Readiness thru Hearing Conservation Military Audiology Readiness thru Hearing Conservation We recommend each audiologist create a talking paper specific to their MTF and commander’s interests. This presentation is meant to used as an outline and may be altered to meet specific needs. POC: Army MAJ. Gates DSN 584-3797 Air Force CPT. Narrigan DSN 785-2393 x 201 Navy LT. Bealer DSN 584-3797

Briefing Outline Mission and Vision DoD Audiology Goals Benefits of Military Audiologists Readiness thru Hearing Conservation Additional Audiology Missions Managed Care Building Healthy Communities

DoD Audiology Mission To Ensure Operational Readiness to the Fighting Force and Quality-of-Life to Eligible Beneficiaries by Providing Cost-Effective Hearing Health Care through State-of-the-Art Audiological Services, Including Prevention, Medical Surveillance, Education, and Research. Developed as Tri-Service effort. Please do not alter.

DoD Audiology Vision Strategically Place Military Audiologists to Support the Fighting Force for Success on the Modern Battlefield. Recognize Military Audiologists as Primary Experts and Providers of Hearing Health Care. Promote Education and Research to Enhance Operational Readiness. Developed as Tri-Service effort. Please do not alter.

DoD Audiology Goals Promote Readiness thru Hearing Conservation Manage Hearing Health Care for Soldiers, Airmen, and Sailors Through Audiological Evaluations for Early Identification of Noise Induced Hearing Loss (NIHL) Build Healthy Communities Through Hearing Conservation, Clinical Audiology, and Community Health Education Hearing conservation is a force multiplier by ensuring force readiness through hearing protection, hearing loss prevention and education. Hearing Conservation Programs support line, occupational health and public health through stringent program monitoring of hazardous noise and potentially ototoxic chemicals. Early identification and prevention of noise induced hearing loss is critical in the militaries overall force readiness. Building healthy communities through base and local education efforts support quality intervention and prevention programs. Education of hazardous noise environments and equipment is the first step in ensuring hearing protection compliance. Hazardous noise affects military members and their families on and off duty.

Benefits of A Military Audiologist Knowledge of Military Missions Ability to Interact with Line Officers Superior Understanding of Specific Military Noise Ability to Gain Trust and Confidence of Junior Enlisted Support to Guard and Reserve Mirror Force Missions Military audiologists are professional military officers who are knowledgeable of our militaries mission. Completion of professional military education and knowledge of the military’s role allows active duty audiologists to interact with command line officers with equal respect of brothers-in-arms. Trust, respect and confidence of the enlisted force is gained by instant acceptance of the uniformed officer. The unique mission of the military creates unique noise environments. Noise sources used on a daily basis in the military are “unheard” of in the civilian community. Military audiologists have superior training and understanding of these noise hazards. Military audiologists serve as hearing conservation referral centers supporting the Guard and Reserve HCPs. The Guard and Reserves have the same requirements as active duty to hearing conservation. Referrals include patient follow-up for shift management, OSHA reportable shifts, fitness for duty, noise collection criteria, adequate hearing protection needs, and Staff Assistance Visits for overall program evaluation.

Benefits of A Military Audiologist CAOHC Certified Course Director Flexible Work Hours Tri-Service Deployment of DOHRS-HC Stringent Regulatory Compliance OSHA; DoDI; and Service Specific Instructions Military audiologists are uniquely qualified as hearing conservation professionals. Of the top three academic audiology programs in the nation only one offers training in hearing conservation. There are 380 nationally certified (CAOHC) course directors. Over 25% of the course directors are active duty military. Tri-Service deployment of DOHRS-HC program will enable base level HCP managers access to local trend reports. This will allow early identification of noise induced hearing loss trends and targeted education efforts. Active duty military audiologists are specifically trained in HCP management and regulatory compliance.

DoD Hearing Conservation Program Medical Readiness Force Multiplier Program Management Prevention Education Surveillance Largest HCP Data Warehouse Readiness is achieved through education, training, and prevention. (The only treatment for noise induced hearing loss is prevention) Hearing profiles (H-1, H-2,H-3 and H-4) categorize hearing loss. They define referral and waiver criteria to assess communication ability. Hearing profiles are also used as guidance for enlistment and commissioning eligibility. HCP management includes, affecting the lines commitment, raising employee involvement, work-site analysis of noise exposure data, hazard prevention and control, safety and health training. This in combination with annual audiometric surveillance and hearing protection compliance noise induced hearing loss is totally preventable.

