Examining the utility of near infrared light as pre-exposure therapy to mitigate temporary noise-induced hearing loss in humans.

Introduction: This study sought to determine the effect of Occupational Safety and Health Administration (OSHA) compliant noise on auditory health and assess whether pre-noise near infrared (NIR) light therapy can mitigate the effects of noise exposure. Methods: Over four visits, participants (n = 30, NCT#: 03834714) with normal hearing completed baseline hearing health assessments followed by exposure to open ear, continuous pink noise at 94 dBA for 15 min. Immediately thereafter, post-noise hearing tests at 3000, 4000, and 6000 Hz and distortion product otoacoustic emissions (DPOAEs) were conducted along with the Modified Rhyme Test (MRT), Masking Level Difference Test (MLD), and Fixed Level Frequency Tests (FLFT) [collectively referred to as the Central and Peripheral Auditory Test Battery (CPATB)] to acquire baseline noise sensitivity profiles. Participants were then randomized to either Active or Sham NIR light therapy for 30 min binaurally to conclude Visit 1. Visit 2 (≥24 and ≤ 48 h from Visit 1) began with an additional 30-min session of Active NIR light therapy or Sham followed by repeat CPATB testing and noise exposure. Post-noise testing was again conducted immediately after noise exposure to assess the effect of NIR light therapy. The remaining visits were conducted following ≥2 weeks of noise rest in a cross-over design (i.e., those who had received Active NIR light therapy in Visits 1 and 2 received Sham therapy in Visits 3 and 4). Results: Recovery hearing tests and DPOAEs were completed at the end of each visit. Participants experienced temporary threshold shifts (TTS) immediately following noise exposure, with a mean shift of 6.79 dB HL (±6.25), 10.61 dB HL (±6.89), and 7.30 dB HL (±7.25) at 3000, 4000, and 6000 Hz, respectively, though all thresholds returned to baseline at 3000, 4000, and 6000 Hz within 75 min of noise exposure. Paradoxically, Active NIR light therapy threshold shifts were statistically higher than Sham therapy at 3000 Hz (p = 0.04), but no other differences were observed at the other frequencies tested. An age sub-analysis demonstrated that TTS among younger adults were generally larger in the Sham therapy group versus Active therapy, though this was not statistically different. There were no differences in CPATB test results across Active or Sham groups. Finally, we observed no changes in auditory function or central processing following noise exposure, suggestive of healthy and resilient inner ears. Conclusion: In this study, locally administered NIR prior to noise exposure did not induce a significant protective effect in mitigating noise-induced TTS. Further exploration is needed to implement effective dosage and administration for this promising otoprotective therapy.

Noise of military weapons, ground vehicles, planes and ships.

Noisy equipment and processes are found throughout military operations, exposing service members to risks of hearing damage due to hazardous noise levels. This article provides an overview of the military noise environment for the non-expert and provides a general characterization of the noise by source type and operational category. The focus of the article is primarily related to the Army, but the same, or similar, equipment is used by the Navy, Marine Corps, and Air Force. Damage risk criteria used by the Army Public Health Command are discussed. In addition, the important role of hearing protection to mitigate the hazards of noise exposure is provided.

Military and industrial performance: the critical role of noise controls.

Noise control is a well understood and important engineering skill. The science has been developed to address operational needs of being quiet on the one hand, and avoiding hearing loss on the other, both in industry and military operations. Noise control is also the first priority step in systems safety risk mitigation for noise hazards, as evidenced in U.S. industry by the requirement stated in Federal OSHA regulation 1910.95: "(b)(1) When employees are subjected to sound exceeding those listed in Table G-16, feasible administrative or engineering controls shall be utilized." In actual practice, engineering controls are of first preference, while the second step is administrative noise controls, reducing noise exposures by removing personnel from high-noise environments. The third is the use of personal protective equipment (PPE), commonly known as earmuffs and earplugs. Each of these topics is discussed herein. The U.S. Navy has developed and/or implemented many groundbreaking noise control efforts on ships, and that provides the basis of discussion in this article. This article, as an overview of noise control, also addresses issues associated with high-noise environments and consideration of noise control techniques.

Engineering out the noise.

The US Navy, through an Office of Naval Research (ONR) lead effort on Noise Induced Hearing Loss (NIHL), is investigating methods and techniques to mitigate hearing loss for the crews and warfighters. Hearing protection is a viable and increasingly popular method of reducing hearing exposure for many ship crew members; however, it has limitations on comfort and low frequency effectiveness. Furthermore, Personal Hearing Protection (PHP) is often used improperly. Proper vessel planning, programmatic changes and advances in noise control engineering can also have significant impacts by inherently reducing noise exposure through ship design and use of noise control treatments. These impacts go beyond hearing loss mitigation since they can improve quality of life onboard vessels and provide enhanced warfighter performance. Such approaches also can be made to work in the lower frequency range where hearing protection is not as effective. This paper describes non-hearing protection methods being implemented to mitigate and control noise within the US Navy and US Marine Corps. These approaches reflect the latest changes to Mil-Std 1474E, Appendix F.

Performance in noise: Impact of reduced speech intelligibility on Sailor performance in a Navy command and control environment.

Noise, hearing loss, and electronic signal distortion, which are common problems in military environments, can impair speech intelligibility and thereby jeopardize mission success. The current study investigated the impact that impaired communication has on operational performance in a command and control environment by parametrically degrading speech intelligibility in a simulated shipborne Combat Information Center. Experienced U.S. Navy personnel served as the study participants and were required to monitor information from multiple sources and respond appropriately to communications initiated by investigators playing the roles of other personnel involved in a realistic Naval scenario. In each block of the scenario, an adaptive intelligibility modification system employing automatic gain control was used to adjust the signal-to-noise ratio to achieve one of four speech intelligibility levels on a Modified Rhyme Test: No Loss, 80%, 60%, or 40%. Objective and subjective measures of operational performance suggested that performance systematically degraded with decreasing speech intelligibility, with the largest drop occurring between 80% and 60%. These results confirm the importance of noise reduction, good communication design, and effective hearing conservation programs to maximize the operational effectiveness of military personnel.

Prelude: noise-induced tinnitus and hearing loss in the military.

Hearing is critical to the performance of military personnel and is integral to the rapid and accurate processing of speech information. Thus, noise-induced hearing loss (NIHL) represents a severe impairment that reduces military effectiveness, safety, and quality of life. With the high levels of noise to which military personnel are exposed and the limited protection afforded by hearing conservation programs, it should be no surprise that annual Veterans Affairs disability payments for tinnitus and hearing loss exceeded $1.2 billion for 2009 and continue to increase. Military personnel work in high-noise environments, yet the Department of Defense (DoD) cannot predict who is susceptible to noise-induced hearing loss and tinnitus. Of those exposed to noise, 80% may also suffer from chronic tinnitus. Despite its prevalence, there are no means to objectively measure the severity of tinnitus in those individuals. A fundamental understanding of the underlying mechanisms of tinnitus and its relation to noise-induced hearing loss is critical. Such an understanding may provide insight to who is at risk for each condition, allow aggressive hearing protection measures in those individuals most at risk, and create areas for treatment for those already suffering from the conditions. The current review will address the scope of the problems of NIHL and tinnitus for the military, discuss the noise environments in which military personnel operate, describe the hearing conservation measures currently in place, and the challenges those programs face. Some recent breakthroughs in NIHL research will be discussed along with some challenges and directions for future research on NIHL and tinnitus.