U.S. Army Center for Health Promotion and Preventive Medicine, Aberdeen Proving Ground, Maryland 21010, USA.
Am J Prev Med. 2010 Jan;38(1 Suppl):S71-7. doi: 10.1016/j.amepre.2009.10.025.
Rates of noise-induced hearing injury (NIHI) among U.S. active duty military have not been previously described using available military medical surveillance data.
NIHI were identified in the Defense Medical Surveillance System (DMSS) using a list of ICD-9-CM diagnosis codes selected in collaboration with military audiologists. To provide a more comprehensive view of the NIHI problem, NIHI-related ICD-9 codes beyond the traditional 388 noise injury-code set were included. Visit rates by gender and age group are reported by quarter, 2003-2005. Overall frequencies and rates by occupational specialty, 2003-2005, are also described.
From 2003 to 2005, rates for men were significantly higher than rates for women, with rate ratios (RR) ranging from 1.15 (95% CI =1.07, 1.23) to 1.78 (95% CI= 1.62, 1.93). Rates among women ranged from 2.9 to 6.2 per 1000 person-years; rates among men ranged from 4.5 to 6.7 per 1000 person-years. NIHI rates were highest among those aged > or =40 years and lowest among those aged 17-19 years, with RRs ranging from 3.06 (95% CI=2.77, 3.40) to 5.51 (95% CI=4.88, 6.30) during this time period. Among occupational groups, general officers/executives had the highest NIHI rate over this time period (29.5/1000 person-years), followed by enlisted personnel in training (14.3/1000 person-years) and scientists and professionals (12.8/1000 person-years).
While data on outpatient injury causes and use of hearing protection are also needed to guide the future design and/or modification of interventions, existing military medical surveillance provides essential information for tracking NIHI and monitoring NIHI intervention effects.
美国现役军人的噪声性听力损伤(NIHI)发生率以前没有使用现有的军事医疗监测数据进行描述。
使用与军事听力学家合作选择的 ICD-9-CM 诊断代码列表,在国防医疗监测系统(DMSS)中确定 NIHI。为了更全面地了解 NIHI 问题,除了传统的 388 噪声损伤代码集之外,还包括了与 NIHI 相关的 ICD-9 代码。按性别和年龄组报告 2003-2005 年每季度的就诊率。还按职业专业描述了 2003-2005 年的总体频率和发生率。
2003 年至 2005 年,男性的发病率明显高于女性,发病率比(RR)范围为 1.15(95%置信区间[CI] = 1.07, 1.23)至 1.78(95% CI = 1.62, 1.93)。女性的发病率范围为每 1000 人年 2.9 至 6.2 例;男性的发病率范围为每 1000 人年 4.5 至 6.7 例。在这段时间内,发病率最高的是年龄大于等于 40 岁的人群,发病率最低的是 17-19 岁的人群,RR 范围为 3.06(95% CI=2.77, 3.40)至 5.51(95% CI=4.88, 6.30)。在职业群体中,在此期间,将军/行政人员的 NIHI 发病率最高(29.5/1000 人年),其次是受训的入伍人员(14.3/1000 人年)和科学家和专业人员(12.8/1000 人年)。
尽管还需要有关门诊伤害原因和听力保护使用的数据来指导未来的干预措施的设计和/或修改,但现有的军事医疗监测为跟踪 NIHI 和监测 NIHI 干预效果提供了重要信息。