Combat Hearing Loss

Roman Mars:
This is 99% Invisible. I’m Roman Mars.

Roman Mars:
The United States Marine Corps buys a lot of earplugs. Visit any military base and you’ll find them. Under the bleachers at the firing range, in the bottoms of washing machines. They are cheap and effective at making noise less noisy.

Mary Roach:
Most earplugs reduce noise by about 30 decibels.

Roman Mars:
That is Mary Roach, author of a bunch of great books. Her latest one is called ‘Grunt’. It’s about the science of humans at war.

Mary Roach:
30 decibels can be significant. Every three-decibel increase in a loud noise cuts in half the amount of time you can be exposed without risking hearing damage.

Roman Mars:
To put that another way, an unprotected human ear can spend eight hours a day exposed to 85 decibels without incurring hearing loss. That’s the level of freeway noise. 85 decibels is also the level of a crowded restaurant. But if you go up to 115 decibels, things like a chainsaw or a really loud concert, your safe exposure time is only half a minute before your hearing can be affected.

Mary Roach:
So without earplugs, you should only be exposed to the sound of a chainsaw for about 30 seconds. But with earplugs, you’ve got closer to eight hours.

Roman Mars:
In a military situation, a reduction of 30 decibels is especially helpful with a steady, grinding background din, like say a Bradley tank clattering over asphalt or the thrum of a Blackhawk helicopter.

Mary Roach:
But there’s a problem with earplugs as the solution on a battlefield.

Aaron Iwanciw:
I will tell you that I’ve never seen a Marine wear earplugs in a combat operation.

Mary Roach:
That’s Aaron Iwanciw. He spent eight years as an infantry marine and served a tour of duty in Fallujah, Iraq. And this is Eric Fallon.

Eric Fallon:
In over 24 years of military experience, I’ve never seen soldiers put a passive ear plugin and go on a dismounted patrol.

Roman Mars:
Soldiers aren’t using their earplugs because when they do, they can’t hear what’s happening around them. And with unprotected ears, a lot of service members are coming home from battle with tinnitus, which is a ringing in your ears, or hearing loss.

Aaron Iwanciw:
It’s not uncommon. Anyone, especially in the infantry, will pretty much tell you that they have hearing loss.

Mary Roach:
When Aaron and his buddies get together in social situations, everyone speaks a little louder.

Aaron Iwanciw:
You know, when we get together, everybody knows who has the worst amount of hearing loss. Typically, if it’s a good set of friends, we know which ear they tend to have hearing loss in. I can tell you two or three friends right off the top of my head. I know, okay, yeah he got hit by an IED on his right side. I need to speak to his left ear.

Mary Roach:
But while Aaron’s fellow Marines are naturally understanding about his hearing loss, his wife and kids find it challenging.

Aaron Iwanciw:
They actually end up getting frustrated with me, and it’s… I don’t know. You just try to play it off sometimes. Pretend like you heard what they had to say, and try to pick it up later on in the conversation or figure it out later, or ask them as though you forgot. You didn’t actually forget. You just never heard them.

Eric Fallon:
When you really think about the advent of black gunpowder, which is really when the military became an extremely noisy environment, think about how long we’ve lived with that. Really without a solution. The solution is to put something in your ears that blocks the sound, and oh, by the way, it doesn’t just block the sound that we want to prevent. It blocks all the sound.

Roman Mars:
Since World War II, the VA has been reporting on what kinds of injuries they treat, and tinnitus and hearing loss have always been the number one and number two most prevalent injuries to service members.

Mary Roach:
Eric Fallon has been studying how to protect the hearing of service members for a long time. He’s an audiologist.

Eric Fallon:
An audiologist is a medical professional that is concerned with the auditory system.

Mary Roach:
Eric used to be the chief audiologist at Walter Reed Medical Center.

Roman Mars:
Some audiologists work with patients to give them hearing tests and diagnose what kind of hearing disorder they have, but Eric’s main focus is trying to find solutions.

Eric Fallon:
The right protective solutions that not only protect their hearing but enhance their performance in some way.

Mary Roach:
Eric now works for the company 3M designing hearing protection for military use, and he’s fond of saying that the military has a noise problem, but…

Eric Fallon:
We have a significant quiet problem.

