Research & Development Policy and Guidance
Hearing injury and loss are increasingly prevalent issues that affect the lives of many. According to the United States Occupational Safety and Health Administration, approximately 30 million people each year in the United States are exposed to hazardous sound and noise levels within their occupations.
The following online resources provide government policies and directives, as well as service-specific guidelines, related to noise pollution, noise reduction, hearing protection, workplace health and safety, and other critical issues:
Congressional Laws and Federal Policies
The following are links to congressionally-mandated government laws as well as federal policies and reports related to occupational health, workplace safety, hearing ear protection use, hearing loss and conservation:
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Occupational Safety and Health Administration (OSHA)
For over 25 years, OSHA has listed noise-related hearing loss as one of the most prevalent occupational health concerns in the U.S. Thousands of workers every year suffer from preventable hearing loss due to dangerous workplace noise levels. Since 2004, the Bureau of Labor Statistics (BLS) has reported that nearly 125,000 workers have suffered significant, permanent hearing loss. In 2009 alone, BLS reported more than 21,000 hearing loss incidents. To learn more, visit OSHA’s Occupational Noise Exposure page.
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Public Law: National Defense Authorization Act (NDAA) for FY 2009
Congress included language in Public Law 110-417, the Duncan Hunter National Defense Authorization Act for FY 2009, which directs the establishment of a “center of excellence focused on the prevention, diagnosis, mitigation, treatment, and rehabilitation of hearing loss and auditory system injury” with a focus on collaboration with the Department of Veterans Affairs (VA). Section 721 defines the key capabilities that must be demonstrated for full operating capability:
- Develop a comprehensive plan and strategy for developing a registry.
- Ensure electronic exchange of registry information with the Secretary of Veterans Affairs.
- Enable the Secretary of Veterans Affairs to access the registry and add treatments, procedures and outcome information.
The full legislation is available through the Government Printing Office (GP0). To review, visit the GPO’s full text version [PDF 1.09 MB].
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Public Law: PL 111-383, Section 704: Wounded Warrior Provisions of NDAA FY 2011
As part of the Wounded Warrior Provisions of FY 2011 NDAA, the “Department of Defense Task Force on the Care, Management and Transition of Recovering Wounded, Ill and Injured Members of the Armed Forces” calls for a study to be conducted to determine the best tests available to identify tinnitus. It mandates that a plan be developed to ensure pre- and post-deployment aural screenings. The findings of the study and the plan will be submitted to the congressional defense committees. To read a complete summary of all of the information corresponding to these provisions, visit the GPO’s full text version [PDF 884 KB].
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National Institute for Occupational Safety and Health (NIOSH)
Occupational hearing loss is the most common work-related injury in the United States. According to NIOSH, an estimated $242 million is spent annually on workers’ compensation for hearing loss disability. NIOSH recommends removing hazardous noise from the workplace whenever possible and using hearing protection devices in situations where hazardous noise has yet to be controlled or eliminated. Learn more about these efforts on the NIOSH Noise and Loss Prevention Program web site.
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Medical Surveillance Monthly Report
In 2006, a multidisciplinary team that represented audiology, epidemiology and other injury-related specialties at what is now the U.S. Army Public Health Command collaborated with the Armed Forces Health Surveillance Center (AFHSC) to obtain medical encounter records of U.S. military members that included injury-specific ICD-9-CM diagnosis codes, including noise-induced hearing injury (NIHI) indicator codes. The data was used to estimate the prevalence of NIHI among U.S. military members. The results were reported to the Defense Safety Oversight Council and published in a peer-reviewed medical journal. The report summarizes medical encounters of U.S. service members that were documented with NIHI indicator ICD-9-CM diagnosis codes during calendar year 2007 through 2010.
GAO Reports and Responses
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U.S. Government Accountability Office (GAO) Report on Hearing Conservation
Hazardous noise can negatively impact both service member health and readiness. Tinnitus now accounts for the top service-connected disability. In FY 2009, hearing-related issues also accounted for some of the most common impairments reported by veterans receiving disability benefits from the Department of Veterans Affairs (VA). The corresponding costs exceeded $1.1 billion. The magnitude of the issue prompted GAO to examine Department of Defense (DoD) efforts to prevent hearing loss. GAO reviewed DoD and service-specific policies and guidance and DoD performance data, interviewed officials and service members, and conducted site visits to nine military bases. To review the report on hearing conservation, visit the GAO Web site.
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Committee Review of National Institute for Occupational Safety and Health (NIOSH) Research Programs
The Institute of Medicine convened a committee of experts to review the NIOSH Hearing Loss Research Program to evaluate the efficacy of its work in fostering improvements in occupational safety and health and the impact of its research on reducing workplace illnesses and injuries. The review also sought to explore the program’s identification and targeting of new research areas, identify emerging research issues and provide advice on ways the program might be strengthened. Based on the outcomes of the review, the committee recommended that the NIOSH Hearing Loss Research Program foster effective leadership in program planning and implementation; further implement program evaluation efforts; gain access to additional intramural and extramural expertise, especially in epidemiology and noise control engineering; and initiate and sustain efforts to obtain surveillance data for occupational hearing loss and workplace noise exposure. To view the full report (in PDF format) or order the book, visit the National Academies Press Web Site.
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Epidemiology of Hearing Impairment and Noise-Induced Hearing Injury (NIHI) Among U.S. Military Personnel
Prior to this report, NIHI rates among U.S. active duty military personnel had not been previously defined using available military medical surveillance data. This report summarizes NIHI rates among service members. To view the full article, visit the online version of the American Journal of Preventive Medicine.
