- Hearing loss can occur at any age, including young adulthood, and is commonly linked to noise exposure, medical conditions, and ototoxic substances.
- Untreated hearing loss affects education, careers, mental health, and parenting, highlighting the importance of early detection and support.
- Consulting with an audiologist to get a hearing test can pave the way for timely interventions like hearing aids or cochlear implants.
The auditory system begins with the outer ear canal that leads to the tympanic membrane (eardrum). Behind the eardrum, there are three bones that make up the ossicular chain, which connects the tympanic membrane to the cochlea (inner ear). The cochlea is a snail shell shaped structure containing hundreds of thousands of cells that become stimulated by sounds moving through the auditory system. Lastly, the auditory nerve connects the inner ear to the brain, sending the signal to the auditory cortex.
Hearing loss can occur anywhere in the auditory pathway. If the cause of the hearing loss is the outer and/or middle ear, it is called conductive hearing loss. If the cause is within the inner ear, it is called sensorineural hearing loss. A combination of the two is called mixed hearing loss.
According to the National Center for Health Statistics, 15% of Americans over the age of 18 report difficulties with hearing in one or both ears [1], and 30 million American adults could benefit from using hearing aids [9].
What causes hearing loss in young adults?
There are many different contributing factors when it comes to the causes of hearing loss in young adults. While not a comprehensive list, this article will discuss noise exposure, disorders/diseases, and the consummation of ototoxic substances.
Noise-Induced Hearing Loss
According to an article published in Noise and Health, over the past 40 years, the occurrence of occupational noise exposure has decreased, but recreational noise exposure has tripled [5]. Recreational noise can include activities such as the use of personal electronic music players and attending concerts or other loud events.
The authors of this study present a correlation of decreased hearing thresholds in those who listen to personal music players than those who do not [6]. Over one-third of participants routinely exposed themselves to hazardous noise levels during recreational activities. This study surveyed young adults and their attitudes regarding noise-induced hearing loss.
According to the authors, young adults with attitudes regarding noise being seen as unproblematic had worse hearing thresholds when compared to the young adults with attitudes where noise is considered problematic [5].
Disorders and Diseases
There are many hundreds of disorders and diseases that can cause hearing loss in young adults. The most common cause of conductive hearing loss in adults is a condition called otosclerosis; this will be discussed later in this article. Other conditions that can cause hearing loss include, but are not limited to: meningitis, multiple sclerosis, diabetes, and more.
Ototoxicity
Many disorders, conditions, and diseases require a patient to take various medications. Some medications can be ototoxic (toxic to the ears). For example, many types of chemotherapies used to treat cancer, such as cisplatin, are known to be ototoxic.
Many aminoglycoside antibiotics used to treat infections are ototoxic. Similar to ototoxic chemotherapies, aminoglycoside antibiotics cause damage to the inner ear, leading to cell death. In addition to medications, exposure to toxic materials can cause hearing loss. These may include exposure to tobacco, excessive consumption of alcohol, and many others.
Otosclerosis in Young Adults
The most common cause of adult conductive hearing loss is otosclerosis. Otosclerosis is a progressive autosomal dominant genetic condition that impacts the ossicular chain. This condition typically manifests in early adulthood. Otosclerosis is more common in women than men, and approximately 1% – 1.3% of the general population are impacted [4]. When the smallest of the ossicles (the stapes) becomes fixed to the inner ear, this results in otosclerosis. Severe and progressive otosclerosis can result in damage to the inner ear. Otosclerosis is often treated with hearing aids to overcome the conductive hearing loss. Surgery may also be recommended, in which the stapes is altered or replaced to reduce hearing loss [10].
Impacts of Hearing Loss in Younger Adults
Academics
There is a significant educational achievement gap between individuals with hearing loss and those without hearing loss. One of the largest health studies performed is the Trondelag Health Study (Hunt Study). In a survey including over 48,600 individuals, hundreds of participants were diagnosed with hearing loss in one or both ears. In addition to measuring the population of people with hearing loss, the survey also included questions regarding higher education and employment.
