Noise-Induced Hearing Injury and Comorbidities Among Postdeployment U.S. Army Soldiers: April 2003–June 2009 Purpose To evaluate noise-induced hearing injury (NIHI) and blast-related comorbidities among U.S. Army soldiers in an effort to understand the morbidity burden and future health service requirements for wounded war fighters returning from the Central Command Area of Responsibility, predominantly from Iraq and Afghanistan deployments. Method Inpatient and ... Research Article
Research Article  |   June 01, 2011
Noise-Induced Hearing Injury and Comorbidities Among Postdeployment U.S. Army Soldiers: April 2003–June 2009
 
Author Affiliations & Notes
  • Thomas M. Helfer
    U.S. Army Public Health Command (Provisional) Institute of Public Health, Gunpowder, MD
  • Nikki N. Jordan
    U.S. Army Public Health Command (Provisional) Institute of Public Health, Gunpowder, MD
  • Robyn B. Lee
    U.S. Army Public Health Command (Provisional) Institute of Public Health, Gunpowder, MD
  • Paul Pietrusiak
    U.S. Army Public Health Command (Provisional) Institute of Public Health, Gunpowder, MD
  • Kara Cave
    Blanchfield Army Community Hospital, Fort Campbell, KY
  • Kim Schairer
    University of Wisconsin—Madison
  • Correspondence to Thomas M. Helfer: thomas.helfer@us.army.mil
  • Editor: Sheila Pratt
    Editor: Sheila Pratt×
  • Associate Editor: Gabrielle Saunders
    Associate Editor: Gabrielle Saunders×
Article Information
Hearing Disorders / Regulatory, Legislative & Advocacy / Attention, Memory & Executive Functions / Traumatic Brain Injury / Research Articles
Research Article   |   June 01, 2011
Noise-Induced Hearing Injury and Comorbidities Among Postdeployment U.S. Army Soldiers: April 2003–June 2009
American Journal of Audiology, June 2011, Vol. 20, 33-41. doi:10.1044/1059-0889(2011/10-0033)
History: Received August 13, 2010 , Accepted March 2, 2011
 
American Journal of Audiology, June 2011, Vol. 20, 33-41. doi:10.1044/1059-0889(2011/10-0033)
History: Received August 13, 2010; Accepted March 2, 2011
Web of Science® Times Cited: 19

Purpose To evaluate noise-induced hearing injury (NIHI) and blast-related comorbidities among U.S. Army soldiers in an effort to understand the morbidity burden and future health service requirements for wounded war fighters returning from the Central Command Area of Responsibility, predominantly from Iraq and Afghanistan deployments.

Method Inpatient and outpatient records with diagnosed NIHI or blast-related comorbidities (e.g., significant threshold shift [STS], noise-induced hearing loss, tinnitus, sensorineural hearing loss, eardrum perforations, mild traumatic brain injury, and posttraumatic stress disorder) were extracted for active duty soldiers returning from combat deployments. Records were limited to those within 6 months of the soldier’s return date from April 2003 through June 2009. To account for changes in STS coding practice, STS rates observed after October 1, 2006, were used to extrapolate prior probable postdeployment STS.

Results Statistically significant increases were observed for tinnitus, dizziness, eardrum perforations, and speech-language disorders. The combination of observed and extrapolated STS yielded a conservative estimate of 27,427 cases.

Conclusions Estimates can be used to forecast resource requirements for hearing services among veterans. This article could serve as a guide for resourcing and innovating prevention measures and treatment in this population. Data provided may also serve as a baseline for evaluating prevention measures.

Acknowledgments
The opinions or assertions contained herein are the views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army, the Department of Defense, the U.S. Government, or any of the institutional affiliations listed. We offer special acknowledgements to additional Army audiologist soldier medics for their recent selfless service in the Central Command Area of Responsibility including LTC Allan White, Medical Operations Officer, Kansas National Guard Reserve; CPT Jillyen Curry-Mathis; CPT Leanne Cleveland; LTC Marjorie Grantham; CPT Mike Murphy; and our coauthor CPT Kara Cave. We acknowledge Kyle Dennis of the VA and Bob Fifer of the University of Miami (FL) Medical School. These audiologists for the past few years have shared their extensive knowledge of audiology ICD-9-CM and Current Procedural Terminology coding. We acknowledge CDR Michael Hoffer of the Naval Medical Center, San Diego, CA, for providing dizziness or imbalance codes for the NIHI TBI ICD-9-CM watch list. We acknowledge Celia Hooper, ASHA past Vice President for Professional Practices in Speech-Language Pathology, and the ASHA National Office Speech-Language Pathology staff for providing ICD-9-CM speech and language pathology codes of interest. We acknowledge Paula Myers, Micaela Cornis-Pop, and Lisa Brenner of the VA as well as Lisa Newman of Walter Reed Army Medical Center for their review and comments on the NIHI and comorbidity ICD-9-CM watch lists. We also wish to acknowledge Deanna Harkins of the U.S. Army Public Health Command (Provisional) for reviewing the manuscript.
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