In my practice as an audiologist, I have observed that many of my patients experienced hearing loss due to issues out of their control. Their loss is caused by things such as genetics or unavoidable health conditions. There is, however, a group of people who do have some control over their hearing loss: the ones who suffer loss from exposure to avoidable noise.
Noise-induced hearing loss results from damage to the cells in the inner ear as a result of acoustic trauma. It can occur following prolonged exposure to noise or, in some cases, a sudden very loud experience such as an unexpected explosion or gunfire. The damage is irreversible and may result in permanent hearing loss. It often affects the high frequencies more than others.
There are many sources of noise induced hearing loss. Common populations who experience noise-induced hearing loss are those in the military, recreational firearms users/hunters, musicians, and employees in noisy workplaces. Noise-induced hearing loss can be caused by home or work power tool use, lawn equipment (weed whackers and leaf blowers are particularly loud), farming equipment, motorcycles, other loud vehicles and machinery, gunshots, explosions, and musical instruments.
There is a hierarchy of recommended steps to reduce noise exposure. The first step is to turn down the noise level. By reducing the volume, risk for noise-induced hearing loss is reduced. If the volume cannot be reduced, then the next step is to move away from the source of loud noise. Distance from noise reduces the volume at the listener’s ear. If neither of these options are acceptable or possible, then hearing protection should be worn.
Hearing Protection For Employment
One particular group of individuals that is largely impacted by noise-induced hearing loss is employees at loud workplaces. In the 1970s, the Occupational Safety and Health Administration (OSHA) initiated programs enforcing employers to determine risk for and mandate protection against these losses. Programs include testing, education, prevention, and provision of hearing protection for employees at high risk for noise-induced hearing loss. It was determined by OSHA that noise levels were unsafe and warranted intervention once levels exceeded 85 dB for eight hours. The first line of defense for employers is to try to reduce the amount of noise admitted by machines. If this is possible, then hearing protection isn’t necessary; however, if noise levels are still unsafe, employees should be provided with appropriate hearing protection such as earplugs or earmuffs. Despite these mandatory actions, many still suffer from noise-induced hearing loss caused by workplace exposures.
Ear Molds As Hearing Protection
As an audiologist, many people ask me: “What is the best type of hearing protection?” My answer is always this: the type that fits. The easiest and most foolproof type to use is earmuff-style hearing protection. These go around the ears and, when worn properly, (in most cases) do not allow outside noise to exceed safe listening levels. Also common are rolled-foam earplugs. When inserted deeply into the ears, these can be excellent tools to reduce noise exposure; however, often these are placed shallowly by individuals limiting their effectiveness. Inserted foam (as well as silicone or rubber tiered) also are problematic for individuals who produce excessive earwax. It can cause the earwax to become impacted resulting in temporary hearing loss from the earwax plug.
A unique solution is to have earplugs that are custom made by audiologists from impressions taken of the ears. Custom earplugs can serve a variety of purposes and be ordered based on the individual’s need. For run-of-the-mill hearing protection, solid silicone earplugs will do the trick. For musicians, however, full plugs may impact their ability to hear music; therefore, specialty musicians plugs are more appropriate with filters in place to allow some noises through but reduce others. A musician with a quieter instrument such as a clarinet might use a 10 dB filter whereas someone with much more noise exposure, such as a percussionist, or someone sitting directly in front of a trumpeter might want a 25 dB filter. Sometimes filtered earplugs are excellent for professionals who work in a noisy environment but need to hear speech. I have prescribed filtered earplugs for dental hygienists and oral surgeons who are exposed to drill noise but must hear their patients.
Custom ear molds are also great for physically protecting the ear. For example, a child who has tubes in their ears due to a history of chronic ear infections or one who is prone to swimmer’s ear might get earplugs to keep water out of the ears when bathing or swimming. A swimmer’s ear mold can also be used for noise protection so this is a great option for children to promote safety and noise reduction.
I have had patients ask me if their hearing aids can be considered hearing protection. While hearing aids (when programmed properly) should not amplify sounds to an unsafe level, an outside sound loud enough to damage ears that hear normally can also damage the hearing of someone with hearing loss (with or without hearing aids). I strongly advocate the use of hearing protection for my patients who wear hearing aids whether this means removing hearing aids to wear hearing protection or wearing earmuff-style hearing protection over their hearing aids.
Another way to emphasize safe levels of noise exposure would be to ensure that earphones fit properly. Many people wear earbud-style earphones. When earphones are loose in the ear and allow outside noise in, the volume of music must be increased to compete. Often the volume levels then exceed safe levels and can result in noise-induced hearing loss. As with hearing protection, wearing around the ear earmuffs-style headphones can often lessen the need to increase volume.
It is possible to make earbuds fit better with the help of an audiologist. Custom molds can be made and placed onto most earbud style headphones. Custom molds reduce the risk the sounds will leak from the headphones or that outside sounds will leak around the headphones into the ear. As a result, the volume of the music does not need to be increased to unsafe levels. It also provides a more secure fit when the earphones are being worn during physical activity.
Importance Of Hearing Protection
I often tell my patients that while I love working with individuals with hearing loss, it would be my preference that they didn’t develop hearing loss in the first place. Many people do not have a choice, but those who are consciously exposed to noise do. With some planning and use of hearing protection, it is possible to eliminate risk for noise-induced hearing loss. As there is no way to cure damage to cells in the ear, it would be better if it could be prevented in the first place. While hearing aids are an excellent way to treat hearing loss, they are not a cure. Hearing aids cannot undo damage to the inner ear caused by noise or other sources. The difference with noise-induced hearing loss is that often exposure to that noise was a choice. If you are a parent, as you would have your child wear knee pads when rollerskating or a helmet when riding their bikes, you should emphasize the use of hearing protection if your child will be exposed to known noise. As an adult it is important to make a conscious choice when around noise to protect your hearing. Don’t take for granted that the noise you’re around is safe. When in doubt, wear hearing protection.
Do you have questions? Ask an audiologist!
