Veterans

Hearing Health Foundation (HHF) thanks our U.S. service members and veterans for their sacrifices. This group is disproportionately at risk for tinnitus and hearing loss.

• Tinnitus and hearing loss are routinely the top two health concerns among military veterans at U.S. Department of Veterans Affairs (VA) medical centers.

  • More than 1.3 million veterans were receiving disability compensation for hearing loss, and more than 2.3 million received compensation for tinnitus, according to fiscal year 2020 Veterans Benefits Administration compensation report.

  • In addition, many veterans who have typical hearing test results have trouble understanding speech. This can be a result of auditory processing disorders, which is often associated with blast exposure. (Please refer to research by an Emerging Research Grants scientist studying blast effects on the brain and hearing.) Blast exposure can also lead to decreased sound tolerance, or hyperacusis, among veterans, according to 2019 research published in Science Reports.

• A 2015 study in the International Journal of Otolaryngology found that 72 percent of veterans with tinnitus also had a diagnosis of anxiety, 60 percent had depression, and 58 percent had both conditions.

  • A 2021 paper in Military Medicine concluded that mental health symptoms are strongly associated with tinnitus severity, after examining a random sample of nearly 900 Veterans diagnosed with tinnitus. The likelihood of screening positive for post-traumatic stress disorder (PTSD), depression, or anxiety was higher among those who reported moderate, severe, or very severe tinnitus.

• The incidence of tinnitus in service members has risen dramatically, according to a 2019 American Journal of Audiology study by the South Texas VA Health Care System and the University of Texas at San Antonio.

  • Scientists examined the health records of over 85,000 active duty service members and found that the rate of tinnitus more than tripled from 2001 to 2015.

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Military-Grade Protection

Hearing loss is often preventable. Proper fitting and consistent wearing of hearing protective devices (HPDs) help prevent hearing loss and tinnitus. Noise-induced hearing loss and tinnitus (ringing in the ears) are the top two health conditions among military veterans. In 2016, Veterans Affairs had 1,610,911 compensation receipts for tinnitus and 1,084,069 for hearing loss. Additionally, many Veterans who score normally on hearing tests have trouble understanding speech. This condition, called auditory processing disorder, is associated with blast exposure.

Military personnel commonly experience these disorders after exposure to loud noise, such as working in an airplane hangar, or exposure to high-intensity noise, such as an explosion. There is a misconception hearing protection inhibits vital communication and mission readiness. With today’s increasingly sophisticated technology, soldiers do not have to choose between protecting their ears or their lives.

Below are some of Hearing Health Foundation's suggestions for hearing protective devices (HPDs) that protect without compromising safety:

Earplugs

Traditional earplugs effectively prevent hazardous noise from entering the ear canal, but they can interfere with mission communication requirements, such as being able to hear speech or low-level combat sounds.

Level-dependent earplugs however use a filter that enables soft noises to be conveyed at full strength yet eliminate high-frequency or impulse noise. Level-dependent earplugs are easily transportable, but should be used in combination with other devices when operating aircraft or combat vehicles.

Earmuffs

Earmuffs block sound by creating an airtight barrier around the entire ear, and are best used for intermittent exposure to noise. Earmuffs provide great protection, warmth, comfort, and durability than earplugs. Although they block softer sounds including speech, some military-grade earmuffs contain an electronic communication system to allow for clear communication.

Noise-Attenuating Helmets

Noise-attenuating helmets protect from hearing loss, crash impact, and eye injury while increasing communication through radio communication. Technologically advanced helmets include active noise-reducing technology to monitor sound energy around the ear and cancel unwanted noise while preserving verbal communication ability. A communications earplug microphone can also be worn to enhance verbal clarity.

Suppressors

In 2017 the U.S. Marines began using suppressors on service weapons. While they don’t completely drown out gunfire, they can reduce noise by more than 30 decibels. Suppressors offer tactical and medical advantages.

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Veteran Stories

I spent more than 20 years working on a variety of aircraft, from two-man OV-10s to C-141 transports. OV-10s were like young children. When they’d run up the engines, they had a high-pitched whine. The transporters had four very large engines, and when they prepared for takeoff, you’d better hold onto your hat and plug your ears. Which I did not, but I kept my hat.

The true demon that contributed to the development of my ringing ears was the helicopter. I worked with every version the Air Force had at the time, and the biggest monster of all was the H-53 rescue helicopter, which only became airborne because it beat the air into submission.

I first noticed the tinnitus while at a movie—“The Empire Strikes Back”—and I thought it was just a passing thing. But then I started noticing that every time the kids were in bed and my wife and I would be sitting and reading or watching TV, I could still hear the ringing. I asked my doctor what the deal was, and he said it should pass but to try something called “ear defenders” (ear muffs) that were worn over your ears. I did. But they only muted the sound.

As I got older and the ringing got worse, I found I had to listen intently during dinner conversations and at meetings (sometimes a blessing). People around me started noticing I was asking them to repeat things. I would tell them “Quasimodo” was acting up. I tried ignoring it, thinking it was just a fact of life.

But sleeping really got to be a problem. My wife is a goddess for putting up with me plugging in ear buds to listen to the radio to drown out the ringing. Music didn’t help, so I listened to sports talk or any talk show. (Eventually I decided on-air psychologists needed to be put in a very large room to analyze one another.) To this day I still use the radio overnight.

