Protect Your Hearing

OVERVIEW

The statistics of the National Institute on Deafness and Other Communication Disorders on hearing impairment in the United States are sobering. Based on standard hearing examinations, one in every eight people aged 12 years or older has hearing loss in both ears. That represents about 30 million people or 13 percent of the population. 1 And, those numbers seem to be growing, especially for adolescents.

There are also problems associated with teens and young adults who raise the sound of personal music players. In response, the American Speech-Language-Hearing Association launched a campaign called “Listen to Your Buds.” (Buds are the portion of the personal music players that fit into the ears. They are speakers in your ears.) The campaign is trying to “educate children and parents about practicing safe listening habits when using personal listening devices, in order to avoid possible noise-inducing hearing loss in the future.” 2 It is always best to lower the volume of your music and limit the amount of time you spend with buds in your ears.

It is possible that you already have hearing loss from excessive noise, a condition known as noise-induced hearing loss. Symptoms of this disorder are ringing, buzzing, or roaring in the ears after hearing loud noise, and the distortion of sounds. 3 If you are experiencing these symptoms, make an appointment with your healthcare provider. You will then be referred to the correct professional for future care and treatment.

WHAT THE EXPERTS SAY

Children Are Able to Learn Healthier Personal Listening Device Behavior

In a pilot study published in 2013 in the journal Noise & Health, researchers from South Africa and Australia wanted to learn if a noise-induced hearing loss prevention program, known as Cheers for Ears, was effective in changing the self-reported listening behaviors of Australian students between 9 and 13 years. All the students participated in two interactive sessions, which were held six weeks apart, and a total of 318 students were selected to be surveyed. At baseline, 91.8 percent of the surveyed students owned or had access to a personal listening device. And, the vast majority, 79.1 percent, could control the volume on their devices. The researchers found that after the sessions, the students reduced the volume of their listening devices. Three months after the program ended, the students were again surveyed. The researchers found that their behavior changes “were stable and sustained.” And, they noted that the program “is effective in increasing knowledge on the harmful effects of noise and therefore, it may prevent future noise-induced hearing loss.” 4

In a study published in 2011 in the journal The Laryngoscope, researchers from Canada assessed the efficacy of a hearing conservation program (Sound Sense™) in elementary school children. The cohort consisted of sixth grade students, between the ages of 9 and 13 years, from 16 Vancouver School Board schools. The schools were randomized to be either an intervention school or a control group school. Students completed an initial questionnaire, a second questionnaire two weeks after the intervention, and a third questionnaire six months later. The surveys, which were administered by the teachers during regular school hours, asked about personal music playing habits, exposure to noise during daily activities, and about the use of earplugs. The students in the control schools completed questionnaires but had no intervention. The researchers learned that at baseline 43 of the 775 students had some degree of hearing loss. The use of a personal listening devise was reported by 515 of the 771 students. When compared to the children in the control, the researchers found that the children who participated in the intervention had significant improvements in use of earplugs. The children in the intervention group also reduced their use of personal music devices. The researchers concluded that the Sound Sense™ program “improved earplug use practices in elementary school children in the short and long term.” Moreover, “the development, implementation and evaluation of a community-based health promotion project around hearing loss can serve as a tremendous opportunity for students to develop their knowledge and skills in health advocacy.” 5

Interventions to Prevent Hearing Loss Made at Younger Ages May Prevent More Serious Problems

In a randomized, controlled trial published in 2012 in the journal Occupational & Environmental Medicine, researchers from Wisconsin and Canada had an opportunity to follow 392 young workers for up to 16 years and to determine if the measures taken to prevent hearing loss when people were still in high school were effective over a long period of time. When the teens were first evaluated, they were 12 to 16 years old, with a mean age of 14.5 years. During their most recent evaluation, they were aged 29 to 33 years. While most of the participants originally worked in agriculture, over time they entered other occupations. The participants completed questionnaires that asked about their exposure to high levels of occupational and recreational noise, as well as their use of hearing protection devices. The researchers found that hearing loss was more evident in the men than the women. As a result, they limited their final analysis to men. They found a high variation in the use of protective devices—ranging from 3.85 to 67.3 percent. Still, the devices “appeared to offer some protection to participants.” The researchers suggested that hearing conservation programs “should focus on a broader range of exposures, whether in occupational or non-occupational settings.” 6

