NOISE AND MILITARY SERVICE Implications for Hearing Loss and Tinnitus Committee on Noise-Induced Hearing Loss and Tinnitus Associated with Military Service from World War II to the Present Medical Follow-up Agency Larry E. Humes, Lois M. Joellenbeck, and Jane S. Durch, Editors THE NATIONAL ACADEMIES PRESS Washington, DC www.nap.edu THE NATIONAL ACADEMIES PRESS • 500 Fifth Street, N.W. • Washington, DC 20001 NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Insti- tute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance. This study was supported by Contract No. V101(93)P-1637 #29 between the Na- tional Academy of Sciences and the Department of Veterans Affairs. Any opinions, find- ings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project. Library of Congress Cataloging-in-Publication Data Noise and military service : implications for hearing loss and tinnitus / Committee on Noise-Induced Hearing Loss and Tinnitus Associated with Military Service from World War II to the Present, Medical Follow- up Agency ; Larry E. Humes, Lois M. Joellenbeck, and Jane S. Durch, editors. p. ; cm. Includes bibliographical references. ISBN 0-309-09949-8 — ISBN 0-309-65307-X 1. Deafness—Etiology. 2. Tinnitus—Etiology. 3. Deafness, Noise induced. 4. Acoustic trauma. 5. Soldiers—Health and hygiene. 6. Veterans—Health and hygiene. 7. Noise—Health aspects. I. Humes, Larry. II. Joellenbeck, Lois M. (Lois Mary), 1963- . III. Durch, Jane. IV. Institute of Medicine (U.S.). Committee on Noise- Induced Hearing Loss and Tinnitus Associated with Military Service from World War II to the Present. [DNLM: 1. Noise—adverse effects. 2. Hearing Loss, Noise-Induced. 3. Military Personnel. 4. Tinnitus. WV 270 N7836 2005] RF291.5.S65N65 2005 617.8′07—dc22 2005030236 Additional copies of this report are available from the National Academies Press, 500 Fifth Street, N.W., Lockbox 285, Washington, DC 20055; (800) 624-6242 or (202) 334-3313 (in the Washington metropolitan area); Internet, http://www.nap.edu. For more information about the Institute of Medicine, visit the IOM home page at: www.iom.edu. Copyright 2006 by the National Academy of Sciences. All rights reserved. Printed in the United States of America. The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. 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The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the gov- ernment, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. Wm. A. Wulf are chair and vice chair, respectively, of the National Research Council. www.national-academies.org COMMITTEE ON NOISE-INDUCED HEARING LOSS AND TINNITUS ASSOCIATED WITH MILITARY SERVICE FROM WORLD WAR II TO THE PRESENT LARRY E. HUMES (Chair), Professor, Department of Speech and Hearing Sciences, Indiana University ELLIOTT H. BERGER, Senior Scientist, Auditory Research, E•A•R/ Aearo Company, Indianapolis, Indiana BARBARA A. BOHNE, Professor, Department of Otolaryngology, Washington University School of Medicine ANTHONY T. CACACE, Associate Professor, The Neuroscience Institute and Advanced Imaging Research Center, Albany Medical College KAREN J. CRUICKSHANKS, Professor, Department of Ophthalmology and Visual Sciences and Department of Population Health Sciences, University of Wisconsin Medical School RICHARD W. DANIELSON, Manager for Audiology and Hearing Conservation, National Space Biomedical Research Institute, Baylor College of Medicine JUDY R. DUBNO, Professor, Department of Otolaryngology–Head and Neck Surgery, Medical University of South Carolina GEORGE A. GATES, Emeritus Director/Professor, Virginia Merrill Bloedel Hearing Research Center, Department of Otolaryngology–Head and Neck Surgery, University of Washington School of Medicine DONALD HENDERSON, Professor, Center for Hearing and Deafness, State University of New York at Buffalo JOHN H. MILLS, Professor, Department of Otolaryngology–Head and Neck Surgery, Medical University of South Carolina MARK R. STEPHENSON, Senior Research Audiologist, Division of Applied Research and Technology, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio RICHARD S. TYLER, Professor and Director of Audiology, Department of Otolaryngology–Head and Neck Surgery, and Department of Speech Pathology and Audiology, The University of Iowa ROBERT B. WALLACE, Irene Ensminger Stecher Professor of Epidemiology and Internal Medicine, Department of Epidemiology, The University of Iowa Project Staff LOIS JOELLENBECK, Senior Program Officer (Study Director) JANE DURCH, Senior Program Officer WILLIAM PAGE, Senior Program Officer v SUSAN VAN HEMEL, Senior Program Officer, Board on Behavioral, Cognitive, and Sensory Science, Division of Behavioral and Social Sciences and Education KRISTEN GILBERTSON, Research Assistant ALLISON BERGER, Program Assistant KAREN KAZMERZAK, Research Associate RICK ERDTMANN, Director, Medical Follow-up Agency PAMELA RAMEY-MCCRAY, Administrative Assistant ANDREA COHEN, Financial Associate Data Operations HARRIET CRAWFORD, IT Project Manager JOHN LARSON, Records Manager, St. Louis Office NOREEN STEVENSON, Research Assistant AL MATTEI, Staff Assistant vi Reviewers This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with proce- dures approved by the National Research Council’s Report Review Com- mittee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published re- port as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their review of this report: Bobby R. Alford, Department of Otolaryngology–Head and Neck Surgery, Baylor College of Medicine Robert A. Dobie, Department of Otolaryngology, School of Medicine, University of California, Davis Roger P. Hamernik, Auditory Research Laboratories, State University of New York at Plattsburgh Richard N. Miller, Institute of Medicine (retired) Theresa Y. Schulz, James H. Quillen VA Medical Center, Mountain Home, Tennessee James B. Snow, Jr., National Institute on Deafness and Other Communication Disorders, National Institutes of Health (retired) Evelyn E. Talbott, Department of Epidemiology, University of Pittsburgh William A. Yost, Parmly Hearing Institute and the Graduate School, Loyola University of Chicago vii viii REVIEWERS Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations nor did they see the final draft of the report before its release. The review of this report was overseen by Hyla Napadensky, Napadensky Energetics Inc. (retired), and Linda D. Cowan, Health Sciences Center, University of Oklahoma. Appointed by the National Research Coun- cil and Institute of Medicine, they were responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution. Preface This report represents the collective efforts of many people over a pe- riod of approximately 15 months. First and foremost are the committee members, who devoted countless hours of volunteer service to address the committee’s charge. The numerous discussions held, both face to face and via conference calls, were thorough and, when opinions differed, were al- ways conducted with respect for divergent views. The report reflects the broad input and consensus of all committee members and is much stronger as a result. Clearly, the charge could not be addressed without a panel hav- ing sufficiently broad areas of expertise, but also a willingness to listen to sometimes differing perspectives with an open mind before moving to con- sensus. I truly appreciate not only the amount of expertise available through the committee, but the manner in which each member shared that expertise and worked together to meet our collective responsibilities. Another group central to the committee’s work included the staff mem- bers from the Institute of Medicine (IOM) and National Research Council (NRC) who supported our efforts. Lois Joellenbeck, who served as study director, and Jane Durch were the committee’s principal guides. We were ably aided as well by research assistant Kristen Gilbertson, whose contribu- tions included not only research and administrative tasks, but also partici- pating in the collection and entry of data from veterans’ medical records. Program assistant Allison Berger managed the logistics of many of the committee’s earlier meetings. Karen Kazmerzak helped initiate our research efforts during the first 3 months of the committee’s work. Susan Van Hemel, a senior program officer with the NRC, contributed advice throughout the study. ix