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Hearing Loss Prevention: Improvements to DOD Hearing Conservation Programs Could Lead to Better Outcomes

GAO-11-114 Published: Jan 31, 2011. Publicly Released: Jan 31, 2011.
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Highlights

Exposure to hazardous noise can have negative implications for both servicemember health and readiness. Moreover, in fiscal year 2009, some of the most common impairments for veterans receiving Veterans Affairs (VA) disability benefits were hearing related, as annual payments for such conditions exceeded $1.1 billion. To examine Department of Defense (DOD) efforts to prevent hearing loss, GAO is reporting on (1) how well the DOD and armed services identify and mitigate hazardous noise; (2) how well the military evaluates hearing conservation program performance; and (3) the status of DOD's Hearing Center of Excellence and the extent that DOD and VA are sharing information to inform this and other efforts. GAO reviewed DOD and services' policies and guidance, reviewed DOD performance data, interviewed officials and servicemembers, and conducted site visits to nine military bases.

Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Office of the Under Secretary for Personnel and Readiness To position DOD and the services to better protect servicemembers from hearing loss, the Under Secretary for Personnel and Readiness should work with the Assistant Secretary for Health Affairs and ensure that DOD and the services improve upon the type, timing, and tracking of training and education provided to servicemembers on hearing protection, by providing information that is more comprehensive and training that is more frequent and possibly earlier in servicemembers' careers.
Closed – Implemented
DOD has taken several actions to improve the type and timing of education and training provided to servicemembers on hearing protection. For example, according to DOD, all services now provide hearing protection training at enlisted and officer accession points. In addition, each of the services and the Hearing Center of Excellence now make online training available to all service members. In 2012, the Marines began to mandate annual hearing protection training and the Army has plans to follow suit in 2015. However, more work remains to improve the tracking of hearing loss training. Each of the services report plans to evaluate the use of current systems to improve the tracking of training completion, but many of these system changes are still in progress.
Office of the Under Secretary for Personnel and Readiness To position DOD and the services to better protect servicemembers from hearing loss, the Under Secretary for Personnel and Readiness should work with the Assistant Secretary for Health Affairs and ensure that DOD work with the services to develop an appropriate set of performance indicators that assess how well services are reducing hearing loss among servicemembers.
Closed – Implemented
In December 2010, DOD updated the DoD instruction 6055.12, "Hearing Conservation Program" to include improved performance indicators. These include measures designed to be more proactive in hazard evaluation and prevention prior to measurable hearing loss, such as the percentage of noise hazardous workplace characterizations completed and an index of unacceptable noise exposures.
Office of the Under Secretary for Personnel and Readiness To position DOD and the services to better protect servicemembers from hearing loss, the Under Secretary for Personnel and Readiness should work with the Assistant Secretary for Health Affairs and ensure that DOD and the services address limitations in the processes used to capture, track, and use performance data. This effort should address issues with data reliability, data entry, reporting capability, and integration across relevant databases.
Closed – Implemented
DOD reports some efforts to improve their ability capture, track, and use performance data through the DOEHRS-HC system, including deployed software upgrades in June, August, and December 2012 to correct some of the limitations in tracking individual hearing testing data and follow-up testing requirements. DOD has also made efforts to improve accuracy in data processing, and ad hoc reporting capability. However, more work remains to improve the system used to track hazardous noise exposure. While DOD has not reported any improvements to the DOEHRS-IH system, the agency has plans to continue to pursue funding to achieve needed system performance improvements, including integration with other relevant databases.
Office of the Under Secretary for Personnel and Readiness To position DOD and the services to better protect servicemembers from hearing loss, the Under Secretary for Personnel and Readiness should work with the Assistant Secretary for Health Affairs and ensure that DOD work with the services to examine the appropriateness and feasibility of expanding those service-level initiatives that hold promise of improving---on a DOD-wide basis---the military hearing conservation programs. Particular attention should be focused on those efforts that already appear to have either increased compliance with program requirements or have demonstrated the potential to reduce hearing loss among servicemembers, such as establishing hearing loss as a readiness issue, improving the comfort and design of hearing protection, and including noise experts more consistently in the procurement process.
Closed – Implemented
To regularly examine appropriateness and feasibility of expanding promising initiatives, the DOD now uses its annual Safety & Occupational Health In-Progress Review (IPR) and the DoD Hearing Conservation Work Group as mechanisms for direct cross-flow and application of individual Military Service improvement initiatives. The working group meets quarterly, provides technical evaluations, and makes recommendations to improve the DOD hearing conservation programs. As result of the working group's efforts, DOD reports the following improvements to its Hearing Conservation Program: an overall decrease in significant threshold shift rates (a measure of hearing loss) over the past 5 years; Military Services emphasizing hearing loss as a readiness issue; working group advice to ODUSD (I&E) and Military Service leadership to improve Hearing Conservation Program policy and guidance documents; developing and sharing improved hearing conservation training products; developing and sharing improved measures of program effectiveness, including use of enterprise management systems to increase senior leadership visibility; identifying and prioritizing system change requests required to improve DOEHRS-HC and DOEHRS-DR functionality; and collaboration and awareness of Military Service research laboratory activities to evaluate new hearing protection devices and equipment noise reduction engineering.

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Topics

Aid for the disabledCombat readinessDisabilitiesEvaluation methodsHealth centersHealth hazardsHearing impairedInteragency relationsMilitary health servicesMilitary personnelMonitoringNoise pollutionNoise pollution controlOccupational safetyPerformance measuresProgram evaluationProtective equipmentRisk assessmentVeterans disability compensationInformation sharingPolicies and procedures