Then about a year ago my wife heard a radio ad for a hearing center that offered the potential of alleviating tinnitus. I made an appointment, had the hearing test, and discussed the use of devices that I wear for about 45 minutes a day. These ear-level devices have three settings that offer some relaxing tones. (They are bell sounds—a ringing sound to take care of my ringing sound!) The theory is the brain does not like “dead zones” in the frequencies our ears can hear, so the devices are intended to rewire the brain. I have had the devices now for some months, and there are days they do make a difference. Other days, not so much. I get frustrated and think, to heck with the ringing—let’s listen to Led Zeppelin!

I have had others who suffer from Quasimodo tell me that you get used to it. Right—like getting used to the annoying neighbor who mows the lawn at the crack of dawn on the weekend. (Hope he gets tinnitus.) My real hope is that as technology advances, we will find a cure or at least some relief. Now, where did I put the Fender…?

A retired Air Force lieutenant colonel and former magazine editor, Roger Lesser lives with his family in Colorado.

My flying experience was as a non-crew member and passenger. Flying at 10,000 feet, the engine roar permeated every part of the body. The droning of the engines made the entire airplane frame vibrate, making it difficult to sleep; hearing other people talk was impossible. It was several days before my hearing returned to normal.

After being discharged from the Air Force, I re-entered college and started working at an aircraft plant, which required my hearing be tested. At age 25, I was informed I had hearing loss. Like most young men, my response was a nonchalant “Oh!” It was not until I was in my late 40s that my hearing loss became more pronounced. In my 50s, I was fitted with hearing aids.

Like many individuals, I did not want others to know I had hearing issues, so I only wore the aids at home. As time progressed, the hearing aids ended up in a jewelry box. When I retired and had a more pronounced need for hearing help, I finally started wearing the aids full time. In 2004, I lost all hearing in my left ear. I was implanted with a cochlear implant in 2005. In 2007, I lost hearing in the right ear, and received an implant for that side too. They work extremely well, and I am now assisting six major universities that are doing research about cochlear implants.

I have 40 percent hearing loss in my left ear and 30 percent in my right ear. I have tinnitus in both ears, especially the left. It was horrible at first. The hearing problems are a direct result of gunfire and loud jet engines on flight line duty. Common sources of noise are gunfire in both training exercises and on deployment as well as the sound of jet engines on the flight line that Security Forces troops secure.

I left the service because of my hearing problems. I was afraid to ever fire a gun again or to be in a situation where I would be exposed to small arms fire or explosions that would make the ringing worse.

I went for treatment while serving as an active guardsman, and I was told by the medical clinic on base that I had to go to the VA Hospital on my off-duty time to address my hearing issues. Since I couldn’t leave work for the appointments, I learned to manage my tinnitus and hearing loss on my own.

I use a white-noise machine, fan, or air-conditioning unit while sleeping to mask the tinnitus. I try to not eat salt or spicy food in excess, or drink too much caffeine or alcohol, as I’m told all of these exacerbate tinnitus. I carry earplugs with me to very loud places.

There were no military requirements for annual hearing tests when I was in the military from 1995 to 2009. There are requirements “on the books” regarding hearing protection—but you need to hear your radio, your buddy, your team, and any notice that can give you a tactical advantage, so no leader I encountered enforced them.

Like many others in the service who had intentions of making it a career, we did not complain about small injuries–real or perceived. It was pretty easy to cover up hearing loss. Virtually no one during my time in the service complained or pointed out any real or perceived hearing loss.

I did not leave the service due to my hearing loss; it was a family decision. My service duties were not made particularly difficult by my hearing loss. They involved regular use of radio communications systems with headsets so I could always turn up the volume. Also, I did not seek treatment while in military service because I did not really acknowledge that I had a hearing loss until I was out of the military. I guess I was fairly typical of men my age.

I acknowledged that I had a significant loss only at the urging of my wife. I knew I had a loss but I denied to myself how serious it was. I went to the VA last year for the first time and established my service-connected hearing loss for the record. I use behind-the-ear hearing devices in both ears now.

It was not in the personal culture of the men I was serving with to call attention to anything that was perceived as impacting our ability to do our duties or to complete our missions. If there was truly serious problem that impacted our ability to perform, we would identify the problem so as to not risk the safety or the lives of others in our teams or units.

But we just dealt personally with the less critical issues; hearing loss was one of those.

I was given my first hearing aid before I left active duty. I don’t think I ever wore it for the first year or two. They tested me pretty regularly up to my discharge. My hearing continued to worsen after I got out of the military, so they tested me yearly. After I got out of college, I went to the VA in Minneapolis and finally received an MRI. I found out that I had an acoustic neuroma (brain tumor) that was causing the right ear to gradually worsen. The VA did the surgery for me, so I’m grateful.

I use a behind-the-ear aid. I work as a civilian now with the military. I see the mobile hearing trucks, so it seems like the military is being more proactive about hearing protection than when I was active duty.

I think hearing loss risks are downplayed to a degree because hearing loss can be very hard to deal with on an individual basis. It’s not something that another person can see, like losing a limb. People don’t understand the difficulties of using hearing aids, or how your hearing changes daily or hourly depending on the battery life, etc.

There will always be some guys who feel they are too tough or too busy for personal protective wear or devices. I also feel there are some jobs, especially in the military, where communication is very important for safety. You have to hear what you’re being told and be able to repeat or relate information when asked. So when you are asked to wear double hearing protection it can be very difficult. You sometimes compromise one safety area or issue to accommodate another.

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