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Headquarters United States Army Europe Wiesbaden, Germany
Headquarters United States Army Installation Management Command Europe Sembach, Germany
Army in Europe Regulation 40 - 501
21 June 2018
Medical Services
Army Hearing Program–Europe
For the Commander:
KAI R. ROHRSCHNEIDER Brigadier General, GS Chief of Staff
Official:
DWAYNE J. VIERGUTZ Chief, Army in Europe Document Management
Summary. This regulation prescribes policy and procedures for the Army Hearing Program in Europe.
Precedence ( Vorrangigkeit ):
● This regulation was translated into German (that is, AE Reg 40-501-G). If discrepancies arise between AE Reg 40-501 and AE Reg 40-501-G, the provisions of AE Reg 40-501 take precedence for all employees except for local-national employees (glossary) in Germany employed under the provisions of the Collective Tariff Agreement II (CTA II)). For those employees, the provisions of AE Reg 40-501-G take precedence.
● Diese Dienstvorschrift wurde ins Deutsche übersetzt (d.h. AE Reg 40-501-G). Sollten zwischen AE Reg 40-501 und AE Reg 40-501-G Abweichungen bestehen, so haben die Bestimmungen der AE Reg 40-501 Vorrang für alle Arbeitnehmer außer für ortsansässige Arbeitnehmer (glossary) in Deutschland, die entsprechend den Bestimmungen des TV AL II beschäftigt sind. Für diese Arbeitnehmer haben die Bestimmungen der AE Reg 40-501-G Vorrang.
NOTE: AE Regulation 40-11 prescribes Army in Europe policy for providing occupational-health services (including hearing-protection services) to local-national employees in Germany. In cases of conflict between the two regulations, AE Regulation 40-11 will take precedence.
Applicability. This regulation applies to all “Army in Europe personnel” (glossary) who live and work in the USAREUR area of responsibility. This regulation is also applicable to other DOD military and civilian personnel who live or work on Army installations or are assigned to Army units in Europe.
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Records Management. Records created as a result of processes prescribed by this regulation must be identified, maintained, and disposed of according to AR 25-400-2. Record titles and descriptions are on the Army Records Information Management System website at https://www.arims.army.mil.
Supplementation. Organizations will not supplement this regulation without approval of the Force Health Protection Branch, Office of the Command Surgeon (OCSURG), HQ USAREUR.
Suggested Improvements. The proponent of this regulation is the Force Health Protection Branch, OCSURG, HQ USAREUR (mil 537-3710). Users may suggest improvements to this regulation by sending DA Form 2028 to the OCSURG, HQ USAREUR, Unit 29351, APO AE 09014-9351.
Distribution. This regulation is available only electronically and is posted in the Army in Europe Library & Publishing System at http://www.eur.army.mil/aepubs/.
CONTENTS
Purpose
References
Explanation of Abbreviations and Terms
Responsibilities
Army Hearing Program Overview
The Army Hearing Program–Europe
AHP-E Roles and Responsibilities
Noise-Hazard Identification
Engineering Controls
Hearing Protection
Hearing Readiness and Monitoring Audiometry
Hearing-Health Education
Operational Hearing Services
Nuisance Noise in the Garrison Environment
Enforcement of the AHP-E
Accessing AHP-E Program Services
Evaluating the AHP-E
Appendixes A. References B. Noise Levels and Noise Characteristics of Common Army Equipment C. Examples of Hazardous Noise-Exposures D. Information for Requisitioning Hearing-Protection Devices E. Tactical Communication and Protective Systems
Tables
- Hearing Readiness Classification System B-1. Steady-State Noise Levels of Common Army Equipment B-2. Impulse-Noise Levels of Common Army Equipment B-3. Steady-State Noise Exposure Limits While Wearing the ACH with Earplugs B-4. Steady-State Noise Exposure Limits While Wearing Double Hearing Protection B-5. Airborne High-Frequency (Ultrasonic) Noise-Exposure Limits
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b. Chief, Safety Division, Office of the Chief of Staff, HQ USAREUR. According to AR 385- and DA Pamphlet 385-10, the Chief, Safety Division, will do the following in support of the AHP-E:
(1) Evaluate compliance with hearing-loss prevention requirements during standard Army safety and occupational health (SOH) inspections.