Roman Mars:
What he means is that service members in combat need ear protection that works for them in both environments, because the transition from quiet to noisy can happen very, very quickly.

Mary Roach:
In a war zone, you have to consider everything. Even just walking down the road has a strategy to it. The “killing radius” of a fragmentation grenade is 15 feet. If troops walked along in a clump like tourists, a single grenade could kill a bunch of them at once, so they try to keep at least 15 feet between each other on patrols, but the more spread out they are, the harder it is to hear one another.

Roman Mars:
Troops in combat and might walk in the quiet for hours. The only noise being just a little bit of chatting, the sound of gravel crunching under their boots, and then suddenly… (sounds of gunfire). This is a video that Eric Fallon likes to show of troops on patrol in Iraq. These troops were just walking along.

Soldier:
“Anybody there?!”

Eric Fallon:
And then all of a sudden things got kinetic very quick.

Soldier:
“Anybody hurt? Are you okay?”

Roman Mars:
In the video, when the troop comes under fire, all the soldiers fall to the ground and begin shooting. It’s loud, and they probably aren’t wearing hearing protection, but Eric says the potential damage to their ears isn’t the only problem. Their lives are in danger and their hearing is one of the main things helping them figure out what to do.

Eric Fallon:
Just because they’re being shot at doesn’t mean that they understand what’s happening to them. They may not know, am I being shot at by 50 people or three people? What’s happening to the left of me? What’s happening to the right of me?

Mary Roach:
One of the major tools to figure out what’s happening in this situation is radio. With a radio, you can connect to someone who has more of a birds-eye view of the place. This might be another soldier somewhere on a roof or someone monitoring from a drone camera. Communication will help the person on the ground answer all the questions running through their head in that moment.

Eric Fallon:
What do I do? Do I push through the assault? Do I hold in place? Do I wait for the quick reaction force to come and help us? Do I call in air support?

Roman Mars:
But it’s loud. They can probably barely hear what the other people around them are saying, let alone what’s on the radio.

Eric Fallon:
And if I can’t hear the signal, I may be missing the information that I need to make the right decision. And so as you’ll see in that video, there’s a young soldier laying on the ground communicating over the radio, and just before the video stops, you’ll hear him say, “I can’t hear you.”

Soldier:
“What? I can’t hear you, but it’s 26967.”

Eric Fallon:
A point that I try to make whenever I use that video is that’s probably one of the more important communications that not only that person but his team members will ever have in their lives because they’re under direct enemy fire.

Mary Roach:
Being able to hear the radio and each other is crucial to their survival.

Roman Mars:
Eric believes that he has a solution to this problem. He thinks that service members on dismounted combat patrols, like the one in that video, should be wearing a device called TCAPS.

Eric Fallon:
Tactical Communication and Protective Systems, or TCAPS, are products that are designed to not only deliver hearing protection but to allow you a better ability to hear what’s happening around you so you can maintain some situational awareness.

Roman Mars:
TCAPS come in a couple of styles. One style fits inside your ear, kind of like a pair of earbuds, and the other style fits over your ear, and they look like the earmuffs you might wear while operating power tools. Both styles are equipped with environmental microphones that pick up the sounds around you and feed them into your ears at levels that your eardrums can tolerate.

Eric Fallon:
And in some cases, these products integrate into a radio system so that you can have more seamless two-way radio communications.

Roman Mars:
With the radio feature, you could be talking with a drone operator or communicating with the command center, and you can actually hear what they’re saying to you because the device is blocking out other noise.

Mary Roach:
And yes, 3M, the company Eric works for, sells TCAPS, but he’s also an audiologist who’s dedicated his career to protecting the hearing of people in the military.

Roman Mars:
Eric sent us a few of the over-the-ear style TCAPS headsets to try out.

TCAPS Audio Notification:
“Power on. Battery status: High.”

Roman Mars:
Each pair have a power button that allows you to toggle between a few settings.

TCAPS Audio Notification:
“Surround volume: six. Radio volume: six. Channel: 16.”

Katie Mingle:
“Okay, test, test, test, test, test.”

