1. Gimeno D 1, Betancourt J 1, Tucker D 2, Cooper S 1, Alamgir A 1, Whitworth K 1, Gorrell N 2, Delclos G 1, Hammill T 3, Senchak A 4, Packer M 3, Sagiraju H 1, Turner C 1 1 UTSPH San Antonio and Houston; 2 The Geneva Foundation; 3 Department of Defense Hearing Center of Excellence; 4 Walter Reed National Military Medical Center Hearing Impairment and Noise-Induced Hearing Injury in the United States Military Background The DoD Epidemiologic & Economic Burden of Hearing Loss study (DEEBoHLS) is a collaborative effort between The University of Texas School of Public Health & the DoD Hearing Center of Excellence. Objective: To examine incidence rates of Service-related hearing impairment and noise- induced hearing injury (HINIHI) among active duty Service members in the U.S. military. Methods Data on members aged 15 and older for fiscal years (FY) 2008 to 2012 (excludes: National Guard and Reserve). Numerator from Military Health Data Repository (MDR) and denominator (at-risk population) from the Defense Manpower Data Center (DMDC). Average population per year 1,443,090. Demographics of the sample appear stable over the study period. Initial unadjusted overall incidence rates increased from 27.0/1000 to 27.6/1000 over the study period. Tinnitus incidence rates increased from 9.3/1000 in FY2008 to 12.3/1000 in FY2012. Sensorineural healing loss (SNHL) rates slightly decreased from 11.4/1000 to 10.7/1000. Rates are higher in males, Army, Senior officers and older members. Summary & Conclusions This is the first preliminary comprehensive estimate of the current burden of HINIHI among active duty Armed Forces. Higher rates among males and among Army soldiers may be related to higher risk of exposure due to occupation and to higher membership. Increased rates among Marines may be due to increased surveillance of hearing loss. Future estimates of adjusted rates are needed to confirm these preliminary findings, as well as rates by occupational codes and based on audiograms. Acknowledgements Funding from Department of Defense Hearing Center of Excellence: “Clinical Investigation of Hearing Injuries, Noise Exposures, and Cost Burden in Active Duty US Military Service Members”. Awarded through BAA 11-01-HPW. Inquires to Dr. David Gimeno at David.Gimeno@uth.tmc.edu Results (continued) Incidence rates of overall hearing loss decreased over the study period for Army and Air Force, while the rates increased for Navy, Coast Guard and almost doubled among Marines. Rates for tinnitus and SNHL also increased for Marines over the period. ICD-9 codesDescriptive 384.xx, 385.xxTympanic membrane & Ossicular disorders 386.xxVestibular system disorders 388.02Transient ischemic deafness 388.1xNoise effects on inner ear 388.2xSudden hearing loss, unspecified 388.3xTinnitus 388.4x, 388.5 Abnormal auditory perception; Auditory nerve disorders 389.xxHearing loss -> Sensorineural In-patient Direct Care 21,443 encounters 16,801 persons 28,519 encounters 21,199 persons 1,865,965 encounters 243,349 persons 8,251,109 encounters 1,865,676 persons 2,521,818 persons Paid Providers Incidence (i.e., any new case in a FY) per 1,000 people based on ICD-9 codes, focusing on the two most prevalent ICD-9 groups. 2012 2008 2012 2008 0%20%40%60%80%100% 2012 2008 37.9% 38.9% 40.3% 41.2% 15-17yrs18-24yrs25-34yrs35-44yrs45-64yrs Female Army Air Force Marine Navy Male Coast Guard 14.1 14.5 85.5 85.9.1 41.1 43.1 39.0 35.9 16.9 17.9 2.9 3.0 38.6 37.4 22.8 13.8 13.9 3.0 2.9 21.7 23.0 Tin-Male Tinnitus 0 5 10 15 20 25 30 35 20082009201020112012 HL-Male HL HL-Female SNHL-Female SNHL-Male SNHL Tin-Female <12% 12-21% 21-45% >45% <12% 12-21% 21-45% >45% <12% Sensorineural Hearing LossTinnitusOverall Hearing Loss 12-21% 21-45% >45% 12-21% 21-45% >45% 12-21% 21-45% >45% <12% Air Force Army Coast Guard Marines Navy Air Force Army Coast Guard Marines Navy 15-17yrs 18-24yrs 25-34yrs 35-44yrs 45-64yrs 0 25 50 75 100 2008 2009 2010 2011 2012 11.9 8.2 5.4 9.0 5.4 85.7 87.0 83.6 81.4 75.1 15-17yrs 18-24yrs 25-34yrs 35-44yrs 45-64yrs 0 25 50 75 100 2008 2009 2010 2011 2012 2.3 1.0 1.5 0.9 0.0 32.7 38.2 38.3 39.9 35.3 15-17yrs 18-24yrs 25-34yrs 35-44yrs 45-64yrs 0 25 50 75 100 2008 2009 2010 2011 2012 4.3 1.0 0.0 4.5 4.0 46.3 43.9 39.0 36.6 33.4 Air Force Army Coast Guard Marines Navy 27.1 22.9 36.7 34.2 27.5 28.1 15.1 29.1 18.2 19.6 0 10 20 30 40 20082009201020112012 9.2 10.5 13.4 15.6 7.9 8.4 5.6 12.6 5.0 8.6 0 10 20 30 40 20082009201020112012 9.3 6.4 17.4 14.0 11.1 10.0 6.5 15.2 6.8 6.7 0 10 20 30 40 20082009201020112012 UTSPH: HSC-SPH-12-0628 USAMRMC: 392796 WRNMMC IRB: 399695 USAMRMC HRPO: A- 18329.A; A- 18329.B IRB Approvals Out-patient Results