What causes hearing loss? Gigs? Listeners? Genetic?


What is the safe level of exposure to prevent hearing loss?

It depends on how long a person is in this environment. Generally, we say a worker can safely be in an 85 decibel environment for about eight hours a day. If you go to a noisier environment, you get less safe time. So once you hit 88 decibels, you get four hours of safe exposure time, 91 decibels, you get two hours of safe exposure time, and so on.

That said, we want to understand and reduce our exposure as much as possible. A simple way to do this is to use a sound meter app. There’s a great one from the National Institute of Occupational Safety and Health (the NIOSH SLM app) – it’s pretty accurate for a free app on your phone.

Exposures are also cumulative over the course of a day. If you work in a noisy environment all day and then come home and mow the lawn, that adds additional noise exposure. You need to be mindful of your recreational activities, whether it’s listening to music, riding ATVs, using power tools and woodworking, or for hunters using firearms at recreational purposes – the latter being probably the greatest risk factor for hearing loss.

Is prolonged exposure generally more damaging?

Prolonged exposures are what we can definitely prevent and are also the riskiest daily activity.

However, noise exposure is a bit difficult for people to understand because some people have really hard ears and some people have really soft ears. Two people can work in the same job with the same amount of noise and end up with totally different hearing later in life. We know that some people are more susceptible to hearing damage from loud noise, but we don’t know who these people are. We have no way to test for risk, so we suggest everyone exercise extra caution.

So is hearing sensitivity mainly genetic?

We think so. We believe there are genetic factors that make a person more prone to hearing loss, more susceptible to noise damage. There are also environmental factors. Certain medications make you more susceptible to hearing loss, such as chemotherapy drugs for cancer, for example. But it is mostly genetically mediated. But right now, we don’t have any genetic tests that tell you what your risk of hearing loss is.

Is the hearing loss permanent?

Hearing loss is permanent when it occurs, so when you lose it, it doesn’t come back. We want to be very careful with hearing protection, so that we don’t prematurely age our ears.

As a worried millennial who has listened to his share of loud music: have you and your colleagues noticed an increase in hearing loss among younger generations?

So statistically, we don’t really see a large increase in rates of hearing loss in young adults and adolescents. Part of the reason is that our data hasn’t been around long enough to see any of it. I suspect that if we look at the statistical data that is progressing a bit, 10 years from now we might start to see some of these changes.

For personal use on your phone or an MP3 player, is the 80-90 rule still the medical advice you would give?

Absolutely. That’s still the recommendation we make. The 80-90 rule is that you can safely listen to 80% of the maximum volume for 90 minutes a day. If you want to be really safe, lower it to 70% and you’ll be able to listen most of the day safely.

So for personal music headphones, noise cancellation versus noise isolation, do you recommend one or the other?

First of all, we recommend that if you’re listening to music in a noisier environment, if there’s any sound around you that causes you to turn up the volume of your music so you can hear it, that’s a good idea to try to reduce the outside sound. You can do this in two ways. One is noise isolating headphones. So headphones that physically block out background noise by sealing your ear. The other option is noise-canceling headphones, which use active electronics to try to reduce sound.

Noise canceling headphones work very well in constant background noise. Thus, transport noises, for example the noise of a bus or the noise of an airplane, work very well. But for environments with varying noise — a cafe with a group of people talking — noise-canceling headphones don’t work as well as noise-isolating headphones.

But honestly, both work well. Use what you are comfortable with. If we know one thing in the world of hearing loss prevention, it’s: If the solution doesn’t work for you, you’re not going to do it. Choose the solution that suits you best.

As an audiologist, do you bring earplugs to concerts or when doing noisy renovations?

If I go to a concert, I always bring earplugs. I keep an extra game in the car actually just as a backup in case I need anything. Cleaning up, I don’t usually wear them. But if I’m doing a project, I like to have hearing protection available when using those louder tools. I’ll hang a set of earmuffs over the ears right next to my miter saw, for example.

How do you identify hearing loss when it can occur for decades and your GP might not detect it? What are the warning signs?

If you have ringing or buzzing in your ears (tinnitus), it’s a good idea to have your hearing checked. We are particularly concerned about persistent tinnitus. If you have ringing in your ears that lasts for a few seconds to a few minutes, it’s completely harmless and happens to almost everyone.

Also, if you start having difficulty understanding conversations in background noise. If you find that you regularly get frustrated in conversations because it’s harder to understand, that’s a concern for us. Or if you feel you are missing sounds that other people might hear or identify, like birds chirping in the distance, for example.

We recommend that you consult an audiologist or have a hearing test if you have any concerns. We could always test your hearing and say, “Hey, it’s okay.” But it is better to know earlier if you are at risk. For people who are heavily exposed to noise, either occupationally or through recreational activities, we recommend monitoring your hearing annually with a hearing test.

Over-the-counter hearing aids are now approved. What do you think of this recent move?

We are excited to see the competition in the industry and to push our technology forward and potentially provide greater access to more people by creating devices at lower cost.

On the other hand, what is on the market today that you can buy over-the-counter is not of good quality. I think we’ll see changes to that in the next six to nine months, but right now we don’t see that. A related challenge is that one of the biggest ways to save money with over-the-counter hearing aids is to get rid of that professional service component. You lose the professional to help you know how to use the devices, provide rehabilitation services, and make sure the devices are right for you.

Some types of hearing loss are medically treatable. And we’d much rather see people understand their ears and hearing before they go shopping for a hearing aid. In many cases, an audiologist can help improve the functioning of over-the-counter devices, or we can consider reasonably priced prescription hearing aids. We strongly recommend that everyone see an audiologist for a hearing evaluation before purchasing any hearing aid, whether over-the-counter or prescription.


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