Economic Burden of Hearing Loss for the U.S. Military: A Proposed Framework for Estimation

Abstract

The goal of this multiphased research is to develop methods to comprehensively determine the economic impact of hearing impairment and noise-induced hearing injury among active duty U.S. Service Members. Several steps were undertaken to develop a framework and model for economic burden analysis: (1) a literature review identifying studies reporting the cost of health conditions and injuries in the Department of Defense, (2) consultation with a panel of subject matter experts who reviewed these cost items, and (3) discussions with DoD data stewards and review of relevant data dictionaries and databases. A Markov model was developed to represent the cumulative economic effect of events along the career span, such as retraining after hearing impairment and injury, by synthesizing inputs from various sources. The model, as developed and proposed in this study, will be a valuable decision-making tool for the DoD to identify high-risk groups, take proactive measures, and develop focused education, customized equipping, and return-to-duty and reintegration programs, thereby maximizing the retention of skilled, experienced, and mission-ready Service Members.

Loud Music and Leisure Noise Is a Common Cause of Chronic Hearing Loss, Tinnitus and Hyperacusis

“…The invention of the audiometer and sound level meter [9] enabled research that eventually led most countries, including the United States in the 1970s, to implement legal limits for exposure to workplace noise [10][11][12][13][14][15][16][17]. While these measures (summarized in Section 2) have helped, noise-induced hearing loss (NIHL) and its associated disorders remain the most common injuries in many industrial and military settings, contributing heavily to the huge global burden of hearing loss [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]. Regrettably, noise limits have rarely been enforced outside of traditional extraction and manufacturing industries [35].…”

Preloaded D-methionine protects from steady state and impulse noise-induced hearing loss and induces long-term cochlear and endogenous antioxidant effects

“…Prevention of NIHL could be a far more effective approach than hearing aids and disability payments in both social and economic terms [ 12 , 15 ]. Preloading of an otoprotective agent may afford us that opportunity, at least for anticipated noise exposures such as weapons training.…”

“…But the financial impact to the U.S. government is undeniable. The U.S. Veteran’s Administration alone paid approximately $24 billion dollars in hearing loss compensation from 1970–1990 [ 13 ] and $1.2 billion in 2012 [ 14 ] although the total costs to the US military are far more extensive including costs for hearing aids, retraining, noise mitigation, medical care, transportation, hearing protection devices and work time loss [ 15 ]. Noise-induced tinnitus is less well studied but is a frequently reported consequence of noise exposures [ 16 ].…”

Emerging Therapies for Sensorineural Hearing Loss

“…61,62 Economic models are currently in development to assess the burden of hearing loss in the U.S. military, but the burden is thought to be significant. 63 The objective of a recent Department of National Defense trial was to augment hearing protection devices, such as ear plugs, for noise exposure that may exceed the protective capability of these devices. 60 The trial will determine the efficacy of D-methionine in preventing either noise-induced hearing loss or tinnitus after eleven days of weapons training for drill sergeant instructor trainees.…”