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NOISE Study News:  

The Military Health System has awarded The Noise Outcomes in Service Members Epidemiology (NOISE) study team the Outstanding Research Accomplishment Award. The team received the award during the 2022 Military Health System Research Symposium (MHSRS) on Sept. 12, 2022. Led by Principal Investigator James Henry, PhD, and comprised of both Geneva researchers and Department of Veterans Affairs (VA) researchers, the team is recognized for its significant achievements in auditory rehabilitation research over the past year. This research effort is jointly conducted by the VA Rehabilitation Research & Development (RR&D) National Center for Rehabilitative and Auditory Research (NCRAR) and the Defense Health Agency Hearing Center of Excellence (HCE) with study sites at Joint Base San Antonio-Lackland and the Naval Medical Center San Diego.

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Dedicated audiologists use clever tools to combat hearing loss

(2 May 2018) Army audiologist Maj. William Gottlick, Lyster Army Health Clinic, Fort Rucker, Ala., uses the “Interpreting the Audiogram” poster from the Comprehensive Hearing Health Program educational materials to counsel a Soldier after he received his annual hearing test. (Photo by Jennifer Stripling/Lyster Army Health Clinic)

By Larine Barr, DoD Hearing Center of Excellence

Navy occupational audiologist Lt. Laura Stephenson has helped roughly 20,000 patients better understand how exposure to hazardous noise at work and off-duty can cause a devastating, invisible injury called noise-induced hearing loss.

According to the Centers for Disease Control and Prevention, noise-induced hearing loss, or NIHL, is usually caused by exposure to excessively loud sounds and cannot be medically or surgically corrected. It can result from a one-time exposure to a very loud sound, blast, or impulse, or from listening to loud sounds over an extended period. 

Hearing loss and tinnitus (the perception of sound – sometimes a ringing sound - without an external source being present) have steadily increased over the last two decades among Veterans.  A Fiscal Year 2017 report released by the Veterans Benefits Administration found that 1.6 million and 1.1 million Veterans receive disability compensation for tinnitus and hearing loss, respectively.  

With prevention in mind, Stephenson, who is assigned to Naval Hospital Jacksonville, Fla., set out in 2016 to reduce hearing loss among local Service members and their families.  She helped to boost awareness using an array of educational tools available through the Comprehensive Hearing Health Program, or CHHP, developed by the Department of Defense Hearing Center of Excellence. 

The CHHP was created in 2013 and is currently being launched across the DoD and VA to reduce the incidence of NIHL through education, protection and monitoring efforts.  The education component includes patient-education sessions during audiology and hearing conservation appointments augmented with HCE-designed educational materials such as brochures, work books and flip charts.  

Col. LaKeisha Henry, HCE division chief, said CHHP was implemented to optimize the current DoD hearing conservation programs, and to serve the non-occupationally exposed, since exposure to hazardous noise can occur off-duty yet impact a Service members' performance while on duty. 

“When I first started using the CHHP materials, I ordered one of everything for our occupational nurses, audiologists, and technicians to use,” explained Stephenson, who distributes the materials at the Jacksonville hospital and its five branch health clinics.  “Our nurses really like the flip charts on speech communication, and our technicians use the sound tracks poster, different degrees of hearing loss posters, and what the colors mean on your hearing test (audiogram) scores. We’ve also gotten great feedback on the tinnitus work book. It’s awesome and really beneficial.”   

Stephenson said the program has especially helped to bring awareness to the installation’s safety managers. “They now know what to look for in hearing protection devices. This really drives the prevention element. Compliance is huge and that’s why our safety managers exist,” she said.   

Since implementing the CHHP, Stephenson said she’s seen less hearing loss among her patients. 

Maj. William Gottlick, an audiologist at Lyster Army Health Clinic at Fort Rucker, Ala., is another strong CHHP advocate.  He started the program in 2014 while assigned at Tripler Army Medical Center, Hawaii, and has continued to embrace it at Fort Rucker.