(2) Record and monitor incidents of hearing loss that are reportable under the Occupational Safety and Health Administration (OSHA) as an occupational illness (that is, repetitive trauma) or as a one-time acoustic trauma. The Safety Division will record these incidents on the OSHA log of injuries and illnesses, except when the loss of hearing is directly attributable to combat.
(3) Facilitate the resolution of safety issues related to hearing-loss prevention.
(4) Coordinate and consult with the HPM-E for any issues related to the AHP-E identified during USAREUR safety councils, advisory councils, or both.
c. Commanders of Army in Europe Units. Army in Europe commanders (that is, unit commanders), activity directors, and supervisors of all Soldiers and all civilians exposed to noise will—
(1) Endorse higher-level and local garrison memorandums that stress the importance of hearing- protection and prominently display their endorsement memorandum.
(2) Develop a standing operating procedure (SOP) for implementing the AHP-E in their units.
(3) Include the AHP-E and the requirement for a unit AHP-E SOP as an item of command interest in the organizational inspection program (OIP).
(4) Appoint, on orders, an individual (military or civilian) who is a staff sergeant, staff sergeant equivalent, or above to act as the unit hearing program (HP) officer. The HP officer is the responsible unit official for hearing readiness (HR) with the AHP-E responsibilities identified in paragraph 7d.
(a) Brigade and battalion-level units must appoint at least one HP officer.
(b) Geographically dispersed battalions will appoint at least one company-level HP officer at each distinct location to provide area coverage.
(5) Ensure their unit-level HP officers enforce the specific unit requirements of the AHP-E (para 7d) at their unit and the unit Soldiers and applicable civilian personnel comply with the specific individual requirements (para 7e) of the AHP-E.
d. The Commander, PHCE. In support of the AHP-E, the Commander, PHCE—
(1) Facilitates medical surveillance and provides oversight for hearing services afforded to all military personnel and identified civilians exposed to hazardous noise according to AR 40-5 and DA Pamphlet 40-501.
(2) Appoints the following on orders:
(a) A military audiologist as the HPM-E with the AHP-E responsibilities listed in paragraph 7a.
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(b) An individual as the IHPM-E with the AHP-E responsibilities listed in paragraph 7b.
(c) An individual as the OHPM-E with the AHP-E responsibilities listed in paragraph 7c.
5. ARMY HEARING PROGRAM OVERVIEW
a. AR 40-501 prescribes the AHP, which comprises Army policy, strategies, and processes to prevent noise-induced hearing loss among U.S. Soldiers, DOD civilian employees (glossary) (that is, U.S. DOD civilian-service employees, local-national (LN) employees of the U.S. Forces (glossary), and DOD-contractor employees supporting the U.S. Forces). According to DA Pamphlet 40-501, paragraph 3-1, the AHP has the following four major components:
(1) Hearing readiness.
(2) Clinical hearing services.
(3) Operational hearing services (para 13).
(4) Hearing conservation.
b. On the advanced technology battlefield, Soldiers must communicate effectively, which requires normal hearing. Normal (good) hearing enables Soldiers and civilian employees to maintain critical situational awareness and effective oral communication in many different environments (for example, in combat, during field operations, in garrison, at industrial worksites, during military training). Hearing loss degrades mission capability, training effectiveness, and ultimately combat readiness. Good hearing is a proven combat multiplier that preserves the lethality and survivability of Soldiers and civilians.
c. Noise-induced hearing loss is one of the most prevalent injuries among DOD military and civilian personnel and represents a significant portion of the annual cost of service-connected-disability compensation. Hearing loss and the associated symptoms (for example, tinnitus) that qualify for permanent disability are in most cases preventable.
d. An under-recognized, yet commonly occurring component of the hearing-related threat to health is nuisance noise. Nuisance noise is any unwanted sound that interferes with communication or the ability to achieve restful sleep periods.
(1) Nuisance noise induces non-auditory effects that create stress and fatigue in dangerous combinations.
(2) Nuisance noise in garrison and workplace environments can also interfere with personnel hearing warning sirens or emergency signals and jeopardize the safety of all installation personnel.
(3) Acceptable nuisance-noise levels are task-specific (for example, the amount of tolerable ambient noise is greater for a tactical operations center (TOC) than for a sleep tent).
