Archive for the ‘Noise levels’ category

Sound Advice

October 6th, 2011

By: Dr. Amin Musani
Doctor of Audiology
The Hearing Clinic
119 W. Main Street
Denison, TX 75021
(903) 462-4022
www.thehearingclinic.org

I watched as the next IDPA shooter stepped up to the firing line. You could tell he had done this before. He carefully but purposefully loaded a magazine into his handgun and chambered a round. On cue, he drew and shot a perfect score in amazing time. His handgun seemed like an extension of his arm. The bullets landed exactly where he willed them to on the cardboard target. After safely holstering he stepped back, turned around and flashed a smile, which told you he was pleased with his results and all that training and endless hours of practice had finally paid off. As he made it back to the observer area I walked over and congratulated him for a job well done. Curious as to what type of handgun he was using I asked him, “What kind is it?” He replied, “It’s 2:30pm.”

It never ceases to amaze me the high number of shooters that I come in contact with that do not wear any type of hearing protection while shooting. Granted, some things in our lives we cannot control. However, noise induced hearing loss (NIHL) and Acoustic Trauma are phenomenon that we most certainly do have control over and yet many shooters ignore the very basic principle of wearing hearing protection.

When is firearm noise is too much? When do we cross that line between loud and damagingly loud? Table 1 [1] displays some of the decibel (dB) levels of various sounds found in our daily lives. A decibel is a unit of measurement and for our purposes here it is measured on a logarithmic scale and there is a 10-fold increase in noise energy for each 10 dB increase. Said another way, an increase of 10 dB doubles the loudness level.

Sounds over 140dB can cause pain, and prolonged exposure to noise over 85-90dB can result in permanent hearing loss. Gunfire may be categorized as an impulse noise, which has the characteristic of an explosive burst. Impulse noise of sufficient intensity and pressure is often a cause of acoustic trauma. Generally, studies have shown that such impulse sounds may result in the shifting, skewing, bending, swelling, bursting, tearing, fusing &/or severe mechanical damage to the inner ear cells, structures, and auditory pathways. That is, short-duration sounds of sufficient intensity (e.g., a gunshot or explosion) may result in an immediate, severe, and permanent hearing loss, which is termed acoustic trauma. The degree of hearing impairment seen after acoustic trauma varies and may range from a mild to profound hearing loss.

Figure 1 (Pickles & Heumen; 2001) compares electron microscopy of normal, healthy outer hair cells (specialized hearing cells in our inner ear) to damaged ones. Once such damage occurs, it is permanent. There is no method of regenerating these cells or “curing the damage.” Bear in mind that this is only one site where such damage can occur from noise exposure along our auditory pathway.

There is evidence to suggest that once deterioration of certain specialized hearing cells (spiral ganglion cells) has begun, there is a corresponding deterioration within the central nervous system at areas higher up in the auditory system (Kim et al., 1997; Morest et al., 1998). Thus, once damage has occurred at lower levels it is not isolated there but rather may progress upwards through the auditory pathway. This is very characteristic of impulse noise such as gunfire that causes acoustic trauma. The inner ear, then, is not the only structure at risk from such exposure.

Figure 1. Normal, healthy outer hair cells (L) vs. damaged outer hair cells (R).

Virtually all of the structures of the ear and hearing system can be damaged from gunfire noise (NIH Consensus Statement; 1990). Generally, for sound levels below 140 dB, different types of sounds produce the same hearing loss. This does not appear to be the case at levels above 140 dB, where impulse noise creates more damage than would be predicted. This may imply that impulse noise above a certain critical level results in acoustic trauma from which the ear cannot recover (NIH Consensus Statement; 1990).

Exposure to noise between 90 and 140 dBA (dBA denotes a decibel measure made with a filter that adjusts for human auditory sensitivity) damages the inner ear metabolically rather than mechanically and causes injury depending on the level and duration of exposure. Noise-induced hearing loss, in contrast to acoustic trauma, develops slowly over years, and is caused by any regular and consistent exposure exceeding a daily average of 85-90 dBA (Clark & Bohne; 1999). Acoustic trauma may occur from just one unprotected exposure to gunfire noise.

For sounds between 75 – 90 dBA, the ear has a natural protective mechanism to reduce its sensitivity to low frequency impact sounds through what is termed the middle ear reflex. Generally speaking, muscles in our middle ear contract and stiffen three tiny bones (the smallest bones in the human body called ossicles; see Figure 2) that relay sound to the inner ear. However, a delay of 300 to 500 milliseconds is required to set this protection fully in operation. Most naturally occurring impact sounds can easily be dealt with by the middle ear, but many man-made sounds, such as explosions from guns, as well as certain industrial noises, occur so quickly that our middle ear protective mechanism cannot respond quickly enough. The hearing loss caused by such sounds is permanent acoustic trauma (Truax; 1999).

Peak sound levels from rifles and shotguns can range from 132 dB SPL (sound pressure level is another unit of measurement) for small-caliber rifles to more than 172 dB SPL for high-powered firearms. Americans collectively own more than 230 million guns, and more than half of men in the American industrial workforce occasionally use guns. The National Rifle Association estimates that 60 to 65 million Americans collectively own more than 230 million guns. Because guns are so prevalent in our culture, shooting firearms is the most important source of excessive noise outside the workplace. The severity of injury produced by impulsive noise exposure and the prevalence of shooting by Americans makes gun noise America’s most serious non-occupational noise hazard. The acoustic energy in a single report from a high-powered rifle or shotgun is equivalent to almost 40 hours of continuous exposure at 90 dBA. In other words, 1 bullet equals 1 week of hazardous occupational noise exposure. An avid target shooter can be exposed to an entire year’s worth of hazardous occupational noise in just a few minutes (Clark & Bohne, 1999; NRA, 1999).

What about firearms themselves? Is a .22LR any better on your ears than a .45ACP? Table 2 [2] compares the dB levels of various cartridges.

Recall that sounds over 85-90 dB can lead to permanent hearing damage without hearing protection. As can be seen from Table 2, even firing a .22LR (134 dB) has the potential of causing permanent, irreversible, inner ear damage.

There are various kind of hearing loss. Conductive hearing loss refers to physical damage, infection or fluid build up in the middle ear cavity (Figure 2). If the gunblast is of sufficient intensity a conductive loss may be seen and accompanied by such symptoms as eardrum rupture or middle ear bone damage.

