Introduction

Acoustic trauma continues to amass as the most prevalent Service-connected disability for Veterans. Of the top 10 VA disabilities in 2024, almost one-third were auditory related (273,502 new claims for tinnitus and 108,105 for hearing loss). From 2023 to 2024, new compensation claims for auditory injury increased from 315,637 to 398,163 or 26.1%. Tinnitus and hearing loss are the two most prevalent disabilities in peace time service periods due to noise exposure in training.1 In 2023, Department of Defense (DoD) hearing surveillance data shows that 5.1% of the active-duty force has permanent auditory injury, and 8.6% developed unique episodes of temporary shifts in hearing.2 Historically, auditory injuries that are invisible, and not life or limb threatening, are not brought to the attention of medical personnel, unless they are associated with other severe injuries, or are disabling in severity.3

The goal of this CPG is to elevate awareness of noise threats, the prevalence of hazardous noise exposure, and the symptoms of acoustic trauma for the purpose of facilitating early identification and intervention of acoustic trauma. Improving outcomes for hearing requires developing trusted and functional prevention practices and technologies, as well as a surveillance and early referral and reporting system. This facilitates timely evaluation and diagnosis within therapeutic windows when intervention may mitigate injury progression. Improving the outcomes from acoustic trauma will preserve hearing capabilities in ranges conducive to continued high-level function and performance.