Hearing Loss Prevention (HLP)
Bailey Braun, AuD
Contract Audiologist
Defense Centers for Public Health-Dayton (DCPH-D)
Beavercreek, Ohio
Disclosure(s): No financial or nonfinancial relationships to disclose.
Jeremiah P. Smith, AuD
Contract Audiologist
Defense Centers for Public Health-Dayton (DCPH-D)
Central Michigan University
Wright-Patterson, Ohio
Disclosure(s): You Tune Hearing Protection, LLC: Intellectual Property/Patents (Ongoing), Ownership Interest (Ongoing), Patent Holder (Ongoing), Research Grant (includes principal investigator, collaborator or consultant and pending grants as well as grants already received) (Ongoing)
John Foster
Disclosure(s): No financial or nonfinancial relationships to disclose.
An Early Warning Sign (EWS) may identify service members who have signs of degrading hearing sensitivity for the Department of Defense (DoD). This retrospective study examined active-duty service members with annual audiometric data in Defense Occupational and Environmental Health Readiness System - Hearing Conservation (DOEHRS-HC) for ten consecutive years to examine the relationship between a positive EWS and the risk of future Standard Threshold Shift (STS) as defined by the DoD. Early identification of individuals at risk for potential permanent hearing loss can improve long-term quality of life, inform targeted interventions, and reduce future hearing loss incurred during military service.
Summary:
MOTIVATION: The Standard Threshold Shift (STS) has been widely considered as an effective method for quantifying hearing changes in service members by the Department of Defense (DoD). The ability to predict if service members are susceptible to an STS in their workplace enables proactive prevention of hearing loss. As such, an Early Warning Sign (EWS), defined by the DoD as a 15 dBHL shift at 1000, 2000, 3000, or 4000 Hz, was established to flag service members who show signs of degraded hearing sensitivity without meeting the criteria of an STS, or requirement for a workplace modification. An EWS is considered a clinically significant shift in audiometric results and may be able to predict a future STS. However, little research has specifically explored the predictive power of EWSs. Establishing the effectiveness and accuracy of using an EWS for predicting future STSs in military populations is critical to reducing hearing loss of service members, targeting hearing related interventions, and accurately tracking hearing damage across military populations.
Objective: To validate the use of an EWS as a predictor for a subsequent STS in active-duty service members.
Methods: Defense Occupational and Environmental Health Readiness System - Hearing Conservation (DOEHRS-HC) demographic and audiometric data for active-duty Air Force, Army, Navy, and Marine service members with ten years of consecutive audiograms were reviewed. An STS was coded according to the DoD instruction as an average decrease in audiometric threshold of greater than or equal to 10 dBHL at 2000, 3000, and 4000 Hz in comparison to the service member’s baseline or reference hearing test. A time-to-event analysis was completed where an event equals a confirmed STS on two consecutive hearing tests. Additionally, this study categorized service members into cohorts based on demographic information to control for potential confounding variables such as age and sex. Logistic regression will be utilized to identify variables predictive of an STS and results will be discussed in detail.
RESULTS A time-to-event analysis will be utilized to identify the predictive potential of the EWS for subsequent STS and results will be discussed in detail.
Learning Objectives: