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Articles | Hearing Loss

A Complete Guide to Noise-Induced Hearing Loss

Noise induced hearing loss sticky notes on audiologist desk

Think about your favorite sound in the world. Is it waves on the beach? Your child’s laughter? Live music? What would you do to keep your ability to hear that sound? Would you turn down the volume or wear earplugs around loud noises?

The National Institutes of Health estimates that 12.5% (5.2 million) of Americans between the ages of 6 and 19 have permanently damaged their hearing from excessive exposure to noise. For adults between the ages of 20 and 69, that number jumps to 17%, or 26 million.

Additionally, the World Health Organization (WHO) estimates that 1.1 billion teenagers and young adults around the world are at risk for hearing loss from unsafe use of audio devices or from exposure to dangerous sound levels at places like nightclubs or sporting events.

But there is good news: noise-induced hearing loss (NIHL) is easily preventable.

What is NIHL?

Physically, NIHL is caused by the damage done to the delicate hair cells inside the ear due to excessive exposure to noise. These hair cells allow your auditory nerve and your brain to work together in order to process sounds. Unlike bird or amphibian hair cells, human hair cells can’t grow back if they’re damaged or killed. Once they’re gone, they’re gone forever.

NIHL can affect you in many ways. It can happen suddenly, after a single incidence of loud noise exposure, or it can build up over time. It can be temporary, or it can be permanent. It can affect one ear or both ears.

What’s more, losing some of your hearing range isn’t the only danger that comes with loud sound levels. Tinnitus, a ringing or buzzing in the ears, is also a common effect. Sometimes noise-induced tinnitus goes away as the ears recover, but sometimes it doesn’t.

All noise-induced damage to the ears, whether injury to hair cells or tinnitus symptoms, is cumulative. This means that if you do a little damage on several separate occasions, each of those pieces of damage never goes away; they add up until the effects are constantly noticeable and disruptive.

Why is NIHL an important topic?

In the WHO’s study of middle- and high-income countries, they found that nearly 50% of all teenagers and young adults put themselves at risk for NIHL with personal audio devices and 40% risk it with damaging volumes at entertainment venues. That’s a lot of young people who might permanently damage their ears.

Even just a little bit of NIHL (or any kind of hearing loss, for that matter) can have significant, negative effects on other aspects of life. Speech, language acquisition and comprehension, communication, learning, and social development are all affected. For young adults, such damage to the ears not only causes noise-induced hearing loss, but also accelerates the process of age-related hearing loss later in life.

Untreated hearing loss has also been linked to other health concerns like heart disease, diabetes, cognitive decline and dementia, and depression.

Tinnitus also presents significant health concerns. Focusing and thinking about the constant symptoms can make people annoyed, depressed, anxious, or angry. It can present an obstacle to concentration. Tinnitus can also interrupt sleep and get in the way of hearing abilities.

With so many people affected and so much at stake, NIHL education and prevention is more important than ever.

Which noises are safe and which are not?

Noise level is measured in units called decibels. Sounds less than 75-80 decibels (the noise level associated with 60% volume on most personal listening devices) are safe for your ears, even after long and repeated exposure. You can listen to them all day, every day and not incur any damage. However, sounds above 85 decibels (the noise level of a typical lawnmower) are not safe.

The safe limit for sounds at 85 decibels is 8 hours of exposure. The louder the sound, the shorter the acceptable length of exposure time. A 100 decibel sound is only safe for a maximum of 15 minutes.

The average noise exposure during the World Cup in 2010 was 100.5 decibels. Personal audio devices, like smartphones or MP3 players, allow headphones to play music as high as 136 decibels. The WHO indicates that many people choose set their headphone volume between 75 and 105 decibels.

Use this handy infographic to see which everyday sounds are safe for your ears and which are not.

Decibel Level Infographic

What are the signs of existing NIHL?

If your ears are ringing or muffled after a concert or exposure to other loud noises, your hearing has been permanently damaged. As stated above, these effects are cumulative and should not be taken lightly. If you find yourself in this situation, take care to protect your hearing in the future.

A single incidence of very loud noise has the power to create sudden noise-induced hearing loss. However, for most people the damage is more gradual. You might not notice it right away, or it might be tempting to hope that the effects will go away on their own. Be on the lookout for these warning signs:

  • Sounds have become distorted or muffled
  • You can hear people, but you can’t quite understand what they’re saying
  • You can’t hear or understand speech from 3 feet away or farther
  • You have to turn the volume up more than others do in order to hear it as well as they can

If you experience any of these effects, you should get your hearing checked by a hearing health professional as soon as you can.

How can NIHL be prevented or kept from getting worse?

NIHL is preventable, which is great news. If you take proper care with music volume and use prevention measures in noisy environments, you should be able to continue hearing your favorite sounds for a long time.

Here are some options to protect your hearing:

  • Wear earplugs: When you’re going to be at live concerts, sporting events, or night clubs, don’t leave the earplugs at home. You should also wear ear protection when you’re going to be doing yardwork, shooting a gun, or spending time around other noisy machinery and events. For only a few dollars, earplugs can reduce the level of loud sounds by 20-30 decibels (and you’ll still be able to hear the concert!). Often, you can also get a custom-fitted pair from your local hearing healthcare provider.
  • Follow the 60/60 rule: When you listen to music with a personal audio device, listen at no louder than 60% volume for no more than 60 minutes a day. Here’s a tip: many smartphones allow you to set a volume cap that’s lower than the phone’s actual sound capability. Put this at 60% so you don’t have to worry about it in the future.
  • Choose over-the-ear headphones: Earbuds are much more dangerous than over-the-ear headphones because they sit very close to the eardrum. It’s safer to opt for the kind that sit over your ears when possible.
  • Take advantage of smartphone apps: Many smartphone apps will monitor the volume level of your smartphone for you. They can warn you if you’re listening too loudly or prevent you from turning it up to unsafe levels.
  • Use musicians’ earplugs: High fidelity earplugs, also commonly called musicians’ earplugs, are fancy little things. They reduce sound levels while maintaining, as closely as possible, the quality of the original sound. They can be useful outside the music scene, of course, but they are most commonly used by members of bands and other people who want a true concert experience without risking their hearing ability.
  • Take a break: When you’re at a nightclub, concert, or sporting event, try to give your ears a break from the noise every so often. This allows the ear’s hair cells to recover from the stress that’s been put on them and can prevent permanent damage.
  • Give your ears time to recover: Research suggests that you need 18 hours of quiet after a night out at a night club or other loud environment in order to truly let your ears recover from the stress.

Do your future self a favor: follow these guidelines and lower your risk for NIHL dramatically.

It’s also recommended that you monitor changes in your hearing health by getting annual hearing tests, just as you get annual vision and dental exams. To get started, you can find your local hearing health provider here.


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Put Your Hearing to the Test

Sometimes, hearing loss happens so gradually that it can be difficult to notice at first. However, there are some common signs that indicate you may have hearing loss. Want some answers now? Take this short survey to determine if it's time for you to make a hearing appointment.

Take a 3-minute hearing test!

Read the following statements and select “yes” if they apply to you most of the time, “sometimes” if they apply once in a while, and “no” if they don't apply at all.

I have trouble hearing the other person on the phone.


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