According to this survey, 27.5% of those without hearing loss obtained some higher education, while only 18.8% of participants with mild hearing loss obtained higher education. The results of this study indicate that people with mild to severe hearing loss were approximately half as likely to obtain higher education when compared to those without hearing loss [3].
Despite all of this, educational support for people with hearing loss has improved over the years. Many students with hearing loss are able to take advantage of various accommodations. These accommodations may include: live captioning or automatic captioning, early access to educational materials, note-taking, and more.
Career Concerns
As discussed above, there are educational disparities between individuals with and without hearing loss, which is found to be strongly correlated with disparities in a person’s career. In a meta-analysis published in Public Health, people with disabilities are more likely to hold occupational positions that require lower qualifications than those without disabilities. These positions often offer less opportunities for career growth and promotions [2].
Parenting with Hearing Loss
A study that surveyed parents with hearing loss analyzed parent communication, language, and psychological status. 143 parents were surveyed, and the authors present a significant correlation between the difficulties in understanding and communicating with their children and the presence of depression. This study suggests that parents reporting frustration and distress regarding communication are eight times more likely to report symptoms of depression [8]. Intervention, such as the use of hearing aids, is shown to improve a person’s quality of life and ability to interact with others.
Hearing Loss in Young Adults: Fighting The Stigma
Overcoming the Stigma
There is a substantial stigma associated with hearing loss. This stigma may lead to the denial of hearing loss, then the denial of the hearing loss’s impact on their life, which may cause individuals to avoid treatment. In a meta-analysis published in the Journal of Hearing Sciences, individuals who realize they may have hearing loss wait an average of 3.5 years before obtaining a hearing test. Additionally, after a person is diagnosed with hearing loss, the average delay in pursuing intervention or amplification is 1.3 years [11].
A large contributor of stigma associated with hearing loss is hearing aid stigma. Even after intervention, approximately 3% of hearing aid owners admit to never using their devices, and 13% admit that they use their devices less than once per week [11]. One study reports that 18% of those with hearing aids are embarrassed to wear them, and 16% were concerned about what others think about their hearing aid usage [11].
One way to fight against stigma is to encourage acceptance of hearing loss and provide positive attitudes towards hearing aids. In order to accept hearing loss, the attitudes from the environment toward the person with hearing loss must be perceived as non-stigmatizing. Hearing loss and hearing aids are often associated with aging, weakness, and being seen as senile. With positive attitudes surrounding those who seek out intervention, a person with hearing loss may feel motivated to speak to their doctor about the topic. These positive attitudes should come from society at large, but particularly those who work in healthcare and the friends and family members of people with hearing loss [11].
Importance of Routine Hearing Tests
Scheduling routine appointments with a primary care provider and an audiologist is essential. Hearing is one of our five senses, but it is often overlooked. When considering the promotion of regular visits to a dentist or optometrist, for example, audiologists should be included in the conversation. As previously discussed, hearing loss is often associated with aging or “getting old.” While hearing loss is more common in the older population, tracking the hearing health of children and young adults is important. The presence of hearing loss can indicate other serious health concerns.
Routine hearing tests allow a person and their medical team to provide early intervention for related health issues. The normalization of hearing healthcare and routine hearing tests for young adults help lessen the stigma surrounding hearing loss and intervention.
Hearing Aids and Other Interventions
In America, the most common medical intervention related to hearing loss is the use of hearing aids. This includes both conventional hearing aids and over the counter hearing aids. Conventional hearing aids are often more sophisticated than over the counter hearing aids, with the ability to accommodate a person’s needs and preferences. These devices can provide adaptive features, such as the improvement of sound quality and background noise reduction in complex listening situations. As Bluetooth is becoming more accessible, many hearing aids have the ability to connect to cell phones and other devices, which can be a motivating factor for someone to use their hearing aids [9].
