The Army Hearing Program:Supporting the Soldier from Training to Combat

National Hearing Conservation AssociationOrlando, FL

February 2010

COL Vickie TutenCPT(P) Jillyen Curry-Mathis

CPT Kara Cave

Briefing OutlinePURPOSE: Provide an overview of the Army Hearing

Program, its impact on the Warrior in training and the role of the deployed Audiologist

1. Introduction to the Army Hearing Program

2. Training Warriors for Combat

3. Proposed “Best Practices” Initiative

4. Early Roles of the Deployed Audiologist

5. Relocation of Theater Assets

6. Evolution of Role in New Setting

7. Future Directions for the Army Hearing Program

8. Conclusion

The Army Hearing Program

Brief Overview

Army Hearing Program The Army Hearing Program (AHP) is a new initiative from Office of The Surgeon General

aimed at improving communication abilities on the battlefield and decreasing the rate of noise-induced hearing loss among soldiers. There are four elements to the AHP IAW

Special Text (ST) Document 4-02.501, which was implemented in February 2008

Hearing Readiness

Hearing Conservation

Operational Hearing Svcs

Clinical Hearing Services

Answering the Challenges of CombatWhat’s Changed?

Hearing Conservation Army Hearing ProgramSeven Elements Four Components

1) Hearing Protectors2) Health Education

1) Hearing Readiness

3) Monitoring Audiometry 2) Clinical Services

***** Missing Piece ***** 3) Operational Services

4) Noise Hazard Identification5) Engineering Controls

4) Hearing Conservation

6) Enforcement7) Program Evaluation

Bonus: Command Emphasis

Traditionally Garrison-Based Bridges the Gap: Garrison Theater

Training Warriors for Combat

From Basic Combat Training (BCT)

to Deployment

Hearing ReadinessHearing Readiness implies that Soldiers have the required

hearing capabilities, personal protective equipment (PPE), and medical equipment that are needed to train and deploy.

•Hearing Tests•Pre-Basic Combat Training Hearing Evaluations•Annual, Pre/Post-deployment Hearing Tests

•Personal Protection •Pre-Range & Pre-Deployment Hearing Protection Fittings•Regular Range Support for Soldiers•Required: Wear of Earplug Carrying Case on Uniform

•Installation Requirement•Moving to Army-wide Requirement

Hearing Readiness

Personal Protection • TRADOC Doctrine Change – “Best Practices” Initiative• Combat Arms Earplug (CAE) Fittings on all Basic Training Soldiers

– Fittings will no longer be completed at reception during in-processing– Combined Operational Hearing Briefing & CAE Fittings within 2-3 days of Range Training– Units will be required to contact Army Hearing Program to Schedule Class

• Required: Wear of Earplug Carrying Case on Uniform– Cadre/Permanent Party Soldiers wear case/earplugs on front right belt loop of ACU trousers– IET Soldiers wear case/earplugs in left-arm pocket (non-flag arm)

• Easy check of uniform using right hand taps

• Reinforce transfer of pocket contents when changing uniforms

• Prevents loss during drills and corrective actions

Clinical Hearing ServicesClinical Hearing Services are required in both garrison and deployed

settings. Although there is some overlap, the variance in services delivered between these two environments is operationally driven.

The AHP evaluates all Soldiers failing hearing tests:•Hearing Waivers of Recruits converted to Profiles – describes impact of loss on Soldier’s performance to Basic Training and Future Leadership (Safety Issue)•H2/H3 Profiles – Soldiers obtain profiles to determine deployable status and to describe impact on performance of mission to leadership• Rehabilitative Services

– Hearing Aids

–Protective Equipment: Combat Arms Earplugs, Tactical Communication & Protective Systems (TCAPS), etc.

•Medical Services for Treatable Hearing Loss

Hearing ConservationThe Hearing Conservation Program (HCP) is designed to protect

Civilian and Military personnel from hearing loss due to occupational noise exposure. The essential elements of the occupational HCP include the seven essential elements outlined in the original Army

Hearing Conservation regulations..

Noise Hazard Identification - Industrial HygieneHearing Protectors - Occupational HealthMonitoring Audiometry - Occupational HealthHearing Education Courses - Army Hearing Program

AHP – Oversight with support from Preventive Med Assets

Operational Hearing ServicesHearing injury prevention and communication enhancement services

delivered to the Solider in every environment with the primary objective of enhancing survivability and lethality. Services include use of TCAPS,

noise surveillance, and injury prevention.

Required Annual & Introductory Education Courses•Integrate within Basic Combat Training Courses – Formal/Informal

• Classes and Fittings can be done in almost any environment, easiest is classroom

• Critical for class to be within days of ranges to minimize loss and maintain relevancy

• Drill Sergeants will be reinforcing correct use/wear of earplugs with BCT Soldiers

• Annual courses for Cadre

Range and Field Exercises with TCAPS

•Variety of ranges: BRM, urban warfare, convoy ops

•Different TCAPS systems for different needs

Noise Abatement Surveys

Roles of the Deployed Audiologist

Evolution of Roles in Theater

Historical Role of Theater Audiologist

Full diagnostic evaluations including:– Fitness-for-duty/Profiles– Hearing Aid Selection and Fitting– Acoustic Trauma– Dizziness– Evacuation to Higher Echelons

Theater Consultant for Iraq Area of Operations (AO)

Historical Role (cont’d)• Guide Theater Policy• Oversee Data from 8 Pure Tone

Testing Sites• Teach CAOHC Classes • Promote Hearing Readiness

Camp Taji

Handover: Move from Level III to Level IIBaghdad, International Zone

Joint Base Balad

Clinic Locations

New Opportunities• Average Encounters

– 157/month OCT 06-07– 125/month NOV 07-08– 85/mo DEC 08-OCT 09

• Garrison ≈74/month• JBB home to 20,000+ Service Members• Co-located with ENT• Clinic Doubled as Classroom• Co-located with Preventive Medicine Detachment

– Conduct noise surveillance throughout theater• Access to More Patients and More Noise!

100.9 dBA

Closer to the Culprit!

Preventive Medicine Detachment & Audiology

332nd supports with equipment

Lessons Learned• Annual testing allowed monitoring

even in theater.– Tracking of unit trends– Identification of patients meant

monitoring of area• Hands-on noise surveillance

allowed for more specific recommendations

• Synergy between noise measurers and interpretation expanded services throughout Iraq

• Great opportunity for education, motivated audience

Fueler = 98.6 TWA

Future Directions• Detachment Great Model for Audiology to Follow

• Independent Unit, Increase Mobility

• Coordination

• If Services Available, They Will Use It!

• Systematic Means for Prevention Definitely Needed

• Bring Services to the Soldiers, Don’t Wait for Them to Come to You

• Not All Pre-deployment Services Created Equal, Need Services in Theater

Conclusions• Components of the Army Hearing Program Translate Well

to Theater

• AHP Components Require Support in Theater– Hearing Readiness

– Clinical Services

– Operational Hearing Services

• Challenges Include Getting Audiologist into Theater

• Other AOC Models Exist to Imitate (i.e.; ESEO)

• 72C Roles Must Vary to Meet Different Operational Needs