How Audiologists and Researchers Are Shaping Military Hearing Health Practices

“The reliance entirely on changes in hearing thresholds is problematic, because there is mounting evidence that service members who regularly experience hearing changes after noise and blast exposure are developing increased hearing difficulties even when the audiogram remains in the normal range (Ear Hear. doi:10.1097/ AUD.0000000000001067; Hear Res. doi:10.1016/j.heares.2025.109183). In some cases, these problems are severe enough to warrant fitting patients who have normal hearing thresholds with a low-gain hearing aid (Healthcare. doi:10.3390/healthcare12050578),” Dr. Kulinski said. “More research is needed to fully understand the role that temporary threshold shifts play in producing hearing difficulties in normal hearing listeners and why some listeners seem to be more susceptible to these temporary hearing changes than others.”

Dr. Clavier explained that many service members, some with extensive training and experience, report difficulty with “understanding speech in background noise—a common task when conducting any military training activity—yet exhibit normal hearing thresholds. These individuals are often told that nothing is wrong because they meet the standards for normal hearing according to their audiogram, yet they experience impaired communication.”

The DoD has curtailed funding for hearing research, Dr. Clavier said, “In order to make a significant reduction in the prevalence and severity of hearing loss, the DoD will need to allocate substantial resources for research and implementation of new hearing conservation measures, including better testing, hearing protector fit-testing, and better monitoring and protection of individuals exposed to repeated low-level blasts.”

As service members transition to veteran status, delays in detection and treatment may occur.

Dr. Reavis said, “The focus of hearing health transitions from population-based prevention and surveillance during active duty to individualized treatment and rehabilitation for veterans, where services are typically driven by veterans’ reported symptoms rather than routine monitoring. During military service, most service members participate in hearing conservation programs that include regular audiometric surveillance. However, this monitoring typically ends at separation because it is part of occupational exposure surveillance that does not translate to general healthcare practices, potentially leading to delays in detection and treatment.”

“As veterans age, tinnitus, hearing loss, and communication difficulties often intersect with mental health conditions, sleep problems, and cognitive demands, amplifying their overall functional impact,” Dr. Reavis said. “This underscores the importance of a sustainable hearing health monitoring program within the VA, coordinated handoffs between military and VA systems, and integrated approaches that support the well-being of veterans post-service.”

Katie Robinson is a freelance medical writer based in New York.