Effects of Noise and Other Exposures on Auditory Functioning in Post-9/11 Veterans: NOISE Study 3.0

噪音和其他暴露对 9/11 后退伍军人听觉功能的影响：噪音研究 3.0

• 批准号: 10188321
• 负责人: JAMES A HENRY
• 金额: --
• 依托单位: PORTLAND VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10188321
• 关键词: Academy; Acoustic Nerve; Address; Adverse effects; Affect; Animals; Audiology; Auditory; Award; Behavioral; Central Auditory Diseases; Central Auditory Processing Disorder; Chemical Exposure; Chemicals; Chronic; Clinical; Clinical Research; Cochlea; Communication; Data; Data Collection; Data Set; Department of Defense; Distress; Electrophysiology (science); Enrollment; Environmental Exposure; Epidemiology; Etiology; Evaluation; Event; Explosion; Exposure to; Functional disorder; Funding; Future; Goals; Grant; Hair Cells; Health; Health Services; Healthcare; Hearing; Hearing problem; High-Frequency Hearing Loss; Human; Individual; Injury; Inner Hair Cells; Institute of Medicine (U.S.); Intervention; Lead; Life Cycle Stages; Longitudinal Studies; Measures; Medical; Medical Research; Medicine; Mental Health; Methods; Military Personnel; Modeling; Nerve Fibers; Nervous system structure; Noise; Occupational Exposure; Occupations; Outcome; Participant; Pathway interactions; Pattern; Peripheral; Persons; Phase; Physiological; Population; Prevention; Prevention strategy; Psyche structure; Quality of life; Recommendation; Rehabilitation Centers; Rehabilitation therapy; Reporting; Request for Proposals; Research; Research Personnel; Research Support; Risk; Risk Factors; Role; Seminal; Series; Services; Site; Societies; Solvents; Source; Surveys; Synapses; Target Populations; Testing; Time; Tinnitus; Traumatic Brain Injury; United States Department of Veterans Affairs; Validation; Veterans; Work; active duty; auditory processing; auditory rehabilitation; blast exposure; cell injury; cochlear synaptopathy; comorbidity; cost; design; disability; early onset; epidemiology study; follow up assessment; follow-up; hearing impairment; hearing loss risk; insight; interest; military service; ototoxicity; physical conditioning; post 9/11; prevent hearing loss; programs; rehabilitation research; research and development; response; service member; treatment strategy

Little is known regarding the epidemiology, etiology, pathophysiology, and comorbidities of hearing loss and tinnitus in the military population. The Department of Veterans Affairs (VA) is consequently unable to predict the risk of auditory disorders in Service members exposed to noise. Compounding this problem, many other military and non-military exposures can cause auditory injury, including solvents, blasts and other sources of traumatic brain injury (TBI), and certain other injuries and medical conditions. Non-military (e.g., recreational) or post-military exposures (i.e., Veterans' occupational exposures) may also contribute to long-term risk. It is critical to attain a fundamental understanding of the epidemiology and pathophysiology of tinnitus and hearing loss, as well as their interrelatedness. Such an understanding could help identify individuals at risk for auditory injury, and ultimately lead toward much-needed rehabilitation methods that target the underlying causes. In 2012, in response to recommendations made by the Institute of Medicine (IOM; now the National Academies of Medicine) in their congressionally-mandated report titled, “Noise and Military Service: Implications for Hearing Loss and Tinnitus,” we assembled a team of audiology, epidemiology, and health services researchers at the VA Rehabilitation Research & Development (RR&D) National Center for Rehabilitative Auditory Research (NCRAR) to design a longitudinal study focused on auditory health in recent Veterans. The Noise Outcomes In Service members Epidemiology Study (“NOISE Study”) was funded in 2013 [Congressionally Directed Medical Research Programs (CDMRP) grant #W81XWH-12- PRMRP-IIRA]. The study enrolls Veterans within 2.5 years of military separation, allowing us to measure their military exposures within a reasonable recall period. In 2014, the Department of Defense (DoD) Hearing Center of Excellence (HCE; San Antonio, TX) was added as a second site to increase enrollment and to expand our target population to include active-duty military Service members. Enrollment at the HCE began in June 2015. The present proposal requests funding to continue study activities for the next 4-year period for the NCRAR site. (Should the HCE not receive continuation funding from the DoD, their participants will be followed by the NCRAR team.) Since the NOISE Study's inception, baseline data have been collected on 644 Veterans at the NCRAR and 373 Service members at the HCE (1,017 participants enrolled across the two sites). The baseline examination includes a full audiologic test battery with an extensive survey component. Participants complete annual follow- up surveys (online) to capture ongoing exposures and any changes in health and functioning. The in-person audiologic examination is repeated every 5 years, allowing us to identify changes in auditory function over time and contrast those changes with Veterans' past military exposures and/or ongoing non-military exposures. For the proposed continuation study (NOISE Study 3.0), we will expand data collection to address current and evolving interests in the field of auditory health, to include focusing on blast as a risk factor for outcomes of auditory functioning, and testing for central auditory processing disorder (CAPD) and cochlear synaptopathy. These efforts will produce an unprecedented epidemiologic dataset revealing cross-sectional and longitudinal associations between a wide range of exposures, medical and mental health conditions, peripheral auditory function, central auditory function, and tinnitus. Deliverables include a series of research reports containing analyses and recommendations with a special focus on: estimates of incident tinnitus and hearing loss following military service and identifying sub-populations at-risk; individual and population-level trajectories of hearing and tinnitus; estimates of the association between cochlear synaptopathy and central auditory dysfunction with incident tinnitus and perceived hearing ability; and confluence of auditory dysfunction and mental distress on quality of life in post-9/11 Veterans. Clinical deliverables include validation of surveys for capturing noise and chemical exposures and distinguishing occasional from chronic tinnitus.

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