Suffering After Sacrifice

By Lauren McGrath

Every Veterans Day, Hearing Health Foundation (HHF) celebrates the brave individuals who have served and sacrificed to defend our country. We are grateful to our active military members and veterans for their courageous protection of American values and freedoms.

As we honor those who have served in the U.S. Armed Forces, we acknowledge a tragic and troubling health problem. An astounding number of veterans—60% of those returning from Iraq and Afghanistan—live with tinnitus and noise-induced hearing loss. In 2017, the Veterans Administration reported 1.79 million disability compensation recipients for tinnitus and 1.16 million compensation recipients for hearing loss, the number one and two disabilities, respectively. In an HHF video about hearing loss treatment, Retired Army Colonel John Dilliard, Chair-Elect of HHF’s Board of Directors, explains, “The noise from repeated gunfire and high-frequency, high-performance aircraft engines takes its toll on the human hearing mechanisms.” Col. Dillard lives with both tinnitus and hearing loss following 26 years of service.

John Dillard and fellow soldiers, Fort Irwin National Training Center, 1977.

Dr. Bruce Douglas, 93, remembers the moment his hearing became severely compromised while serving in the Navy during the Korean War. “On what was my 26th birthday, after pulling the trigger on the M1 rifle with no protection (none of us had any) multiple times, I was left with tendonitis in both knees—and worse, permanent, chronic tinnitus due to acoustic trauma. My hearing went downhill ever after, and every imaginable kind of sound and sensation has resulted from my tinnitus,” Douglas writes in the Fall 2018 issue of Hearing Health.

Hearing protection training must start as soon as one enters the military. But there is a misconception that hearing protection inhibits vital communication and mission readiness because hearing signs of danger is imperative to survival. “Soldiers want to be able to hear the snap of the twig and want to be able to be situationally. As a result, they are often resistant to wearing hearing protection,” Col. Dillard says.

Fortunately, sophisticated hearing protection technology does exist so that military personnel do not have to choose between protecting their ears or their lives. Examples include noise-attenuating helmets, which use ear cups to protect against hazardous sound, and Tactical Communication and Protective Systems, which protect against loud noises while amplifying soft ones.

The U.S. military continues to work toward safer hearing in the service. The U.S. Army has developed the Tactical Communication and Protective System (TCAPS), which are earbuds that dampen dangerous noises to safe levels using microphones and noise-canceling technology, while also providing amplification of softer sounds and two-way communication systems. An initiative by the U.S. Air Force called Total Exposure Health (TEH), meanwhile, focuses on overall health both on and off the job, will measure cumulative noise exposure over the course of 24 hours. These developments and others, which HHF applauds, are covered in greater detail in Hearing Heath’s Fall 2017 issue.

As greater preventative technology for our military becomes available, HHF remains dedicated to finding better treatments and cures for tinnitus and hearing loss to benefit the lives of millions of Americans, including veterans, a disproportionately affected group. We hope you will join us in remembering their sacrifices with gratitude and compassion.

Simple Treatment May Minimize Hearing Loss Caused by Loud Noises

John Oghalai, M.D. (a 1996–97 ERG scientist), of the University of Southern California, coauthored a May 7, 2018, study in the Proceedings of the National Academy of Sciences showing promise for preventing noise-induced hearing loss. Using a mouse model, the investigators found that in addition to immediate hair cell death after loud noise exposure, a fluid buildup in the inner ear occurs, eventually leading to nerve cell loss. Because the extra fluid shows a high potassium level, the researchers saw a method to rebalance the fluid by injecting a salt and sugar solution into the ear. Nerve cell loss was reduced by 45 to 64 percent, which the team says may preserve hearing. The team sees future applications for military service members exposed to blast trauma and patients with the hearing and balance disorder Ménière’s disease. —Y.L.

Let’s Make Noise Safer

By Vicky Chan

April 25 is International Noise Awareness Day, an annual, vital reminder to take a stand against noise exposure and to spread awareness about the underestimated threat of noise-induced hearing loss (NIHL). Seemingly harmless rhythms, roars, and blasts heard daily from music, trains, and machinery are, in fact, among the top offenders of NIHL.

Noise-induced hearing loss (NIHL) progressively occurs after chronic exposure to loud sounds. The frequency and intensity of the sound level, measured in decibels (dB), increases the risk of NIHL. Gradual hearing loss can result from prolonged contact with noise levels of 85 dB or greater, such as heavy city traffic. Noises of 110 dB or more, like construction (110 dB), an ambulance (120dB), or the pop of firecrackers (140-165 dB) can damage one’s hearing in a minute’s time.

NIHL is the only type of hearing loss that is completely preventable, yet billions of individuals endanger themselves daily. Over 1.1 billion young adults ages 12 to 35—an age group that frequently uses headphones to listen to music—are at risk. Already, an estimated 12.5% of young people ages of 6 to 19 have hearing loss as a result of using earbuds or headphones at a high volume. A device playing at maximum volume (105 dB) is dangerous, so exposure to sounds at 100 dB for more than 15 minutes is highly discouraged.

