Preserving the Hearing Health of Military Service Members

Prevention: a Good Place to Start

Although such research efforts are rewarding, Dr. Erbele’s primary focus remains on caring for the hearing health needs of military personnel. As with many clinical conditions, when it comes to hearing loss, prevention is key. For active military personnel, that means the use of hearing protection devices. But that’s not always easy. One of the most difficult places to use such devices is in the field, where service members often have mixed feelings about a device that may adversely affect their situational awareness, safety, and effectiveness during battle or other risky deployments, Dr. Erbele noted. The answer to meeting that challenge, he said, is twofold: education and improved technology.

The education component “comes down to convincing service members that if they don’t use hearing protection, they likely will suffer hearing loss that can hurt their ability to perform on the battlefield or even to continue in military service,” he said. Although baseline thresholds for hearing function vary based on the type of military activity, “our service members need to know that using these hearing protection devices correctly can ensure they continue to meet those performance thresholds.”

There have been some encouraging developments in hearing protection technology, Dr. Erbele noted. He cited, as an example, the 3M PELTOR system, which was designed for combat and combat support operations in conjunction with firearms and ballistic combat helmets. The system employs hearing protectors featuring external microphones that allow for environmental listening, so that “operators can maintain auditory situational awareness,” while safeguarding them from loud noises and other insults in the field, according to the manufacturer (3M. bit.ly/3HXrOUK).

Hearing protection fit testing is another important key to ensuring optimal use, Dr. Erbele stressed. Under a November 2023 mandate from the DOD, fit testing has to be done in all military personnel who have documented noise exposures greater than or equal to 95dBA and who are enrolled in a service hearing conservation program, according to Health.mil, the official website of the Military Health System (https://bit.ly/4oYDJ5g).

“It seems very obvious, but the better these hearing protection devices fit an individual service member, the more likely they are to use them,” Dr. Erbele said.

Jason Adams, MD, an otolaryngologist and researcher at Brooke Army Medical Center in San Antonio, Texas, applauded the DOD’s 2023 mandate for fit testing. “If you just have one day of exposure to occupational noise or some other insult, you have to get fit-tested,” said Dr. Adams, who is a major in the AirForce. “Of course, it’s up to the units to implement the new policy. But it’s a good one and should yield some improvements in terms of prevention, although I haven’t seen that data yet.”