Conductive losses are typically open to medical treatment from a physician who specializes in diseases of the ear (Otologist or Otolaryngologist). Sensorineural hearing loss refers to damage within the inner ear. This is usually, incorrectly, referred to as “nerve type deafness” which really only occurs in about 1% of the American population (Mueller and Hall, 1998). Sensorineural hearing loss is the most common type of hearing loss in America, and noise induced hearing loss or acoustic trauma from firearms is typically sensorineural. It is permanent, irreversible and with proper hearing protection, can be avoided or minimized.

Probably the most common excuse I have heard from shooters is that “my ears have toughened up from shooting and I don’t have to wear hearing protection.” Well, I’m sorry to say that this is not possible. What is more likely is that you have sustained sensorineural hearing loss and some sounds just don’t seem as loud any longer (along with speech). However, it is still critical to wear hearing protection as the hearing you do have left can still be harmed from unprotected firearm exposure. As researchers and educators have noted, “Ears don’t get tough, they get deaf.” (Mueller & Hall, 1998).

Typically, noise induced hearing loss and acoustic trauma affect the high frequencies first. Our ears respond to sounds across a wide range of frequencies, from about 20 to 20 000 Hertz (Hz). Speech frequencies are roughly located between 250-8000 Hz. Low frequencies are used to “hear people” while the highs are what we use to understand what they say. To put it another way, the power of speech (vowels) is located in the low frequency range while the clarity of speech (consonants such as s, k, th, sh, f, th) is located in the highs. High frequency consonants are necessary to maximize speech intelligibility. Noise damage from firearms affects these high frequencies first due to, some believe, anatomical reasons (Mueller & Hall, 1999). Figure 3 [4] depicts an audiogram (record of one’s hearing) of a sensorineural hearing loss typical of shooters.

As such, many people complain that “I hear people, but sometimes I don’t understand what they said.” Women’s and children’s voices, typically in the high frequency range, are usually the most difficult to understand when one has such a high frequency hearing loss. Add to all this that our hearing gets worse just from the normal aging process and you quickly realize just how important hearing protection really is.

Other factors also determine how susceptible one is to firearm noise exposure. For examples, blue-eyed individuals may be more susceptible than people with greater melanin content in their eyes. Some studies have shown that males are more susceptible to noise induced hearing loss (NIHL) than females. Newborns and older individuals also seem to be more likely to develop hearing loss from NIHL. Finally, some studies have also shown that smoking increases one’s chances of acquiring hearing loss from noise. This may be due to the carbon monoxide in the smoke (Henderson, Subromaniam, & Boettcher; 1993).

I’ve also noticed that some shooters will wear their hearing protection, but only while shooting. When observing from just a few yards away, they do not wear their hearing protection. This is simply not good hearing conservation practice and is against competition rule #7 of your IDPA manual. In fact, if one was to comply with this rule, anyone within 50 yards of the firing line must wear not only hearing protection, but eye protection also. Some handguns at IDPA produce a very discernible boom that can still damage your ears (see Table 2), even if you are not shooting and are only a few feet to yards away. Of course, this will vary with the type of firearm, cartridge, and distance from the shooter, but Table 2 clearly shows that even a report from a .22 can damage your ears. Though not relevant to IDPA purposes, the use of muzzle brakes and ports dramatically increases the level of noise exposure from firearms.

In the consideration of sounds that can damage hearing, one point is clear: it is the acoustic energy of the sound reaching the ear, not its source, which is important. That is, it does not matter if the hazardous sound is generated by a machine in the workplace, by a loudspeaker at a rock concert, by a lawnmower or a firearm during an IDPA event. Significant amounts of acoustic energy reaching the ear may create damage–at work, at school, at home, or during leisure activities. Although there has been a tendency to concentrate on the more significant occupational and transportation noise, the same rules apply to all potential noise hazards, including and especially firearms (Clark and Bohne; 1999).

Sound advice dictates that when at the gun range, by all possible means, take appropriate measures to practice safe gun handling. Wearing hearing protection (along with eye protection) falls into this category, whether you are the shooter or an observer. Think of it this way: hearing aids could cost you anywhere from $600 to $8000 per pair! Protect your hearing and you could spend that on more important things…like firearms, ammunition, training & IDPA.

References
  • American Academy of Audiology. http://www.audiology.org/consumer/guides/aural.php
  • Clark, W.W. & B.A. Bohne (1999). Effects of noise on hearing. Medical Student Journal of American Medical Association. May 5th, Vol. 281: 17.
  • E.A.R., Inc. (2001). http://www.earinc.com/howhearingworks.html
  • Henderson, D., Subromaniam, M., & Boettcher, F. (1993). Individual susceptibility to noise-induced hearing loss. Ear and Hearing, 14(3): 152-156.
  • Kim, J., Morest, D.K., and Bohne, B.A. (1997). Degeneration of axons in the brain stem of the chinchilla after auditory overstimulation Hear Res, 103:169-191.
  • Kramer, W. Gunfire and Hearing Protection. Ball State University, Muncie, Indiana.
  • Mestel, R. (2000). Los Angeles Times. Original print date February 28, 2000. http://www.audiology.org/consumer/guides/aural.php
  • Morest, D.K., Kim, J., Potashner, S.J., and Bohne, B.A. (1998). Long-term degeneration in the cochlear nerve and cochlear nucleus of the adult chinchilla following acoustic overstimulation. Micro Res Tech 41:205-216.
  • Mueller, H.G. & Hall, J.W. (1998). Audiologists’ Desk Reference. Vol. I Singular Publishing: San Diego
  • Mueller, H.G. & Hall, J.W. (1998). Audiologists’ Desk Reference. Vol. II. Singular Publishing: San Diego.
  • National Rifle Association (1999). Fact Card. http://www.nraila.org/research/99fctcrd.htm.
  • NIH: National Institute of Health Consensus Statement Noise and Hearing Loss. Online 1990 Jan 22-24;8(1): 1-24. http://text.nlm.nih.gov/nih/cdc/www/76txt.html
  • Pickles, J., & Heumen, W. (2001). Hearing Unit. Vision Touch and Hearing Research Centre, University of Queensland. http://www.vthrc.uq.edu.au/hearing/hearing_home.html
  • Truax, B. (1999). Handbook of Acoustic Ecology (2nd Edition). Cambridge Street Publishing.

Dr. Amin Musani is a Clinical Audiologist practicing in Denison, TX. Any comments or questions may be directed to DrAminMusani@cableone.net or The Hearing Clinic 119 W. Main St. Denison, Texas, USA 75021, Phone: (903) 463-9900, FAX: (903) 463-9911.

[1] Mueller and Hall (1998).

[2] William Kramer, Ph.D.

