Capt. David McIlwain, the lone American military audiologist in Iraq, stands in front of his soundproof testing booth at the 10th Combat Support Hospital in Baghdad’s Green Zone.

Capt. David McIlwain, the lone American military audiologist in Iraq, stands in front of his soundproof testing booth at the 10th Combat Support Hospital in Baghdad’s Green Zone. (Anita Powell / S&S)

BAGHDAD — Spc. Anthony DeLeon made it through the four roadside bombs without a scratch.

The inside of his right ear, however, was not so lucky.

During his recent yearlong tour of duty north of Baghdad, the 20-year-old Texan picked up an increasingly common badge of experience from the war in Iraq: hearing damage.

“It just rings all the time,” he said, turning his head slightly so that his left ear — the good one — tilts toward the speaker.

“The first week I got here, was my first (roadside bomb),” said DeLeon, who was with the 1st Battalion, 187th Infantry Regiment, 3rd Brigade Combat Team of the 101st Airborne Division of Fort Campbell, Ky. “[My hearing] got a little better. But then the second one hit, the third one hit, the fourth one hit.”

While loud noise has been part of military life since muskets and cannons were part of the arsenal, Iraq is proving one of the noisiest battlegrounds yet. Roadside bombs — the signature of the country’s insurgency — regularly hit patrols, popping eardrums in their wake.

Also, more soldiers are being exposed to noise: According to a 2004 study by the Veterans of Foreign Wars, 82 percent of soldiers in Iraq engaged in combat, versus an average of 15 percent in other wars.

According to Veterans Affairs data, major hearing loss disability cases held steady through the late 1990s. The number rose markedly from nearly 40,000 cases in 2002 to about 50,000 in 2005, the latest year for which data was available.

In 2005, Veterans Affairs spent nearly $800,000 treating major hearing loss — a nearly 20 percent jump from 2004. Over half of that money was spent on members of the Army.

Medics say roadside bombs regularly rob soldiers’ hearing in Iraq.

“We’ve had quite a number who have been hit by [roadside bombs],” said Capt. Rodney Dycus, a physician’s assistant who served a year at a clinic near Beiji, north of Baghdad. “And quite a few of them have some temporary hearing loss.”

Dycus said that in his experience, as many as 30 percent of people who are exposed to bombs suffer some form of hearing loss, temporary in most cases. All of those affected who have been seen at his clinic were returned to duty, he said.

Treatment can include temporary hearing aids and surgery.

While many soldiers shrug off their hearing loss, military medical officials say hearing loss is a serious issue.

Capt. David McIlwain, the lone American military audiologist in Iraq, operates out of a small hearing booth at the 10th Combat Support Hospital in Baghdad’s Green Zone. Once a month, he said, he sees a servicemember who has sustained significant hearing loss. He has recommended the medical discharge of two soldiers for hearing reasons.

“Hearing is the most important survival sense for soldiers,” he said. “In the Army, good hearing can mean the difference between life and death.”

He said he’s saddened by the impact of roadside bombs on unprotected eardrums — and by the fact that few take precautions.

Many combat-arms soldiers say they won’t wear their issued two-tone combat earplugs because they interfere with their ability to hear background noises or communicate with one another on the radio.

The consequences of that, McIlwain said, can be serious.

“You’re talking about 19-year-olds who can hear worse than my grandfather,” he said. “Hearing problems are to a large extent preventable. For the most part, a $5 pair of earplugs can prevent a great amount of it. … People I have seen here, those who did have the (issued) earplugs in, did not suffer ruptured eardrums.”

Some soldiers have been equipped with headsets that let them communicate with one another in vehicles, yet help protect them from loud noises such as bomb blasts.

Even soldiers who don’t regularly hear blasts are at risk, McIlwain said. Typically, he said, a career soldier — one who never deploys — will lose 6 percent of his hearing during his career.

“Loud noise equals hearing loss,” he said. “Period. No doubt about it.”

He said servicemembers need to be attentive to the danger and take precautions.

“When you lose your hearing, there’s no pain, no blood,” he said. “And it can happen gradually. What you’re exposed to today might not show up for 10 years.”

The military should do more to educate soldiers before they deploy about using earplugs, according to an article by hearing specialists with the U.S. Army Center for Health Promotion and Preventive Medicine in the December 2005 issue of American Journal of Audiology.

The specialists also said unit commanders should be better informed about how to protect and evaluate their troops’ hearing and ensure that all blast victims be referred to audiologists for evaluation.

For soldiers like DeLeon, living with his loss is a daily adjustment.

“I’m pretty sure I won’t hear the same as I used to,” he said, adding that he’s sure he’ll be able to remain in the military. “I’ve grown used to that.”

But like many soldiers, he said he’s grateful that his run-ins with roadside bombs have taken so little from him.

“It’s a lot better than losing my leg,” he said.

Recent numbers

Veterans’ hearing loss disability cases in 2005:

Army: 51,621

Air Force: 12,477

Navy: 18,135

Marine Corps: 7,308

Source: U.S. Dept. of Veterans Affairs

Facts on hearing loss

• If a soldier has been exposed to an explosion, the hearing loss may be temporary. The symptoms, including mild hearing loss, dizziness and ringing in the ears, can last for several days. Too many incidents such as this will result in permanent hearing loss years later.

• If the eardrum is ruptured, it will heal on its own if the ear is kept clean and dry. About 10 percent of the surface area will heal per month. Soldiers with eardrum perforations should not place anything in the ear and be very careful not to let water get into the ear until the perforation is completely healed.

• If the rupture is very large, a specialist may use surgery to repair it and then monitor the healing process. Hearing aids are not dispensed for ruptured eardrums because the prescription would change as the eardrum heals.

For more information on eardrum perforations, see, or

Source: U.S. Army audiologists

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