The loudest sounds on Earth occur in combat. It’s no surprise, then, that tinnitus and hearing loss rank as the first and second most common health problems faced by American veterans returning home, with the VA purchasing 1 out of every 5 hearing aids sold in the U.S., at a cost of about $348 per hearing aid. For tinnitus and hearing loss combined, the U.S. has issued about 3 million compensations, making these the most expensive conditions afflicting our veterans. Soldiers are at increased risk for all kinds of hearing loss, including noise-induced hearing loss (NIHL) and “hidden hearing loss.”
Veterans Suffer More Hidden Hearing Loss
Veterans suffer disproportionately high rates of so-called “hidden hearing loss,” a condition where the patient has difficulty understanding speech or differentiating sounds in noisy environments but gets a result of “normal” on a hearing test. This condition is on the rise generally in the U.S., due to the noisiness of modern life, but the exposure faced by members of the military to potentially traumatic sound levels is far greater. And with hidden hearing loss, a hearing aid cannot help the situation. The damage is actually in the myelin sheaths around the auditory nerves, which keep neurotransmitters in line. Damaged myelin sheaths mean that the auditory nerve’s ability to transmit the electrical signals from the ears to the brain is limited, which is why the patient is able to hear in the controlled conditions of the hearing test but can’t make sense of things in the outside world: not enough information is coming down the pipe.
While there are genetic treatments being developed that will hopefully one day treat tinnitus and hearing loss, at present there is no cure. The best medicine is prevention. Unfortunately, from the years 2003-2015, the 3M company supplied the U.S. Department of Justice with defective earplugs, knowing they were too short to be effective, which means both that veterans living in the U.S. now are dealing with more hearing loss than they should be, and that future generations will likely suffer less.
Protective measures that combatants can take include (non-defective) earplugs, earmuffs, noise-attenuating helmets, and suppressors. While there is a frequent complaint that using hearing, protection limits a soldier’s ability to hear crucial communications or approaching dangers around them, all of the aforementioned technologies exist in forms today that eliminate this concern:
Level-dependent earplugs allow softer sounds through, and only engage when they encounter loud bursts of sound. They should, however, be used along with other protective technologies when loud sound is more consistent, such as in combat vehicles or aircraft.
Earmuffs, usually a more comfortable and more effective means of sound reduction, can have speakers included that allow for radio communication.
Noise-attenuating helmets offer protection from traumatic injury to the head and face, while also providing hearing protection. Radio communication technology can be employed here as well, with noise-canceling capabilities like those used on consumer headphones designed for use on airplanes. Technology on the microphone-side of these helmets can help reduce or eliminate background noise as well.
Suppressors for use on weapons, commonly employed since 2017, reduce the sound produced by the weapon by as much as 30 dBA (decibels A-weighted). Of course, even with earplugs in, the reduced noise from the soldier’s own firearm means they can hear more of everything else.
A Solution in Place?
The Tactical Communications and Protective System (TCAPS) became available in 2014 and is now issued to most recruits on active duty. This is a dual-purpose system that employs walkie-talkie-style radio technology with in-ear plugs, providing both hearing protection and communications improvement. With this and other measures, we will hopefully see a sharp decline in tinnitus and hearing loss for our veterans from now on.
Everyone Needs Hearing Protection
While advances in hearing aids have been dramatic over the last few decades, and the new technology of cochlear implants can restore some hearing ability to the deaf, there is no treatment available that can restore a person’s hearing to normal. It is more important than ever to keep the volume low on our listening devices and use hearing protection whenever we are around loud noises. And remember: sound levels do not need to be painful to cause hearing loss. Even using a gas-powered lawn mower will cause hearing loss over time. Consider using a cell phone app to measure the sound levels in your environments, and if it exceeds 85 dBA, pop in the earplugs.