Hearing Loss and Irritability Reporting Without Vestibular Differences in Explosive Breaching Professionals

Claire M Modica; Brian R Johnson; Christopher Zalewski; Kelly King; Carmen Brewer; John E King; Angela M Yarnell; Matthew L LoPresti; Peter B Walker; Kristine C Dell; Elena Polejaeva; Alycia Quick; Bobby Arnold; Eric M Wassermann; James R Stone; Stephen T Ahlers; Walter Carr

doi:10.3389/fneur.2020.588377

Hearing Loss and Irritability Reporting Without Vestibular Differences in Explosive Breaching Professionals

Front Neurol. 2020 Dec 16:11:588377. doi: 10.3389/fneur.2020.588377. eCollection 2020.

Authors

Claire M Modica¹, Brian R Johnson², Christopher Zalewski³, Kelly King³, Carmen Brewer³, John E King⁴, Angela M Yarnell⁵, Matthew L LoPresti², Peter B Walker⁶, Kristine C Dell^{7

8}, Elena Polejaeva^{7

9}, Alycia Quick^{7

10

11}, Bobby Arnold^{1

7

11}, Eric M Wassermann⁷, James R Stone¹², Stephen T Ahlers¹, Walter Carr^{2

13}

Affiliations

¹ Naval Medical Research Center, Silver Spring, MD, United States.
² Walter Reed Army Institute of Research, Silver Spring, MD, United States.
³ Audiology Unit, Otolaryngology Branch, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, United States.
⁴ Independent Researcher, Bethesda, MD, United States.
⁵ Military Emergency Medicine Department, Uniformed Services University, Bethesda, MD, United States.
⁶ DoD Joint Artificial Intelligence Center, Washington, DC, United States.
⁷ Behavioral Neurology Unit, National Institutes of Health, National Institute of Neurological Disorders and Stroke, Bethesda, MD, United States.
⁸ Department of Psychology, The Pennsylvania State University, University Park, State College, PA, United States.
⁹ Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States.
¹⁰ School of Psychology, University of Glasgow, Glasgow, United Kingdom.
¹¹ The Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, MD, United States.
¹² Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA, United States.
¹³ Oak Ridge Research Institute for Science and Education, Oak Ridge, TN, United States.

Abstract

Background: Blast exposure is a potential hazard in modern military operations and training, especially for some military occupations. Helmets, peripheral armor, hearing protection, and eye protection worn by military personnel provide some acute protection from blast effects but may not fully protect personnel against cumulative effects of repeated blast overpressure waves experienced over a career. The current study aimed to characterize the long-term outcomes of repeated exposure to primary blast overpressure in experienced career operators with an emphasis on the assessment of hearing and vestibular outcomes. Methods: Participants included experienced "breachers" (military and law enforcement explosives professionals who gain entry into structures through controlled detonation of charges) and similarly aged and experienced "non-breachers" (non-breaching military and law enforcement personnel). Responses to a clinical interview and performance on audiological and vestibular testing were compared. Results: Hearing loss, ringing in the ears, irritability, and sensitivity to light or noise were more common among breachers than non-breachers. Breachers reported more combat exposure than non-breachers, and subsequently, memory loss and difficulty concentrating were associated with both breaching and combat exposure. Vestibular and ocular motor outcomes were not different between breachers and non-breachers. Conclusion: Hearing-related, irritability, and sensitivity outcomes are associated with a career in breaching. Future studies examining long-term effects of blast exposure should take measures to control for combat exposure.

Keywords: blast overpressure; career breaching; hearing loss; symptom reporting; vestibular.