Abstract

The purpose of this paper is to demonstrate the feasibility and utility of developing economic cost models for noise-induced hearing loss (NIHL). First, we outline an economic model of NIHL for a population of US Navy sailors with an "industrial"-type noise exposure. Next, we describe the effect on NIHL-related cost of varying the two central model inputs--the noise-exposure level and the duration of exposure. Such an analysis can help prioritize promising areas, to which limited resources to reduce NIHL-related costs should be devoted. NIHL-related costs borne by the US government were computed on a yearly basis using a finite element approach that took into account varying levels of susceptibility to NIHL. Predicted hearing thresholds for the population were computed with ANSI S3.44-1996 and then used as the basis for the calculation of NIHL-related costs. Annual and cumulative costs were tracked. Noise-exposure level and duration were systematically varied to determine their effects on the expected lifetime NIHL-related cost of a specific US Navy sailor population. Our nominal noise-exposure case [93 dB(A) for six years] yielded a total expected lifetime cost of US $13,472 per sailor, with plausible lower and upper bounds of US $2,500 and US $26,000. Starting with the nominal case, a decrease of 50% in exposure level or duration would yield cost savings of approximately 23% and 19%, respectively. We concluded that a reduction in noise level would be more somewhat more cost-effective than the same percentage reduction in years of exposure. Our economic cost model can be used to estimate the changes in NIHL-related costs that would result from changes in noise-exposure level and/or duration for a single military population. Although the model is limited at present, suggestions are provided for adapting it to civilian populations.

Highlights

  • Our economic cost model can be used to estimate the changes in noise-induced hearing loss (NIHL)-related costs that would result from changes in noise-exposure level and/or duration for a single military population

  • NIHL has been shown to lead to accidents and injury in the workplace [4, 5] and may constitute an operational hazard in the military [6]

  • The total cost of NIHL generated by the United States (US) military is unknown but probably much higher because of additional NIHL-related costs, such as those attributable to annual monitoring audiometry and the distribution of hearing aids

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Summary

Methods

We have previously described the development of our NIHL cost model in detail [10]. In this paper, we summarize the most salient information in order to demonstrate the feasibility of developing such a model and provide background for our discussion of the sensitivity analysis and possible adaptations of the model.Model descriptionCosts due to NIHL are divided into those incurred during active duty and payable by the US Navy, and those incurred during retirement and payable by the US Department of Veterans Affairs (VA). We have previously described the development of our NIHL cost model in detail [10]. Cost data are primarily for the Baltimore, Maryland area in 2004. They were obtained from official correspondence, websites, and consultation with US Navy and VA officials and audiologists. Probabilities were derived from data in existing military databases and consultations with Navy and VA officials and audiologists. Computations required only addition, multiplication, and logarithms, so the model was fully deterministic (probabilities were treated as fixed fractions). Both EXCEL (Microsoft Corporation, Redmond, MA, USA) and MATLAB (The MathWorks, Natick, MA, USA) were used

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