Gottlick said he and his staff use the ABC approach: advertising, briefings and counseling, to administer the CHHP at his clinic. "For the advertising element at Tripler, we distributed posters and pamphlets and held an internal health fair so other providers would stop by.  The most interested were our behavioral health providers.  They understood the relationship between TBI, PTSD and hearing loss and tinnitus."

Gottlick said his technicians at Lyster deliver an educational briefing using CHHP materials to Soldiers before their hearing tests and audiologists use the flip charts to discuss the physiologic process of hearing loss with their patients.

To further tailor the materials, Gottlick and the Lyster Audiology staff crafted their own 10-minute educational video by combining key points from several HCE-produced CHHP videos. They play the video when Soldiers come in for their annual hearing test and hearing protection fitting.

“A large amount of patients don’t comprehend the dangers,” Gottlick stressed.  “Having these materials is definitely beneficial.  There is something for everyone—hearing education, protection and hearing devices. Its purpose has been fulfilled.” 

The CHHP educational materials can be viewed from the HCE website at hearing.health.mil, under resources, audio and print materials.   These resources are free to DoD/VA providers, and can be ordered via the Government Printing Office link on the HCE website and sent directly to clinics.   

(Article link) Dedicated audiologists use clever tools to combat hearing loss

(23 March 2018)  The Department of Defense Hearing Center of Excellence, in collaboration with the Army Gaming Studio and subject matter experts from all Services, developed the Hearing Education and Readiness (HEAR) Course.  The HEAR course allows for better tracking for the annual education requirement for those enrolled in a Hearing Conservation Program (HCP), as detailed in DoDI 6055.12, Hearing Conservation Program, as well as Service-specific HCP regulations.  

The HEAR Course consists of:

• 25-minute required training modules; one for military and one for noise-exposed civilians
• 15-minute scenario exercise
• 15-minute leadership module
• Additional optional training (45 minutes, separated into an introduction, three 14-minute lessons that can be viewed independently, and a conclusion)

The HEAR Course is downloadable for your use within your local HCP and can be accessed from the HCE website at the following link:

 Hearing Education and Readiness Course or HEAR

Download for FREE!  Available at the Google Play Store

The Warfighter’s Hearing Health Instructional Primer (WHHIP) is a new hearing healthcare app.  The WHHIP was created through a collaboration between the Naval Submarine Medical Research Laboratory (NSMRL) and the Sensimetrics Corporation with funding provided by the Office of Naval Research (ONR).  The project was managed by the Hearing Center of Excellence’s northeast regional administrator, Kelly Watts, Au.D.  The WHHIP was released on November 30, 2016 and is available as a free download from the Google Play Store with plans for release to the Apple App Store in the fall of 2017. A link for the WHHIP will be coming soon to the Navy App Locker.

The WHHIP can be accessed by the Warfighter on his/her own personal mobile phone (Android). The app was designed as a supplement for the learning and training of military hearing conservation programs as well as an additional educational tool for occupational audiology clinics. The WHHIP includes 4 activities: Learn, Demos, HPD Check, and Glossary. The Learn and Glossary activities allow the Warfighter to scroll through various informative themes – including descriptions of noise, results of hearing tests, and definitions of technical jargon – providing answers to questions such as “What does it mean that I have sensorineural hearing loss?”  The Learn section also includes videos and auditory demonstrations.  Even more demonstrations are found in the Demos activity, where the Warfighter will have the opportunity to explore the difficulties that hearing loss and tinnitus pose to sound identification and discrimination as well as to speech understanding.  The HPD check feature allows the Warfighter to take a “selfie” of the fit of hearing protection devices (HPDs) in his/her own ears, and then compare the image to one that he/she had previously taken or of a standard image of a good professionally fit device.

Presentations on the WHHIP have been given to the audiology community at the Joint Defense Veterans Audiology Conference (JDVAC) in February 2017, as well as the safety and industrial hygiene communities at the Joint Safety and Environmental Professional Development Symposium in April 2017. Future poster presentations are planned for the HCE’s Collaborative Auditory Vestibular Research Network (CAVRN) meeting and the Mountain Home VAMC’s Appalachian Spring Meeting in June 2017.

https://play.google.com/store/apps/details?id=com.sens.whhip