Is Hearing Loss Inevitable?

By Christopher Spankovich, AuD, PhD, MPH

It is a common misperception that hearing loss is inevitable. While it is true there are a greater percentage of persons with hearing loss as we age, it is not necessarily “age” causing hearing loss. Rather, so-called age-related hearing loss refers to our lifetime of general health, lifestyle (e.g. smoking, diet, etc.), noise exposure, use of ototoxic medications, and of course, genetics. In reality, there are a number of factors that contribute to hearing loss, some of these you cannot change (e.g. genetics), but others are modifiable. Excessive noise exposure is one of the most common causes of hearing loss and also one that is nearly 100% preventable. Noises that tend to be dangerous to the auditory pathway are not usually natural environmental sounds. Rather most noise that is dangerous is usually made by a machine, including everything from power tools to speakers at a concert.

How do you gauge risk? Risk for noise induced hearing loss is based mostly on the level and the duration of the exposure. In other words, the louder the sound the shorter the duration permissible before risk of hearing loss becomes likely. For example, a popular firearm for target shooting and hunting, the Armalite rifle model 15 (AR-15) can produce levels that peak over 180 dB SPL (Lobarinas, Scott, Spankovich, and Le Prell 2016). The current occupational noise limit set by the Occupational Safety and Health Administration (OSHA) is 140 dB SPL for impulse sounds (an impulse sound is a brief high intensity sound, like a firecracker). Therefore a single noise shot from a firearm can potentially damage hearing. For this reason most shooting ranges require use of hearing protection.

On the other end of the spectrum you have sound exposure that is less impulsive in nature and more steady state. For example, everyday you see people of all ages walking around with an mp3 player, i-something, smartphone, etc. and listening to music or talking on the phone. There is a good deal of concern in the hearing conservation community that this may alter risk for hearing loss. Can listening to music through an i-something increase risk for hearing loss? Yes, but again this is dependent on the level and duration of the exposure, i.e. the louder the music the shorter duration you can be exposed. The maximum output of the iPod with standard earbuds (the most popular music player) is approximately 105 dB SPL (this level can vary by type of earphone). Using the OSHA standards as reference you could listen to that level for approximately 1 hour “safely”. However, music and factory noise for which OSHA standard were created are not exactly same thing. A rule of thumb (with standard earbuds and ipod) is called the “80-90 rule”; do not listen at greater than 80% maximum volume and limit to 90 minutes and then take a break. If you want to use longer reduce the level, 50% of max volume should keep you safe for longer listening. Now you may say I can't hear my music on a plane or bus or in a crowd at only 50%. Another tip is to get sound isolating or noise reducing headphones, people are more likely to increase the level of their music when there is noise around covering up their tunes, isolating/noise reduction headphones can allow a person to achieve the music coma they seek without the need for high levels to battle background noise.

When you go to a concert/live music type venue do wear hearing protection? Unfortunately probably most of us would answer, "No". There are many reasons people do not wear hearing protection: 1. don't think there is any risk of damage, 2. think the amount of damage if even happened would be minimal, 3. think hearing loss is inevitable, so who cares, and 4. feel hearing protection diminishes the experience (i.e. music does not sound as good). There is some truth to these excuses, attending a concert once and while is not going to make you go deaf and many forms of hearing protection make music sound less than great. However, recognize that repeated noise exposure is cumulative and new research suggests that even single noise exposures may have much greater effects than previously thought including acceleration of age related hearing loss. If you are concerned about enjoying the show look into music earplugs, you can find non-custom pairs online for about $10-12 and they are reusable. Musician earplugs provide less attenuation and a flatter filtering (meaning not having greater attenuation of higher frequencies and less in the lows and therefore distorting the sound) which can allow you to protect your ears and still enjoy the show.

Finally, hearing loss is not the only reason to start protecting your hearing now. Tinnitus, the perception of a ringing, buzzing, humming sound without an external source, can develop. Tinnitus can often be experienced after noise exposure and is usually only temporary. Though, with repeated exposure slight damage to the pathway can results in a chronic and permanent tinnitus. There is no cure for tinnitus, but there are effective treatments to help tinnitus suffers cope. For both tinnitus and hearing loss, prevention is key. Use safe listening practices and hearing protection when around loud sounds; your ears will thank you.

Check with you local audiologist about hearing protection options for music, shooting/hunting, work, and etc. Also if you have tinnitus causing distress there is help available, contact your local audiologist.

• Lobarinas E, Scott R, Spankovich C, Le Prell CG (2016). Differential effects of suppressors on hazardous sound pressure levels generated by AR-15 rifles: Considerations for recreational shooters, law enforcement, and the military, Int J of Audiology, 55, S59-S71.