VA RR&D National Center for Rehabilitative Auditory Research (NCRAR), Veterans Affairs Portland Health Care System, Portland, Oregon, USA.
Department of Otolaryngology/Head & Neck Surgery, Oregon Health & Science University, Portland, Oregon, USA.
Ear Hear. 2021 July/Aug;42(4):870-885. doi: 10.1097/AUD.0000000000000974.
Military Service members and Veterans commonly report hearing loss and tinnitus, both of which can result in significant disability. During military service, Service members are exposed to many different types of loud noise, which is strongly associated with hearing loss and tinnitus. Other military-related exposures, such as chemicals and traumatic brain injury (TBI), are also linked with auditory problems. The purpose of the "Noise Outcomes in Servicemembers Epidemiology" (NOISE) study is to gather information from Active-Duty Service members and recently separated Veterans about their military and nonmilitary noise exposures, other relevant military and nonmilitary exposures, and potential outcomes of these exposures including tinnitus, hearing loss, and other hearing-related health concerns.
The NOISE study assesses lifetime noise exposures, chemical and blast exposures, TBI, physical and psychiatric comorbidities, and other military and nonmilitary exposures and outcomes that can affect auditory function. Participants undergo comprehensive in-person audiologic examinations; those who experience tinnitus undergo a complete tinnitus assessment. Exposures and select outcomes are reassessed annually by mail, and the comprehensive in-person assessment is completed every 5 years. This report presents descriptive, baseline data obtained from the first 690 participants enrolled between 2014 and 2018.
Some notable findings from this analysis include: (1) the prevalence of hearing loss in the sample was 8% for low frequencies (0.25 to 2 kHz), 20% for high frequencies (3 to 8 kHz), and 39% for extended high frequencies (9 to 16 kHz); (2) the prevalence of tinnitus was 53%; (3) the prevalence of both hearing loss and tinnitus was higher among those with higher age, more years of military service, greater degree of noise exposure, and exposures to blasts and/or TBI in the military; and (4) tinnitus was most prevalent among participants who serve/served in the Army relative to the other military branches.
The NOISE study is acquiring comprehensive data on military-related auditory dysfunction. It is the first of its kind to enroll active Service members and recently separated Veterans into a longitudinal study to examine the etiology and outcomes of tinnitus and hearing loss in this population. Although these data do not necessarily represent the entire military and Veteran populations, ongoing enrollment is focused on increasing generalizability and will also provide the statistical power to conduct multivariable analyses. This will allow us to examine longitudinal associations of interest while controlling for potential confounders and other possible sources of error. These data will provide critical knowledge to refine future military hearing conservation efforts and inform efforts to develop future treatments.
军人和退伍军人常报告听力损失和耳鸣，两者均可导致显著残疾。在服役期间，军人会接触到许多不同类型的强噪声，这与听力损失和耳鸣密切相关。其他与军事相关的暴露，如化学品和创伤性脑损伤（TBI），也与听觉问题有关。“军人中噪声相关健康结果的流行病学（NOISE）”研究的目的是从现役军人和最近退伍的军人那里收集有关其军事和非军事噪声暴露、其他相关军事和非军事暴露以及这些暴露可能导致的耳鸣、听力损失和其他听力相关健康问题的信息。
NOISE 研究评估终生噪声暴露、化学品和爆炸物暴露、TBI、身体和精神合并症以及其他可能影响听觉功能的军事和非军事暴露和结果。参与者接受全面的现场听力检查；那些经历耳鸣的人接受完整的耳鸣评估。通过邮件每年重新评估暴露和部分结果，每 5 年完成一次全面的现场评估。本报告介绍了从 2014 年至 2018 年期间招募的前 690 名参与者的描述性基线数据。
本分析的一些显著发现包括：（1）该样本的低频（0.25 至 2 kHz）听力损失患病率为 8%，高频（3 至 8 kHz）听力损失患病率为 20%，扩展高频（9 至 16 kHz）听力损失患病率为 39%；（2）耳鸣的患病率为 53%；（3）在年龄较大、服役年限较长、噪声暴露程度较高、在军队中接触爆炸物和/或 TBI 的参与者中，听力损失和耳鸣的患病率较高；（4）与其他军种相比，在陆军服役/服役的参与者中，耳鸣的患病率最高。
NOISE 研究正在获取有关军事相关听觉功能障碍的综合数据。这是第一个招募现役军人和最近退伍军人参加纵向研究的研究，以研究该人群中耳鸣和听力损失的病因和结果。尽管这些数据不一定代表整个军队和退伍军人人口，但正在进行的招募工作侧重于提高普遍性，并将提供进行多变量分析的统计能力。这将使我们能够在控制潜在混杂因素和其他可能的误差来源的同时，检查感兴趣的纵向关联。这些数据将提供关键知识，以改进未来的军事听力保护工作，并为开发未来治疗方法提供信息。
