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BMJ Mil Health. 2020 Mar 5. pii: jramc-2019-001378. doi: 10.1136/jramc-2019-001378. [Epub ahead of print]

Associations between earplug use and hearing loss in ROK military personnel.

Author information

Department of Public Health, Graduate School, Yonsei University, Seodaemun-gu, Seoul, Republic of Korea.
Division of Management Logistics, Korea Ministry of National Defense, Seoul, Republic of Korea.
Division of Medical Corps, Second Operational Command, Daegu, Republic of Korea.
Secretary's office, Armed Forces Medical Command, Seongnam, Republic of Korea.
Department of Operation, 7th Division Medical Detachment, Seoul, Republic of Korea.
Department of Nursing, Yonsei University, Seodaemun-gu, Seoul, Republic of Korea.
Department of Preventive Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Republic of Korea



The easiest way to prevent noise-induced hearing loss (NIHL) is to wear earplugs. The Republic of Korea (ROK) Ministry of National Defense (MND) is supplying earplugs to prevent NIHL, but many patients still suffer from this. We speculated that earplugs would have a high NIHL rate, depending on the rate of use of earplugs, regardless of the rate of supply. Therefore, we conducted this study to investigate the relationship between the use of earplugs and hearing loss by ROK military personnel.


The study used data from the Military Health Survey conducted in 2014-2015, which included 13 470 questionnaires completed by ROK military personnel. Hearing loss and earplug use were self-reported. Logistic regression analysis was used to assess associations between earplug use and hearing loss.


The study sample included 13 470 ROK military personnel (response rate of 71.2%) (Army, 8330 (61.8%); Navy/Marines, 2236 (16.6%); and Air Force, 2904 (21.6%)). Overall, 18.8% of Korean military personnel reported that they always wore earplugs, and 2.8% reported hearing loss. In logistic regression analysis, there were significant differences in the rates of hearing loss associated with wearing earplugs sometimes (OR=1.48, 95% CI 1.07 to 2.05) and never wearing earplugs (OR=1.53, 95% CI 1.12 to 2.10). In subgroup analysis, in Air Force, non-combat branch, forward area and long-term military service personnel increased hearing loss was associated with not wearing earplugs.


Our study confirmed that within the ROK military, there is an association between hearing loss and lack of earplug use. In the ROK MND, Army, Navy/Marines and Air Force headquarters must provide guidelines for the use of earplugs during field training to protect military personnel's hearings and, if necessary, need to be regulated or institutionalised.


health policy; medical education & training; otolaryngology


Conflict of interest statement

Competing interests: None declared.

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