Preserving the Hearing Health of Military Service Members

Dr. Adams agreed that convincing service members to wear protective devices can be a challenge, even after ensuring a good fit. Echoing Dr. Erbele, he noted that concerns over situational awareness are one of the most common reasons for pushback. “But I’ve also found that a bit of education on that score goes a long way,” he said. “I try to make them understand the implications of losing hearing from even one occupational noise exposure, not only in terms of their own quality of life but also their ability to support their unit effectively, not to mention remaining deployable. Plus, there can be administrative punishments for not wearing protective devices. That messaging really resonates.”

John Marinelli, MD, a neurotology fellow at Mayo Clinic in Rochester, Minn., also has found that education can help improve compliance with hearing protection devices. But he cautioned that it doesn’t always work. “I have plenty of friends who are in the infantry, and they tell me there’s a real incentive to take their hearing protection out when they’re in the middle of a firefight because you must hear the people around you to stay safe and effective in battle. So, in some cases, they are going to risk hearing loss to make sure they and their fellow soldiers stay alive.”

That’s why the new improvements in hearing protective devices are so encouraging, noted Dr. Marinelli, who spent five years as a neurotology resident in the San Antonio Military Medical Center, managing hearing-related conditions in active-duty service members and veterans.

An Early Warning System

Screening is another important tool, if not for preventing hearing loss, at least for intervening as early as possible. Dr. Erbele cited an innovative technology known as boothless audiometry, where personnel can be fitted with specialized headphones to gain an accurate reading of their hearing thresholds. To date, the technology has been used in two successful pilots, with another pilot in progress, according to a VA Diffusion Marketplace report (bit.ly/4g2bCOt).

Samuel A. Spear, MD, who spent three years as the chief of the DOD’s Hearing Center of Excellence when work in boothless audiometry was done, lauded the technology. “It’s important to be able to get screening done in a way that fits in with the realities of military life,” said Dr. Spear, who is now in private practice at ENT and Allergy Associates of Florida. “Boothless technology allows us to detect hearing loss much earlier than would otherwise be feasible and get noise-exposed service members to treatment quicker, whether it be steroids or hearing aids or other interventions.”