Army
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This regulation establishes practical measures for the preservation and promotion of health and the prevention of disease and injury. This regulation applies to all elements of the U.S. Army across the full spectrum of military operations from peacetime through major theater warfare. This regulation applies to all Army personnel to include the Active Army; the Army National Guard/Army National Guard of the United States; U.S. Army Reserve personnel on active duty or in drill status; U.S. Military Academy cadets; U.S. Army Reserve Officer Training Corps cadets, when engaged in directed training activities; foreign national military personnel assigned to Army components; and civilian personnel and non-appropriated fund personnel employed by the Army worldwide.
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The pamphlet defines and establishes programs, services, functions and procedures for implementing the essential elements of Army Preventive Medicine; it is to be used with AR 40-5. This pamphlet applies to active Army, the Army National Guard of the United States, and the U.S. Army Reserve, unless otherwise stated.
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This pamphlet outlines the U.S. Army Hearing Conservation portion of the Army Hearing Program. This pamphlet applies to Active Army, the Army National Guard, the U.S. Army Reserve, and civilian personnel employed by the Army worldwide.
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This special text (ST) is designed to provide techniques and procedures that govern the prevention of noise-induced hearing loss (NIHL) in soldiers and to ensure their maximum combat effectiveness. As a result of hearing issues identified in Operation Iraqi Freedom (OIF), the Army Medical Command, Operation Order 07-10, Army Operational Hearing Program Field Manual (FM), directed that an ST be developed and implemented on operational hearing in order to mitigate the impact of traumatic acoustic injuries sustained by soldiers.
This ST will provide information to assist commanders in preventing NIHL. Current actions being staffed will, upon approval, incorporate these changes into relevant doctrine, technical guides, Army regulations (ARs), and Department of the Army pamphlets (DA Pams). This publication will assist commanders in the planning and execution of the prevention of soldier hearing loss.
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This publication provides information on medical fitness standards for induction, enlistment, appointment, retention and related policies and procedures. This regulation applies to the active Army, the Army National Guard of the United States, and the U.S. Army Reserve, unless otherwise stated. It also applies to candidates for military service. During mobilization, the proponent may modify chapters and policies contained in this regulation.
Navy and Marine Corps
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The purpose of this OPNAV Instruction is to affirm the Navy Safety and Occupational (SOH) Program for all Navy personnel and implement DoDI 6055.1 (“DoD SOH Program”).
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The purpose of this OPNAV Instruction is to implement the Navy SOH Program and the requirements of OPNAV Instruction 5100.23G for “afloat” commands. Chapter B4 is specific to the HCP and addresses: responsibilities; program elements; noise measurement and exposure assessment; noise abatement; personal hearing protective/protection devices; hearing testing and medical exams; training; and recordkeeping.
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The NMCPHC-TM 6260.51.99-2 provides guidance for the implementation of those portions of the Navy HCP for which the medical department is responsible as dictated by OPNAVINST 5100.23 (Series) and OPNAVINST 5100.19 (Series). This manual was created to further specify OPNAV Instruction HCP program and procedures to include: program elements; noise measurements and exposure analyses; audiometry; hearing protection devices; education; record keeping requirements; and program performance evaluation. In addition, this manual offers several samples that may be used or modified for field use.
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The purpose of this MCO is to establish and maintain an HCP for Marine Corps personnel and to amplify the MCO P5100.8F policy on the prevention of occupational illness. Specifically, this document delineates responsibilities of the commanders, commanding officers, officers-in-charge, supervisors, military and civilian personnel, and installation safety officers as they pertain to the HCP. Some of these responsibilities involve the use of noise surveys, the labeling of hazardous noise areas and equipment, noise abatement issues, determining and appropriately disseminating personal hearing protection, and administering testing, training and record keeping.
Air Force
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This Instruction provides directive to implement policy and update responsibilities and procedures for administering a DoD HCP to prevent occupational illness under DoD Directive 4715.1 titled, “Environmental Security.” This Instruction applies to the Office of the Secretary of Defense, the military departments (Army, Navy, Air Force and Marine Corps), the Chairman of the Joint Chiefs of Staff, the Combatant Commands, the DoD Office of the Inspector General, the Defense agencies, the DOD field activities, all other organizational entities in the DoD, and all DoD military and civilian personnel and operations worldwide.
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This standard implements policy and updates responsibilities and procedures for administering the Air Force HCP, which is one of the vital military safety programs, to prevent occupational illness and injuries under federal and DoD references. The Air Force HCP is a component of the Air Force Office of Safety and Health Program designed to protect workers from the harmful effects of hazardous noise. This requires identifying all areas where workers are exposed to hazardous noise and implementing noise reduction measures, reducing exposure, through engineering or administrative controls, personal protective equipment (PPE) or worker placement.
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Requirements for medical standards and medical exams ensure readiness, accession and retention of members who are medically acceptable for military duty. This document establishes procedures, requirements, recording and medical standards for medical examinations conducted by the Air Force. It prescribes procedures and references the authority for retiring, discharging or retaining members who, because of physical disability, are unfit to perform their duties. The instruction applies to all applicants for military service and scholarship programs. It also applies to Air Force Reserve Command (AFRC) units, Individual Mobilization Augmentee (IMA), Air Force Pre-trained Individual Manpower (PIM), and Air National Guard (ANG). It does not apply to Air Force civilian employees or applicants to the civilian workforce.
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This Instruction provides guidance for the organization and delivery of medical care. It implements various publications of DoD-recognized professional organizations, the Joint Commission, the Accreditation Association for Ambulatory Health Care (AAAHC) and appropriate health and safety agencies. It applies to all personnel assigned to, or working in, Air Force Medical Treatment Facilities (MTF), Air Reserve Component (ARC) medical and Aeromedical Evacuation units. This includes Reserve and Guard personnel during their active duty and unit training assembly periods as well as civilian and volunteer personnel and trainees.