyond the hazard level of 84 decibels for civilian jobs, the audit service found. Navy officials who developed the Boeing-made jet and the similar EA-18G Growler “made no initial attempt to mitigate the flight-line/deck jet noise hazard through design selection,” according to the report. “We also found that there was no mention of noise limitations in the F/A-18E/F and EA-18G acquisition strategy and contract Statement of Work.”  Full Story

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Army says new earplugs will save your hearing

September 2009

A next-generation earplug designed to make it easier for troops to protect their eardrums will soon hit the war zone. The challenge for leaders is getting every soldier to wear the plugs. The new Combat Arms Earplug is made of the same washable plastic as the current earplug and has the same “triple flange” construction to keep it in place. But instead of removing the plug to operate a dial that regulates the amount of sound entering the ear canal, the new earplug uses a rocker switch that is operated without removing the earplug. Soldiers can adjust the rocker with a quick “click” depending on the amount of protection they need. When it’s in the open or “weapons fire” position, sound can travel through the sound channel filter into the ear. For noisy environments that don’t require an acute listening capability, such as around helicopters, troop carriers or generators, the rocker can be switched to the closed or “constant protection” position. Hearing protection has been standard issue for combat forces since 2002, but even so, one in four soldiers returning home report hearing loss, dizziness or ringing in the ears, according to Army audiologists.  Full Story

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Two-thirds of Afghan war veterans are suffering from hearing damage

December 2009

More than two-thirds of British troops returning from Afghanistan are suffering severe and permanent hearing damage, according to the most comprehensive study into one of the less well-known side-effects of the conflict in Helmand. Internal defence documents reveal that of 1,250 Royal Marine commandos who served in Afghanistan, 69% suffered hearing damage due to the intense noise of combat. The findings indicate that complaints such as tinnitus or almost complete deafness among combat troops are considerably greater than previously reported. One audiologist said the report revealed that hearing loss was endemic among Afghan veterans, with many suffering defects that could bar them from frontline service.  Full Story

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Hearing Loss No. 1 Diagnosis for U.S. Soldiers in Afghanistan

January 2010

When gearing up for a mission in Afghanistan, a service member wouldn’t dream of forgetting their helmet, gloves, weapon, eye protection or body armor. But what about hearing protection? According to Air Force Staff Sgt. Lee Adams, an ear, nose and throat (ENT) technician at Bagram Air Field, more than 50 percent of the patients seen in the ENT walk-in clinics are there for hearing-related issues.  The first question I ask a patient who comes in with a hearing complaint is, ‘Were you wearing hearing protection?’ says Air Force Col. Joseph A. Brennan, the ENT doctor at Bagram. Since I arrived here in May, I have not had one service member answer yes to that question. Deployed service members are exposed to many dangers while in combat zones. According to Brennan, many troops do not use hearing protection while out on missions because they feel that the hearing protection negatively affects their ability to do their job and complete their missions.  Full Story

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Military, VA audiologists are confronting a wave of IED-related hearing damage

January 2011

As long as American soldiers are sent off to fight on noisy battlefields, many are bound to come home with hearing-related injuries. The continuing conflicts in Iraq and Afghanistan are no exception. However, the ear-related disorders that military audiologists are diagnosing this time around are markedly different from the problems common among soldiers who fought wars in previous decades. Widespread exposure to improvised explosive devices, or IEDs, has resulted in much greater numbers of traumatic brain injuries, or TBI, that manifest as more complex acoustic trauma such as central auditory processing disorders (CAPD), as well as many more complaints of tinnitus and non-hearing-related complications. That’s different from the experience of those who fought in the first Persian Gulf War, Vietnam, and other conflicts of the 20th century. In those theaters of war, soldiers were also exposed to hazardous noise, but the source was typically small-arms fire and the hearing injuries were more commonly found in the ear instead of the brain, according to military audiologists.  Full Story

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The Military Paradox

August 2011

The sense of hearing is important for communication. In the military, hearing is crucial for the instruction, teamwork, and reporting that are necessary for mission accomplishment. Hearing is also a critical defense for the war fighter, warning against threat and danger and promoting self-preservation. The military paradox lies between the ongoing need for enhanced, clear communication, and the need to protect the auditory system from the engines and mechanization of war. Hearing loss is truly a silent disability. It often has no visible external manifestation of injury and has low priority for care in the trauma setting. However, hearing loss and auditory system injury often confounds other injuries and can present as an immediate barrier to communication and understanding, which is especially dangerous in life-and-death war situations.   Full Story

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