[3] Mestel, 2000.

[4] E.A.R. Inc.

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Posted in Audiologist, Clinical Audiologist, Decibles, Decreased Hearing, Ear Protection, Hearing Aid, Hearing Care, Hearing Damage, Hearing Loss, Noise Exposure, Noise Hazards, Noise levels, Noise-induced, Protecting Ears, Texas

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Otoprotectants for Noise Induced Hearing Loss

June 29th, 2011

Hearing Professional Center
By: Allison McKenzie , Au.D.
Doctor of Audiology
5462 Glen Lakes Drive
Dallas, TX 75231
(214) 987-4114
Follow Hearing Professional Center | Facebook | Twitter | Youtube
www.hearing-center.com

Noise induced hearing loss (NIHL) is the second most common cause of sensorineural hearing loss (SNHL) in industrialized societies. Excessive noise exposure is the only preventable cause of SNHL (Kopke, 2007). The hair cells of the inner ear are the specific structures damaged by excessive noise exposure and, in mammals, are unable to regenerate spontaneously. This physical damage can cause permanent and irreversible hearing loss as well as degrade a person’s quality of life. Knowing how the physical structure is affected by noise can aid researchers in their search for therapeutic agents that act as otoprotectants against NIHL (Ciorba et al, 2008). Personal hearing protection devices along with environmental engineering are the most prevalent protection methods of hearing conservation programs. Even with the required participation in hearing conservation programs, by workers who are exposed to noise at or above the action level, NIHL is still quite common. The current methods of protection are limited in their ability to save every listener from a NIHL. Researchers are actively searching for a pharmacologic approach that, when combined with environmental engineering and personal hearing protection devices, will more completely protect people from NIHL (Kopke, 2007).

Antioxidants

Vitamin E

Oxidative stress has been proven to contribute to the degradation of hair cells in the cochlea. Drugs with antioxidant properties, such a vitamin E, have been tested on both animals and humans. The success with vitamin E as an otoprotectant in animals is far greater than the results seen is human subjects. The different effects of antioxidants between human and animal subjects may be due to differences in pharmacokinetic and pharmacodynamic principles. More research is needed to determine when and in what intervals antioxidant treatments are needed to be the most useful in preventing NIHL in humans (Fetoni et al, 2008).

N-acetyl-l-cysteine (NAC)

The glutathione pathway is a very important antioxidant pathway in the cochlea. NAC acts as a glutathione substrate and aids the body in glutathione synthesis. Research shows the effectiveness NAC has on NIHL when given intraperitoneally and via oral gavage. ABR recordings on chinchillas show the differences between dosing methods and different types of noise exposure. Many studies have shown the otoprotectant effectiveness of NAC in animal subjects, but this particular study chose to administer high-kurtosis noise in order to simulate a typical industrial environment. The goal was to show whether NAC would be considered an effective treatment method in human subjects with a NIHL (Bielefeld et al, 2007).

Clifford and Rogers (2009) looked at the effect of antioxidants as otoprotectants for impact noise trauma. They stated that people who are exposed to impact noise are at greater risk for NIHL. They chose to study the otoprotectant effect of NAC on chinchillas. The antioxidant effected the way the cochlea reacted to changes in oxygen and nitrogen which helped protect the inner ear from severe hair cell damage. There were limitations to this study due to the difficulty the researchers faced when trying to measure the physical changes during impulse noise stimulation. Clifford and Rogers (2009) cite the work of Kopke’s unpublished pilot study of 566 Marine recruits which reported a 25% reduction in the number of Marines suffering a NIHL after a two-week period of M16 rifle exposure. These Marines were given NAC as the antioxidant otoprotective agent. There is more research on the usefulness of antioxidants as otoprotectants currently being conducted with military personnel.

A study conducted in 2006 looked at NAC given thirty minutes prior to exposure to loud music. This is the only study that administered the NAC by effervescent tablet form. The results indicated that the results from the NAC group were no different than the results from the placebo group. The author pointed out other research that suggests dosing schedule is very important to the success of NAC in preventing permanent threshold shifts (Kramer et al, 2006).

Hearing Professional Center StaffHPC Staff: (From Left) Dr. Allison McKenzie, Jared Lacy & Dr. Deborah Price

C-Jun N-terminal Kinase (JNK) Inhibitors

JNKs are stress activated protein kinases that have been shown to be responsible in the apoptosis or death of oxidative stress-damaged cells. Knowing the signaling chain of JNKs can effectively help researchers provide otoprotectants that are efficient in preventing cochlear damage. JNK inhibitors are cell permeable peptides that target specific protein groups and block the JNK from carrying out its natural course in the cell. One research study showed that the  peptide conjugate D-JNKI-1 can be injected locally to the scala tympani of explanted cochleas to provide protection from acoustic trauma as well as aminoglycosides. JNK inhibitors as otoprotectants have shown the ability to keep a temporary threshold shift from becoming a permanent hearing loss (Zine and Van de Water, 2004).

A more recent study looked at the effect of JNK inhibitors on patients whose hearing was affected by firecrackers on New Year’s Eve. The 11 subjects were selected within 24 hours of the firecracker display and had at least a 30 dBHL loss at 4 and 6 KHz. The subjects were given topical anesthesia and then given a single intratympanic injection of either .4 or 2.0 g/ml of the JNK inhibitor AM-111. The results showed no difference between the dosage groups. The study shows improvement in the thresholds of all 11 subjects, but there was not a control group to compare these results to. There is not enough evidence to say that AM-111 should be used clinically to treat acute acoustic trauma (Suckfuell et al, 2007).

Coenzyme Q10

Coenzyme Q10, which is used to increase cellular metabolism, was used to determine otoprotective effectiveness in 30 guinea pigs. The coenzyme Q10 was given intraperitoneally 2 hours before the guinea pigs were exposed to 130 dBSPL of noise centered at 4 KHz for 3 hours. ABR was used to measure pre and post results. The guinea pigs showed no differences in ABR recordings prior to noise exposure, but 7 days after the exposure the treatment group showed less of a shift than the control group. There was a marked improvement in antioxidative activity noticed 2 days post coenzyme Q10 injection (Hirose et al, 2008).

Hepatocyte Growth Factor (HGF)

HGF is a protein responsible for cell growth and different morphogenic factors. Gelatin hydrogels that had been dipped in either HGF or saline were placed on the round window of 18 guinea pigs 1 hour after a 3 hour exposure to 120 dBSPL noise. The results were measured using ABR throughout the testing process. The ABR results showed that the guinea pigs who were given the gelatin hydrogels dipped in HGF had better ABR thresholds than the saline group. The results differed in the basal portion of the cochlea only. The apical region remained unchanged for both groups (Inaoka et al, 2009).

