Medical Modeling, Simulation, and Mission Support Department, Naval Health Research Center, San Diego, California.
Am J Epidemiol. 2018 Jan 1;187(1):7-15. doi: 10.1093/aje/kwx199.
Exposure to hazardous intensity levels of combat noise, such as blast, may compromise a person's ability to detect and recognize sounds and communicate effectively. There is little previous examination of the onset of hearing health outcomes following exposure to blast in representative samples of deployed US military personnel. Data from the prospective Blast-Related Auditory Injury Database were analyzed. We included only those participants with qualified hearing tests within a period of 12 months prior to, and following, injury (n = 1,574). After adjustment for relevant covariates and potential confounders, those who sustained a blast injury had significantly higher odds of postinjury hearing loss (odds ratio = 2.21; 95% confidence interval: 1.42, 3.44), low-frequency hearing loss (odds ratio = 1.95; 95% confidence interval: 1.01, 3.78), high-frequency hearing loss (odds ratio = 2.45; 95% confidence interval: 1.43, 4.20), and significant threshold shift compared with a group with non-blast-related injury. An estimated 49% of risk for hearing loss in these blast-injured, deployed military members could be attributed to the blast-related injury event. This study reinforced that it is imperative to identify at-risk populations for early intervention and prevention, as well as to consistently monitor the effects of blast injury on hearing outcomes.
接触危险强度级别的战斗噪声，如爆炸，可能会损害一个人检测和识别声音以及有效沟通的能力。在具有代表性的部署美军人员样本中，先前很少有研究考察暴露于爆炸后听力健康结果的发生。对前瞻性爆炸相关听觉损伤数据库的数据进行了分析。我们只包括那些在受伤前 12 个月内和受伤后有合格听力测试的参与者（n = 1574）。在调整了相关协变量和潜在混杂因素后，那些遭受爆炸伤的人发生损伤后听力损失的可能性显著更高（优势比=2.21；95%置信区间：1.42，3.44），低频听力损失（优势比=1.95；95%置信区间：1.01，3.78），高频听力损失（优势比=2.45；95%置信区间：1.43，4.20），与非爆炸相关损伤组相比，阈值变化显著。这些爆炸受伤的部署军事人员中，估计有 49%的听力损失风险可归因于与爆炸相关的损伤事件。这项研究强化了这样一个观点，即必须确定高危人群，以便进行早期干预和预防，并持续监测爆炸伤对听力结果的影响。