Cochlear implants are another option for individuals whose hearing loss is severe enough for them to no longer benefit from hearing aids. While a hearing aid increases the volume of environmental sounds, a cochlear implant is a surgical option in which an electrode array is inserted into the inner ear, essentially replacing the damaged cochlear cells. A meta-analysis indicates that the use of cochlear implants can improve speech understanding, increased social functioning, and an improvement in a person’s perceived quality of life [9].
Importance of Using Hearing Protection
A study in Noise and Health aimed to examine the impacts of having educational sessions on hearing conservation in young adults. 78 individuals ages 18 – 30 years participated in this study. 7% of the participants already had noise-induced hearing loss prior to the educational session. The authors tracked behaviors and attitudes regarding hearing protection and hearing conservation prior to the educational session, and six months following the session. 12% of participants increased the use of hearing protection devices [7].
The authors of the above-mentioned study conclude that health-related behavior surrounding noise-induced hearing loss is determined by several factors: the seriousness of noise-induced hearing loss, the benefits of preventative actions, and social norms. Investing in hearing conservation programs for young adults can reduce noise-induced hearing loss in young adults [7].
Hearing Health Starts Early: Take Action to Protect and Preserve Your Hearing
To conclude, hearing loss can occur at all ages, including young adults. Many factors can contribute to the onset of hearing loss, including excessive noise exposure, disorders and diseases, and consuming ototoxic materials.
Providing education regarding hearing conservation and the seriousness of noise-induced hearing loss can reduce the occurrence in young adults. While hearing loss is still stigmatized, the normalization of hearing healthcare and the use of interventions such as hearing aids can help reduce this stigma.
References
- Blackwell, D. L., Lucas, J. W., & Clarke, T. C. (2014). Summary health statistics for U.S. adults: National Health Interview Survey. National Center for Health Statistics.
- Garramiola-Bilbao, I. & Rodriguez-Alvarez, A. (2016). Linking hearing impairment, employment, and education. Public Health, 141.
- Idstad, M. & Engdahl, B. (2019). Childhood sensorineural hearing loss and educational attainment in adulthood: Results from the HUNT study. Ear and Hearing, 40.
- Keefe, D. H., Archer, K. L., Schmid, K. K., Fitzpatrick, D. F., Feeney, M. P., & Hunter, L. L. (2017). Identifying otosclerosis with aural acoustical tests of absorbance, group delay, acoustic reflex threshold, and otoacoustic emissions. Journal of the American Academy of Audiology, 28.
- Keppler, H., Dhooge, I., & Vinck, B. (2015). Hearing in young adults. Part I: The effects of attitudes and beliefs towards noise, hearing loss, and hearing protector devices. Noise and Health, 17.
- Keppler, H., Dhooge, I., & Vinck, B. (2015). Hearing in young adults . Part II: The effects of recreational noise exposure. Noise and Health, 17.
- Keppler, H., Dhooge, I., & Vinck, B. (2015). The effects of a hearing education program on recreational noise exposure, attitudes and beliefs toward noise, hearing loss, and hearing protector devices in young adults. Noise and Health, 17.
- Kushalnager, P., Bruce, S., Sutton, T., & Leigh, I. W. (2016). Retrospective basic parent-child communication difficulties and risk of depression in deaf adults. Journal of Developmental and Physical Disabilities, 29.
- Michels, T. C., Duffy, M. T., & Rogers, D. J. (2019). Hearing loss in adults: Differential diagnosis and treatment. American Family Physician, 100.
- Musiek, F. E., Baran, J. A., Shinn, J. B., & Jones, R. O. (2012). Disorders of the auditory system. Plural Publishing, Inc.
- Rawool, V. (2018). Denial by patients of hearing loss and their rejection of hearing healthcare: A review. Journal of Hearing Science, 8.