Tacrolimus (TCR) and Melatonin (MLT) vs. Dexamethasone (DXM)

A recent study compared TCR, MLT and DXM under the same conditions to determine which if any was the most effective otoprotectant. TCR is a calcineuron inhibitor that was administered to a group of rats the day before exposure to traumatic noise and for 14 days following the noise exposure. The TCR group of rats showed an improvement in ABR thresholds within one week post noise exposure. The rats given MLT, a pineal gland hormone and antioxidant, were reported to show a marked improvement in ABR thresholds by week three post noise exposure. The group given DXM, an anti-inflammatory and immunosuppressant, showed no difference in ABR threshold recordings from the control group (Bas et al, 2009).

Implications

Most of the research on otoprotectants that has been published is based on an animal model. There are a few human subject based articles, but the methods of otoprotectant use are varied. The study that looked at the effect of NAC on people exposed to loud music used an effervescent tablet. I question whether the outcome would have been different if the dosing method had been different. My concern is the feasibility of intratympanic injections every time a person is exposed to excessive amounts of noise. More research is needed to determine which of the treatments presented in this paper are useful clinically. Every research article mentioned the need for more research to fully understand how the system works. I would like to see more human subject research to better understand how an otoprotectant might be most effective.

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Posted in Cochlea, Dallas, Hair Cell Damage, Hearing Conservation Programs, Hearing Loss, Hearing Professional Center, Hearing protection, inner ear, Noise Exposure, Noise Hazards, Noise levels, Noise-induced, Otoprotectants, Sensorineural Hearing Loss, Texas, Uncategorized

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Hearing Loss Contributes to Lost Income & Impacts Employers

May 25th, 2011
By: Jennifer Bentley, Au.D.
Doctor of Audiology
The Hearing Assessment Center
9101 Franklin Square Drive
Baltimore, MD 21237
(410) 583-7021
Follow The Hearing Assessment Center | Facebook | Twitter | Youtube
www.hearingassessment.com
 

When the topic of hearing loss comes up in a conversation, most people don’t think twice about it—dismissing it as a problem faced by “old” people, and more of an inconvenience than a real health issue.

The fact is, hearing loss is a serious condition affecting nearly 30 million Americans. Studies report that one out of six baby boomers (ages 42-60) and one out of 14 in the Gen X population (age 30-41) are affected by hearing loss. Given these age breakdowns, it is fair to assume that most of these individuals are still active in the workforce.

Jennifer Bentley, Au.D. - Doctor of Audiology Baltimore, MarylandFor this large portion of the work force, hearing loss is more than “inconvenient.” If left untreated, even a mild hearing loss can jeopardize safety and cost them (and their employers) dearly.

In terms of safety, consider this: a person with untreated hearing loss, regardless of age, is given instructions to take medicine at specific times and in certain dosages. If those instructions are not crystal clear, the results can be life-threatening. Add in other outside factors such as the noise from the hospital emergency room, or a crying toddler, and the difficulty of hearing proper instructions increases.

The “danger” in these scenarios doesn’t even factor in the ability to hear sirens, smoke alarms, baby cries, car horns, and other alerting signals. The more significant the hearing loss, the greater the risk is to oneself or others, and that’s more than an inconvenience.

In addition to safety, job security and income for an employee with untreated hearing loss may be at risk. Consider a scenario where a boss gives a series of instructions and deadlines to a staff person. Even a mild hearing loss could impair the employee’s ability to hear the details correctly. This puts the project at risk and may even jeopardize that person’s job.

A survey conducted by the Better Hearing Institute indicates, “Working Americans who ignore their hearing problems are collectively losing at least $100 billion a year in earnings.” The survey showed that, “Even people with mild hearing loss, who may miss a consonant here or a word there, may lose income if they can’t completely grasp the latest news at the water cooler or a phone message from the boss.”

The report goes on to estimate that the average worker with untreated hearing loss loses from $1,000 per year (those with mild hearing loss) to $12,000 a year with profound hearing loss.

Given the fact that most hearing loss is noise-induced (contrary to years of thinking it was related to age), it is not likely that the number of people suffering from hearing loss will decline in our noisy society. As a matter of fact, there is an epidemic of hearing loss in young people.

Reports indicate that children as young as 7 are being diagnosed in unprecedented numbers with noise-induced hearing loss. The impact of this epidemic, of course, is yet to even be a reality for employers.

Being Proactive Can Make A Difference

It is easy to be proactive in addressing hearing loss in the workplace. The best place for individuals and businesses alike to begin is with a hearing-loss awareness program. The goal of an awareness program is to commit to the prevention and the proactive treatment of hearing loss for those who are affected.

In terms of prevention, hearing conservation programs are recommended for noisy businesses. When around high levels of occupational noise, the employee’s hearing sensitivity should be monitored on an annual basis. In low-noise environments, such as an office building, employers should include hearing-loss awareness education as part of their worksite wellness programs.

In terms of proactive treatment, encourage employees to get their hearing tested and treated if a loss does exist. Offering to help pay or share the cost of hearing aids (or other assistive listening devices) could speak volumes about an employer’s commitment to staff and hearing health. Such minor “investments” on the part of the business can be huge in terms of employee loyalty and enhancing morale.

Additionally, businesses can take steps to make it easier for employees with hearing loss to hear more efficiently.

For instance, offer phone amplifiers, install loop systems in meeting rooms, and encourage greater sensitivity and awareness among all staff members—offering tips or training to help them communicate more effectively with their co-workers who have hearing loss.

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May is Better Hearing Month!

May 4th, 2011

By: Peter J. Marincovich, Ph.D., CCC-A
Audiology Associates
1111 Sonoma Ave., Suite 308
Santa Rosa, CA 95405
(707) 827-1630
www.audiologyassociates-sr.com

May is Better Hearing month—but despite the fact that more than 34 million Americans report some type of hearing problem, relatively few are screened annually. With about 1 in 10 Americans reporting some type of hearing difficulty, hearing loss is the third most common health problem in the United States. Although hearing problems are commonly associated with the aging process, hearing loss affects all age groups. More than half of hearing impaired persons in the United States are under age 65, including 6 million people between the ages of 18 and 44—and more than 14 million are school-age children. Here are some things to be aware of concerning hearing.

