An Analysis of GWOT Auditory Blast Exposures
COL David Chandler and 1LT Kara Delaney
Blast exposure can have both immediate and long-term auditory consequences. Over 250 blast-exposed patients from the Global War on Terrorism have been seen at the Army Audiology and Speech Center. Audiometric results of these patients were analyzed, and the occurrence of hearing loss, tinnitus, otalgia, dizziness, and tympanic membrane perforation will be discussed. The incidence of hearing loss in those with traumatic injuries (i.e. amputations and traumatic brain injury) as compared to those without will also be discussed. Pre-deployment and post-deployment audiograms will be compared to study the changes in hearing. Age correction factors will be applied to the baseline audiograms to examine changes in hearing for which age cannot account.
Preventive Medicine Staff Officer Experiences: Task Force Katrina
MAJ Eric Fallon
The future of the 72C AOC is dependent upon our ability to further integrate into the preventive medicine community. Taskings and assignments not historically given to the 72C are becoming more commonplace. Having served as a PM Detachment Commander and as a PM staff officer for Joint Task Force-Katrina, thoughts regarding the 72C’s ability to successfully compete for and complete these assignments, methods to better prepare one’s self, as well as PM Staff scenarios will be discussed and presented.
A Response from Fort Jackson
LTC Mark Stevens
Dealing with new recruits (or nearly new) who have been assessed into the military with pre-existing hearing impairment (H-2 and H-3) has long been a problematic issue. This presentation will discuss the many variables surrounding this challenge and offer a series of recommendations to potentially resolve the difficulties generated by this problem. Discussion will include interfacing with local Chain of Command and medical waiver authority, NGB, USAR, and MEPS.
What We Are Doing Differently: Fort Lewis
CPT Dan Ohama
Efforts are being focused on greatest-quality services for Brigade Combat Team (BCT), Combat Support (CS) and Combat Service Support (CSS) units (primary combat force/heavy-noise exposed). Currently, an equivalent of 30 battalion-sized units is provided with maximum support and easy-access to our services and training courses. They are kept informed of our capabilities and what we can do for their Soldiers (to include training for their medical assets) to help them best plan, prepare and accomplish their mission. Simple information packets that provide basic outline of available services (service capabilities) and a sample SOP are distributed to BCT and specific CS/CSS unit commanders, CSMs and 1SGs. The objective is to improve understanding/awareness of the hearing conservation program, improve access to our services, and improve command emphasis. We will ask 1st Corps Surgeon to support this effort among 1st Corps unit commanders.
Navy
Presentations from the Navy included the following:
Earplug Controversies: De-Rating Alternatives and Other Issues
LCDR Tony Joseph
In the real world of hearing protector use, military audiologists are faced with the challenge of establishing an engaging inventory of devices that conform to the needs of the end user. Government employees would be well served if their noise exposure level, attenuation level, and exposure duration were consistently documented, which would permit estimation of an under-the-protector exposure level. By producing this estimate, audiologists could decide if the protective product in use was suitable, or if over-protection or under-protection was indicated.
Although instruments capable of producing reliable estimates of hearing protector attenuation exist, generally hearing conservationists do not physically verify the level of attenuation achieved by their users, in the clinic or the field. Instead, occupational audiologists have opted to derate the level of attenuation reported as best fit on the product label, while some do not address the issue of attenuation at all, perhaps because they do not have the time to obtain measurements or make calculations. This discussion will advocate that, in addition to furnishing audiograms and hearing protection devices, attenuation measurements, ear canal size measurements, and appropriate motivational hearing protection education should be administered. At a minimum, a conditional derating of the manufacturer’s noise reduction rating should be conducted.
Air Force
Presentations from Air Force members include the following:
In-Services “On the Fly”
LtCol Angela Williamson
Three in-service presentations were developed to support efforts of audiologists to educate fellow staff, parents or teachers with an interest in specific aspects of Audiology.
This presentation will discuss the topics of the in-services, mode of presentation, and ability of the end-user to update as needed. The topics include:
1. Introduction to Audiology: review of basic audiometric symbols, tests and audiogram interpretation, test methods for various age groups are reviewed.
2. Physiologic Measures in Audiology: explanation of auditory evoked potentials, OAE and immittance measures.
3. Assistive Technology in Audiology: review of state of the art hearing aids, assistive devices and cochlear implants.
Broadband ANR Control Strategies to Improve A-Weighted Reduction
John Allan Hall
Traditional Active Noise Reduction (ANR) technologies have been limited to active control of frequencies below 750 Hz. These strategies are ideal for tracked vehicle, rotary wing and/or fixed wing turbo-prop noise environments. But these legacy technologies may short of sufficient A-weighted reduction in many high level broad spectral noise situations typical in fast attack jets. Recent USAF sponsored R&D, however has made broadband ANR in the ear canal a reality. Broadband ANR offers significant benefit in targeting overall dBA reduction for environments with significant acoustic energy above 1000 Hz.
BAHA: Subjective and Objective Performance
1Lt Gretchen Haywood
Wilford Hall Medical Center (WHMC) is the primary Air Force location for BAHA (Bone Anchored Hearing Aid) surgery and fittings. The BAHA is an alternative to traditional hearing aids for individuals with single sided deafness, conductive and mixed hearing losses. Questionnaires created by BAHA as well as WHMC will provide information pertaining to subjective evaluation of performance of BAHA vs. traditional hearing aids, objective data of BAHA benefit, ease of use, and reasons for use of BAHA. The presentation will include questionnaire information provided by future present BAHA patients as well as behavioral audiometric results obtained by those wiling to come in for additional testing.
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