After years of Grateful Dead concerts and providing medical care to attendees at loud rock performances, Dr. Flash Gordon discovered he was missing out on sounds that most people take for granted.
"One day I wore my hearing aid as I walked to lunch, and I heard birds chirping in the trees. I had always seen the birds, but I never noticed them chirping," said Gordon.
Gordon, who today is a primary care physician in San Francisco, must use an electronic stethoscope that amplifies heart and lung sounds because his hearing aid prevents a conventional stethoscope from fitting in his ears.
Gordon is not alone. According to the National Institutes of Health, noise-induced hearing loss is the most common work-related disease. Thirty million people are at risk in the workplace, in recreational settings and at home. An estimated 10 million Americans have already permanently damaged their hearing.
Regardless of age, too much exposure to loud noise can permanently damage hearing, say experts, adding that the threat is everywhere. Devices like power tools, lawn equipment and firearms can cause hearing loss. Even entertainment can be partly to blame.
"Movies are incredibly loud. It's not uncommon to leave a movie theater or sporting event with ringing ears. This is a sign that damage has been caused," says Dr. Robert Labadie, a head and neck surgeon at Vanderbilt University in Nashville, Tenn.
Temporary damage represents dysfunction of small hair cells in the ear and is common after exposure to excessive noise. Repeated episodes and severe one-time events can cause permanent damage because the hair cells are permanently lost.
Labadie suggests that a large percentage of physicians do not regularly screen for hearing impairment in adults. In an article published in the January 2005 issue of Ear, Nose & Throat Journal, he recommends routine screening and suggests formal hearing tests for people who watch television more loudly than usual or have trouble hearing normal conversation.
Not all hearing loss is work-related. Arnold Mathias has experienced constant ringing in his ears since an explosion in Germany during World War II. He noticed hearing loss shortly thereafter.
"My wife would talk to me across the room. I could hear the sounds, but I didn't understand," said Mathias.
He learned to read lips and sat on the front row at conferences. Still, Mathias had difficulty at receptions, which were standard in his work with the U.S. Chamber of Commerce in Dallas.
"With everyone talking, it caused a general noise over which I couldn't hear the person next to me talking. It sounded like a bee hive," said Mathias.
"One of the biggest misconceptions about hearing loss is that hearing aids fix hearing like glasses fix vision. There's just no substitute for the fine tuning of the normal ear," said Dr. Peter Rabinowitz, assistant professor of Occupational and Environmental Medicine at Yale University in New Haven, Conn.
Rabinowitz believes that hearing protection is crucial. He works with the Council for Accreditation for Occupational Hearing Conservation to enhance the quality of job-based programs that preserve workers' hearing. The programs include engineering and administrative controls to decrease noise exposure, employee training and annual hearing tests.