Better Hearing Health Across the Department of Defense

By Theresa Y. Schulz, Amy Blank, April J. Taylor, and Kelly S. Paul

This article is a part of the September/October 2020, Volume 32, Number 5, Audiology Today issue.

Originating from the rehabilitation of noise-induced hearing losses (NIHL) incurred during World War I and II, the Department of Defense (DoD) has historically led the fields of hearing conservation and audiology   (Bergman, 2002).

In fact, the earliest hearing-conservation regulations came from the military services with the Air Force in 1956. The change that the U.S. Army made to the Army Hearing Program in 2008 to make hearing capabilities rather than hearing-loss prevention the primary focus has continued this tradition of innovation and leadership.

That leadership and innovation endure as significant changes continue to challenge the Military Health System. The United States (U.S.) military health-care systems have been reorganized under the Defense Health Agency (DHA). The DHA is a joint, integrated combat- support agency that delivers the quadruple aim of:

1. Increased readiness,
2. Better health,
3. Better care, and
4. Lower cost.

The military has the latter three of these aims in common with our non-military audiology colleagues. Unique to the military is that our primary aim is readiness. We maintain physical, mental, and medical preparedness to deploy when needed, during both peacetime and wartime.

While undergoing the largest merger of health-care systems ever attempted, the DHA has worked closely with the services to provide medical readiness and health-care delivery that is more integrated, efficient, and effective than ever before (U.S. Defense Health Agency, 2020).

The Air Force, Army, and Navy have active duty (military), as well as civilian audiologists and technicians. We partner with industrial hygiene, public health, occupational health, and safety to deliver hearing-loss-prevention care.

In 1978, military hearing-conservation programs were standardized across the three services with the publication of a U.S. Department of Defense Instruction (DoDI 6055.12, 2019). This document is updated periodically to provide guidance and requirements for hearing-conservation implementation.

Although there are some differences among service programs, all the programs collaborate in many ways. The DoD Hearing Conservation Working Group has representatives from each service who provide expert consultation to the Department of Defense on noise control, hearing injury metrics/trends, hearing-loss prevention, and hearing-conservation research initiatives.