(4) Intrusive nuisance-noise has been heavily researched. The strategies for controlling nuisance noise that resulted from this research can improve short- and long-term care of deployed and garrison- based Soldiers and civilian employees.
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b. DOD civilian employees and military personnel will be enrolled in a comprehensive unit HRCP when they are exposed to either of the following:
(1) Steady-state noise with a time-weighted average (TWA) of 85 A-weighted “decibels” (dBA) (glossary) or greater. Common sources of hazardous steady-state noise include aircraft, generators, and tactical vehicles. Appendix B, table B-1, provides the noise levels of commonly used models of Army equipment for reference and use in determining the exposure risk.
(2) Impulse noise of 140 decibels peak-measurement (dBP) or greater. Appendix B, table B-2, provides the noise levels of commonly used models of Army weapons.
NOTE: All current Army weapons exceed 140 dBP, even when firing blanks. Because all Soldiers must conduct weapons-qualification training annually, all Soldiers must be enrolled in a comprehensive unit HRCP.
(3) Airborne high “frequency” (glossary) or ultrasonic noise, regardless of duration, that meets or exceeds the applicable values listed in Appendix B, table B-5.
(4) Known or suspected ototoxins (ear poison) measured at one-half of the occupational exposure limit. Appendix C, table C-1 provides a list of potential ototoxins.
(a) An excessive exposure to a workplace ototoxin can, on its own, result in hearing loss.
(b) In combination with even marginal noise exposure, ototoxins can have a synergistic effect on hearing and cause more damage than a higher exposure to either single hazard. Activities where noise and ototoxins often combine include, but are not limited to construction, manufacturing (for example, metal, leather, petroleum products), painting, and printing.
c. According to the European Union (EU) Noise Directive (Directive 2003/10/EC), the DOD must offer AE LN employees a hearing-monitoring program (for the Army, that is the HR component of the AHP). Therefore, LN employees—
(1) May participate in the comprehensive unit HRCP when occupational noise levels exceed either 80 dBA TWA or 135 dBP.
(2) Must participate in the comprehensive unit HRCP when noise levels equal or exceed either 85 dBA TWA or 137 dBP.
d. Individual host-nation laws and regulations may apply more stringent conditions or differ from the EU standard in non-EU European nations. AE regional industrial hygienists can provide additional details on host-nation regulations that are applicable to the local area (that is, applicable to all DOD military and civilian employees (including LN employees)).
7. AHP-E ROLES AND RESPONSIBILITIES
a. HPM-E. The HPM-E manages and coordinates the AHP and AHP-E for the U.S. Army in Europe. The HPM-E is responsible for—
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(1) Developing AHP-E policy recommendations, educational course standards, and SOPs that are adapted to the USAREUR area of responsibility (AOR) and meet or exceed the intent and regulatory requirements of the AHP.
(2) Providing guidance and support to regional “hearing program managers” (HPMs) (glossary) to ensure local regions comply with program policy, training standards, and procedures. The HPM-E will also help regional HPMs acquire resources and equipment necessary for program implementation. In addition to the HPM-E, the Army in Europe currently has two regional HPMs:
(a) HPM Bavaria. The HPM Bavaria is located in Vilseck, Germany, manages the AHP-E at the regional level, and is responsible for the AE sub-region that comprises the United States Army Garrison (USAG) Ansbach, the USAG Bavaria, the USAG Stuttgart, and the Kosovo Force AORs as well as supporting the United States Army Central Command AOR as required.
(b) HPM Rheinland-Pfalz. The HPM Rheinland-Pfalz is located in Kaiserslautern, Germany, manages the AHP-E at the regional level, and is responsible for the AE sub-region that comprises the USAG Benelux, the USAG Italy, the USAG Rheinland-Pfalz, and the USAG Wiesbaden AORs as well as supporting the United States Army Africa/Southern European Task Force AOR if required.
(3) Providing staff oversight of agencies that provide audiometric-monitoring services for all military personnel and for civilian employees who are exposed to noise or ototoxins. The HPM-E ensures agencies use only audiometric equipment, computer software, and guidance authorized by the “Defense Occupational Environmental Health and Readiness System–Hearing Conservation” (DOEHRS-HC) (glossary) program and according to DA Pamphlet 40-501, paragraph 4-2. The HPM-E will establish a standard SOP and validate local SOPs to ensure uniform processing at hearing test sites across the USAREUR AOR.
