Description
The effects of adverse auditory outcomes in military members have been an increasing problem in the United States. Currently the Veterans Administration spends millions of dollars in disability costs. There are hearing conservation programs in place to monitor these outcomes, however, the number of claims being filed is increasing. Today, new types of weaponry are being used in the form of impulse blasts, with a potential to adversely affect the auditory system. The Navy's current regulations for hearing conservation only requires certain occupations that have been determined to be at risk for adverse auditory outcomes be mandated to participate in the program with periodic audiograms to track these outcomes. Occupations such as health care are not included in these programs. This study examines the role of occupation in deployed Navy personnel on the onset of adverse auditory outcomes after adjusting for demographics and deployment related variables. Included in this study were 1,046 active duty Navy personnel that were deployed for at least 31 days but not more than 18 months in support of OIF/OEF. Demographics examined in this population included age, deployment length, deployment history, military rank, deployed location and occupational specialty. Enlisted and officer populations were analyzed separately. Approximately 5.8% of personnel used in this analysis were diagnosed with an adverse auditory outcome. The top diagnoses included dizziness and giddiness (154 of 1046; 14.7%), tinnitus (136 of 1046; 13%), unspecified otitis media (118 of 1046; 11.3%), sensorineural hearing loss unspecified (97 of 1046; 9.3%) and impacted cerumen (72 of 1046; 6.9%). Age-adjusted logistic regression was applied in this study and variables included in the analysis were deployment length, deployment history, military rank, deployed location occupational specialty and gender. For the enlisted population age was significantly associated with adverse auditory outcomes (odd ratio [OR] = 1.05 per year, 95% confidence interval [CI] = 1.03-1.06, p-value <0.01) after adjusting for all other variables. Being female was also found to be a significant factor (OR = 1.3, 95% CI 1.08-1.64, p-value = 0.01). In regard to occupation, adverse auditory outcomes were found to be significantly associated with being a health care specialist (OR = 1.40, 95% CI 1.13-1.73, p-value = 0.002). In officers, age was a significant factor (OR = 1.06 per year, 95% CI 1.04-1.08, p-value <0.0001). The limitations of this study include the use of ICD-9-CM coding as opposed to audiogram data. Though many adverse auditory outcomes can be diagnosed by physicians, audiograms may pick up smaller outcomes that can't be detected. There may also be underrepresentation in this study, only those who sought out attention were included. And as with any study the association could have risen by chance.
