Development and Initial Validation of the Lifetime Exposure to Noise and Solvents Questionnaire in U.S. Service Members and Veterans

Abstract

Purpose A need exists to investigate the short- and long-term impact of noise exposures during and following military service on auditory health. Currently available questionnaires are limited in their ability to meet this need because of (a) inability to evaluate noise exposures beyond a limited time frame, (b) lack of consensus on scoring, (c) inability to assess impulse exposures (e.g., firearm use), (d) lack of a single questionnaire that assesses both military and nonmilitary exposures, and (e) lack of validity and reliability data. To address these limitations, the Lifetime Exposure to Noise and Solvents Questionnaire (LENS-Q) was developed. The purpose of this report is to describe the development and initial validation of the LENS-Q as a measure of self-reported noise exposure. Method Six hundred ninety participants, consisting of current Service members and recently military-separated (within about 2.5 years) Veterans, completed the LENS-Q, additional study questionnaires, and comprehensive audiometric testing. Noise exposure scores were computed from LENS-Q responses using a simple scoring algorithm that distinguishes between different cumulative levels of exposure and allows for the inclusion of both continuous and impulse noise exposures. Results The LENS-Q demonstrates good construct validity as evidenced by measures of hearing loss, tinnitus, and subjective hearing difficulties all increasing with an increase in noise exposure scores. A logistic regression, adjusting for age and sex, revealed that participants in the highest exposure group were 2.4–3.9 times more likely to experience hearing loss, 2.7–2.8 times more likely to experience tinnitus, and 3.0–3.7 times more likely to report hearing difficulties compared with individuals in the lowest exposure group. Conclusions The LENS-Q captures noise exposure over an individual's lifetime and provides an alternative scoring metric capable of representing exposure to both continuous and impulse noise. Findings suggest that the LENS-Q is a valuable tool for capturing and measuring both military and nonmilitary noise exposure. Supplemental Material https://doi.org/10.23641/asha.14582937

The Impacts of Noise Exposure on the Middle Ear Muscle Reflex in a Veteran Population

“…As described in Bramhall, McMillan, and Kampel (2021), the Lifetime Exposure to Noise and Solvents Questionnaire (LENS-Q) was used to assess lifetime noise exposure in all study participants (Bramhall et al, 2017;Gordon et al, 2017;Griest-Hines et al, 2021). Two Veterans did not report firearm use on the LENS-Q, which was most likely a reporting error because military service members typically complete firearms training during basic training.…”

Does Exposure to Noise During Military Service Affect the Progression of Hearing Loss with Increasing Age?

“…A common consequence of noise exposure is tinnitus (Griest-Hines et al, 2021; Yankaskas, 2013). Tinnitus is thought to be associated with damage to the cochlea, even for those with normal audiograms (Schaette & McAlpine, 2011).…”

Relative changes in the cochlear summating potentials to paired-clicks predict speech-in-noise perception and subjective hearing acuity

“…We obtained subjective hearing acuity and noise exposure history of each participant by using the Lifetime Exposure to Noise and Solvents – Questionnaire (LENS-Q) 23 , and two additional noise questionnaires [see in Appendix 1 of Liberman et al (2016)]. Moreover, we measured otoscopy, ipsilateral acoustic reflex thresholds (ARTs), and distortion product otoacoustic emissions (DPOAEs) from participants’ right ears according to standard audiological conventions.…”