(4) Ensuring audiometric test records are maintained using authorized forms (that is, “DD Form 2215” (glossary) or “DD Form 2216” (glossary), which are generated by the DOEHRS-HC system) (not applicable to contractors). The HPM-E also ensures that all audiometric records are uploaded to the “Defense Occupational Environmental Health and Readiness System–Data Repository” (DOEHRS-DR) (glossary) for DOD-wide access (not applicable to contractors).
(5) Notifying appropriate personnel (for example, commanders, civilian supervisors, safety officers, unit HP officers, occupational health (OH) managers) when an individual has sustained a positive “significant threshold shift” (STS) (glossary) or permanent hearing loss that may endanger the individual and others. Notifications may include, but are not limited to, the need for an STS followup test with hearing technicians, a diagnostic evaluation with a provider, a physical profile (recorded on DA Form 3349 with appropriate recommendations for maximum remediation of risks), a referral to a medical retention board, and, if applicable, a written confirmation of a permanent hearing shift.
(6) Ensuring that medically certified personnel fit noise-exposed individuals with approved earplugs and re-verify the condition and fit of earplugs at least annually.
(7) Providing hearing-health education courses taught by subject-matter experts (SMEs) at least annually for all Soldiers and noise-exposed civilian personnel. The HPM-E will annually establish an AE standard training package for unit education.
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(2) Provide a survey report with pertinent recommendations for personnel to commanders, preventive-medicine personnel, OH nurses, and safety managers (as appropriate) following an initial evaluation or re-evaluation.
(3) Maintain a current list of all noise-hazardous areas using DD Form 2214 and the DOEHRS– Industrial Hygiene database, as applicable.
(4) Maintain a current list of all ototoxin-hazardous areas and operations.
(5) On an annual basis, provide the HPM-E a list of personnel who were exposed to high- intensity noise or ototoxins during that fiscal year. The list should identify personnel by name and an identification number (for example, common-access-card number (preferred), Social Security number (discouraged)), and specify the magnitude of the exposure and the location where the exposure occurred.
(6) Provide notification letters outlining noise-dosimetry results to supervisors, with instructions to provide a copy to the surveyed employee. The IHPM-E will forward an additional copy of the notification letter to the OH nurse to assist with tracking the employee in the unit HRCP, as necessary.
c. OHPM-E. In support of the AHP and the AHP-E, the OHPM-E will—
(1) Coordinate with the IHPM-E and HPM-E to identify and maintain a database of all DOD civilian employees that are exposed to ototoxins (measured at one-half of the occupational exposure limit) or high-intensity noise.
(2) Ensure DOD civilian employees being monitored in unit HRCPs are referred to the appropriate medical facility for placement, periodic, and termination audiometric evaluations and receive appropriate hearing-protection devices (HPDs). The OHPM-E will also—
(a) Refer DOD civilian-service employees for further evaluation of hearing as appropriate and provide appropriately trained personnel to fit DOD civilian-service employees with the proper size and type of HPDs.
(b) Ensure that contractor and LN personnel for whom the U.S. Government has specific contractual obligations for medical care are medically referred for appropriate audiometric monitoring (usually to a contracted local OH physician), are fit with HPDs by medically certified personnel, and receive annual hearing-health education that meets the AE training standard (if provided by an outside agency).
(3) During worksite visits, ensure that preformed earplugs and all other HPDs are checked for fit and any signs of deterioration.
(4) Provide appropriately trained personnel to incorporate education classes on hearing-loss prevention into the annual health-education training plan of the unit HRCP. The course content must meet or exceed the Army in Europe course standard established by the HPM-E (a(1) above).
d. Unit HP Officers. Unit HP officers will—
(1) Complete a unit-level HP-officer certification course provided by or coordinated through the AHP-E.
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(2) Serve as the designated officials responsible for managing the hearing program and monitoring personnel HR at the unit level. HP officers may request guidance and technical support for implementing a comprehensive unit HRCP through the regional HPM or the HPM-E. The HP officer will also inform the unit commander of AHP-E requirements, provide the commander with regular updates for unit HRCP statistics, and ensure the unit complies with the following AHP-E unit-level requirements:
(a) Post and maintain noise-hazard danger and caution signs and decals for all identified areas and equipment according to AR 420-1 and DA Pamphlet 385-11.
