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Recommendations for a Military Health System Auditory Blast Injury Prevention Standard.

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The Department of Defense needs better auditory injury prevention standards for service members. The Blast Injury Prevention Standards Recommendation (BIPSR) Process recommended the 8-hour Equivalent Level (LAeq8hr) as an interim standard.

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Area of Science:

  • Military Health System research
  • Auditory injury prevention
  • Blast injury standards

Background:

  • Existing auditory injury prevention standards offer some benefit to warfighters.
  • The Department of Defense requires enhanced understanding and mitigation of auditory injuries, including hearing loss, tinnitus, and central processing deficits, among service members.
  • The Blast Injury Prevention Standards Recommendation (BIPSR) Process was initiated to address the need for biomedically valid Military Health System (MHS) Blast Injury Prevention Standards across all military services.

Purpose of the Study:

  • To establish a robust process for developing and evaluating Military Health System (MHS) Blast Injury Prevention Standards.
  • To incorporate stakeholder input and expert consensus in the development of auditory injury prevention standards.
  • To identify and address gaps in existing auditory injury datasets and evaluation methodologies.

Main Methods:

  • A broad-based, non-advocacy Subject Matter Expert (SME) panel was convened, comprising members from industry, academia, and government.
  • The SME panel defined evaluation criteria, weighted priorities, and assessed candidate MHS Auditory Blast Injury Prevention Standards.
  • Multi-attribute utility theory was employed to aggregate expert evaluations and compare proposed standards.

Main Results:

  • Existing auditory injury datasets were collated to identify gaps and facilitate data sharing for comprehensive standard evaluation.
  • Candidate standards were evaluated, leading to the development of recommendations for an MHS Blast Injury Prevention Standard.
  • Key characteristics, capabilities, and limitations of candidate standards and current datasets were identified, highlighting a need for more human exposure data.

Conclusions:

  • The BIPSR Process revealed critical insights into the evaluation of auditory blast injury prevention standards and datasets.
  • The 8-hour Equivalent Level (LAeq8hr) is recommended as the interim MHS Auditory Blast Injury Prevention Standard.
  • Further research is necessary to address identified knowledge gaps and enhance the validity of auditory injury prediction and prevention.