title: Noise-induced hearing injury and comorbidities among postdeployment U.S. Army soldiers: April 2003-June 2009.
abstract: OBJECTIVE
  To evaluate noise-induced hearing injury (NIHI) and blast-related comorbidities among U.S. Army soldiers in an effort to understand the morbidity burden and future health service requirements for wounded war fighters returning from the Central Command Area of Responsibility, predominantly from Iraq and Afghanistan deployments.
  
  
  METHODS
  Inpatient and outpatient records with diagnosed NIHI or blast-related comorbidities (e.g., significant threshold shift [STS], noise-induced hearing loss, tinnitus, sensorineural hearing loss, eardrum perforations, mild traumatic brain injury, and posttraumatic stress disorder) were extracted for active duty soldiers returning from combat deployments. Records were limited to those within 6 months of the soldier's return date from April 2003 through June 2009. To account for changes in STS coding practice, STS rates observed after October 1, 2006, were used to extrapolate prior probable postdeployment STS.
  
  
  RESULTS
  Statistically significant increases were observed for tinnitus, dizziness, eardrum perforations, and speech-language disorders. The combination of observed and extrapolated STS yielded a conservative estimate of 27,427 cases.
  
  
  CONCLUSIONS
  Estimates can be used to forecast resource requirements for hearing services among veterans. This article could serve as a guide for resourcing and innovating prevention measures and treatment in this population. Data provided may also serve as a baseline for evaluating prevention measures.
authors.affiliation: U.S. Army Public Health Command (Provisional) Instituteof Public Health, Gunpowder, MD, USA. thomas.helfer@us.army.mil
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Helfer
authors.forename: Nikki N
authors.initials: NN
authors.lastname: Jordan
authors.forename: Robyn B
authors.initials: RB
authors.lastname: Lee
authors.forename: Paul
authors.initials: P
authors.lastname: Pietrusiak
authors.forename: Kara
authors.initials: K
authors.lastname: Cave
authors.forename: Kim
authors.initials: K
authors.lastname: Schairer
mesh_terms: D000293:Adolescent; D000328:Adult; D055826:Afghan Campaign 2001-; D001753:Blast Injuries / Q000150:complications / Q000175:diagnosis; D001930:Brain Injuries / Q000150:complications; D005260:Female; D006317:Hearing Loss, Noise-Induced / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D013064:Speech Disorders / Q000150:complications / Q000175:diagnosis; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000175:diagnosis; D014012:Tinnitus / Q000150:complications / Q000175:diagnosis; D018058:Tympanic Membrane Perforation / Q000150:complications / Q000175:diagnosis; D055815:Young Adult