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Ear Health: Common Hearing Disorders
Noise-induced Hearing Loss
Know the Facts
Noise-induced hearing loss (NIHL) is hearing loss that occurs when an individual is exposed to harmful sounds, either sounds that are too loud or sounds that are loud over a long time. This exposure causes damage to the sensitive structures of the inner ear.
If you think you have grown used to a loud noise, it probably has damaged your ears, and there is no treatment-no medicine, no surgery, not even a hearing aid-that completely restores your hearing once it is damaged by noise. When noise is too loud, it begins to kill the nerve endings in the inner ear. As the exposure time to loud noise increases, more and more nerve endings are destroyed. As the number of nerve endings decreases, so does your hearing. There is no way to restore life to dead nerve endings; the damage is permanent.
NIHL can be caused by a one-time exposure to loud sound as well as by repeated exposure to sounds at various loudness levels over an extended period of time. There are three things to consider about noise: How loud? How long? How close? The loudness of sound is measured in units called decibels. For every six decibels, the intensity of the sound doubles:
- 20 decibels: whispered voice.
- 40 decibels: refrigerator humming.
- 60 decibels: normal conversation.
- 80 decibels: city traffic.
- 90 decibels: subway trains, lawn mower, motorcycle; prolonged exposure to any noise above 90 decibels can cause gradual hearing loss.
- 100 decibels: woodworking shop; recommend avoiding more than 15 minutes of unprotected exposure.
- 110 decibels: chainsaw; regular exposure of more than one minute risks permanent hearing loss.
- 120 decibels: snowmobile.
- 140 decibels: rock concert, firecracker.
For examples of these and others, click on the Interactive Loudness Scale.
The symptoms of NIHL increase gradually over a period of continuous exposure. Sounds may become distorted or muffled, and it may be difficult for the person to understand speech. The individual may not be aware of the loss, but it can be detected with a hearing test.
More than 30 million Americans are exposed to hazardous sound levels on a regular basis. Individuals of all ages, including children, adolescents, young adults, and older people, can develop NIHL. Of the 28 million Americans who have some degree of hearing loss, about one-third can attribute their hearing loss, at least in part, to noise.
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Know Your Risk Factors
Exposure occurs in the workplace, in recreational settings and at home.
- Noisy recreational activities include target shooting and hunting, snowmobiling, riding go-carts, woodworking and other noisy hobbies, and playing with power horns, cap guns, and model airplanes.
- Harmful noises at home include vacuum cleaners, garbage disposals, gas-powered lawn mowers, leaf blowers, and shop tools.
- An extreme noise like a firecracker, experienced at close range, can damage hearing permanently in an instant.
- Repeated exposure to engines and machines like motorcycles or chain saws can erode hearing more slowly. The result is the same: irreversible hearing loss.
- If you are standing next to a person wearing a personal radio with earphones and you can hear the lyrics to the song, that person's hearing is being damaged.
- If your kids are watching you cut wood with a power saw and you're not wearing protection, you are all experiencing hearing damage.
- If your teenager is doing lawn work for the summer, using a gasoline engine and not wearing hearing protection, hour after hour, it's doing damage.
- If anyone in your family uses a firearm for recreational shooting, and does not use hearing protection their hearing is being damaged.
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Manage Your Risk Factors
NIHL is preventable. All individuals should understand the hazards of noise and how to protect their hearing in everyday life.
- Be alert to damaging noise in the environment.
- Know which noises can cause damage (those above 90 decibels).
- Be prepared to protect your hearing. Carry earplugs or other protection.
- Wear earplugs or other hearing protective devices when involved in a loud activity (special earplugs and earmuffs are available at hardware stores and sporting good stores).
- Protect children who are too young to protect themselves.
- Help your kids understand how hearing works and how it can be damaged.
- Make family, friends, and colleagues aware of the hazards of noise.
- If you are exposed to noise at work, make sure your hearing protection is the right size and fit for you and that you replace it when it wears out.
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Work with Your Doctor
Hearing problems are serious. The most important thing you can do if you think you have a hearing problem is to go see a doctor.
Your doctor may refer you to an otolaryngologist (oh-toe-lair-in-GAH-luh-jist), a doctor who specializes in the ear, nose, and throat. An otolaryngologist will try to find out why you have a hearing loss and offer treatment options.
Your doctor may also refer you to another hearing professional, an audiologist (aw-dee-AH-luh-jist). An audiologist can measure your hearing. Sometimes otolaryngologists and audiologists work together to find the treatment that is right for you.
When was your last hearing test?
- Anyone regularly exposed to hazardous noise should have a hearing test every year.
- Those who are not exposed to hazardous noise should have a hearing test every 3 years.
- Anyone who notices a change in his/her hearing should have a hearing test right away.
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Presbycusis
Know the Facts
Presbycusis (prez-bee-KYOO-sis) is age-related hearing loss.
It is common in people over the age of 50:
- About 30-35 percent of adults between the ages of 65 and 75 years have a hearing loss.
- About 40-50 percent of people 75 and older have a hearing loss.
- Presbycusis most often occurs in both ears, affecting them equally. Because the process of loss is gradual, people who have presbycusis may not realize that their hearing is diminishing. The degree of hearing loss varies from person to person.
Symptoms
With presbycusis, sounds often seem less clear and lower in volume. This contributes to difficulty hearing and understanding speech. Individuals with presbycusis may experience several of the following:- The speech of others seems mumbled or slurred.
- The hearing loss associated with presbycusis is usually greater for high-pitched sounds.
- It may be difficult for someone to hear the nearby chirping of a bird or the ringing of a telephone. However, the same person may be able to hear clearly the low-pitched sound of a truck rumbling down the street.
