Implications of War-related hearing loss

Recently, a number of articles have appeared in newspapers and news-related Web sites, as well as in hearing conservation-related journals, concerning war-related hearing loss.  A recent study from the US Army indicates that one in four soldiers serving in Iraq and Afghanistan have damaged hearing.  In addition to the sheer amount of human suffering this hearing loss represents, the long-term cost to our society will be many millions of dollars in Veterans Administration-related compensation and services.

So what might be the immediate hearing conservation related consequences to employers as these brave servicemen and women return from military service to their jobs?  Our experience with returning Gulf War veterans provides some insights.

First, it is important to quickly provide a hearing test for veterans upon return to work.  This will provide a measure of how much change in hearing has occurred since departure for military service.  Some will have incurred more change than others, and those with moderate to severe hearing loss will face new challenges to communicating and working safely in the workplace.  The hearing test will provide the audiologist or physician overseeing the hearing conservation program with valuable information with which to help the employer assist the hearing-impaired employee to work safely and communicate effectively on-the-job.

Second, it is likely that some newly returned employees will experience a change in hearing mathematically qualifying as possibly recordable on the OSHA 300 Log:  an age-related Standard Threshold Shift (STS) and average hearing loss greater than 25 dB HL.  The recordability rule states that this change in hearing must be recorded if the employer is thought to contribute even partially to the change.  Thus, the employer cannot automatically exclude consideration for recording simply based upon war-related noise exposure.  Whether it becomes an actual recordable is dependent upon a number of factors, including the degree of change from baseline that took place prior to the employee’s departure for military service.  It is advisable to include the audiologist or physician overseeing the hearing conservation program in this work-relatedness determination.

Third, we experienced that many employers wanted an automatic baseline revision for returning veterans.  It is not permissible to automatically revise the baseline upon return from military service.  Many veterans will return having little-to-no significant change in hearing, thus baseline revision will be unwarranted.  Further, the OSHA Noise Exposure Standard states clearly that the baseline is revised in the presence of a persistent STS.  Nor does the provision for revising baselines for rehires apply as these veterans are returning to work rather than being rehired.

Fourth, some of these employees should be evaluated by a physician and/or an audiologist to investigate potential medical issues and hearing aid use.  For instance, tinnitus (constant ringing in the ears) is a quite common result of noise-induced hearing loss, can be severe enough to cause distress, and can be managed.  Other veterans will have experienced ruptured eardrums and may need ongoing medical management.  It is appropriate for the employer to inquire as to whether the veteran is “service connected for hearing loss” with the VA.  If the answer is yes, the veteran is entitled to VA services.

Finally, let us remember that these veterans have served our country with honor and are worthy of our respect and compassion.  Let this thought be our guide as we endeavor to help them transition from their role as warrior to their role in the workplace.