1. Sagiraju HKR 1, Betancourt JA 1, Tucker DL 2, Gorrell NS 2, Whitworth KW 1, Marko D 1, Douphrate DI 1, Cornell JE 3, Cooper SP 1, Delclos GL 1, Whitehead LW 1, Alamgir H 1, Chien LC 1, Senchak AJ 4, Gimeno D 1 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 Natasha.Sotolongo@uth.tmc.edu <12% 12-21% 21-45% >45% <12% 12-21% 21-45% >45% <12% ICD-9 codesDescriptive 384.xx, 385.xx Tympanic membrane & Ossicular disorders 386.xx Vestibular system disorders 388.02 Transient ischemic deafness 388.1x Noise effects on inner ear 388.2x Sudden hearing loss, unspecified 388.3x Tinnitus 388.4x, 388.5 Abnormal auditory perception; Auditory nerve disorders 389.xx Hearing loss -> 389.1x- Sensorineural (SNHL) 0 5 10 15 20 25 30 35 20082009201020112012 HINIHI-Male HINIHI HINIHI-Female SNHL-Female Tin-Male Tinnitus SNHL-Male SNHL 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 2008 37.9% 38.9% 40.3% 41.2% 15-17yrs 18-24yrs 25-34yrs 35-44yrs 45-64yrs Female Male Army Air Force Marine Coast Guard Navy.1.2 37.5 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 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 TinnitusSNHL HINIHI 15-17yrs 18-24yrs 25-34yrs 35-44yrs 45-64yrs 0 50 100 150 200 2008 2009 2010 2011 2012 15.0 29.6 9.6 16.8 3.7 164.9 148.6 133.9 127.7 111.6 15-17yrs 18-24yrs 25-34yrs 35-44yrs 45-64yrs 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 81.6 73.0 15-17yrs 18-24yrs 25-34yrs 35-44yrs 45-64yrs 0 50 100 150 200 2008 2009 2010 2011 2012 5.013.5 0.07.0 2.5 95.9 87.1 77.2 74.3 66.3 Air Force Army Coast Guard Marines Navy 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 20082009201020112012 12.914.5 17.6 19.8 9.2 10.5 15.9 7.4 12.4 0 10 20 30 40 50 20082009201020112012 11.9 8.5 22.5 17.8 13.0 12.5 7.8 18.5 8.9 8.1 0 10 20 30 40 50 20082009201020112012 Per 1,000 Age 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