The Impact of Tinnitus Severity on Work Functioning among U.S. Military Veterans with Tinnitus

Laura Coco; Elizabeth R Hooker; Tess A Gilbert; Graham R Harker; Khaya D Clark; Kelly M Reavis; James A Henry; Tara L Zaugg; Kathleen F Carlson

doi:10.1055/s-0043-1770152

The Impact of Tinnitus Severity on Work Functioning among U.S. Military Veterans with Tinnitus

Semin Hear. 2023 Jul 24;45(1):40-54. doi: 10.1055/s-0043-1770152. eCollection 2024 Feb.

Authors

Laura Coco^{1

2

3

4}, Elizabeth R Hooker¹, Tess A Gilbert¹, Graham R Harker^{1

5}, Khaya D Clark², Kelly M Reavis^{2

5}, James A Henry^{2

3}, Tara L Zaugg², Kathleen F Carlson^{1

2

5}

Affiliations

¹ VA Health Services Research & Development Center of Innovation, Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System, Portland, Oregon.
² VA Rehabilitation Research & Development Service, National Center for Rehabilitative Auditory Research (NCRAR), Veterans Affairs Portland Health Care System, Portland, Oregon.
³ Department of Otolaryngology/Head and Neck Surgery, Oregon Health & Science University, Portland, Oregon.
⁴ School of Speech, Language, and Hearing Sciences, San Diego State University, San Diego, California.
⁵ School of Public Health, Oregon Health & Science University, Portland, Oregon.

Abstract

Tinnitus is highly prevalent among military Veterans. Severe tinnitus can be associated with negative impacts on daily life. Veterans with severe tinnitus may also have greater difficulties in functional roles, including work. However, few studies have explicitly explored this relationship. Traumatic brain injury (TBI), also prevalent among Veterans, is associated with tinnitus and can additionally impair work functioning. This quantitative investigation used a population-based survey to assess the relationship between tinnitus severity, measured using the Tinnitus Functional Index (TFI), and the impact of tinnitus on work, measured using a composite score from the Tinnitus History Questionnaire, among a stratified random sample of VA healthcare-using Veterans diagnosed with tinnitus, with and without comorbid TBI. Analyses were weighted to account for sampling design and Veteran non-response; multiple imputation was used to account for missing data. Results indicated that for every 1-point increase in TFI score, there was an average 8% increase in the odds of reporting a high level of impact on work functioning (OR: 1.08; 95% CI: 1.06, 1.11). Veterans with a comorbid TBI diagnosis, compared with those without, were more likely to have high tinnitus-related impact on work functioning (OR: 2.69, 95% CI: 1.85, 3.91), but the relationship between tinnitus severity and the impact of tinnitus on work functioning did not differ by TBI status. These data can help researchers and clinicians understand complex symptoms experienced by Veterans with tinnitus, with and without TBI, supporting the improved provision of clinical services to these patients.

Keywords: Veterans; disability; tinnitus; traumatic brain injury; work functioning.

The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).

Publication types

Review

Grants and funding

Funding/Acknowledgments We are grateful to the Veterans who participated in this survey for their contributions to health sciences and their service to the U.S. military. This research was supported by grants from the Veterans Health Administration, Office of Research and Development, Rehabilitation Research and Development Service (SPiRE I21 RX002216-01 to K.F.C.; C9427S to J.A.H.) and from the Oregon Clinical and Translational Research Institute at Oregon Health and Science University (1 UL1 RR024140 01).