Better Hearing & Speech MonthSound voids. Do you hear “ool” but not sure if someone said “pool,” “tool” or “cool”? Do you find yourself saying “I hear OK, but I have trouble understanding,” or “Soft sounds are too soft but loud sounds are too loud.” Hearing clearly when there’s background noise can be especially difficult for someone with hearing loss and trying to explain your hearing situation can often be difficult.

It’s common for people to be unaware of their hearing loss due to the gradual nature of its progression. As hearing slowly declines, an individual develops compensation strategies without even realizing it. Often it’s others, who are trying to communicate with the hearing-impaired individual, who are more aware of the situation. Hearing problems often go unrecognized, sometimes taking years before sufferers seek professional help.

Causes. There are many causes of hearing loss. Sometimes it’s readily apparent, such as wax build-up in the external ear canal, a condition that’s easily treated but unfortunately goes unrecognized in many individuals. Other causes can include hereditary factors, trauma, ear disease and certain medications. The cause of hearing loss is sometimes presumed. For instance, noise-induced hearing loss attributed to the use of stereo systems or portable music players is a growing phenomenon. Avoiding loud noise may help prevent premature hearing loss and the perception of sound voids.

There are easy ways to tell if a particular sound is potentially harmful. Do you have difficulty talking or hearing others talk over the sound? Does the sound make your ears “ring” (tinnitus), “hurt” or seem “muffled” after exposure? If you answered “yes” to any of these questions, the noise may be damaging your hearing. Most people don’t realize how loud everyday sounds actually are. Nearly 30 million Americans are exposed to dangerous noise levels each day, and 10 million Americans suffer from irreversible hearing damage due to noise.

The diagnostic hearing tests. The purpose of a complete evaluation is to determine the true nature of any hearing loss. The diagnostic process may include a variety of tests, depending on the assessment of your needs: audiometric tests to measure hearing at different pitches; speech evaluation to measure how well you hear and recognize ordinary conversation at different volumes; immittance tests of the middle ear; and complete medical evaluations.

Tinnitus is a medical condition characterized by persistent ringing in one or both ears, which can only be heard by the affected individual. These sounds can come and go; however, most suffers experience symptoms 24 hours a day, 7 days a week. The American Tinnitus Association estimates more than 50 million Americans suffer from tinnitus. It’s also the number one complaint from United States veterans. In some cases, tinnitus retraining therapy (TRT) and tinnitus retraining instruments (TRI) may provide individual solutions.

The balance system, due to its close proximity to the hearing mechanism, is also part of a comprehensive hearing evaluation. Fear of falling is a major health concern of individuals in their latter years. Nearly 300,000 hip fractures result from balance-related falls every year. The natural aging process may affect any one or all of the senses, as well as the central nervous system’s ability to interpret and react quickly to them. It’s very common to hear from someone who has fallen that they saw the curb or step, but just were not able to react fast enough or to keep their balance. With proper diagnosis and therapeutic exercise called balance retraining, many older adults are able to return to a more active lifestyle.

The Communication Needs Assessment in addition to the diagnostic hearing evaluation and after medical evaluation, if an individual still suffers from difficulty communicating; a complete communication needs evaluation is now the gold standard of hearing care. The fist step is identifying the individual’s need: What are the listening situations where the individual would like to hear well? The second step is identifying the individual’s lifestyle. For example, not just if they have trouble hearing in restaurants, but how often they do, or would they like to, go to restaurants.

May is Better Hearing & Speech MonthTechnology alone doesn’t help people hear better. Instead, it’s how well the practitioner works with the individual and applies the technology. If an individual doesn’t see well through a pair of glasses, it’s not due to the “glass,” per se. It has to do with either the measurement of the individual’s vision, the prescription or fit, or some combination. Hearing Aids are similar in application. What helps someone hear better is the correct amount of sound at the appropriate pitches for that individual’s hearing loss, environment and communication needs. Individuals with similar hearing loss may require completely different amplification strategies based on all of the factors mentioned here.

The all-important aftercare completes a comprehensive communication needs assessment for an exceptional sound experience. This includes assessment of need for assistive listening devices for telephone, Bluetooth, TV, loops or music systems. In addition to assistive solutions, aftercare will include lip reading and listening skills counseling.

It’s important that a hearing-impaired individual take an active role in listening and participate in the recommended auditory retraining and rehabilitation program to ensure he or she hears and understands as much as possible. The auditory system may not have heard certain voices and sounds for many years, and the reintroduction of new sounds and voices needs to be presented gradually. In other words, just as the hearing loss may have occurred gradually, the reintroduction of new sound needs to occur gradually. Through this process, each individual will adapt and develop necessary listening skills.

A hearing screening can quickly and accurately evaluate an individual’s hearing, determine the degree of hearing loss and put them on the path toward treatment. After treatment, it’s important to monitor the hearing loss to ensure the technology is meeting an individuals needs.

 

Peter J. Marincovich, Ph.D, CCC-A, is clinical director and owner of Audiology Associates, a full-service audiology practice since 1984, with offices in Santa Rosa, Mendocino, Novato and Mill Valley.

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Sound Advice: Noise-Induced Hearing Loss Prevention

April 22nd, 2011

By: Peter J. Marincovich, Ph.D., CCC-A
Audiology Associates
1111 Sonoma Ave., Suite 308
Santa Rosa, CA 95405
(707) 827-1630
www.audiologyassociates-sr.com

Have you noticed that daily life in our society gets louder every year? The change is subtle and is a problem that most of us take for granted and even ignore. According to many leading Audiology professionals, casually ignoring the sounds around us can lead to serious hearing problems, including noise-induced hearing loss (NIHL).

One of those professionals is David Coffin, Audiology clinic coordinator at Indiana’s Ball State University. “We are exposed to all sorts of sounds that can lead to permanent hearing loss,” Coffin says. “The average person will wear a helmet when riding a bike, or a seat belt in a vehicle, but doesn’t even think about ear protection when going to watch a rock band, a fireworks display, or even an auto race.”

According to the Better Hearing Institute, 30 million Americans are exposed to dangerous noise levels each day and 10 million Americans have already suffered irreversible hearing damage from noise.

The problem of noise induced hearing loss has been around for decades. It occurs at home, in the yard, at the office, at the factory, on the farm and in the military. But today, because of technology, virtually everyone is effected and at younger and younger ages. It is not uncommon for audiologists to see 20-year-olds with the hearing of 60-year-olds.

However, there is good news as well: NIHL is easily identifiable and completely preventable. Today, audiologists can assist with the prevention, diagnosis and rehabilitation of hearing loss.

