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Blast Overpressures as a Military and Occupational Health Concern.

Anthony T Cacace1, Batoul Berri1,2

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Environmental stressors like blast overpressure and noise can harm hearing, balance, and overall health. Novel treatments such as repetitive transcranial magnetic stimulation (rTMS) and vagus nerve stimulation with tones (VNS-t) show promise for mitigating these effects.

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Area of Science:

  • Environmental Health
  • Neuroscience
  • Audiology
  • Vestibular Science

Background:

  • Environmental stressors, including blast overpressures and various noise types (continuous, intermittent, impulsive), pose significant risks to auditory and vestibular systems.
  • Acoustic toxicants can lead to hearing loss and tinnitus, impacting quality of life.
  • High-intensity, rapid sound pressure changes are increasingly recognized for their potential to disrupt vestibular and balance functions, increasing fall risk.

Purpose of the Study:

  • To review the effects of environmental stressors on hearing, tinnitus, vestibular, and balance functions.
  • To explore novel neuromodulation paradigms for treating noise-induced hearing loss and tinnitus.
  • To emphasize the importance of considering overall health and well-being in relation to these effects.

Main Methods:

  • Review of existing literature on the physiological effects of acoustic toxicants and blast overpressures.
  • Focus on clinical data and research strategies for neuromodulation techniques, specifically repetitive transcranial magnetic stimulation (rTMS).
  • Examination of vagus nerve stimulation paired with tones (VNS-t) as a therapeutic approach.

Main Results:

  • Acoustic toxicants are strongly linked to hearing loss and tinnitus.
  • Evidence suggests significant impacts of rapid sound pressure changes on vestibular and balance functions, potentially causing falls due to otolith damage.
  • Vagus nerve stimulation with tones (VNS-t) may present complexities such as vocal dysfunction; gait parameter evaluation is crucial for monitoring neurological health.

Conclusions:

  • Environmental acoustic stressors have multifaceted detrimental effects on sensory and neurological functions.
  • Neuromodulation techniques like rTMS and VNS-t offer potential therapeutic avenues for mitigating these adverse outcomes.
  • Enhanced information exchange among professionals and caregivers is vital for managing the benefits and complications associated with these health issues.