Hearing threshold comparisons between 2001-02 NHANES and 2003-05 Fort Bliss U.S. Army Service components.

This study compares population mean hearing threshold levels in decibels (dB) at 4 kHz among the 2001-02 National Health and Nutrition Examination Survey (NHANES) (n=1872) and the 2003-05 Fort Bliss Army Active Duty (AD) (n=9096), National Guard (NG) (n=3842), and Reserve Components (RC) (n=2025) and by gender. Comparisons between male populations show that mean hearing thresholds are not significantly different (p<0.05) between U.S. Army Active Duty males and NHANES males, which differ from a 1984 U.S. Army Active Duty/1971-74 NHANES study showing significantly higher hearing thresholds for the Army Active Duty population. In addition, this study shows that Active Duty males have significantly lower hearing thresholds than National Guard males at ages <40 years old. Female groups generally have significantly lower hearing thresholds than male groups at all ages, but there are not significant differences between female military and civilian populations.

Modeling hospital response to mild and severe influenza pandemic scenarios under normal and expanded capacities.

William Beaumont Army Medical Center conducted quantitative modeling with FluSurge 2.0 (Centers for Disease Control and Prevention) to determine hospital capabilities in responding to patient arrival surges of the Fort Bliss population in mild 1968-type and severe 1918-type influenza pandemics. Model predictions showed that William Beaumont Army Medical Center could adequately care for all intensive care unit (ICU) and non-ICU patients during a mild pandemic, particularly if hospital capacity was expanded using the emergency management plan, excess surge plan, or activation of a contagious disease outbreak facility. For a severe influenza pandemic, model predictions showed that hospital beds, ventilators, and other resources would be exceeded within 2 or 3 weeks. Even at maximal hospital expansion, for a 12-week severe pandemic with a 35% attack rate there would be peak demand for 214% of available non-ICU beds, 785% of ICU beds, and 392% of ventilators. Health care planners and decision-makers should prepare for resource challenges when developing plans for the next influenza pandemic.

Comparison of nondeployable hearing profiles by Army component (Active Duty, National Guard, and Reserve) and by gender.

The Hearing Conservation Service at Fort Bliss conducted baseline-hearing assessments from January 2003 to March 2005 on 14,974 soldiers in the Active Duty (AD), National Guard (NG), and Reserve Component (RC). The percentages of soldiers with >H-2 (i.e., nondeployable) hearing profiles based on Army component and gender are as follows: AD male = 2.21%; AD female = 0.65%; NG male = 5.05%; NG female = 1.64%; RC male = 5.02%; and RC female = 0.54%. Female soldiers in all three components and AD male soldiers are not significantly different (p < 0.05) from each other and have a significantly lower percentage of >H-2 hearing profiles than NG and RC male soldiers after adjusting for age. With the Army engaged in worldwide missions, these results should prove useful to commanders and medical officers for assessing deployment capabilities and for hearing conservation interventions.

Audibility of patient clinical alarms to hospital nursing personnel.

The audibility of patient clinical alarms to nursing personnel was tested during the first shift on a medical/surgical in-patient ward at William Beaumont Army Medical Center. This study was conducted during normal hospital operations, and we tested the Joint Commission on Accreditation of Healthcare Organizations 2004 National Patient Safety Goal, Section 6b to determine whether patient alarms could sufficiently compete against environmental background noises. Patient clinical alarms were audible at distances of > or = 95 feet with room doors open but were not sufficiently audible to hospital staff members when room doors were closed or during floor-buffing activities. This study suggests that, under these circumstances, hospitals may not meet Joint Commission on Accreditation of Healthcare Organizations 2004 National Patient Safety Goal, Section 6b. Because the audibility of patient clinical alarms directly affects patient safety, satisfaction, and quality of care, we provide recommendations for engineering controls and modifications to work routines.