(b) Enforce the mandatory use of HPDs for all personnel when around noise-hazardous areas and (request commanders) take appropriate action for noncompliance.
- Provide all Soldiers and personnel exposed to noise a pair of preformed earplugs and the earplug carrying case and require them to maintain those items as individual equipment.
- Require Soldiers to wear the earplug carrying case containing earplugs as part of the Army combat uniform (ACU) (universal camouflage pattern (UCP)) and ACU (operational camouflage pattern (OCP)) as prescribed by USAREUR (para 10a).
(c) Ensure Soldiers and noise-exposed civilian personnel complete annual, pre- and postdeployment, termination, and followup hearing evaluations as required.
(d) Ensure all Soldiers and noise-exposed civilian personnel complete annual hearing-health education briefings that meet or exceed the AHP-E training standard.
(e) Ensure medical-threat and predeployment briefings include noise-hazard descriptions and preventive measures (for example, hearing-protection requirements, noise-abatement strategies).
(f) Coordinate with the HPM-E and IHPM-E to properly identify positions that require working in noise-hazardous areas and annotate this requirement on job descriptions. Unit HP officers will ensure that annotated job descriptions include the requirement to wear personal protective equipment (PPE) (for example, HPDs) and noise-survey dosimeters when requested, and to report for scheduled medical examinations as required. They will enforce survey recommendations for mitigation of exposure risks.
(g) Notify employees about noise and ototoxic chemical exposure levels as needed and provide them copies of survey results and hearing program documents on request.
(3) Prepare a unit-level hearing-protection SOP for the commander’s approval. HP officers should also review the unit range SOP for inclusion of hearing-loss prevention procedures as necessary.
(4) Ensure unit compliance with AHP-E requirements for all OIP inspections.
(5) Monitor the unit data in the hearing-readiness module in the Medical Protection System (MEDPROS) on a monthly basis to screen the hearing-readiness classification (HRC) of all assigned personnel. Refer all Soldiers identified with a status of HRC class 4 (HRC-4) to the local hearing test site for completion of an annual, pre- or postdeployment, or other hearing test, as applicable.
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(16) Conduct periodic checks of maintenance and operational areas to determine if noise levels are increasing, areas are posted as noise-hazardous, and personnel are using HPDs. If noise levels have changed or new equipment is being used or emplaced, the HP officer should request a noise-hazard evaluation by the local industrial-hygiene office.
(17) Research new equipment during the unit’s acquisition process to determine best options for lowering generated noise levels. (For example, when purchasing weedeaters, $20.00 more per weedeater may result in a tool that operates at less than 85 dBA.)
e. Soldiers and Noise-Exposed Civilian Personnel. All Soldiers and noise-exposed civilian personnel in the Army in Europe will—
(1) Report to hearing test sites for in- and outprocessing (includes placement and termination), pre- and postdeployment, and annual hearing examinations as directed by their unit. Personnel must also complete any necessary followup testing as directed by clinic personnel or unit HP officers.
(2) Maintain a pair of preformed earplugs and an earplug carrying case as individual items of PPE. Soldiers will wear the earplugs and carrying case as part of their uniform (para 10a).
(3) Correctly maintain and consistently wear approved and properly fitted HPDs when exposed to hazardous noise (for example, while conducting weapons firing, simulated training exercises (including when firing blanks), or military operations on urbanized terrain; while operating motorboats, motorcycles, power tools, or tactical vehicles).
(4) Report for hearing-health education briefings at least annually.
(5) Immediately report to their supervisor any suspected hearing loss resulting from weapons firing or exposure to blasts or explosions that occur in combat or training environments to facilitate appropriate medical attention.
8. NOISE-HAZARD IDENTIFICATION
a. As a part of the Army in Europe Industrial Hygiene Program (IHP-E) and the AHP-E, industrial- hygiene personnel will—
(1) Conduct noise surveys of all suspected noise-hazardous areas, vehicles, and equipment at least once before areas or equipment are used and within 30 days after any change in operating conditions that affect noise levels.
