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 adequately identified by healthcare professionals?
Only 38% of adults ages 70 years and older and 29% of adults ages 20–69 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 U.S. 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, frequently complain of frustration in relationships and various communicative situations, an 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, such as wax buildup in the external ear canal or an ear infection, is readily apparent. In other instances, the cause of hearing loss might 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 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% of adults between the ages of 65 and 75 years have a hearing loss, while an estimated 40–50% 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 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 U.S. 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 workplace 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 blowdryers for styling hair can 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 the 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 of 120 dB or more (no matter how brief the time) can leave hearing permanently impaired. Prolonged exposure to only 85 dB (which can be generated by a commonly used appliance such as a blowdryer or handheld 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 stereos, 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 practicing 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 and 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 ensuring 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 hearing impairment less obvious to those it affects. All radiation and chemotherapy patients should insist on baseline hearing assessments before, during, and after their course of treatment to ensure 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 a 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 African Americans, who were 70% less likely than white participants to present with hearing loss.
With the dramatic increase in airbag use, motor vehicle accidents (MVAs) are common culprits for increased risk of hearing loss. In fact, 17% of those involved in MVAs 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 to 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% of adults ages 70 years and older and only 29% of adults ages 20–69 have had their hearing tested within the last 5 years. If you’re over 65, a yearly hearing evaluation conducted by a board certified audiologist should become part of your annual medical maintenance program.
(Sources: BHI, NIDCD, ABA)