Roman Mars:
99pi producers, Katie Mingle and Sam Greenspan, tested out the TCAPS in front of our office where there’s been a bunch of loud construction happening all week, and Katie recorded what the world sounds like through her TCAPS.

Roman Mars:
So in this clip, Katie and Sam are standing on the sidewalk wearing TCAPS, looking like a couple of weirdos, basically. People are walking past, a construction worker is sweeping, and despite the fact that they’re wearing big, padded earmuffs, they can hear it all really well. Because the environmental microphones are picking up the noise around them and feeding it into their ears.

Sam Greenspan:
“Yeah, I can totally hear them way clear.”

Roman Mars:
That’s Sam talking to Katie using the radio feature on the TCAPS.

Sam Greenspan:
“They do not seem that concerned.”

Roman Mars:
Now someone has started to saw through the concrete nearby, but the TCAPS are attenuating the sound so that Sam and Katie can still hear it, but it’s a much lower volume. But if they take the TCAPS off…

Sam Greenspan:
“Katie, why don’t you try taking them off, and recording what it sounds like without them?” (sound of chainsaw increases dramatically)

Roman Mars:
I won’t make you listen to that very long, but basically, the TCAPS allowed Katie and Sam to communicate through some very loud construction noises while also protecting their ears, and when it was quiet, they were able to hear the environment around them. Soft sounds, like sweeping and people talking.

Mary Roach:
TCAPS are also being marketed for use in industrial and construction settings, just like the one Katie and Sam were standing in the middle of. In the military, they’ve been used since the early 2000s, mostly by special operations groups like Navy Seals, but they’re not standard issue, even for troops in combat who would be exposed to the kind of noise that can damage your hearing.

Eric Fallon:
The conventional forces do what I think that conventional forces have done for many, many years. They just accept that communicating is going to be a challenge.

Mary Roach:
Communication challenges and hearing loss are so much a part of the culture of combat that Eric says when he was a soldier, he actually wanted hearing loss so that people would know he had experience.

Eric Fallon:
So if you didn’t have a degree of hearing loss, it was obvious that you were one of the new guys, and that you had not really been around much noise, and you really had not fired that many artillery rounds downrange.

Roman Mars:
While soldiers are actively serving, they do have to undergo fairly comprehensive hearing tests and periodic checkups. These tests are administered by an audiologist, but the results of those tests get passed on to the unit commander and he or she decides what to do with them, and a soldier who is found to have degraded hearing, often won’t be taken out of their position.

Eric Fallon:
We’re just so accustomed to finding workarounds with hearing loss. You will sometimes find soldiers that have a significant degree of hearing loss, but their unit leadership may be so dependent on that person that they also want that person to remain where they are. I look forward to the day when we put as much emphasis on maintaining good hearing as we do good vision.

Mary Roach:
Eric has found that in order to get the military interested in protecting people’s hearing, he’s had to sell it differently.

Eric Fallon:
When I was a young officer, when I would go out and do a unit briefing, I would actually talk to them about how much money the VA spends on hearing loss, because I thought that that was pretty significant.

Mary Roach:
But that didn’t really work. It’s not a unit commander’s job to be concerned with what the VA spends on hearing loss. When Eric talked to unit commanders, he had to make the argument tactical. He had to explain that when people can hear, they can be more effective on the battlefield.

Roman Mars:
This points to a larger disconnect between the Department of Defense, which is tasked with defending the nation, and the VA, which provides health care to veterans. If the DOD is given a choice between spending their money on bombs or hearing protection, it’s not hard to see why they might choose to kick the can to the VA.

Mary Roach:
But to defend the Department of Defense, they have made an effort in the last couple of decades to do better. There’s more testing than there used to be, and in 2009, they established the Hearing Center of Excellence, which researches hearing loss and advocates for more protection.

Colonel Mark Packer:
This invisible injury of hearing loss is very significant. The big part of our job is to advocate and build awareness.

Mary Roach:
That’s Colonel Mark Packer. He’s the director of the Hearing Center of Excellence and he says, yeah, TCAPS are great, but they’re not perfect.

Colonel Mark Packer:
All hearing protection has some fallibility. If you’re out on a hot mission in the desert, and you have those earmuffs down over your ears, they are hot.