Most major cities around the world have transit systems that put commuters in contact with sounds at 110 dB. BBC News found that London’s transit systems can get as loud as 110 dB, which is louder than a nearby helicopter taking off. The sound levels of some stations exceed the threshold for which occupational hearing protection is legally required. New York City has one of the largest and oldest subway systems in the world where 91% of commuters exceed the recommended levels of noise exposure annually. In a study on Toronto’s subway system, 20% of intermittent bursts of impulse noises were greater than 114 dB.

People who work in certain fields are more vulnerable to NIHL than others. Professional musicians, for instance, are almost four times as likely to develop NIHL than the general public. Military personnel, who are in extremely close proximity to gunfire and blasts, are more likely to return home from combat with hearing loss and/or tinnitus than any other type of injury. And airport ground staff are surrounded by high-frequency aircraft noises at 140 dB. In all of these professions, the hazard of NIHL can be significantly mitigated with hearing protection.

NIHL is permanent. Increased exposure to excess noise destroys the sensory cells in the inner ears (hair cells), which decreases hearing capacity and leads to hearing loss. Once damaged, the sensory cells cannot be restored. To find a solution, Hearing Health Foundation’s (HHF) Hearing Restoration Project (HRP) conducts groundbreaking research on inner ear hair cell regeneration in hopes of discovering a life-changing cure.

Nearly three-quarters of those who are exposed to loud noises rarely or never use hearing protection. It is our dream that someday, NIHL will be reversible as a result of the HRP. Until then, to make noise safer, HHF advises protection by remembering to Block, Walk, and Turn. Block out noises by wearing earplugs or protective earmuffs. Walk away or limit exposure to high-levels of noises. Turn down the volume of electronic devices.

You Can Change Lives

By Nadine Dehgan

On behalf of folks like John—Thank you for your continued support of Hearing Health Foundation (HHF), the largest U.S. nonprofit funder of hearing loss and tinnitus research in America.

We are dedicated to discovering better treatments and permanent cures.

John—a Retired U.S. Army Colonel—served during the Cold War. Constant exposure to gunfire and high-pitched helicopter engines took a toll on his hearing. He was diagnosed with tinnitus and hearing loss in 1996. His diagnosis fueled his desire to improve the lives of active duty personnel and veterans since.

Tragically, John's circumstances are not unique. Tinnitus is the most common physical ailment for returning military personnel, followed by hearing loss. 60% of Iraq and Afghanistan veterans suffer from one or both of these conditions.

Many Veterans, even those who pass their hearing test, have trouble understanding speech. This condition, known as auditory processing disorder, is often caused by blast exposure.

Today John teaches at the Naval Postgraduate school where he often counsels young military officers as they cope with their tinnitus, as tinnitus can cause significant sleep, concentration, and mood issues.

Can you help bring us closer to better treatments and cures for tinnitus for John and the 65 million other Americans with tinnitus, many of whom are also veterans? 

PLEASE, IF YOU ARE ABLE, GIVE TO HHF TODAY. 100% OF YOUR GENEROUS GIFT WILL BE DIRECTED TO THE AREA OF YOUR DESIGNATION. 

One Man's Military Perspective

By Colonel John T. Dillard, U.S. Army (Retired)

The top two disabilities for our returning veterans from Iraq and Afghanistan are hearing loss and tinnitus, or ringing of the ears (which is actually a sound inside the brain). Both conditions became a problem for me and for many of my friends in the service. A lifetime spent in the U.S. Army, starting in the 1970s, meant frequent exposure to gunfire and proximity to screaming jets and helicopter engines.

Even during a peacetime career in the military, our soldiers, sailors, airmen, and marines are subject to a barrage of auditory insults from the weapons and equipment they operate. It all stacks up to a gradual, although sometimes very abrupt, loss of hearing, usually starting at the higher frequencies. For those in the service, any age-related decline in hearing gets accelerated, to the extreme, by repeated exposure to noise at unsafe levels.

For me, tinnitus began faintly and increased with more hearing loss, reaching a crescendo with one big acoustic trauma—a gunshot right next to me in 2009. I immediately began searching for any kind of treatment that would alleviate the loud ringing in my head, which was actually measured in a laboratory at being around a constant 70 decibels. That is roughly equivalent to the noise inside a fairly strong shower, and I soon discovered that people would use long showers to find a bit of relief by masking their tinnitus. (However, I take short showers!)

Armed with a background in biology and technology, I began to review all the research I could find. As it turns out, the typical tinnitus condition consists of several brain components: auditory (hearing it); attentional (your awareness of it); memory (persistence); and emotional (how it affects your mood). After many hours on the web, I spent thousands of dollars on things that didn't work, undergoing treatments in all areas of pharmacology, sound therapy, acupuncture, hyperbaric oxygen, and even transcranial magnetic stimulation.

