Prevention of hearing loss

Prevention of the auditory effects of noise. The hearing pain threshold (120 decibels) is higher than the danger limit (85 decibels); consequently, it is of vital importance that a preventive behavior be put in place as soon as one finds oneself exposed to a level of more than 85 decibels. For information, as long as the noise level allows for a normal conversation, this level is below 85 decibels. When one has to yell to communicate, the existing noise exposure may pose a risk to hearing.

Presbycusis: what is it?
Presbycusis is probably the most frequent cause leading to deafness in adults over 50.
It corresponds to the continuing decline of hearing generated by the ageing process of the hearing system. It particularly results from a gradual and continuous reduction of the number of cochlea cells. The resulting loss is bilateral and symmetrical.
What are the warning signs?
• Difficulties of comprehension when in noisy environment
• Increase of TV and radio audio loudness experienced by the person's circle of family and friends
Most of the time, presbycusis develops when about 60 years old but may occur before due to genetic links. It exacerbates the other factors responsible for the decline in hearing:
 Chronic otitis
 Ossicles damage
 Noise trauma
Presbycusis is not the only sign for auditory impairment, and it is often associated with tinnitus.
Tinnitus: what is it?
Tinnitus (ringing or roaring in the ears) describes noises heard by a person without the person’s circle of family and friends hearing them or even without the emission of such sounds.
Tinnitus may:
• be the symptom of hearing system pathology,
• take place after:
 A sound trauma,
 A barotrauma (decompression thickness when in a plane or diving)
 An emotional trauma
Tinnitus may be mitigated by:
 Drug treatment used for other therapies which may alleviate effects (vasodilators and anxiolytics)
 Wearing a prosthesis generating white noise may significantly reduce tinnitus perception.
 Behavioral and cognitive therapies.
 Alternative medical therapies (acupuncture, homeopathy, …).
Tinnitus affects 15% of the population at one point in life and 30% of the elderly population.
What are the main contributory factors in hearing impairments?
Noise harmfulness is related to:
• The duration of the exposure
• The frequency (acute noises are more harmful)
• The intensity
In addition, the factors will vary depending on the host, his age and his ENT medical history.
The accepted harmfulness noise level is of 85-90 dB over a period of 8 hours per day.
How can hearing impairment be prevented?
Hearing impairment treatment calls for prevention, early detection, illness management and rehabilitation.
• Reducing noise exposure (occupational and recreational), thanks to:
• Individual noise protection devices (anti-noise stoppers, headbands or hearing protections)
• Noise control (reflected sound waves absorption, sound waves propagation reduction).
• It is highly advisable to reduce the surrounding noise to a minimum and to educate children so that they maintain their hearing assets.
When to call for a visit?
Seeing one’s GP is mandatory when considering an ENT check-up, to be carried out with an ENT specialist as soon as the first symptoms develop:
• Difficulties of comprehension when in noisy environment
• Increase of TV and radio audio loudness experienced by the person's circle of family and friends
What can the ENT specialist do?
His diagnosis relies, first of all, on a clinical examination investigating each circumstance relating to the first signs of discomfort and to their evolution.
The ENT specialist will then carry out additional examinations (hearing tests):
• Tonal audiometry in order to obtain a quantitative measurement of each ear’s hearing and to corroborate patient’s deafness or decline in hearing
• Vocal audiometry, based on tests, in order to assess your hearing and understanding abilities when listening to a normal conversation.
The doctor may then prescribe a hearing aid as soon as you may feel uneasy when having to communicate within a group.
A hearing aid, when put in place at the first signs, will help partially compensate for such a decline in hearing. These devices must be used on a daily basis and often necessitate an adjustment period.
Hearing rehabilitation and learning lip/speech reading with the assistance of an orthophonist may effectively reinforce hearing aids use.
How can I protect and improve my hearing?
Some key points:

 Do not place yourself, when in a live venue, where the noise is at its highest level.
 Use hearing protection systems (earplugs) as soon as the noise level is high.
 Go see a doctor as soon as you are facing comprehension difficulties or when you hear ringing not noticed by your circle of family and friends.
 Be patient when using hearing aids and prosthesis as you will need time to adapt.

Date: 06/04/2013
Author: Sylvie ERVE
Organization: centich
Only for Members: No
Content type: Good practises
Tags: audition, prévention
Categories: Medical & Functions, Ear - Hearing imp