Roman Mars:
Soldiers might remove them, and then be unprotected when they need it. Other arguments against TCAPS, they are this extra thing to carry, and they have to be charged, and if they break, they’re expensive to replace.

Colonel Mark Packer:
Not everybody needs a $1,500 tactical radio device.

Mary Roach:
There are some solutions in between TCAPS and the cheapest foam earplugs. There’s what’s called level-dependent earplugs that are made to protect against high impulse noises, like weapons fire, while allowing other environmental noises to pass through. But Eric and others we spoke to said that these earplugs still make it difficult to hear the environment around you, and for that reason, a lot of people will opt not to wear them.

Roman Mars:
Whether TCAPS are the solution for all combat troops or not, it’s worth saying that Colonel Packer and Eric Fallon, they’re basically on the same side about this, and they’re both working, sometimes together, to find a solution to one of the oldest, most prevalent, and most invisible problems in the military.

Roman Mars:
99% Invisible was reported this week by Mary Roach, and produced by Katie Mingle with Delaney Hall, Sharif Youssef, Emmett FitzGerald, Kurt Kohlstedt, Sam Greenspan, Avery Trufelman, and me, Roman Mars. This episode was based off a chapter of Mary Roach’s excellent bestselling book, ‘Grunt: The Curious Science of Humans at War’. I cannot recommend her books enough. They are the best time you can have learning weird things about science.

  1. Guru

    Very good episode, always fascinated by the endless complexity of modern warfare.

    While a world without war would be amazing the fact remains that it is necessary due to the inherent nature of humans and the unavoidable flaws of all civilizations.

    P.S. Helmet cam videos are addictive…

  2. CPT Hughson

    I’m an 18 year military veteran, and I have had tinnitus for a while. I usually only notice it when the ambient noise level is low. Unfortunately, ear protection (or Ear Pro), wasn’t as well enforced as it is today. Even within the last few years, I have forgotten mine during a rifle range. I spent the next few days hearing everything as if I was at the bottom of a well. If there was a way to integrate the system into our helmets, I would be willing to give it a try. Like any other piece of military equipment, if the thing doesn’t work, it gets tossed aside to make room for something that does.

    1. Mart

      I’m a 16 year Infantry veteran and I’m completely deaf in my right ear.
      We had ear protection but for the reasons listed in this article, no one wore them. We didn’the even wear them to the firing range because the few times people bothered they would end up missing an important command and the potential for danger becomes huge when people can’t hear commands at military firing ranges.
      Even without the danger, watching the person that missed the condition getting beasted is enough to put anyone off wearing ear muffs in the future lol.

  3. Ricardo

    I would disagree that battles on became noisy with the advent of gunpowder. Before that it was normal for armies to be accompanied by drummers with the goal of intimidating others. Moreover, I imagine that the clash of metal armor would be also incredibly noisy.

  4. As an aging boomer and a professional Audio Video producer, I value my sight and my hearing. About 5 years ago I noticed a slight ringing in my right ear. The onset of Tinnitus. Now with my right ear at a constant ringing, my left ear will suddenly ring then “back down” to normal. I learn to live with it and sometimes use it to my advantage when my wife is asking me to do something around the house… If i become independently rich, I will invest in working on a cure for both Migraines, (for my daughter) and Tinnitus.

  5. Katie/Mary, we at TEA Headsets currently supply and manage the only “approved” products and systems for the US Army TCAPS program. The system currently fielded/issued to several active US Army BCT’s is the INVISIO X50 Advanced Tactical Headset System with the INVISIO X5 dual in-ear headset. This program covers a variety of soldier applications, such as:

    – Non Radio Hearing Protection System (provides the highest level of certified hearing protection and enhanced 360 degree auditory awareness)

    – Single/Dual Net Radio Hearing Protection (provides same as above as well as integration into portable 1-2 radios as well as vehicle intercom systems).

    To learn more about these products go to http://www.TEAheadsets.com or feel free to contact our Director of Business Development to learn more about the next generation of the TCAPS program, hearing protection solutions currently in use at a program level across the other branches of the DoD and the future direction of these products and systems.

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