Acoustic trauma has continued to amass veteran disability at a 13-18% annual rate. Of the 2.35 million unique cases of auditory system disability at the end of FY 2013, approximately 870,000 are attributed to the Gulf War era and approximately 551,000 from exposure during operations in Iraq and Afghanistan.1 Within the Department of Defense (DoD), 2% of the total force develops permanent injury annually, and 11-14% have unique episodes of temporary shifts in hearing. Historically, auditory injuries that are invisible and not life or limb threatening are not brought to the attention of medics, unless they are associated with other sever injuries, or are disabling in severity.2

The goal of this CPG is to elevate the awareness of noise threat, the prevalence of hazardous noise exposure, and the symptoms of acoustic trauma for purpose of facilitating early identification and early intervention of acoustic trauma. Improving outcomes for hearing requires developing a trusted surveillance and early referral and reporting system so that significant symptomatic exposures can be evaluated and diagnosed in a timely manner within therapeutic windows when intervention may mitigate injury progression, rather than current trends that put off consultations that delay care past the point of successful management. Improving the outcomes from acoustic trauma will preserve hearing capabilities in ranges conducive to continued high level function and performance.