The Canadian Forces is not tracking how many of its soldiers are suffering from service-related hearing loss and traumatic brain trauma, two of the so-called signature injuries of the conflicts in Afghanistan and Iraq.
The Defence Department doesn't have the systems working or in place to record the number of people returning from tours overseas who have identified hearing loss or brain injuries, giving them little sense as to the extent of what are thought to be rising problems in the ranks.
Unlike the British and American militaries, which have better means of tracking conditions affecting their troops, the Canadian Forces has yet to implement computerized programs that can digitally compile information and point to any trends for certain injuries.
"We have no way to systematically collect that data," Steve Tsekrekos, an occupational medicine specialist with Force Health Protection, said from Ottawa.
"There's much room for improvement compared to what we're currently doing. It's a question of continually to push that this is an issue that we need to address."
Forces members are examined for a variety of possible injuries in theatre and when they return from a deployment, but the data in most cases is contained in a paper record that goes into individual files.
It's also up to soldiers to indicate in questionnaires if they suspect they have sustained certain injuries.
Info useful for tracking injury patterns
To test for hearing loss at home, military doctors have to rely on antiquated 1970s-vintage audiometres for which replacement parts are not being made and can produce only a paper document.
The absence of any condensed data on injuries has left the Forces without a global, detailed picture of the injuries affecting soldiers serving in environments characterized by bomb blasts, gunfire and loud equipment.
"The usefulness of that sort of data is to provide us with a track record as to changes in the patterns of injuries or illnesses," says Bryan Garber, a deployment health specialist with the Canadian Forces health services group in Ottawa.
"We don't actually have any current numbers on the incidence of mild traumatic brain injury in the Canadian Forces population serving in Afghanistan."
Statistics and studies coming out of the U.S. indicate one in four soldiers serving in Iraq or Afghanistan have damaged hearing, caused largely by blasts from improvised explosive devices, suicide bomb explosions and prolonged exposure to noisy vehicles.
According to Veterans Affairs Canada, close to 320 military personnel who served in Afghanistan since 2001 are now receiving disability benefits linked to hearing loss.
Of the total number of Canadian veterans receiving benefits, roughly half are due to a hearing impairment.
"There are a lot we do in the military that are very damaging to hearing and that has always been so," said Maj. Sandra West, a base surgeon at the Ottawa military clinic who spent seven months in Afghanistan earlier this year.
"It's very hard to protect your hearing all the time just because of the sorts of things we do."
Hearing loss a 'huge problem'
In 2001, Veterans Affairs had 37,374 clients in receipt of treatment benefits for their hearing loss with total expenditures of $22.6 million.
By this March, that number had risen to 47,347 clients at a cost of $38.5 million.
"This is a huge problem," said Tsekrekos. "Hearing loss is the biggest occupational health issue in the Canadian Forces."
More than seven years after troops have been on the ground in Afghanistan, the Forces are in the process of trying to implement systems to collect data on brain injuries and hearing loss.
Tsekrekos says they plan on introducing new computerized audiometres possibly in the next few years that will create a digital record and help produce a Force-wide picture of hearing loss.
The military is also implementing a system to collect information on brain injuries used by the United States called the Joint Theatre Trauma Registry. Garber said the system should be up and running sometime next year.
He estimates that the numbers of troops indicating mild traumatic brain injuries could range up to 20 per cent, but that most wouldn't likely have long-term problems.
"It should be providing more stable statistics on the incidence of this and what the recovery looks like," he said.
A recent study by the U.S. RAND Corp. found that 320,000 former serving members sustained mild traumatic brain injuries, but that the majority had no persistent symptoms.
Garber said reports on brain injuries among international troops have overstated the extent of the problem and fail to explain that the bulk of people who experience mild brain injuries recover spontaneously within weeks or months.