Differential effects of suppressors on hazardous sound pressure levels generated by AR-15 rifles: Considerations for recreational shooters, law enforcement, and the military

Impulse noise measurement in view of noise hazard assessment and use of hearing protectors

Experience shows the occurrence of situations when the measurements of impulse noise parameters are made with measurement equipment unsuitable for such conditions. The results of using such equipment were compared with the results of using equipment with a sufficiently large upper limit of the measurement range. The analysis was carried out on the example of noise generated during shots from a Mossberg smooth-bore shotgun and AKM rifle, as well as produced in the forge. The use of the unsuitable equipment allowed to indicate the exceeding of the exposure limit value of the peak value of the signal (L_Cpeak), but this is not always possible when determining the energy properties of the signal (L_EX,8h). While the inadequate properties of the measurement equipment will generally not prevent the conclusion that noise in a particular workplace is hazardous to hearing, the results of measurements cannot be used to select hearing protectors.

Noise-induced hearing disorders: Clinical and investigational tools

A series of articles discussing advanced diagnostics that can be used to assess noise injury and associated noise-induced hearing disorders (NIHD) was developed under the umbrella of the United States Department of Defense Hearing Center of Excellence Pharmaceutical Interventions for Hearing Loss working group. The overarching goals of the current series were to provide insight into (1) well-established and more recently developed metrics that are sensitive for detection of cochlear pathology or diagnosis of NIHD, and (2) the tools that are available for characterizing individual noise hazard as personal exposure will vary based on distance to the sound source and placement of hearing protection devices. In addition to discussing the utility of advanced diagnostics in patient care settings, the current articles discuss the selection of outcomes and end points that can be considered for use in clinical trials investigating hearing loss prevention and hearing rehabilitation.

Evaluation of hidden hearing loss in normal-hearing firearm users

Some noise exposures resulting in temporary threshold shift (TTS) result in cochlear synaptopathy. The purpose of this retrospective study was to evaluate a human population that might be at risk for noise-induced cochlear synaptopathy (i.e., "hidden hearing loss"). Participants were firearm users who were (1) at-risk for prior audiometric noise-induced threshold shifts, given their history of firearm use, (2) likely to have experienced complete threshold recovery if any prior TTS had occurred, based on this study's normal-hearing inclusion criteria, and (3) not at-risk for significant age-related synaptopathic loss, based on this study's young-adult inclusion criteria. 70 participants (age 18-25 yr) were enrolled, including 33 firearm users experimental (EXP), and 37 non-firearm users control (CNTRL). All participants were required to exhibit audiometric thresholds ≤20 dB HL bilaterally, from 0.25 to 8 kHz. The study was designed to test the hypothesis that EXP participants would exhibit a reduced cochlear nerve response compared to CNTRL participants, despite normal-hearing sensitivity in both groups. No statistically significant group differences in auditory performance were detected between the CNTRL and EXP participants on standard audiom to etry, extended high-frequency audiometry, Words-in-Noise performance, distortion product otoacoustic emission, middle ear muscle reflex, or auditory brainstem response. Importantly, 91% of EXP participants reported that they wore hearing protection either "all the time" or "almost all the time" while using firearms. The data suggest that consistent use of hearing protection during firearm use can effectively protect cochlear and neural measures of auditory function, including suprathreshold responses. The current results do not exclude the possibility that neural pathology may be evident in firearm users with less consistent hearing protection use. However, firearm users with less consistent hearing protection use are also more likely to exhibit threshold elevation, among other cochlear deficits, thereby confounding the isolation of any potentially selective neural deficits. Taken together, it seems most likely that firearm users who consistently and correctly use hearing protection will exhibit preserved measures of cochlear and neural function, while firearm users who inconsistently and incorrectly use hearing protection are most likely to exhibit cochlear injury, rather than evidence of selective neural injury in the absence of cochlear injury.

Digital sampling of acoustic impulse noise: Implications for exposure measurement and damage risk criteria

Current standards for the measurement of impulse noise (e.g., MIL-STD-1474E) recommend using a sampling rate of at least 200 kHz in order to accurately estimate the risk of hearing damage. The given motivation for this high sampling rate is to ensure a temporal resolution in the impulse waveform fine enough to accurately capture the peak pressure. However, the Nyquist-Shannon sampling theorem specifies that a sampled signal can accurately reconstruct both the amplitude and phase information of a signal given the sampling rate is at least twice the highest frequency present in the original signal. Thus, it is possible to reconstruct a band limited signal with the same temporal resolution as one captured at a higher sampling rate if the contributions of energy above the Nyquist rate can be ignored. In this study, resampling techniques are applied to a signal sampled at 48 kHz to extract A-weighted sound pressure energy estimates within 0.1 dB of those obtained at a higher sampling rate. Our results suggest sampling rates for impulsive noise should be based on the range of frequencies expected to make a contribution to injury risk rather than on concerns about temporal resolution.