Hazardous Noises

Normal conversations occur at approximately 60 decibels. Raising your voice over a noise in order to be heard by someone an arm’s length away is a good indication that the noise could be within risky range. Knowing which noises can cause damage, such as jet engines, lawn mowers, motorcycles, chainsaws, powerboats, and personal media players is the best arsenal against NIHL.

“Risky noise,” says Coffin, “can come in the form of the pop of fireworks, the snarls of traffic, the buzz of lawn mowers, or the percussive tones of marching bands.”

According to Coffin, such sounds are typically within the range of 90 to 140 decibels, but any noise above 80 can cause long-term hearing damage. The maximum exposure time per day for the exposed ear is 8 hours at 90 decibels. The risk of noise-induced hearing loss depends on both the intensity and duration of the exposure. As intensity increases, the length of time for which the exposure is “safe” decreases. For example, exposure to 85 decibels (often produced by gas-engine lawn mowers) for 8 hours can be as equally damaging as exposure to 110 decibels (often produced by a chain saw) for only a few minutes. For every 5 decibel increase in volume, the maximum exposure time is reduced by 50 percent. Therefore, according to Sight and Sound Associates, the maximum daily exposure time at 95 decibels is four hours; at 120 decibels, seven minutes, 30 seconds.

Warning signs that exposure to hazardous noise has occurred or is occurring include: the inability to hear someone a few feet away, ear pain after leaving a noisy area, ringing or buzzing (tinnitus) in the ears immediately after exposure to noise, or hearing people talking but being unable to understand them.

Loud explosions that peak for a few milliseconds at levels greater than 130 to140 decibels may cause hearing loss. More often, however, hearing loss is caused by repeated exposure to noise above 85 decibels over long periods. Some sources of common noises and associated decibels are: lawn mower, 90 decibels; stereo headphones, 105-110 decibels; automobile horn, 110 dB; baby’s cry, 115 decibels; rock concert, 115-120 decibels; and firearms, 125-140 decibels.

The commercial popularity of portable media players with earphones, such as the iPod and similar devices, and their long-term use by consumers, increase the risk of NIHL in those users. According to the National Center for Health Statistics, almost 15% of Americans below the age of 19 suffer from some measure of hearing loss. And according to Sight and Hearing Association, the incidents of teenage hearing loss has increased 400 percent over a ten-year period, as found in a recent study of eighth graders.

Symptoms of NIHL

NIHL usually develops gradually. People may lose a significant amount of hearing before becoming aware of its presence. The first sign of NIHL is not being able to hear high-pitched sounds, such as the singing of birds, or not understanding speech when in a crowd or an area with a lot of background noise. If damage continues, hearing declines further, and lower pitched sounds become hard to understand.

Signs of hearing loss from unsafe sound exposure include the inability to comprehend somebody talking from two feet away, hearing muffled speech, experiencing pain or ringing in the ears following exposure, and needing others to speak louder in conversation.

People often fail to notice the impacts of unsafe exposure to noise because it causes few symptoms. Hearing loss is rarely painful. Symptoms may go away minutes, hours or days after the exposure to noise ends. Many people naturally assume that if the symptoms abate, their ears have recovered to normal. However, even in the absence of more symptoms, some cells in the inner ear may have been destroyed by the noise. Hearing returns to normal only if enough healthy cells are left in the inner ear. But if the noise exposure is repeated and more cells are destroyed a lasting hearing loss will develop.

Sensorineural Hearing Loss

When the hearing system is exposed to noise at a risky or hazardous level, mechanical and metabolic changes can occur. Scientific research, based on studies of industrial workers, as well as lab studies of humans and animals, have investigated the effects of noise on hearing.

In these studies, excessive noise stimulated cells in the inner ear, resulting in chemical processes that can exceed the cells’ tolerance. This damages cell function and structure and results in sensorineural hearing loss (as opposed to a conductive hearing loss, where the outer or middle ear have been affected) and tinnitus (ringing of the ears).

The sensory cells in the cochlea may recover from their damage (as you have possibly experienced after a loud concert or work with a loud machine). Usually, recovery from temporary threshold shift (or TTS) occurs quickly, largely disappearing in 16 to 48 hours after exposure to loud noise. However, if the hearing sensitivity does not recover within a few days, an irreversible and permanent threshold shift has taken place.

Prevention

Hearing loss is not reversible, but NIHL is preventable. Individuals vary in their susceptibility to hearing loss and hearing typically declines with age, but a healthy person who is not exposed to hazardous noises can enjoy normal hearing into his senior years.

Noise is probably the most common occupational hazard facing workers today. Employers at noise-hazardous workplaces, and physicians, are in a position to advise those at risk for developing NIHL that there are three simple keys to prevention:

1)      Understand what noises put them at risk – those above 85 decibels, commonly portable media players, lawn mowers, motorcycles, chain saws, jet engines, etc. A general rule of measurement is that if one has to shout to be heard an arm’s length away, assume the noise is above a hazardous threshold.

2)      If possible, decrease noise at the source – for example, keep the volume low on portable media players, purchase motorized equipment with an effective muffler, etc.

3)      Buffer loud noises with earplugs or other forms of hearing protection. These are known as hearing protective devices (HPDs) and are required by law to be labeled with a Noise Reduction Rating (NRR) based on performance obtained under ideal laboratory conditions. HPDs are powerful tools for preventing NIHL if worn correctly and throughout the duration of the hazardous noise. Also sound absorbing materials, such as floor mats, can help reduce noise.

Early identification is important in order to recognize the presence of NIHL and take steps to prevent further hearing loss. Those regularly exposed to hazardous noise in the workplace or elsewhere should have an annual hearing test. If hearing loss is developing, it might indicate under-protection and could suggest preventative measures, such as better HPDs or turning down the volume on the iPod

Dr. Peter J. Marincovich, Ph.D., CCC-A

Clinical Audiologist

Dr. Peter Marincovich earned his graduate degree in communicative disorders from Louisiana State University, and his Ph.D., in Audiology from the University of Memphis. A Santa Rosa native, Dr. Marincovich has practiced in his hometown since 1984. Dr. Marincovich works with patients of all ages and levels of hearing loss. He is also a frequent presenter at seminars and academic conferences. He holds specialized credentials in teaching the handicapped, and conducts courses at Santa Rosa Junior College. Dr. Marincovich is owner of Audiology Associates with offices in Marin, Santa Rosa and Mendocino.

References

ANSI (1996). American National Standard: Determination of occupational noise exposure and estimation of noise-induced hearing impairment. New York: American National Standards Institute, Inc., ANSI S3.44-1996.

