sagiraju hkr 1, betancourt ja 1, tucker dl 2, gorrell ns 2, whitworth kw 1, marko d 1, douphrate di...
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Sagiraju HKR1, Betancourt JA1, Tucker DL2, Gorrell NS2, Whitworth KW1, Marko D1, Douphrate DI1, Cornell JE3, Cooper SP1, Delclos GL1, Whitehead LW1, Alamgir H1, Chien LC1, Senchak AJ4, Gimeno D1
1 UTSPH San Antonio and Houston; 2 The Geneva Foundation; 3 UTHSC-San Antonio; 4 Walter Reed National Military Medical Center
The burden of hearing loss among the military community: Initial findings of the Department of Defense Epidemiologic and Economic Burden of Hearing Loss Study (DEEBoHLS ).
Background
• DEEBoHLS is an ongoing collaborative effort
between the UTSPH and the DoD Hearing
Center of Excellence.
• Goal: To examine incidence of service-related
hearing impairment and noise-induced hearing
injury (HINIHI) cases among active duty armed
forces members of the U.S. military.
Methods
• Data on members aged 15 and older for fiscal
years (FY) 2008 - 2012 (excludes National
Guard and Reserve).
• Numerator from clinical encounters from DoD
direct care and paid provider records.
• Denominator is aggregated force strength from
the Defense Manpower Data Center (DMDC).
• Incidence by FY per 1,000 people based on
ICD-9 codes, focusing on the two most prevalent
ICD-9 groups.
Summary & Conclusions
• First comprehensive estimate of the current
burden of HINIHI among active duty Armed
Forces.
• Demographics of the sample remained
unchanged over the study period.
• Overall HINIHI incidence decreased.
• Tinnitus incidence increased while SNHL
incidence appear stable.
• Gender gap: Higher incidence among males.
• Age effect: Higher incidence among older
members.
• HINIHI incidence decreased for Army and Air
Force but almost doubled among marines.
• Tinnitus and SNHL incidence also increased
for marines.
Acknowledgements
Funding awarded through BAA 11-01-HPW from DoD Hearing Center of Excellence: “Clinical Investigation of Hearing Injuries, Noise Exposures, and Cost Burden in Active Duty US Military Service Members”.
Inquires to Natasha Gorrell, Project. Coord., at [email protected]
<12%
12-21%
21-45%>45%
<12%
12-21%
21-45%
>45%
<12%
ICD-9 codes Descriptive384.xx,385.xx
Tympanic membrane & Ossicular disorders
386.xx Vestibular system disorders388.02 Transient ischemic deafness388.1x Noise effects on inner ear388.2x Sudden hearing loss, unspecified388.3x Tinnitus388.4x,388.5
Abnormal auditory perception; Auditory nerve disorders
389.xx Hearing loss -> 389.1x- Sensorineural (SNHL)
0
5
10
15
20
25
30
35
2008 2009 2010 2011 2012
HINIHI-Male
HINIHI
HINIHI-Female
SNHL-Female
Tin-MaleTinnitusSNHL-MaleSNHL
Tin-Female
Figure 1. Crude incidence of HINIHI, tinnitus & SNHL by gender, FY 2008-2012
2012
2008
2012
2008
0% 20% 40% 60% 80% 100%
2012
200837.9%
38.9%
40.3%
41.2%15-17yrs 18-24yrs 25-34yrs 35-44yrs 45-64yrs
Female Male
Army Air Force MarineCoast Guard Navy
.1
.237.5
41.2
42.1
38.4
17.2
17.5
3
3
14.8
14.4
85.2
85.6
38.1
37.4
22.9
22.8
14.0
14.0
2.9
2.9
22.1
22.8
Table1. Demographics of the sample, FY 2008 & 2012
Figure 2. Crude incidence of HINIHI, tinnitus and SNHL by age & branch of service, FY 2008-2012
Results
Tinnitus SNHLHINIHI
15-17yrs18-24yrs
25-34yrs35-44yrs45-64yrs
0
50
100
150
200
2008 2009 2010 2011 2012
15.029.6 9.6 16.8
3.7
164.9148.6
133.9 127.7111.6
15-17yrs18-24yrs
25-34yrs35-44yrs45-64yrs
0
50
100
150
200
2008 2009 2010 2011 2012
2.7 1.8 4.1 1.4 1.2
71.6 76.7 78.6 81.673.0
15-17yrs18-24yrs
25-34yrs35-44yrs
45-64yrs
0
50
100
150
200
2008 2009 2010 2011 2012
5.0 13.50.0 7.0 2.5
95.987.1
77.2 74.366.3
Air Force Army Coast Guard Marines Navy
Per 1
,000
Per 1
,000
Per 1
,000
32.0
24.7
44.3
33.3
29.3 27.4
17.5
31.7
21.1 21.5
0
10
20
30
40
50
2008 2009 2010 2011 2012
12.9 14.5
17.6 19.8
9.210.5
15.9
7.4
12.4
0
10
20
30
40
50
2008 2009 2010 2011 2012
11.98.5
22.5
17.813.0 12.5
7.8
18.5
8.9 8.1
0
10
20
30
40
50
2008 2009 2010 2011 2012
Per 1
,000
Per 1
,000
Per 1
,000
AgeAgeAge
Per 1
,000
Next steps
• Adjusted incidence using DMDC individual
data.
• Confirm trends with audiogram data.
• Examine differences by occupation (available
from DMDC individual data).
Average population per FY: 1,396,330