(2) Determine the 8-hour TWA sound level for all DOD civilian employees routinely working in hazardous-noise areas and military personnel working in hazardous-noise industrial-type operations at least once before the areas are used and within 30 days after any change in operating conditions that affect noise levels.
(3) Complete visits to each potentially noise-hazardous area at least annually according to AR 385-10 requirements. Annual visits may also be provided by SOH professionals (with a referral to industrial-hygiene personnel if new equipment or operating conditions are identified on site that could affect current noise levels).
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b. Industrial-hygiene technicians or personnel trained to use noise-measurement equipment will—
(1) Perform noise surveys as required.
(a) United States Army Public Health Command (formerly, United States Army Center for Health Promotion and Preventive Medicine) Technical Guide 181 (USAPHC TG 181) provides guidance for performing noise surveys.
(b) DA Pamphlet 40-501, paragraph 7-5, provides information about survey equipment and calibration guidelines.
(2) Complete standardized reports that identify hazardous-noise survey results. Reports will be distributed and maintained according to DA Pamphlet 40-501, paragraph 3-2d.
c. DOD military and civilian employees may request a noise survey any time potentially noise- hazardous equipment is purchased or following any change in operating conditions. In addition, units may request previous noise-survey records for specific locations. Unit HP officers may contact the local industrial-hygiene office or the IHPM-E (mil 486-8237) for noise-survey requests or requests for previous noise-survey records.
d. Unit commanders and supervisors are responsible for ensuring that danger and caution signs and decals (including noise-contour warning signs ((2) below) are posted at entrances to, on the periphery of, and on noise-hazardous equipment and vehicles according to DA Pamphlet 385-11. In addition, units must post a copy of 29 CFR 1910.95 in all industrial, noise-hazardous areas.
(1) DA Pamphlet 385-11 provides general information and a list of references for specific commodities, hazardous materials, and operations.
(2) HP officers should request assistance from industrial-hygiene personnel to determine and define applicable 85 dBA and 140 dBP noise contours in order to advise the unit commander or supervisor about where to locate the appropriate contour signs.
9. ENGINEERING CONTROLS The most desirable hearing-loss prevention measure is to reduce noise levels sufficiently at the source to eliminate harmful health effects.
a. The ideal opportunity to implement noise controls is at the time when the organization is procuring new equipment, facilities, or vehicles. The unit’s objective should be to review all acoustic specifications before a purchase to ensure, if possible, that a steady-state noise level of less than 85 dBA is achieved at all personnel work locations for normal operating conditions.
b. For existing equipment and facilities, units should employ control measures to reduce the noise level to the maximum extent possible such that—
(1) Steady-state noise levels are reduced to below 85 dBA.
(2) Impulse-noise levels are reduced to below 140 dBP.
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c. Requisition of HPDs. HPDs are required and considered mission-essential PPE for military deployments and for all personnel working in potentially noise-hazardous areas.
(1) Units will requisition and issue HPDs (at no charge to personnel) to all military personnel and all DOD civilian employees working in potentially noise-hazardous areas. Units must also provide an earplug carrying-case at no charge with each set of preformed earplugs. This case may also be used for handformed (temporary-issue) earplugs.
(2) HPDs are usually requisitioned as a class VIII supply item by unit supply personnel (that is, company supply sergeants or the battalion S4) using standard methods for requesting medical supplies.
(a) Appendix D, table D-1 and table D-2, provide more information (that is, national stock numbers (NSNs), Defense Medical Logistics Standard Support (DMLSS) (glossary) system item numbers, and product descriptions) to assist units with their requisitions.
(b) Units may also requisition HPD supplies as follows:
- Directly from the United States Army Medical Materiel Center, Europe (USAMMCE), at https://usammce-cust.amedd.army.mil/.
- Directly from the Government Services Administration (GSA) Advantage online shopping portal at https://www.gsaadvantage.gov/advantage/main/start_page.do.
- Through their medical support units using the DMLSS system. DMLSS is an information-technology system that is part of the Defense Medical Logistics–Enterprise Solution.
(3) Units are required to maintain a sufficient supply of various sizes and types of HPDs to enable mission-appropriate fittings for all personnel. To account for the differences in ear-canal sizes among unit personnel while minimizing expense, preformed earplugs must be ordered in specific size ratios. Tables D-3 and D-4 provide examples of a typical HPD purchase for two types of military units.