Prevention of Noise-Induced Hearing Loss Using Investigational Medicines for the Inner Ear: Previous Trial Outcomes Should Inform Future Trial Design

Significance: Noise-induced hearing loss (NIHL) is an important public health issue resulting in decreased quality of life for affected individuals, and significant costs to employers and governmental agencies. Recent Advances: Advances in the mechanistic understanding of NIHL have prompted a growing number of proposed, in-progress, and completed clinical trials for possible protections against NIHL via antioxidants and other drug agents. Thirty-one clinical trials evaluating prevention of either temporary or permanent NIHL were identified and are reviewed. Critical Issues: This review revealed little consistency in the noise-exposed populations in which drugs are evaluated or the primary outcomes used to measure NIHL prevention. Changes in pure-tone thresholds were the most common primary outcomes; specific threshold metrics included both average hearing loss and incidence of significant hearing loss. Changes in otoacoustic emission (OAE) amplitude were relatively common secondary outcomes. Extended high-frequency (EHF) hearing and speech-in-noise perception are commonly adversely affected by noise exposure but are not consistently included in clinical trials assessing prevention of NIHL. Future Directions: Multiple criteria are available for monitoring NIHL, but the specific criterion to be used to define clinically significant otoprotection remains a topic of discussion. Audiogram-based primary outcome measures can be combined with secondary outcomes, including OAE amplitude, EHF hearing, speech-in-noise testing, tinnitus surveys, and patient-reported outcomes. Standardization of test protocols for the above primary and secondary outcomes, and associated reporting criterion for each, would facilitate clinical trial design and comparison of results across investigational drug agents. Antioxid. Redox Signal. 36, 1171-1202.

Auditory changes following firearm noise exposure, a review

Firearms produce peak sound pressure levels (peak SPL) between ∼130 and 175 dB peak SPL, creating significant risk of noise-induced hearing loss (NIHL) in those exposed to firearm noise during occupational, recreational, and/or military operations. Noise-induced tinnitus and hearing loss are common in military service members, public safety officers, and hunters/shooters. Given the significant risk of NIHL due to firearm and other noise sources, there is an interest in, and demand for, interventions to prevent and/or treat NIHL in high-risk populations. However, research and clinical trial designs assessing NIHL prevention have varied due to inconsistent data from the literature, specifically with end point definitions, study protocols, and assessment methodologies. This article presents a scoping review of the literature pertaining to auditory changes following firearm noise exposure. Meta-analysis was not possible due to heterogeneity of the study designs. Recommendations regarding audiologic test approach and monitoring of populations at risk for NIHL are presented based on critical review of the existing literature.

Audiometric assessment of hearing loss sustained during military service

An analysis is presented of the audiograms, obtained using Telephonics TDH39 headphones (Huntington, NY), of 80 men claiming compensation for noise-induced hearing loss (NIHL) sustained during military service. A comparison with an independent database of audiograms collected using other headphones suggested that no adjustment was needed to the hearing threshold levels (HTLs) at 6 kHz to allow for the use of TDH39 headphones. The method of Moore [(2020). J. Acoust. Soc. Am. 148, 884-894] for diagnosing military noise-induced hearing loss (M-NIHL) gave a positive diagnosis for 92.5% of right ears and 97.5% of left ears. The mean HTLs were maximal and similar at 4, 6, and 8 kHz but with considerable individual variability. A comparison with age-expected HTLs showed that M-NIHL was typically greatest at 3, 4, 6, or 8 kHz but with considerable individual variability. M-NIHL values were positive from 0.5 to 8 kHz. The HTLs were significantly higher for the left than for the right ears, but the asymmetry varied across individuals and could usually be ascribed to specific features of the noise exposure. The asymmetry existed over the range from 0.5 to 8 kHz, supporting the idea that M-NIHL occurs over a wide frequency range. Tinnitus was reported by 76 of the 80 men.

