Hearing loss
Overview
Hearing loss that occurs
gradually as you age (presbycusis) is common. Almost half the people in the
United States older than age 65 have some degree of hearing loss. One in eight people over the age of 12 in
the United States have hearing loss in both ears.
Hearing loss is defined as
one of three types:
Conductive (involves outer
or middle ear)
Sensorineural (involves
inner ear)
Mixed (combination of the
two)
Aging and chronic exposure
to loud noises both contribute to hearing loss. Other factors, such as
excessive earwax, can temporarily reduce how well your ears conduct sounds.
You can't reverse most types
of hearing loss. However, you and your doctor or a hearing specialist can take
steps to improve what you hear.
Signs and symptoms of
hearing loss may include:
Muffling of speech and other
sounds
Difficulty understanding
words, especially against background noise or in a crowd
Trouble hearing consonants
Frequently asking others to
speak more slowly, clearly and loudly
Needing to turn up the
volume of the television or radio
Withdrawal from
conversations
Avoidance of some social
settings
When to see a doctor
If you have a sudden loss of
hearing, particularly in one ear, seek immediate medical attention.
Talk to your doctor if
difficulty hearing is interfering with your daily life. Age-related hearing
loss occurs gradually, so you may not notice it at first.
Causes
To understand how hearing
loss occurs, it can be helpful to first understand how you hear.
How you hear
The inside of your ear
Your ear consists of three
major areas: outer ear, middle ear and inner ear. Sound waves pass through the
outer ear and cause vibrations at the eardrum. The eardrum and three small
bones of the middle ear amplify the vibrations as they travel to the inner ear.
There, the vibrations pass through fluid in a snail-shaped structure in the
inner ear (cochlea).
Inner ear
The inner ear contains a
group of interconnected, fluid-filled chambers. The snail-shaped chamber,
called the cochlea (KOK-lee-uh), plays a role in hearing. Sound vibrations from
the bones of the middle ear are transferred to the fluids of the cochlea. Tiny
sensors (hair cells) lining the cochlea convert the vibrations into electrical
impulses that are transmitted along the auditory nerve to your brain. This is
where the initial damage and hearing loss occur due to age, noise exposure or
medication. For example, high doses of
aspirin and some antibiotics can cause hearing loss.
The other fluid-filled
chambers of the inner ear include three tubes called the semicircular canals
(vestibular labyrinth). Hair cells in the semicircular canals detect the motion
of the fluid when you move in any direction. They convert the motion into
electrical signals that are transmitted along the vestibular nerve to the
brain. This sensory information enables you to maintain your sense of balance.
Causes of hearing loss
include:
Damage to the inner
ear. Aging and exposure to loud noise may cause wear and
tear on the hairs or nerve cells in the cochlea that send sound signals to the
brain. When these hairs or nerve cells are damaged or missing, electrical
signals aren't transmitted as efficiently, and hearing loss occurs.
Higher pitched tones may
become muffled to you. It may become difficult for you to pick out words
against background noise.
Gradual buildup of
earwax. Earwax can block the ear canal and prevent
conduction of sound waves. Earwax removal can help restore your hearing.
Ear infection and
abnormal bone growths or tumors. In the outer or middle
ear, any of these can cause hearing loss.
Ruptured eardrum
(tympanic membrane perforation). Loud blasts of noise,
sudden changes in pressure, poking your eardrum with an object and infection
can cause your eardrum to rupture and affect your hearing.
Note: Items within this
content were created prior to the coronavirus disease 2019 (COVID-19) pandemic
and do not demonstrate proper pandemic protocols. Please follow all recommended
Centers for Disease Control and Prevention guidelines for masking and social
distancing.
Risk factors
Factors that may damage or
lead to loss of the hairs and nerve cells in your inner ear include:
Aging.
Degeneration of inner ear structures occurs over time.
Exposure to
loud sounds can damage the cells of your inner Loud noise ear. Damage can occur
with long-term exposure to loud noises, or from a short blast of noise, such as
from a gunshot.
Heredity.
Your genetic makeup may make you more susceptible to ear damage from sound or
deterioration from aging.
Occupational noises.
Jobs where loud noise is a regular part of the working environment, such as
farming, construction or factory work, can lead to damage inside your ear.
Recreational noises.
Exposure to explosive noises, such as from firearms and jet engines, can cause
immediate, permanent hearing loss. Other recreational activities with dangerously
high noise levels include snowmobiling, motorcycling, carpentry or listening to
loud music.
Some medications.
Drugs such as the antibiotic gentamicin, sildenafil (Viagra) and certain
chemotherapy drugs, can damage the inner ear. Temporary effects on your hearing
— ringing in the ear (tinnitus) or hearing loss — can occur if you take very
high doses of aspirin, other pain relievers, antimalarial drugs or loop
diuretics.
Some illnesses.
Diseases or illnesses that result in high fever, such as meningitis, may damage
the cochlea.
Comparing loudness of
common sounds
The chart below lists common
sounds and their decibel levels. The Environmental Protection Agency's (EPA)
safe noise level is 70 decibels. The louder the noise, the less time it takes
to cause permanent hearing damage.
Sound levels of common
noises
Decibels Noise source
Safe range
30 Whisper
40 Refrigerator
60 Normal conversation
75 Dishwasher
Risk range
85 Heavy city traffic, school cafeteria
95 Motorcycle
100 Snowmobile
110 Chain saw, jackhammer, rock concert, symphony
115 Sandblasting
120 Ambulance siren, thunder
140-165 Firecracker, firearms
Maximum
sound-exposure durations
Below are the maximum noise
levels on the job to which you may be exposed without hearing protection, and for
how long.
Maximum job-noise exposure
allowed by law:
Sound level, decibels Duration, daily
BASED ON OCCUPATIONAL SAFETY
& HEALTH ADMINISTRATION, 2008
90 8 hours
92 6 hours
95 4 hours
97 3 hours
100 2 hours
102 1.5 hours
105 1 hour
110 30 minutes
115 15 minutes or less
Complications
Hearing loss can have a
significant effect on your quality of life. Older adults with hearing loss may
report feelings of depression. Because hearing loss can make conversation
difficult, some people experience feelings of isolation. Hearing loss is also
associated with cognitive impairment and decline.
The mechanism of interaction
between hearing loss, cognitive impairment, depression and isolation is being
actively studied. Initial research suggests that treating hearing loss can have
a positive effect on cognitive performance, especially memory.
Prevention
The following steps can help
you prevent noise-induced hearing loss and avoid worsening of age-related
hearing loss:
Protect your ears. Limiting
the duration and intensity of your exposure to noise is the best protection. In
the workplace, plastic earplugs or glycerin-filled earmuffs can help protect
your ears from damaging noise.
Have your hearing tested.
Consider regular hearing tests if you work in a noisy environment. If you've
lost some hearing, you can take steps to prevent further loss.
Avoid recreational risks.
Activities such as riding a snowmobile, hunting, using power tools or listening
to rock concerts can damage your hearing over time. Wearing hearing protectors
or taking breaks from the noise can protect your ears. Turning down the music
volume is helpful too.
Jan Ricks Jennings, MHA,
LFACHE
Senior Consultant
Senior Management
Resources, LLC
Jan.JenningsBlog.Blogpost.com
412.913.0636 Cell
724.733.0509 Office
November 20, 20121
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