(a) Table D-3 provides an example by earplug type and size of an earplug requisition for a table of distribution and allowances (TDA) unit using an average population size-fit.
(b) Table D-4 provides an example by earplug type and size of an earplug requisition for a modified table of organization and equipment (MTOE) or table of organization and equipment (TOE) unit using an average population size-fit.
d. Initial Fittings and Annual Integrity Checks. Medically certified unit HP officers will conduct preformed earplug fittings for Soldiers during inprocessing activities and for civilian employees during inprocessing, if applicable, or when requirements are identified. If Occupational Health Services entry physicals for DOD civilian employees are required, OH personnel will perform the fittings for those civilian employees.
(1) Units should conduct earplug fit re-verification and integrity checks during annual, predeployment, or postdeployment hearing evaluations.
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(2) Units may request additional support for mass fittings, integrity checks, or both from the regional HPM or the local hearing test-site technicians, as needed. The HPM-E (mil 486-6034) can also provide the unit with appropriate POCs for fitting support at the unit’s required location.
e. Protection Requirements. Civilian and military personnel must wear appropriate HPDs when working with or around equipment, tactical vehicles, or weapons that produce hazardous levels of noise. Appendix B, table B-1, table B-2, and paragraph B-3, provide information about the steady-state and impulse-noise levels produced by common items of military equipment. The following are the hearing- protection strategies that DOD Servicemembers and civilian employees must use at the defined hazardous noise levels:
(1) A steady-state noise level of 85 dBA or higher and lower than 103 dBA (regardless of duration). This noise level requires personnel to wear single hearing protection.
(2) A steady-state noise level of 103 dBA or higher and lower than 108 dBA (regardless of duration). This noise level requires personnel to wear double protection (that is, earplugs and a noise- attenuating helmet or earplugs and noise muffs). If the operational environment requires personnel to wear the ACU helmet and compatible noise muffs are not available, personnel must wear earplugs and comply with the time limits for daily noise exposure applicable to wearing earplugs and the ACU helmet (table B-3).
NOTE–Caution: The use of noise muffs precludes the use of most eyewear. If eye protection is required, a minimal break of the earmuff’s circumaural cup (the enclosure around the ear) at the temples (by the eyewear) is strongly encouraged; however, any break of the earmuff seal will significantly reduce the amount of noise attenuation.
(3) A steady-state noise level of 108 dBA or higher and lower than 129 dBA. This noise level requires personnel to wear double hearing protection and comply with the time limits on daily noise exposure applicable to the wear of double hearing protection (table B-4).
(4) A steady-state noise level of 129 dBA or higher. The Surgeon General must approve any protection strategy for operations that expose personnel to this noise level.
(5) An impulse-noise level of 140 dBP or higher and lower than 165 dBP. This noise level requires personnel to wear single hearing protection.
(6) An impulse-noise level of 165 dBP or higher and lower than curve Z (MIL-STD 1474G, requirement four, fig 4-1). This noise level requires personnel to wear earplugs in combination with noise muffs or a noise-attenuating helmet.
(7) An impulse-noise level equal to or higher than curve Z. The Surgeon General must approve any protection strategy for operations that expose personnel to this noise level.
f. HPDs in Combat Environments. In combat, Soldiers should wear nonlinear HPDs, especially when firing weapons or riding in tactical vehicles or aircraft.
(1) Nonlinear HPDs improve HR and help prevent permanent hearing loss and “temporary threshold shifts” (TTSs) (glossary) while preserving the ability to communicate and to detect and localize quiet or low-level combat sounds.
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(3) To meet HR requirements (b and c below), unit HP officers may schedule unit personnel in groups for their DOEHRS-HC-certified hearing tests by contacting the local hearing test site and reserving blocks of time with the lead hearing technician or by directing personnel to use the normal walk-in hours established at each hearing test site. HP officers may request test sessions for company, battalion, or brigade-sized elements.
(4) If required, the HPM-E (mil 486-6034) can provide units POC information for regional hearing test sites.
b. Audiometry Requirements for DOD Civilian Employees. New or reassigned DOD civilian employees who have a potential for hazardous-noise exposure, exposure to ototoxins measured at one- half of the occupational exposure limit, or both must have a reference audiogram performed as soon as possible and no later than 30 days after an initial exposure. Appendix C provides additional information about noise and ototoxin exposure guidelines.