National Institutes of Health (1990). Noise and Hearing Loss. NIH Consensus Development Conference Consensus Statement 1990, Jan 22-24; 8 (1).

National Institute for Occupational Safety and Health (1998). Revised Criteria for a recommended standard – Occupational noise exposure, U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication 98-126.

National Institute on Deafness and Other Communication Disorders (1999). Noise-Induced Hearing Loss. NIH Pub. No. 97-4233.

Occupational Safety and Health Administration (1983). Occupational Noise Exposure Standard. 29 CFR Chapter XVII, Part 1910.95.

Yattaw, M. (1999, July 21). Audiology doctorate among nation’s first. Ball State University News. Retrieved October 19, 2010, from http://www.bsu.edu/news/article/0,1370,-1019-1169,00.html

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Noise, Hearing Loss and Your Health

October 8th, 2010

By Kevin M. Liebe, Au.D., CCC-A
Doctor of Audiology
Columbia Basin Hearing Center
1149 N. Edison Street, Suite D
Kennewick, WA 99336
(509) 736-4005
www.columbiabasinhearing.com

Exposure to hazardous noise still remains one of the most common causes of irreversible hearing loss today.  The National Institutes of Health currently estimates that approximately 10 million Americans have suffered irreversible hearing loss due to noise, with another 30 million being exposed to dangerous noise levels on a daily basis.

For most people, the symptoms of Noise-Induced Hearing Loss (NIHL) tend to be subtle in the earlier stages.  Hearing loss begins to occur first for high-pitch sounds.  As a result, the bass or “volume” of speech appears unchanged, but the clarity of speech decreases.  The ability to communicate in the presence of background noise becomes increasingly difficult and can cause anxiety, stress and fatigue for the individual trying to understand speech.  Over time, communication even in quiet environments can become difficult for the affected individual if a person is not directly facing them when they speak.

While it is possible to obtain immediate hearing loss after exposure to a loud sound, most often NIHL is the result of repeated exposure to loud sounds over an extended period of time.  Prolonged exposure to sounds reaching or exceeding 85 decibels (dB) can result in permanent hearing loss.  The louder the noise, the less time an individual can be exposed before permanent damage will occur.  Beyond hearing loss, exposure to loud noise can even cause physical changes to occur in other parts of your body:  increased blood pressure, disturbed digestion, increased breathing rate, fatigue, irritability and sleeping difficulty.  A ringing or buzzing in the ears, called tinnitus, is one of the most common side effects and may become permanent.  When combined with exposure to various chemical compounds, such as those frequently encountered by industrial workers (vehicle exhaust, paint, organic solvents, etc), the damaging effects of noise can be increased.

NIHL is almost always preventable.  You can help prevent NIHL by:

  • Limiting the length of your exposure
  • Always wearing your hearing protection in the presence of loud noise
  • Advocating for hearing conservation programs with your employer
  • Having your hearing tested and monitored by a licensed Audiologist

Foam plugs are no longer the only option to preserve your hearing when you’re exposed to loud noise.  Advancements in hearing protection technology now allow customized hearing protection for a variety of applications, including military personnel, musicians, sport shooters and industrial workers.  In addition, for those parents concerned about their child’s exposure to loud music through personal music (MP3) players, a new type of earphones were recently released that have the ability to regulate the volume to prevent dangerous levels of sound from being produced. Kidzsafe Earbuds® are compatible with all types of MP3 players and will help ensure the music your child enjoys will stay safely below 85 dB, giving parents peace of mind.

Facts/figures:

 

110 dB

Exposure of more than 1 minute risks permanent hearing loss.

100 dB

No more than 15 minutes of unprotected exposure recommended.

85 dB

Prolonged exposure to any noise at or above 85 decibels can cause gradual hearing loss.

****(Table adapted from National Institutes of Health, 2010)***

How Loud is too Loud?
Decibels (dB) Noise Source
150+ Firecracker
120 Ambulance siren
110 Chain saw, Rock concert
105 Personal stereo system at maximum level
100 Wood shop, Snowmobile
95 Motorcycle
90 Power mower
85 Heavy city traffic
60 Normal conversation
40 Refrigerator humming
30 Whispered voice
0 Threshold of normal hearing

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Posted in Columbia Basin Hearing & Balance Center, Hearing Loss, Hearing protection, Kennewick, Kevin Liebe, Noise Exposure, Noise levels, Noise-induced, Ringing in the Ears, tinnitus, Uncategorized

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Now Hear this…. Are You at Risk for a Hearing Loss?

June 18th, 2010

By: Bettie Borton, Au.D., FAAA
Doctor of Audiology
Doctors Hearing Clinic
7025 Halcyon Park, Suite A
Montgomery, AL 36117
(334) 396-1635
www.doctorshearingclinic.com

Did you know hearing loss…

  • Is the third most prevalent chronic health condition in America, behind high blood pressure and arthritis?
  • Affects 36 million Americans (about 17% of adults)?
  • Is more common in men than women?
  • Costs our economy billions of dollars in lost wages and hidden costs annually?

Is not being adequately identified by healthcare professionals? Only 38 percent of adults ages 70 years and older and only 29 percent of adults ages 20 to 69 have had their hearing tested within the last 5 years!

Do you or someone you love have a hearing loss? If so, you’re not alone. Almost 20% of adults in the United States will develop hearing loss during the course of their lives, and if undiagnosed and untreated, its affects can be devastating. Impaired hearing can have a profound impact on emotional, physical, economic, and social well-being.  People with hearing loss have documented decrease in quality of life, reporting symptoms of depression, dissatisfaction with life, reduced functional health, and social isolation. Statistically, they have lower income levels, and frequently complain of frustration in relationships and various communicative situations, as well as inability to enjoy social situations, and fatigue. Despite the fact that most people with hearing loss can be helped with today’s state of the art amplification, many never seek help, or resist the use hearing aids or other assistive listening technologies.

The causes of hearing loss are varied and resultant impact on auditory capability may range from mild to pronounced. Sometimes the cause or etiology, such as wax build up in the external ear canal or an ear infection, is readily apparent. In other instances, the cause of hearing loss may be more obscure. Decreased hearing is often called “the invisible handicap”. Because hearing impairment (especially loss related to aging) often presents very gradually, those with significant hearing impairment can be unaware of their loss. Family members, significant others, co-workers and friends are frequently the first to notice communication problems related to decreased hearing sensitivity.

Given that 36 million Americans are faced with this “invisible handicap” what kinds of risk factors increase the likelihood that someone will develop hearing loss? Why do some people develop hearing loss and while others do not? Some risk factors are obvious, but others are much more obscure.