Diagnosis and quantification of military noise-induced hearing loss

The diagnosis and quantification of noise-induced hearing loss (NIHL) in a medico-legal context are usually based on the pattern of hearing loss that is typically associated with long-term exposure to steady broadband noises, such as occur in noisy factories. Evidence is reviewed showing that this pattern is not typical for hearing loss produced by intense impulsive sounds of the type that military personnel are exposed to. The audiometric characteristics of noise-exposed military personnel are reviewed. A set of audiograms from a sample of 58 hearing-impaired noise-exposed military veterans was analyzed and used to develop methods for the diagnosis and quantification of military NIHL. Three requirements are specified for diagnosing military NIHL. Quantification of any loss is done by comparison with audiometric thresholds for non-noise exposed individuals, as specified in ISO7029 [International Organization for Standardization, 2017].

Toward an improved hearing safety standard for impulse noise exposure in the Canadian Armed Forces

Introduction: Current hearing safety standards for the Canadian Armed Forces (CAF) do not adequately address exposure limits for mitigation of noise-induced hearing loss (NIHL) from weapon noise. Recommendations for updating the hearing safety standard are being formulated by the recently initiated Noise Health Hazard Working Group (NHHWG). In this article, we aim to provide a way forward for the NHHWG. Methods: On the basis of experience with auditory research, noise measurement, acoustic standards development, interactions with CAF members, and a review of the literature, we present an overview of the current state of knowledge regarding impulse noise. The topics include impulse noise measurement, engineering and administrative controls for noise exposure, and use of personal hearing protection devices (HPDs). Results: Although technology for impulse noise measurements and ways to account for HPDs have improved substantially in recent years, not much has changed in hearing damage risk criteria. Energy-based metrics can account for the impulse duration and frequency-dependent characteristics of the HPD, which are important considerations in calculating allowed exposures. Discussion: The NHHWG is recommended to focus on measurements of current weapons systems in various configurations and training environments and to evaluate the use of energy-based metrics, together with frequency-dependent HPD insertion loss.

Inflammatory and immunological changes caused by noise exposure: A systematic review

Today, due to the growth of industries and spread of the use of various instruments and devices that produce high noise levels, it is necessary to pay more attention to the effects of exposure to noise on organs and tissues in the body. The importance of the immune system in fighting external and pathogenic factors has raised the need to consider external factors (such as harmful physical factors) and make efforts to avoid producing them. In this systematic review, 811 potentially relevant studies were found in Google Scholar, PubMed, and Web of Science databases, of which 32 different English-written articles were included in the study. The method of searching and systematically reviewing articles was based on the assessment tool of the multiple systematic reviews (AMSTAR) method. The results of this study suggested that noise could affect the function of the immune system and its components by affecting other systems and organs of the body, including the central nervous system, auditory system, circulatory system, and endocrine gland. Moreover, it can be hypothesized that noise affects immune system by producing the NADPH oxidase (Nox) and reactive oxygen species (ROS).

Force and Sound Pressure Sensors Used for Modeling the Impact of the Firearm with a Suppressor

In this paper, a mathematical model for projectiles shooting in any direction based on sensors distributed stereoscopically is put forward. It is based on the characteristics of a shock wave around a supersonic projectile and acoustical localization. Wave equations for an acoustic monopole point source of a directed effect used for physical interpretation of pressure as an acoustic phenomenon. Simulation and measurements of novel versatile mechanical and acoustical damping system (silencer), which has both a muzzle break and silencer properties studied in this paper. The use of the proposed damping system can have great influence on the acoustic pressure field intensity from the shooter. A silencer regarded as an acoustic transducer and multi-holes waveguide with a chamber. Wave equations for an acoustic monopole point source of a directed effect used for the physical interpretation of pressure as an acoustic phenomenon. The numerical simulation results of the silencer with different configurations presented allow trends to be established. A measurement chain was used to compare the simulation results with the experimental ones. The modeling and experimental results showed an increase in silencer chamber volume results in a reduction of recorded pressure within the silencer chamber.

Noise of military weapons, ground vehicles, planes and ships

Noisy equipment and processes are found throughout military operations, exposing service members to risks of hearing damage due to hazardous noise levels. This article provides an overview of the military noise environment for the non-expert and provides a general characterization of the noise by source type and operational category. The focus of the article is primarily related to the Army, but the same, or similar, equipment is used by the Navy, Marine Corps, and Air Force. Damage risk criteria used by the Army Public Health Command are discussed. In addition, the important role of hearing protection to mitigate the hazards of noise exposure is provided.

