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Commentary: Protecting Your Hearing—How Loud Is too Loud?

Commentary
08/14/2018 Lawrence R. Lustig, MD, Columbia University Medical Center and New York Presbyterian Hospital;

Picture yourself at a playoff game. Your team is losing, but mounting a comeback. With each play, the crowd gets louder and louder. Finally, the jumbotron flashes “MAKE SOME NOISE!!!” and the stadium goes wild. The energy is overwhelming and pushes your team to make a play and take the lead.

In that moment, with everyone in the stadium cheering at the top of their lungs, most people aren’t thinking much about the damage they may be doing to their hearing. But many don’t pay attention to hearing loss at other times, either. In fact, nearly six in 10 Americans (59 percent) say they rarely think about hearing loss, according to a recent survey by Harris Poll on behalf of the Manuals. Yet 86 percent admit to doing noisy activities in the last 12 months, including listening to audio (e.g., music, podcast) through headphones or earbuds (58 percent), landscaping their homes with a power mower, weed whacker, or leaf blower (42 percent), and attending live concerts or events with a band/DJ (34 percent) or professional sporting events (33 percent).

All of these activities can be loud enough to do permanent hearing damage. It’s why hearing loss is the most common sensory disorder in the U.S. But when someone suffers hearing loss as a result of noise, what’s actually happening?

How hearing loss works

When sound reaches the ear canal, it vibrates the ear drum. Those vibrations travel to the inner ear, where thousands of tiny “hair cells” respond to the vibrations and send signals to the brain. Loud noise can cause these hair cells to become damaged or destroyed, and these cells do not regrow. This damage can lead to what doctors call sensorineural hearing loss. Even being exposed to loud noise that doesn’t damage your hearing makes you more likely to suffer noise-induced or age-related hearing loss later on. And there’s also a genetic component. More than a third of Americans (34 percent) weren’t aware that people are more likely to be affected by hearing loss if it runs in their family.

How loud is too loud?

To answer that question, you have to know not only how loud a particular sound but also how long you’re exposed to it. Short bursts of noise may cause no problem or only temporary hearing loss whereas more prolonged exposure to the same volume may cause permanent damage.

When it comes to the workplace, safety standards require ear protection for any noise averaging more than 85 decibels (dB, a measure of loudness) over the course of eight hours. For every 5 dB increase, safe exposure time is cut in half. There are plenty of day-to-day activities that create noise at that level. Heavy traffic registers at about 90 dB, riding a motorcycle can be 100 dB, and a loud rock concert is about 115 dB (which in the workplace would require hearing protection for more than a 15 minute exposure!). Earbuds on portable music devices can easily surpass 100 dB, and people often turn them to high volume to override outside noise.

Here’s a good rule of thumb—if you have to speak above your normal tone of voice to be heard, chances are your surroundings are too loud.

Keys to preventing hearing loss

While safety standards have helped to manage the risk of workplace sound exposure, recreational noise remains a growing issue. In particular, the rise of smart phones and earbuds means many people, especially children, are listening to music at potentially damaging volumes for many hours a day.

According to the survey, majority of Americans (64 percent) said they do try to take preventative measures to protect their hearing whenever possible, and there are several resources that can make this easier. For example, some phones warn users when the volume is reaching dangerous levels, and there are also a number of sound meter apps that can indicate when ear protection may be needed.

Keeping earplugs nearby when you expect to be in loud situations is one of the best ways to protect your hearing.

Tackling the stigma of hearing aids

Once hearing loss occurs, using a hearing aid remains one of the most effective ways to manage it. Yet while nearly two thirds (63 percent) of Americans said hearing aids are essential to maintaining quality of life, national data consistently show only about one in five individuals who could benefit from hearing aids actually use them. When asked their opinions on hearing aids, more than half (55 percent) of Americans in the survey said getting hearing aids can be very expensive, while 31 percent said they can be uncomfortable and 2 in 5 feel they can be embarrassing (20 percent). These answers suggest some possible reasons for low use of hearing aids.

Technological advancements have made today’s hearing aids more effective and less cumbersome. At the same time, recent legislation in the US now permits over-the-counter personal sound amplification products (PSAPs). These products are sound amplifiers.  While they cannot be personalized to each person’s specific hearing deficits to the same degree that conventional hearing aids can, they are nonetheless a less expensive alternative that may work for some people. PSAPs may be particularly helpful for people in developing countries who can’t afford a full professional evaluation and hearing aid.

Being aware of noise exposure and taking steps to protect your ears is the best way to prevent the need for hearing loss treatment. For people suffering from hearing loss, having a doctor’s evaluation to look for rarer, serious causes of hearing loss, followed by a professional hearing test, can help determine how to best keep a loss of hearing from interfering with a productive and enjoyable daily life.