Last partial update: July 2016 - Please read disclaimer before proceeding
Adult onset hearing loss in Australia - a huge problem
After dental caries, adult-onset hearing loss is the Australia’s most common health problem and one whose importance is underestimated. It is one of the top sixteen causes of total burden of disease, especially in males in the 45 to 65 year age group. It is a problem that worsens as people get older and particularly affects males from 45 years onwards. While only about three per cent of 40-year olds have hearing impairment, by the time people reach 60 their chances of being affected are 50 per cent.
People with impaired hearing have difficulties with hearing conversation and, even when they concentrate, they can still miss half of what is said. This causes frustration and can lead to social isolation, which is already a significant problem for many elderly people. The risk of accidents on the road and at work is greater because hearing may be impaired enough so that ‘warning’ sounds are missed and having to turn up the car radio does not help matters. The everyday sounds that surround people are one of life’s great joys. Being unable to hear music is a real loss.
The cause of adult onset hearing loss
There are numerous causes of adult-onset hearing loss, but by far the most important is long-term exposure to loud noise. Chronic exposure to loud noise damages or even breaks the very delicate hair-like structures in the cochlear part of the inner ear, which play an integral part in detecting sound. The part of the cochlear that detects high-pitched sounds is affected first. Hearing loss from this chronic noise exposure occurs so gradually that most people are very unlikely to even notice it.
Noise does not have to be painfully loud to cause this damage. Long-term exposure to noise such as that made by a ride on mower is enough. To prevent hearing loss, the World Health Organization recommends not being exposed to noise levels of 85dB(A) (or more) for more than eight hours a day. This is about the level of heavy traffic noise. The figure below gives an indication of the time people can listen to a sound without damage to their hearing.
Young people’s exposure to loud music is a considerable area of concern. Young males tend to be exposed to more noise of this kind than young women and are also exposed to more noise at work. For this reason, they can expect to encounter deafness about ten years earlier.
Our modern urban environments are generally much noisier than in times past and it is likely that this will lead to hearing loss as early as forty years of age.
Time taken to cause permanent hearing loss at different noise levels
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Preventing hearing loss
The most important thing to do is to protect ears from loud noises. This should start from early in life and should be especially encouraged in teenagers and young people. In general, sudden, very loud noises are worse than continuous loud noise. Some practical tips include the following.
- Use headphones rather than turning the volume up when listening to personal stereos.
- Avoid long periods of loud noise.
- Wear proper protective earplugs or earmuffs when working in a noisy environment or doing loud household chores, such as lawn mowing. Earplugs can also be used intermittently at loud concerts.
- Make work environments as quiet as possible.
- Give ears rest periods when continuously exposed to noise.
Continuous exposure to excess noise at work is a problem for many people, especially males. This can be reduced by locating noisy equipment in isolated or sound-proofed areas, purchasing less noisy equipment, ensuring that workers are only exposed to higher noise levels for short periods (i.e. they are given noise rests), and enforcing the mandatory use of protective earplugs or ear muffs. People exposed to loud noises at work should have their hearing checked regularly to identify hearing loss as early as possible.
It is also important to protect ears by treating ear infections early and never putting objects into ear canals as this is a common cause of ear damage.
Hearing loss due to MP3 / iPOD use
Many adolescents and young adults are suffering permanent hearing loss from the use of MP3 players and iPODs. This is both because the volume is often too high and the length of time the player is being used.
Use in situations where there is a high noise level outside, such as when travelling on a bus or train, is a particular problem as the volume is usually turned up even higher to overcome the noisy outside environment. People who commute every day should probably not get into the habit of using these players in such situations or do so only for a short period each trip. Remember that permanent hearing loss is due to long term exposures just like this. People who choose to use players in noisy situations need to remember to turn them down when the outside environment becomes quiet again. Noise-cancelling headphones are useful in reducing outside noise and thus reducing the need to raise the volume.
The best way to avoid sound exposures that is likely to damage hearing is to follow this advice.
- Avoid music that is too loud.
- The person should ensure that he or she is able to comfortably carry on a normal conversation with a person who is sitting close by while also listening to their player. Shouting responses indicates the volume is too high.
- People in the same room should not be able to hear a player. (Deaf parents / grandparents are not a good guide!!)
- Limit the amount of time spent listening each day; 60 minutes is a figure that is commonly recommended but no level is safe if the volume is too loud.
- Avoid using players when the outside environment is noisy. Try reading a book or magazine.
There is some evidence that external ear covering headphones are better than in-ear types but in the end it is the volume that counts.
Musician’s earplugs
For those working in the music industry, special earplugs that are designed to reduce overall sound levels while preserving sound quality are now available. These devices deliver a flat-response attenuation of sound and come in a range that deliver different levels of sound attenuation. They are available from most audiologists.
Diagnosis and treatment of hearing loss
As stated before, hearing loss is often so gradual that it usually goes unnoticed. Many of those that do notice it deny they have a problem, preferring to believe people are not speaking properly etc. This is partly due to a belief that there is nothing that can be done about their hearing loss. This of course is not true.
The above facts mean that the diagnosis of hearing loss is often delayed. Here are some questions that will help identify whether a person is likely to have a hearing loss problem (Australian Hearing).
- Do you have difficulty understanding people unless they are facing you?
- Do you find it hard to understand conversations in a noisy room?
- Do you fail to hear the doorbell or telephone ring?
- Do people complain that you turn the TV or radio up too loud?
- Do you often ask people to speak up or repeat themselves?
- Do you have difficulties understanding telephone conversations?
- Do people complain that you do not hear them?
- Do you sometimes have ringing or buzzing in the ear?
If the answered to any of these questions is yes, then the person needs their hearing checked. This can be arranged through a GP and should be done by a qualified audiologist.
Hearing aids are often necessary to treat significant hearing loss and assist by making heard sounds louder. (Unfortunately, they do not always improve sound clarity.) In addition to better communication, improvement in hearing can enhance mood, socialization and thinking.
All hearing aids are not the same and treatment needs to be coordinated by a qualified audiologist who can design a suitable individual aid. The use of hearing aids in both ears where hearing is impaired in both ears is often preferable as it can give a more natural sound, helps with determining which direction the sound is coming from and improves the ability to discriminate speech in background noise. It also gives a 'back up' if one device fails.
Tips for talking to people with hearing loss
- Face the person directly, preferably at their eye level.
- People should make sure the hearing-impaired person can see their face by keeping hands away from their face and ensuring that bright lights are not shining into the hearing-impaired person’s eyes.
- Do not shout.
- Keep background noise to a minimum by turning off the TV and radio.
- Find a different way of saying something when not being understood.
Further information
Hearing Australia