Perhaps the most widely recognized risk factor is aging. Presbycusis, or the loss of hearing that gradually occurs as we grow older, is a familiar scenario for those of us with older family members. In fact, about 30-35 percent of adults between the ages of 65 and 75 years have a hearing loss, while an estimated 40-50 percent of people 75 and older have a hearing impairment.

Loss associated with presbycusis is usually greater for high-pitched sounds, resulting in the frequent comment “I can hear people talking, but can’t understand them clearly”. It is most commonly binaural (in both ears), affecting the ears equally. Because this type of loss in hearing sensitivity is so gradual, people who have presbycusis frequently lose their frame of reference for normal loudness of sounds, and often do not realize that their hearing acuity is diminishing.

The resultant relationship dynamic is frequently the subject of jokes – “My husband suffers from ‘selective’ hearing and he’s driving me crazy”! In reality, however, hearing impairment is no laughing matter and can take quite a toll on communication with significant others. Research indicates that for couples where one person has unaddressed hearing loss, the divorce rate is actually significantly higher.

Most people would agree that we now live in a very noisy world. Noise levels for rock concerts, radios, motorcycles, traffic, industrial and lawn equipment, and even our personal listening devices constantly bombard our auditory system. It is not surprising that noise exposure is another one of the most frequently cited risk factors for hearing loss, and now rivals aging as the number one cause of hearing loss in this country.  Noise from occupational, recreational and sporting activities all pose significant hazards to hearing in the United States today. Firearm use is one of the biggest culprits in our area of the country. A single shot from a shotgun, experienced at close range, can permanently damage hearing.  Repeated exposures to loud machinery in the work place or as part of yard maintenance or recreational experience may, over an extended period of time, present a serious risk to hearing. Even something as seemingly benign as blow dryers for styling hair put hearing at risk.

Consider the noise levels for such activities as NASCAR, jet ski and power boat usage, and lawn equipment. The cumulative effects of these noise hazards and many others pose a serious risk for hearing. Noise exposure risk is a time weighted function – in other words, the longer the exposure time, the greater the risk, and lower the loudness level required to cause damage. According to the National Institute on Deafness and Other Communication Disorders (NIDCD), 10 million Americans have already suffered irreversible hearing damage from noise, and 30 million more are exposed to dangerous noise levels each day. A one-time exposure to hazardous noise resultant from gunfire or a rock concert, no matter how brief the time, of 120 dB or more can leave hearing permanently impaired. Prolonged exposure to only 85 dB (which can be generated by a commonly used appliance such as a blow dryer or hand held power tool) can do the same. 

Children and young adults are bombarded with potentially damaging noise exposure, most of which is easy to overlook. Most people intuitively recognize that “boom boxes”  IPODS, and other personal listening devices, if played too loudly, constitute a risk to hearing. However, consider the noise levels inherent to playing in a school band or orchestra. Students engaged in this commonplace activity spend hours practice in noisy environments within the context of their academic activities, yet many of them are not wearing appropriate ear protection, nor are schools effectively addressing this problem. To complicate matters, for reasons that are not fully understood some people are more susceptible to noise exposure than others.  As an example, research indicates that those with blue eyes are more prone to noise exposure than those with darker eye color!

Aging and noise exposure are two rather obvious risk factors for hearing loss, but there are many other factors that are more insidious. Studies suggest that there is a strong genetic component inherent to hearing loss, both for childhood deafness as well as presbycusic loss. If your parent or grandparent had hearing loss, your risk factor for developing a similar impairment may increase. If you had a relative who was hearing impaired from birth, family members of child bearing age need to be mindful of this risk factor, and be particularly vigilant with regard to insuring that the newest members of the family are effectively screened at birth for hearing sensitivity.

Various diseases of the ear certainly pose risk to hearing sensitivity. Ear infection, otosclerosis (a bony growth in the middle ear cavity), Meniere’s Disease, acoustic neuroma (a tumor on the auditory nerve), and a host of other maladies are obvious risk factors for hearing loss. But did you know that hearing loss is about twice as common in adults with diabetes compared to those who do not have the disease, according to a new study funded by the National Institutes of Health (NIH)? Visual deficits have long been associated with diabetes, but hearing loss is an under-recognized complication. Because of the strong correlation between diabetes and hearing loss, The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), recently suggested that people with diabetes should consider having their hearing tested.

Use of common drugs such as antibiotics, aspirin, diuretics and chemotherapy can cause hearing loss. Typically, hearing loss from ototoxic drugs is high frequency, which often results in the hearing impairment less obvious to those it affects. All radiation and chemotherapy patients should insist on baseline hearing assessments before, during, and following their course of treatment to insure that auditory effects of ototoxic interventional strategies are carefully monitored and treated.

Race and gender also play a role in hearing loss risk factor determination. Researchers now know that compared to women, men are five and one half times more likely to have hearing loss. White and Mexican American men have a higher incidence of both high-frequency hearing loss and hearing loss in both ears than blacks, who were 70 percent less likely than white participants to present with hearing loss.

With the dramatic increase in airbag use, motor vehicle accidents (MVA’s) are common culprits for increased risk of hearing loss. In fact, 17% of those involved in MVA’s with airbag deployment will have permanent loss of hearing as a result. Other insidious risk factors for hearing loss include smoking and cardiovascular disease. The incidence of hearing loss is significantly more pronounced among smokers, as well as those with any type of cardiovascular disease.

Many healthcare professionals simply don’t make these associations, and as a result, do not refer patients for hearing evaluation as often as risk factors might dictate. So, the message is be aware, and be proactive in assessing your risk, or that of your loved one, for hearing loss. For a comprehensive audiometric evaluation, see a Board Certified Doctor of Audiology. If you’ve never had a baseline audiogram, it’s certainly in your best interest to do so. Only 38 percent of adults ages 70 years and older and only 29 percent of adults ages 20 to 69 have had their hearing tested within the last 5 years.   If you’re over 65, hearing evaluation each year by a Board Certified Audiologist should become part of your annual medical maintenance program.
(Sources: BHI, NIDCD, ABA)

Dr. Bettie Borton is a Board Certified Doctor of Audiology, and a nationally recognized expert in hearing healthcare. She has more than 30 years’ experience diagnosing and treating hearing impairment in children and adults. Dr. Borton has served as the President of the Alabama Academy of Audiology, National Chair of the American Board of Audiology, and currently serves on the National Board of Directors for the American Academy of Audiology.

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