The association between hearing problems and blasts in UK Armed Forces personnel deployed to Iraq and Afghanistan, 2003-2009
研究英国军人部署至伊拉克和阿富汗后听力问题与爆炸暴露的关联，发现部署、战斗角色及多种爆炸暴露显著增加听力问题风险，对职业听力保护有启示。
Objectives: Hearing problems can impair occupational functioning. Since coalition forces have been in Iraq and Afghanistan, the US military have reported an increase in hearing problems. This can result in personnel being discharged, reducing their quality of life and future employment opportunities. Deploying personnel with hearing problems can also impair military capability. Hearing problems represent a substantial cost to the government who provide clinical services and compensation. We investigate whether there are associations between hearing problems and deployment to Iraq/Afghanistan and blast exposure within UK military personnel. Methods: This is a two-phase cohort study of UK military personnel in which respondents completed questionnaires about deployment experiences and health outcomes. Data were collected between 2004 and 2006 and again between 2007 and 2009 (n=9984). Key demographic, military and deployment factors predicting hearing problems are explored using univariable and multivariable logistic regression. Results: We identified 1978 (19.4%) military personnel with hearing problems. Factors associated with hearing problems included being male (odds ratio 1.43, 95% CI 1.15-1.75), older than forty (1.44, 1.20-1.72), deployed to Iraq or Afghanistan (1.55, 1.24-1.94) and in a combat role (1.56, 1.34-1.81). Further investigation of deployed personnel showed that exposure to small arms/rocket-propelled grenade fire (2.11, 1.68-2.66), mortar attacks (1.50, 1.18-1.90), landmine strikes (2.80, 1.11-7.05), improvised explosive devices (2.37, 1.45-3.88) and firing a weapon in direct combat (2.92, 2.20-3.86) were associated with hearing problems. Conclusions: Hearing problems are associated with deployment to Iraq and Afghanistan and with exposure to blasts. These results have implications for occupational hearing conservation programmes.