BARRIERS AND PROBLEMS

Hearing Loss Interventions May Only Work for a Relatively Short Period of Time

In a study published in 2011 in the journal Pediatrics, researchers from Wisconsin, Minnesota, and Canada examined the long-term effects of a well-designed hearing conservation intervention. The researchers wanted to learn if the intervention reduced the amount of hearing loss and sufficiently supported the sustained use of hearing protective devices. Between 1992 and 1996, 34 rural Wisconsin schools with vocational agriculture programs were recruited. The students in 17 of these schools, who were all in grades 7 through 9, were randomly assigned to receive a comprehensive, three-year hearing conservation intervention or no intervention. Noise exposure questionnaires were completed at the beginning and ending of the intervention. From 2009 to 2010, the researchers made “extensive efforts” to contact all 690 of the students who had completed the original trial. The researchers were able to recruit 392 participants from the original trial—200 were in the intervention group and 192 were in the control group. Of these, 355 completed a questionnaire and had clinical hearing tests conducted by trained audiologists. The researchers found that among the participants exposed to agricultural noise, the members of the intervention group were significantly more likely to use hearing protection than those in the control group. The members of the intervention group were also more likely to use hearing protection when they used firearms. But, in other areas of their lives, the members of both groups used about the same amount of protection. The researchers found no significant difference between the groups with respect to objective measures of noise-induced hearing loss (NIHL). The researchers concluded that their “findings suggest that this comprehensive, well-designed, well-executed intervention aimed at educating rural high school students about hearing conservation was of limited effectiveness in preventing early NIHL.” 7

Most Teens Appear to Need More Information About Hearing Health 8

In a study published in 2013 in the International Journal of Audiology, researchers from Australia noted that occupational noise tended to be fairly predictable. So, work environments may already have plans in place to protect hearing. On the other hand, noise in leisure environments may be variable, and protecting oneself from such noise is dependent on “personal regulation,” the ability of each individual to take action to protect his or her hearing. The researchers wanted to learn more about the ability of people to take this action. The cohort consisted of 1,000 Australian males and females between the ages of 18 and 35 years. They all completed an online questionnaire, which asked about participation in noisy leisure activities and what the participants did to protect their hearing. While most of the participants reported good current hearing health, more than one-fifth showed the early signs of damage. About half took some measures to reduce their exposure to noise. However, this preventive action was found not to be related to hearing loss symptoms or “perceived personal risk” of damage from noise. Instead, these measures were taken because of the participants’ “beliefs about the risk posed by leisure noise, hearing health awareness, and the importance of hearing.” The researchers underscored the need for more education about the risks leisure time activities may pose to hearing. “Placing a stronger emphasis on educating young adults about the risk for hearing loss from their leisure activities, and personalizing this risk to make it relevant to their own participation is likely to be an important motivator.” 9

Undergraduate Music Students May Have a Greatly Increased Risk of Hearing Loss 10

NOTES

1. National Institute on Deafness and Other Communication Disorders, http://www.nidcd.nih.gov.

2. American Speech-Language-Hearing Association, www.asha.org.

3. The Nemours Foundation, http://kidshealth.org.

4. D. S. Taljaard, N. F. Leischman, and R. H. Eikelboom, “Personal Listening Devises and the Prevention of Noise Induced Hearing Loss in Children. The Cheers for Ears Pilot Program,” Noise & Health 15, no. 65 (2013): 261-68.

5. Anastasia Neufeld, Brian D. Westerberg, Shahin Nabi et al., “Prospective, Randomized Controlled Assessment of the Short- and Long-Term Efficacy of a Hearing Conservation Education Program in Canadian Elementary School Children,” The Laryngoscope 121 (2011): 176-81.

