Hearing Loss: A Preventable Problem


April 14, 2005 — -- 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.

But employee training isn't always enough to protect workers, especially in emergency situations.

"People mean to protect themselves. [But] they get hung up in the minute. They get caught up in the work," said Michael Reynolds, who worked as a survival flight nurse at the University of Michigan Medical Center in Ann Arbor, accompanying trauma patients on noisy helicopter rides.

Reynolds fears that workers who do not protect their hearing could jeopardize flight safety and patient care.

In an article published in the March 2005 issue of Air Medical Journal, Reynolds advocates for hearing conservation programs that meet federal standards and are tailored for helicopter emergency services personnel.

Individuals can decrease the risk of hearing loss by avoiding excessive noise and using hearing protection.

Sounds louder than 85 decibels can damage hearing. Normal conversation is about 60 decibels, and stereo headphones often reach 100 decibels. Rock concerts, chainsaws and hammer drills register at over 100 decibels.

Earplugs or special earmuffs should be worn with exposure to dangerous levels of noise. Disposable and custom-fitted earplugs can provide 20 to 40 decibels of protection when used correctly.

And Gordon, who co-founded the non-profit organization H.E.A.R. (Hearing Education and Awareness for Rockers), recommends an easy hearing test that can be done in the car.

Before going into a noisy environment, change the car radio to an all-talk station. Close the car windows and decrease the volume until it is barely audible. If there is difficulty hearing the station upon returning to the car, there has at least been some temporary hearing loss.

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