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Strategies for hearing loss prevention help service members stay ready

Image of An infographic with the words "World Hearing Day" at the top, images of people using their hears to listen, and "educate, protect, monitor" at the bottom. Click to open a larger version of the image. The Defense Health Agency is one of many healthcare entities celebrating World Hearing Day on March 3. (Courtesy of the Defense Health Agency’s Hearing Center of Excellence)

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Nearly 466 million people worldwide are estimated to be living with hearing loss, according to the World Health Organization. The WHO also predicts this number to climb to 900 million by 2050.

To raise awareness about global hearing loss and the importance of hearing health care, the WHO has designated March 3 as World Hearing Day.

"Hearing loss is a complex condition and has a variety of causes - exposure to hazardous noise, genetic conditions, or complication of other diseases such as measles and mumps," said Dr. Theresa Schulz, prevention division chief for the Department of Defense Hearing Center of Excellence, a division within the Defense Health Agency's Research and Development Directorate.

Noise-induced hearing loss from hazardous noise is the most common cause of hearing injury for veterans, as reported in the annual Department of Veterans Affairs' Veterans Benefits Administration compensation report.  In 2019, there were 2.17 million disability compensation recipients for tinnitus (ringing, buzzing and other sounds in the ears or head) and 1.3 million compensation recipients for hearing loss. However, overall hearing health for active-duty service members is steadily improving, according to a recently released DOD report, "Hearing Health Surveillance Data Review, Military Hearing Conservation - Calendar Year 2019," which shows hearing impaired service members fell from 18% in 2013 to 14% in 2019.

Schulz explained that the current decrease in hearing loss is the result of several ongoing DOD initiatives, along with substantial hearing conservation programs managed by each service component.

"Several initiatives have been underway for a number of years to combat hearing loss and improve hearing health care for service members and veterans," said Schulz."

One of these initiatives is a joint service and center project to develop a Hearing Protection Device Evaluated Products List of protective devices that are tested using the latest standards set by the American National Standards Institute. The list was developed to help solve the dual but competing needs of delivering hearing protection while also maintaining a service member's situational awareness.

"This resource can help service members and their supervisors select products that meet their hearing protection and operational needs," Schulz explained.

According to Schulz, the use of individual fit-check systems is also being advanced as a more precise way to verify the level of protection a device is giving to an individual, and ensure service members properly wear and use their issued hearing protection. "Proper fit is especially important as weapon systems become increasingly more powerful and hazardous," added Schulz.

Military personnel installing weapons on an aircraft
Navy Petty Officer 3rd Class Adam Vasquez wears hearing protection while installing an AGM-84D Harpoon missile on a P-8A Poseidon aircraft at Naval Air Station Sigonella, Italy, Jan. 23, 2021. (Photo by: Navy Petty Officer 2nd Class Austin Ingram)

Another initiative combatting hearing loss is the Comprehensive Hearing Health Program (CHHP), which involves three major components to reduce hearing loss: educate, protect, and monitor. The center and the services are deploying the multi-faceted program across the DOD to increase awareness about hearing loss prevention strategies and to influence healthy hearing behaviors in service members and their families, according to Schulz. Local implementation at audiology clinics includes providers' use of CHHP information materials to deliver standardized hearing health education, and hearing protection fittings during clinical and hearing conservation patient visits.

In 2019, the center received funding under the Joint Incentive Fund (JIF) to develop a DOD and Department of Veterans Affairs Hearing Technician Training and Certification Program, as a pilot effort to implement a hybrid/virtual training platform with the goal to standardize and ensure best practice care delivery across the continuum of service member to veteran status.

The program also ensures hearing technicians are trained to the nationally recognized standard of the Council for Accreditation in Occupational Hearing Conservation (CAOHC). According to Schulz, the CAOHC recently approved the program, enabling it to continue as a model to train more than 5,000 hearing technicians across the DOD and VA. To date, 184 hearing health technicians have obtained training and certification through the pilot program.

"With more hearing technicians certified virtually, I believe this has created extra time for DOD and VA audiologists to focus on more complex audiology cases, which in turn is increasing access to care," said Schulz.

A new JIF initiative, set to launch in March 2021, involves an interventional audiology effort called the VA-DoD Boothless Audiometry Hearing Health Project. During the project, audiologists will integrate boothless hearing test equipment into three Air Force primary care clinics and two VA health care facilities that have tele-audiology capabilities.

Schulz explained the project focuses on key VA-DOD priorities, which are to increase access to care for service members and veterans, develop more capacity to match supply and demand, deliver quality care, and ensure patient safety through infection control by using low-touch/no touch audiology services.

"World Hearing Day makes us all take a pause to realize how fragile and important hearing health is in our daily lives, and I believe through these innovative programs, we're making strides to improve overall hearing health and care for our service members and veterans," said Schulz.

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