- High-pitched sounds such as "s" and "th" are difficult to hear and tell apart.
- A man's voice is easier to hear than the higher pitches of a woman's voice.
- Conversations are difficult to understand, especially when there is background noise.
- Certain sounds seem annoying or overly loud.
- Tinnitus (a ringing, roaring, or hissing sound in one or both ears) may also occur.
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Know Your Risk Factors
There are many causes of presbycusis:
- Presbycusis is usually a sensorineural hearing disorder.
Sensorineural hearing loss is caused by disorders of the inner ear or auditory nerve. It is most commonly caused by gradual changes in the inner ear. The cumulative effects of repeated exposure to daily traffic sounds or construction work, noisy offices, equipment that produces noise and loud music can cause sensorineural hearing loss. This can occur as a result of hereditary factors as well as aging, various health conditions, and side effects of some medicines (aspirin and certain antibiotics).
A hearing loss is sensorineural (sen-soh-ree-NOO-ruhl) when it results from damage to the sensory receptors (hair cells) in the cochlea (inner ear) or to the auditory nerve, often as a result of the aging process and/or noise exposure. Sounds may be unclear and/or too soft. Sensitivity to loud sounds may occur.
- Presbycusis may be caused by changes in the blood supply to the ear because of heart disease, high blood pressure, vascular (pertaining to blood vessels) conditions caused by diabetes, or other circulatory problems. The loss may be mild, moderate, or severe.
- Sometimes presbycusis is a conductive hearing disorder, meaning the loss of sound sensitivity is caused by abnormalities of the outer ear and/or middle ear. Such abnormalities may include reduced function of the tympanic membrane (the eardrum) or reduced function of the three tiny bones in the middle ear that carry sound waves from the tympanic membrane to the inner ear.
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Manage Your Risk Factors
Much of the hearing loss caused by noise exposure can be prevented. Awareness of potential sources of damaging noises, such as firearms, snowmobiles, lawn mowers, leaf blowers, woodworking machinery and loud appliances is important. Earplugs or special fluid-filled earmuffs can protect against damage to hearing. Excessively loud everyday noises, both at home and at work, can pose a risk to a person's hearing. Avoiding loud noises and reducing the amount of time one is exposed to everyday noises may be helpful.
Keep any medical conditions you have, such diabetes or hypertension, in good control. Take your medications as prescribed. Be careful about taking over-the-counter medications with prescription medications.
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Work with Your Doctor
Hearing problems are serious. The most important thing you can do if you think you have a hearing problem is to go see a doctor. Your doctor may refer you to an otolaryngologist (oh-toe-lair-in-GAH-luh-jist), a doctor who specializes in the ear, nose, and throat. An otolaryngologist will try to find out why you have a hearing loss and offer treatment options.
Your doctor may also refer you to another hearing professional, an audiologist (aw-dee-AH-luh-jist). An audiologist can measure your hearing. Sometimes otolaryngologists and audiologists work together to find the treatment that is right for you.
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Tinnitus
Know the Facts
- Tinnitus (tih-NIE-tuhs) accompanies many forms of hearing loss, including those that sometimes come with aging.
- People with tinnitus may hear a ringing, roaring, clicking, hissing or some other noise inside their ears.
- Tinnitus may be caused by loud noise, hearing loss, certain medicines, and other health problems, such as allergies and problems in the heart and blood vessels. Often it is unclear why the ringing happens.
- Tinnitus can come and go, it can stop completely, or it can stay. Some medicines may help ease the problem.
- It is estimated that 12 to 36 million Americans have tinnitus.
- There is no cure for tinnitus.
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Know Your Risk Factors
- Hearing loss. Doctors and scientists have discovered that people with different kinds of hearing loss also have tinnitus.
- Loud noise. Too much exposure to loud noise can cause noise-induced hearing loss and tinnitus.
- Medicine. More than 200 medicines can cause tinnitus, including medications such as anti-inflammatories, antibiotics, sedatives, antidepressants and aspirin. If you take aspirin or other medications and your have tinnitus, talk to your doctor or pharmacist about whether your medicine could be involved.
- Other health problems. Tinnitus may also be caused by allergy, high or low blood pressure (blood circulation problems), a tumor, diabetes, thyroid problems, injury to the head or neck.
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Manage Your Risk Factors
- If you are a construction worker, an airport worker, or a hunter, or if you are regularly exposed to loud noise at home or at work, wear ear plugs or special earmuffs to protect your hearing and keep your tinnitus from getting worse.
- Avoid exposure to loud sounds and noises.
- Get your blood pressure checked. If it is high, get your doctor's help to control it.
- Decrease your intake of salt. Salt impairs blood circulation.
- Avoid stimulants such as coffee, tea, cola, tobacco and alcohol.
- Exercise daily to improve your circulation.
- Get adequate rest and avoid fatigue.
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Work with Your Doctor
If you have tinnitus, the most important thing you can do is to go see your doctor. Your doctor can try to determine what is causing your tinnitus. He or she can check to see if it is related to blood pressure, kidney function, diet, or allergies. Your doctor can also determine whether your tinnitus is related to any medicine you are taking.
To learn more about what is causing your tinnitus, your doctor may refer you to an otolaryngologist (oh-toe-lair-in-GAH-luh-jist), a doctor who specializes in the ear, nose, and throat. An otolaryngologist will try to find out why you have tinnitus and offer treatment options.
Your doctor may also refer you to another hearing professional, an audiologist (aw-dee-AH-luh-jist). An audiologist can measure your hearing. Sometimes otolaryngologists and audiologists work together to find the treatment that is right for you.
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