The long war is a loud war, too

Prolonged noise in Iraq harmful to troops’ hearing
by Bruce Taylor Seeman

Thousands of U.S. soldiers sent to Iraq have suffered serious hearing damage from bombs, rocket explosions and other combat noise, a new Army study suggests.

Many of these injuries might have been prevented. But earplugs have been in short supply. And the Army has not told soldiers enough about the noise risks of battle or monitored them adequately for hearing damage, according to the report published today in the American Journal of Audiology.

Meanwhile, the Army operates with a reduced force of audiologists — half the estimated 70 hearing specialists it employed in the 1990s — and currently has only one deployed to Iraq at any given time, said Thomas Helfer, the retired Army reservist and hearing specialist who led the study.

The issue has important consequences for communications and self-protection.

“Our soldiers on patrol can hear a weapon that is being cocked from 1,000 meters if their hearing is intact, but only from 46 meters if there is significantly degraded hearing due to unprotected exposure to noise,” Helfer wrote in an e-mail interview…

The Army study follows an Institute of Medicine report that last fall delivered a harsh assessment of military efforts to protect service members’ hearing since World War II.

Auditory problems are the third most common veterans’ disability, the IOM report said. It said veterans whose primary impairment is hearing loss or tinnitus — ringing in the ears — receive about $850 million in compensation each year from the Department of Veterans Affairs.

The IOM, federally chartered to conduct research requested by Congress, noted that service members are often exposed to prolonged loud noises — from guns, rockets and other weapons, plus heavy-duty vehicles, planes and ships. Yet between the early 1980s and 2002, the IOM found, only about 30 percent of Navy or Marine Corps personnel were given hearing tests at the beginning and end of service. For the Army and Air Force, the rate was around 12 percent.

The new Army study examined the cases of 806 U.S. soldiers diagnosed with “post deployment noise-induced hearing loss” at audiology clinics worldwide between April 2003 and March 2004. By comparing the hearing of those who had served in Iraq with the hearing of those who had not, researchers concluded that soldiers sent to battle zones were 52.5 times more likely to suffer auditory damage.

“These are not just mild hearing losses that you and I might have from listening to music, or from aging,” said Brenda Lonsbury-Martin, director of science and research for the American Speech-Language-Hearing Association. “These are pretty severe hearing losses that will impact your life.”

Six percent of the soldiers studied suffered “acoustic trauma,” often resulting from a single loud noise, like a bomb blast. Two percent had broken eardrums, which often heal but in the meantime leave soldiers vulnerable to inner ear infections in unsanitary battlefield environments.

In 16 percent of those studied, the report found, the hearing losses were likely to affect their performance in combat.

Helfer said a greater effort is under way to test the hearing of all new soldiers in basic combat training and those preparing for deployment. He said the Army in recent months has broadened its distribution of ear protection and increased training.

The Army’s study, however, almost certainly underestimates the rate of hearing injury, Helfer said, because it does not fully count injuries among Army Reserve and National Guard troops. Those soldiers typically seek treatment from civilian doctors or other providers outside the military medical system.

Moreover, Helfer said, “many soldiers with blast injuries had hearing loss as a secondary injury, with primary wounds that needed immediate surgical attention.” While primary wounds were treated, hearing injuries may not have been examined in military audiology clinics, he said.