None of these had any effect for me whatsoever. And despite some incredible recent advances in neuroscience to better understand all of the brain’s complexities, there is still no proven cure or even a viable treatment for tinnitus or to reverse hearing loss.

I eventually realized I would have to tackle my tinnitus with the only things out there that to me were credible for managing tinnitus. I eventually found an audiologist who would fit me with hearing aids that provided a built-in tinnitus masking sound. Without a doubt, this became the best purchase decision of my life...

Continue here to read the full version of "One Man's Military Perspective" in the Fall 2017 issue of Hearing Health. Colonel John T. Dillard, U.S. Army (Retired), resides in Carmel, California, with his wife of 30 years. A senior lecturer at the Naval Postgraduate School in Monterey, Dillard spent his army career serving in mechanized and parachute infantry assignments and managing programs to bring new technological capabilities to warfighters. He serves on a consumer review panel of tinnitus treatments for the Department of Defense (DoD)’s Congressionally Directed Medical Research Programs and also conducts acquisition policy research for the DoD.

What's That Noise?

By Laura Friedman

In honor of World Tinnitus Day April 18, Hearing Health Foundation (HHF) wants to draw attention to the effects and challenges associated with tinnitus.

The U.S. Centers for Disease Control estimates some 15% of Americans—about 50 million people—have experienced tinnitus. Roughly 20 million people struggle with chronic tinnitus, while 2 million have extreme and debilitating cases. It is also a top war wound among active U.S. military personnel and veterans.

Tinnitus is defined as the perception of sound when there is no external, acoustic source. Individuals with tinnitus may describe the noise as buzzing, hissing, whistling, swooshing, or clicking. Roughly 90 percent of tinnitus cases occur with an underlying hearing loss.

Tinnitus can be either intermittent or chronic. People who experience intermittent tinnitus occasionally hear sounds in their ears that can last from minutes to hours after being exposed to excessively loud noises. An example would be someone sitting near the fence of a NASCAR race without wearing hearing protection. People with chronic tinnitus, on the other hand, often experience noise more frequently, which can last for more than three months.

The impact of tinnitus on everyday life differs from person to person. Researchers found that most people with chronic tinnitus are not too bothered by it. Many of these people prefer to only see a doctor for assurance that their tinnitus is not an indication of a serious disease or impending deafness. People who were bothered by their tinnitus reported that it was annoying, invasive, upsetting, and distracting in daily life. In a small tinnitus self-help group, some members frequently describe having problems sleeping, understanding speech, poor concentration, inability to relax, and depression.

People with age-related hearing loss, or presbycusis, may also experience a ringing, hissing, or roaring sound in the ears. Presbycusis progresses over time and is generally more severe in men than in women and the risk increases with age, as shown in epidemiological surveys.

Although there is no cure for tinnitus, there are available treatments that can minimize tinnitus symptoms. Tinnitus Activities Treatment (TAT), cognitive behavioral therapy (CBT), and Tinnitus Retraining Therapy (TRT) are sound therapies that can lessen the effects of tinnitus, often times very helpful in combination with counseling. Furthermore, by using hearing protection and noise reduction technologies, and by avoiding excessive noise, many people can prevent significant hearing problems.

Taking care of your hearing should always be part of keeping healthy overall. If you suspect a hearing loss or tinnitus, HHF recommends getting your hearing checked. If you do have a hearing loss or tinnitus, talk with your hearing healthcare professional about available treatments. For more information, visit hhf.org/tinnitus or email us at info@hhf.org.

Laura Friedman is the Communications and Programs Manager of Hearing Health Foundation.

Veterans Day

By Morgan Leppla

Can you guess the number one and two war wounds among veterans? Tinnitus and hearing loss, respectively.

Sixty percent of vets return from war with hearing loss and tinnitus. Enlisted for 11 years, Sergeant Nathan Heltzel has a 40 percent hearing loss in his left ear, a 30 percent hearing loss in his right ear, and tinnitus that is a direct result of gunfire and loud jet engines on flight line duty.

He recalls that during his time in the military from 1995 to 2009 there technically was a requirement to wear ear protection, but hearing the radio, team, and anything else that could be advantageous was prioritized over protection, so it was not enforced.

He left service because of hearing loss and has learned to manage tinnitus on his own, using a white-noise machine to mask ringing sounds while he sleeps.

Another serviceman, Major Richard Uzuanis, says it is not in military culture to address things that could impact one’s ability to perform duties and missions, so many people ignore their hearing loss or tinnitus. Uzuanis adds that it contributes to the overall safety of troops if people are hearing clearly.

Hearing Health Foundation wants to thank service members and veterans and remind them that they are disproportionately at risk for sustaining hearing loss and tinnitus. Hearing loss affects how one conducts missions and follows instructions. Take precautions and protect your ears from the dangers of noise, to ensure your safety, and the safety of those around you.

Lastly, check out our veterans’ resources page today!