Noise-induced hearing loss and its prevention: Integration of data from animal models and human clinical trials

Animal models have been used to gain insight into the risk of noise-induced hearing loss (NIHL) and its potential prevention using investigational new drug agents. A number of compounds have yielded benefit in pre-clinical (animal) models. However, the acute traumatic injury models commonly used in pre-clinical testing are fundamentally different from the chronic and repeated exposures experienced by many human populations. Diverse populations that are potentially at risk and could be considered for enrollment in clinical studies include service members, workers exposed to occupational noise, musicians and other performing artists, and children and young adults exposed to non-occupational (including recreational) noise. Both animal models and clinical populations were discussed in this special issue, followed by discussion of individual variation in vulnerability to NIHL. In this final contribution, study design considerations for NIHL otoprotection in pre-clinical and clinical testing are integrated and broadly discussed with evidence-based guidance offered where possible, drawing on the contributions to this special issue as well as other existing literature. The overarching goals of this final paper are to (1) review and summarize key information across contributions and (2) synthesize information to facilitate successful translation of otoprotective drugs from animal models into human application.

Selection of Level-Dependent Hearing Protectors for Use in An Indoor Shooting Range

The high sound pressure level generated by impulse noise produced in an indoor shooting range makes it necessary to protect the hearing of the people it affects. Due to the need for verbal communication during training at a shooting range, level-dependent hearing protectors are useful. The objective of this study was to answer the question of whether it is possible to properly protect the hearing of a shooting instructor using level-dependent hearing protectors. The noise parameters were measured in the places where the instructor was present at the shooting range. The division of a specific group of trained shooters into subgroups consisting of three or six simultaneously shooting individuals did not significantly affect the exposure of the shooting instructor to the noise. An assessment of noise reduction was carried out for eight models of earmuffs and two variants of earplugs, using computational methods for the selection of hearing protectors. Among the noise parameters, both the A-weighted equivalent sound pressure level and the C-weighted peak sound pressure level were taken into account. Depending on the assessment criterion adopted, a sufficient reduction in impulse noise was provided by either four or six out of the 10 hearing protectors included in the study.

Prevention of Noise-Induced Hearing Loss from Recreational Firearms

In the United States and other parts of the world, recreational firearm shooting is a popular sport that puts the hearing of the shooter at risk. Peak sound pressure levels (SPLs) from firearms range from ∼140 to 175 dB. The majority of recreational firearms (excluding small-caliber 0.17 and 0.22 rifles and air rifles) generate between 150 and 165 dB peak SPLs. High-intensity impulse sounds will permanently damage delicate cochlear structures, and thus individuals who shoot firearms are at a higher risk of bilateral, high-frequency, noise-induced hearing loss (NIHL) than peer groups who do not shoot. In this article, we describe several factors that influence the risk of NIHL including the use of a muzzle brake, the number of shots fired, the distance between shooters, the shooting environment, the choice of ammunition, the use of a suppressor, and hearing protection fit and use. Prevention strategies that address these factors and recommendations for specialized hearing protectors designed for shooting sports are offered. Partnerships are needed between the hearing health community, shooting sport groups, and wildlife conservation organizations to develop and disseminate accurate information and promote organizational resources that support hearing loss prevention efforts.

Effects of noise on speech recognition: Challenges for communication by service members

Speech communication often takes place in noisy environments; this is an urgent issue for military personnel who must communicate in high-noise environments. The effects of noise on speech recognition vary significantly according to the sources of noise, the number and types of talkers, and the listener's hearing ability. In this review, speech communication is first described as it relates to current standards of hearing assessment for military and civilian populations. The next section categorizes types of noise (also called maskers) according to their temporal characteristics (steady or fluctuating) and perceptive effects (energetic or informational masking). Next, speech recognition difficulties experienced by listeners with hearing loss and by older listeners are summarized, and questions on the possible causes of speech-in-noise difficulty are discussed, including recent suggestions of "hidden hearing loss". The final section describes tests used by military and civilian researchers, audiologists, and hearing technicians to assess performance of an individual in recognizing speech in background noise, as well as metrics that predict performance based on a listener and background noise profile. This article provides readers with an overview of the challenges associated with speech communication in noisy backgrounds, as well as its assessment and potential impact on functional performance, and provides guidance for important new research directions relevant not only to military personnel, but also to employees who work in high noise environments.