Aural Blast Injury/Acoustic Trauma and Hearing Loss

TLDR

Hearing is essential for military performance, yet hazardous noise exposure—common in training, combat, and off‑duty activities—causes cumulative, often invisible damage, with acoustic trauma and tinnitus affecting over 765,000 Gulf War veterans. The guideline seeks to promote early identification and intervention for hearing loss through a trusted surveillance system to protect Service Members' hearing health and readiness. Implementation requires advocacy, education, and encouraging self‑reporting of symptomatic noise exposures for evaluation. Early identification and intervention are expected to optimize troop performance and reduce injury risk and mishaps.

Abstract

Hearing is a critical sense to military performance. The ability to detect, identify, and localize sounds, the ability to maintain spatial awareness on the battlefield and the awareness to control one's own noise production can be vital to troop's stealth, survivability, and lethality. Hazardous noise is an environmental public health threat encountered in training at war, and in many off-duty activities. The risk to hearing and the resultant damage from any of these hazardous exposures is generally invisible, insidious and cumulative. Regardless of the source of injury, hearing loss degrades the sensor that integrates Service Members with their environment, provides for unity of effort, and ensures command and control.Acoustic trauma-induced hear loss and tinnitus are the two most prevalent disabilities in veterans, with over 765,000 cases in the Gulf War era alone. To counter this threat, it is necessary to push for early identification and early intervention through a trusted surveillance system. Success will require advocacy, education, and encouragement of self-reporting for evaluation following symptomatic noise exposures. This Clinical Practice Guideline (CPG) is a step to ensure the hearing health, readiness, protection, and care of Service Members. This will in turn optimize troop performance and minimize injury risk and mishap.