Blast Exposure Associations With Hearing Loss and Self-Reported Hearing Difficulty.
Level 4 - case-series / case-control
Cross-sectional observational study.
PubMed 38984918 · doi:10.1002/ohn.890
What was done
A cross-sectional multicenter study evaluated 494 Active-Duty Service Members (ADSM) and 533 Veterans from the Noise Outcomes in Servicemembers Epidemiology (NOISE) study at tertiary referral centers. Participants completed a comprehensive blast questionnaire to determine exposure history. Hearing and auditory handicap outcomes were assessed using standard pure-tone hearing thresholds, extended-high frequency pure-tone thresholds, the Speech Recognition in Noise Test, the Hearing Handicap Inventory for Adults (HHIA), and the Speech, Spatial and Qualities of Hearing Scale (SSQ)-12.
What was found
Self-reported blast exposure was present in 21.0% (102/494) of ADSM and 36.8% (196/533) of Veterans. Blast-exposed ADSM had significantly higher odds of high-frequency (3–8 kHz) hearing loss (OR = 2.5, 95% CI: 1.3–4.7) and extended-high frequency (9–16 kHz) hearing loss (OR = 3.7, 95% CI: 1.9–7.0) compared to unexposed ADSM. Self-reported hearing difficulty on the HHIA was significantly higher in blast-exposed individuals among both ADSM (OR = 1.9, 95% CI: 1.1–3.3) and Veterans (OR = 2.1, 95% CI: 1.4–3.2). Blast exposure was also associated with worse SSQ-12 scores (ADSM mean difference = -0.6, 95% CI: -1.0 to -0.1; Veteran mean difference = -0.9, 95% CI: -1.3 to -0.5). Objective pure-tone results for Veterans and data for the Speech Recognition in Noise Test were not reported in the abstract.
Why it matters
The study shows that military blast exposure is associated with measurable high-frequency and extended-high frequency auditory deficits in active personnel, as well as persistent subjective hearing handicaps in both active-duty service members and veterans.
Limits
The study is cross-sectional, which limits causal inference. Blast exposure history was self-reported via questionnaire and subject to recall bias. The abstract omits numerical results for the Speech Recognition in Noise Test, objective audiometry data in the Veteran cohort, and details regarding adjustment for non-blast occupational noise exposures.
Cited by
- supports Tinnitus or ringing in the ears frequently results from prior exposure to loud sounds or explosions that caused ear damage.