(1) If IHP-E noise surveys identify that DOD civilian employees should be enrolled in the HC component of the AHP (that is, the unit HRCP), Army in Europe Occupational Health Program (OHP-E) personnel will refer—
(a) DOD U.S. civilian-service employees to a Government hearing test site (or other appropriate hearing test site if necessary).
(b) Contractor and LN personnel for whom the U.S. Government has specific contractual obligations for medical care to an appropriate hearing test site (usually a non-Government, contracted, local OH physician).
(2) All civilian personnel exposed to high-intensity noise or ototoxins (except (3) below) must receive reference (baseline), initial (90-day), annual, and termination audiograms. As necessary, followup hearing tests (e below) must also be provided after any of these audiograms. Annual audiograms must be performed by 12 months after the last audiogram.
(3) Deaf civilian employees who are working in noise-hazardous areas must receive only reference and termination audiograms.
(4) Termination audiograms must be conducted as part of outprocessing or when a worker will stop working in a designated noise-hazardous area (for example, transferred between departments).
c. Audiometry Requirements for Soldiers. All Soldiers are noise exposed because of their Army- directed annual training requirements. All Soldiers (including those assigned to TDA units) must receive reference, pre- and postdeployment, annual, and termination DOEHRS-HC audiograms. Based on the test results, followup hearing tests (e below) may also be required after any of these audiograms.
(1) Annual audiograms must be performed within 12 months after the last audiogram.
(2) Predeployment audiograms must be performed within 6 months before the scheduled deployment date.
(3) Postdeployment audiograms must be performed within 6 months after the redeployment date.
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d. HR and Deployable Status. To be deployable, Soldiers must maintain an HR status of HRC class 1 (HRC-1) or HRC class 2 (HRC-2).
(1) Table 1 provides the definitions for the four HRC classes.
(2) The following are the deployability statuses associated with the four HRC classes:
(a) Soldiers with a status of HRC-1 or HRC-2 are deployable.
NOTE: According to AR 40-501, a medical board is required only for a physical profile functional capacity (PULHES) (glossary) code of “H-3.”
(b) Soldiers with a status of HRC-3A through HRC-3C are nondeployable and require a referral to an audiologist to complete a diagnostic evaluation and, if applicable, update the profile, or schedule a military medical review board (MMRB), military occupational specialty administrative retention review (MAR2) board, or both.
(c) Soldiers with a status of HRC-3D through HRC-3E are nondeployable because they require either a hearing-aid fitting, a 6-month supply of batteries for any issued hearing aids, or both.
Table 1 Hearing Readiness Classification System HR Class HRC Code Definition Class I HRC- 1 No corrective action is required. The Soldier has completed a hearing evaluation within the last 12 months, and unaided hearing is within the standards (AR 40-501) of profile class “H- 1” for both ears. Class II HRC- 2 No corrective action is required. The Soldier’s unaided hearing is within the standards (AR 40-501) of profile class “H- 2 ” or “H- 3 .” The Soldier has a current hearing profile class of “H- 2 ” or “H- 3 ” assigned and a completed MMRB (for H-3 only) that showed no active middle-ear disease or medical pathology in the ear. If the Soldier wears hearing aids, the Soldier must possess hearing aids appropriate for the hearing loss and a 6 - month supply of batteries. Class III HRC- 3 A comprehensive audiologic examination is required to establish a profile, make a recommendation for an MMRB, or verify the need for hearing aids or TCAPS HPDs. MMRB is required only for H- 3 profiles. The Soldier has completed a hearing evaluation within the last 12 months, however, unaided hearing is within the standards of profile class “H- 2 ” or “H- 3 ” and no current hearing profile is assigned. Class IV HRC- 4 The HRC is unknown and the Soldier requires a hearing examination. The Soldier does not have a hearing evaluation (that is, a DOEHRS-HC audiogram) from within the last 12 months in the medical record. This includes Soldiers without a reference (baseline) audiogram (DD Form 2215) or whose last periodic audiogram (DD Form 2216) is older than 12 months. NOTE: Soldiers with an HRC-3 or HRC- 4 status at the time of medical-record screening will immediately be reclassified in MEDPROS after they obtain corrective-hearing or hearing-aid services.
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