Hearing Loss and Irritability Reporting Without Vestibular Differences in Explosive Breaching Professionals

Abstract

Background: Blast exposure is a potential hazard in modern military operations and training, especially for some military occupations. Helmets, peripheral armor, hearing protection, and eye protection worn by military personnel provide some acute protection from blast effects but may not fully protect personnel against cumulative effects of repeated blast overpressure waves experienced over a career. The current study aimed to characterize the long-term outcomes of repeated exposure to primary blast overpressure in experienced career operators with an emphasis on the assessment of hearing and vestibular outcomes.Methods: Participants included experienced “breachers” (military and law enforcement explosives professionals who gain entry into structures through controlled detonation of charges) and similarly aged and experienced “non-breachers” (non-breaching military and law enforcement personnel). Responses to a clinical interview and performance on audiological and vestibular testing were compared.Results: Hearing loss, ringing in the ears, irritability, and sensitivity to light or noise were more common among breachers than non-breachers. Breachers reported more combat exposure than non-breachers, and subsequently, memory loss and difficulty concentrating were associated with both breaching and combat exposure. Vestibular and ocular motor outcomes were not different between breachers and non-breachers.Conclusion: Hearing-related, irritability, and sensitivity outcomes are associated with a career in breaching. Future studies examining long-term effects of blast exposure should take measures to control for combat exposure.

Single and repeated high-level blast, low-level blast, and new-onset self-reported health conditions in the U.S. Millennium Cohort Study: An exploratory investigation

“…As with previous research, the most consistent findings emerged primarily for conditions that were neurological, hearing-related, or mental health-related. Specifically, these findings provide yet more evidence of the association between overpressure exposure (including single HLB, repeated HLB, and occupational LLB exposure) and hearing loss and tinnitus diagnosis ( 1 , 11 – 13 , 17 , 33 – 35 ). Additionally, this research builds on previous research reporting on the adverse reproductive health consequences of HLB in that it reports that such effects occur for those who work occupations at high (but not low) risk for occupational exposure to LLB ( 36 , 37 ).…”

Chronic Effects of Breaching Blast Exposure on Sensory Organization and Postural Limits of Stability

“…It is important to remember that SOT VES scores are not diagnostic and do not reveal potential damage to the vestibular system but rather they reveal balance problems when using vestibular information for postural control 34 . Breachers were thoroughly examined in a separate clinic in this outpatient study with specific vestibular testing and found to have no vestibular abnormalities as a group 29 . A closer examination of the two individuals (10%) with clinically abnormal SOT VES scores showed one individual also scored abnormally for SOT VIS and the other had a history of prior head trauma symptomology (e.g., memory problems, ringing in ears, etc).…”

“…A variety of neurophysiological and behavioral measurements were collected in this study and specific findings related to those measures have been reported elsewhere. 28,29 The focus of the current report is objective assessments of balance.…”

“…34 Breachers were thoroughly examined in a separate clinic in this outpatient study with specific vestibular testing and found to have no vestibular abnormalities as a group. 29 A closer examination of the two individuals (10%) with clinically abnormal SOT VES scores showed one individual also scored abnormally for SOT VIS and the other had a history of prior head trauma symptomology (e.g., memory problems, ringing in ears, etc). Overall, our results agree with Littlefield et al, 18 who reported no group-wise differences between breachers and controls on the SOT vestibular scores in acute and subacute post-blast exposures but did report some individuals with abnormal VES SOT scores.…”

“…35 Breachers delayed RT may have resulted from slight auditory and cognitive issues (55% of the breachers endorsed problems concentrating, 65% ringing in the ears, and 55% diminished hearing). 29 The LOS test indirectly tests cognitive functioning through postural tasks that involve attention, processing speed, and decision making. Acute blast exposure adversely affects procedural RT 7 ; however, there is limited research on if it impacts cognitive functioning longitudinally.…”