sagiraju hkr 1, betancourt ja 1, tucker dl 2, gorrell ns 2, whitworth kw 1, marko d 1, douphrate di...
TRANSCRIPT
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