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20 years is different of course.
I simply said that I have had acoustic trauma and couldn’t hear throughout the day, and yet today I can hear just fine at even high frequencies.
So I’m guessing yes, prolonged use can make it difficult to hear; but I doubt it is “from one time”. Maybe multiple multiple times.
Especially for veterans who get into surprise firefights without ear protection etc.
I think though a lot of soldiers simply are fine with the reduced hearing they get from live fire without ear protection.