Readiness Army research has shown that detection distance of combat sounds decreases as hearing loss increases. For example A normal hearing soldier can hear footsteps in leaves at 100 meters whereas a soldier with >H-2 hearing can detect only at 1 meter. A normal hearing soldier can hear a rifle bolt closing over 1.000 meters whereas a soldier with >H-2 hearing cannot detect that sound until 46 meters. Talk about specific research

Additional Audiology Care for Military Service Members Diagnostic Audiology Services Follow-up Evaluations for STS Site of Lesion Testing Identification of Malingerers Monitoring and Documenting Hearing Profiles Fitness for Duty Evaluations Diagnostic services include air / bone puretone assessment, middle ear impedance and acoustic reflex evaluation, electrophysiological testing of the eight cranial nerve, distortion/ transient products, aural rehabilitation and amplification. Diagnostic evaluation are used for site-of-lesion testing to rule-out acoustic tumors. Audiologic evaluations are also used for identification of malingerers. The safety and health of our military force cannot be separated from our readiness mission. In order to ensure safety in the workplace fitness for duty evaluations are accomplished and reasonable accommodations are made on a case by case basis. This process allows military audiologists to assess communication needs and ability.

Audiology Care for Military Family Members Clinical Audiology Services to Family Members and Retired Personnel Retiree Hearing Aid Purchase Program Universal Newborn Hearing Screenings Support ENT, OH, Flight Medicine, and Other Clinics Work/Equipment Sharing with Veterans Administration Military audiologists provide complete clinical services to military family and retired members. Programs like the Retiree at Cost Hearing Aid Purchase Program (RaCHAP) were developed and implemented by military audiologists. This program allows retired military members to purchase hearing aids at a federally contracted price. (total cost is about 25% of the civilian cost) Saving to MTF is $____________ Clinical audiology settings support MTF through referrals. Referrals are common from ENT, Pediatrics, Primary Care, Internal Medicine, Flight Medicine, and Occupational Health. Cost per visit is $____________ Work and equipment sharing agreements are common between military and Veterans Administration audiology services. These programs ensure better access to care and eliminates duplication of costly equipment and services. Cost saving through VA work sharing agreement is $____________

Audiology Care In Building Healthy Communities Hearing Loss Prevention Programs Operation BANG (Be Aware of Noise Generation) Hearing Loss Screening Programs Infant; School Age; Health Fair Occupational Hearing Conservation Programs for the Civilian Workforce Comprehensive Program Management Military audiologists are active with many education and prevention programs both on base and in the local community. Operation BANG targets hazardous noise education for elementary school children. New born hearing assessments are a requirement of the Joint Committee for Infant Hearing Screening.

Military Audiologists Summary Are Uniquely “Suited” Increase Fighting Force Readiness Provide Comprehensive HCP Management Provide Full Spectrum Audiology Support Active duty military audiologists are uniquely “suited” to provide complete hearing health care from cradle to grave. Ensure force readiness through hearing conservation while providing a full range of diagnostic tests and and treatments. Military audiologists provide direct support to the line mission through hearing loss profiles, waivers and fitness for duty assessments. Every military audiologist is a clinician, HCP manager, professional military officer, and hearing loss prevention educator for the base and local community. Civilian academic audiology programs don’t teach hearing conservation. Hearing conservationists are trained after entering the profession. Over 25% of the nations certified experts in hearing conservation are currently on active duty. Military audiologists are pillars of medical service strategy through support of core competency, managed care, total care system, and quality intervention and prevention.

DoD HC Program Elements Noise Hazard Identification and Engineering Controls Hearing Protectors Monitoring Audiometry Health Education Enforcement Program Evaluation These are the key elements for a successful hearing conservation program. Together they build the foundation for hearing conservation. Like the pillars of medical service strategy each is important in supporting mission and vision of military audiology.

Annual Cost Analysis Military Audiologist = $ Cost Savings Mission Uniformed Civilian Contract Audiologist Audiologist Audiologist To Manage The HCP Diagnostic & Special Tests Military Audiologist = $ Cost Savings

Other Ideas Prevalence Study 24% Reduced H-3 Profiles