Hear the Enemy, Stay Alive

Thursday, June 25, 2009 - MHS

For the first time ever, the Army has deployed audiologists to combat zones, placing them in Iraq and Afghanistan to educate and train troops on hearing protection, and to monitor and treat soldier hearing problems. The influx of hearing experts is part of the new Army Hearing Program (formerly known Army Hearing Conservation), which is being implemented to ensure adequate hearing services are provided to soldiers in all environments, including during pre-and post-deployment operations.

“[Hearing loss] is an invisible injury. You don’t see it, so it’s easily overlooked,” said Col. Kathy E. Gates, audiology consultant for the Army Surgeon General and director of the Army Audiology and Speech Center, at an overview of the Army Hearing Program presented May 21 to a group of military and veterans service organizations. “We are working to raise command awareness of how hearing is a critical sense for soldier survivability and lethality, [through a campaign called] ‘Hear the enemy, stay alive’.”

In 2004, Gates worked with the Office of the Army Surgeon General, Health Policy and Services, and the Proponency Office for Preventive Medicine to institute pre-deployment hearing services for deploying soldiers. In February 2009, policy was changed to include a post-deployment hearing test for all redeploying soldiers. The military’s overall hearing program leadership is now working to expand the role of an audiologist to include operational hearing services in deployed environments, including the battlefield.

Both military and civilian audiologists are supporting the mission. Currently, 30 Army audiologists work in preventive medicine and support AHP. Working with civilian audiologists, who support the direct health care mission and provide clinical or rehabilitative services to eligible beneficiaries, Army audiologists relay the message that “hearing health is critical” to about 324,000 deploying soldiers, who will be routinely exposed to hazardous noise in theater.

A post-deployment health assessment conducted by the Army between March of 2003 and September 2007 concluded that 75 percent of those deployed suffered exposure to extreme noise decibels, and 41 percent experienced vibration. Thirteen percent and 16 percent recorded instances of dizziness and ringing in the ears, respectively. These symptoms are often synonymous with traumatic brain injury, or TBI, and there has been a collaborative effort to merge health care procedures between the Army TBI Multi-Disciplinary Team and Army audiology specialists. A recent report from the VA estimated that nearly 70,000 of the 1.3 million soldiers who have served in Iraq and Afghanistan are collecting disability for tinnitus, a hearing loss symptom that manifests as a ringing sound in one or both ears. In addition to those suffering from tinnitus, more than 58,000 veterans are currently on disability for hearing loss, costing the VA nearly $805 million annually.

To help prevent hearing loss in the ranks, the Army and Marine Corps have distributed thousands of pairs of the Combat Arms Earplug (CAE), an innovative device designed to block hazardous noise, while still allowing nearly normal hearing. Unfortunately, audiologists and combat veterans say many troops who receive the earplugs either ignore or misuse them due to lack of instruction and training. Efforts are underway to ensure soldiers are provided education, training and fitting of the CAE at Initial Entry Training sites.

But even as troops are trained to use the CAE, the more technologically sophisticated QuietPro is currently being screened for standard use in theater. QuietPro is a digital, lightweight tactical communication headset with built-in, intelligent, high-level hearing protection. The headset provides effective noise reduction of loud blasts while still allowing situational awareness for infantry by letting less harmful combat sounds to come through. The military hopes that the QuietPro device will allow troops more efficient communication during hearing-sensitive tasks like patrol on listening posts, urban warfare, and battlefield commands.

"Soldiers not only want to hear, they want to hear well," Gates said, adding that a QuietPro-type of device both enhances and protects hearing. One of the drawbacks of QuietPro is its price tag: about $600 per unit. The Combat Arms Earplug is $10. The Army Rapid Equipping Force initiative has placed a few thousand QuietPro units in rotation to gauge its overall effectiveness during deployment, and the Marines and Navy are also issuing these particular units.

“The Army is very excited about our road-ahead mission in moving the AHP forward into the 21st Century, where hearing loss is no longer an acceptable by-product of military service," said Gates.