6. Barbara Marlenga, Richard L. Berg, James G. Linneman et al., “Determinants of Early-Stage Hearing Loss Among a Cohort of Young Workers with 16-Year Follow-Up,” Occupational & Environmental Medicine 69 (2012): 479-84.

7. Barbara Marlenga, James G. Linneman, William Pickett et al., “Randomized Trial of a Hearing Conservation Intervention for Rural Students: Long-Term Outcomes,” Pediatrics 128, no. 5 (2011): e1139-e1146.

8. Jeffrey L. Danhauer, Carole E. Johnson, Aislinn F. Dunne et al., “Survey of High School Students’ Perceptions About Their iPod Use, Knowledge of Hearing Health, and Need for Education,” Language, Speech, and Hearing Services in Schools 43 (2012): 14-35.

9. Megan Gilliver, Elizabeth Francis Beach, and Warwick Williams, “Noise with Attitude: Influences on Young People’s Decisions to Protect their Hearing,” International Journal of Audiology 52 (2013): S26-S32.

10. Christopher Barlow, “Potential Hazard of Hearing Damage to Students in Undergraduate Popular Music Courses,” Medical Problems of Performing Artists 25 (2010): 175-82.

REFERENCES AND RESOURCES

Magazines, Journals, and Newspapers

Auchter, Melissa, and Colleen G. Le Prell. “Hearing Loss Prevention Education Using Adopt-a-Band Changes in Self-Reported Earplug Use in Two High School Marching Bands.” American Journal of Audiology 23 (2014): 211-26.

Barlow, Christopher. “Potential Hazard of Hearing Damage to Students in Undergraduate Popular Music Courses.” Medical Problems of Performing Artists 25 (2010): 175-82.

Danhauer, Jeffrey L., Carole E. Johnson, Aislinn F. Dunne et al. “Survey of High School Students’ Perceptions About Their iPod Use, Knowledge of Hearing Health, and Need for Education” Language, Speech, and Hearing Services in Schools 43 (2012): 14-35.

Gilliver, Megan, Elizabeth Francis Beach, and Warwick Williams. “Noise with Attitude: Influences on Young People’s Decisions to Protect their Hearing.” International Journal of Audiology 52 (2013): S26-S32.

Marlenga, Barbara, James G. Linneman, William Pickett et al. “Randomized Trial of a Hearing Conservation Intervention for Rural Students: Long-Term Outcomes.” Pediatrics 128, no. 5 (2011): e1139-e1146.

Marlenga, Barbara, Richard L. Berg, James G. Linneman et al. “Determinants of Early-State Hearing Loss Among a Cohort of Young Workers with 16-Year Follow-Up.” Occupational & Environmental Medicine 69 (2012): 479-84.

Neufeld, Anastasia, Brian D. Westerberg, Shahin Nabi et al. “Prospective, Randomized Controlled Assessment of the Short- and Long-Term Efficacy of a Hearing Conservation Education Program in Canadian Elementary School Children.” The Laryngoscope 121 (2011): 176-81.

Rosemberg, Marie-Anne S., Marjorie C. McCullagh, and Megan Nordstrom. “Farm and Rural Adolescents’ Perspective on Hearing Conservation: Reports from a Focus Group Study.” Noise & Health 17, no. 76 (2015): 134-40.

Taljaard, D. S., N. F. Leischman, and R. H. Eikelboom. “Personal Listening Devices and the Prevention of Noise Induced Hearing Loss in Children. The Cheers for Ears Pilot Program.” Noise & Health 15, no. 65 (2013): 261-68.

Web Sites

American Speech-Language-Hearing Association. www.asha.org .

National Institute on Deafness and Other Communication Disorders. http://www.nidcd.nih.gov .

The Nemours Foundation. http://kidshealth.org .

  This information is not a tool for self-diagnosis or a substitute for professional care.