Teens need to wear hearing protection now for a lifetime of listening enjoyment
Exposure to loud music may be a leading cause of hearing loss in teens--and it is preventable. That's the message that Boston-area audiologist Joan McCormack is working to convey. "I think healthy hearing habits should be included in high school health classes. We insist that kids wear seat belts and go to the dentist, but we ignore protecting their hearing," says McCormack, a doctor of audiology at Atlantic Hearing Care in Swampscott, Mass.
As part of her education efforts, McCormack brings a mannequin named Decibelle, who is equipped with a sound-level meter and microphone in her ear, to test the volume levels of personal listening devices at health fairs and local high schools. Decibelle is based on the work of the Dangerous Decibels Education Project, of the Oregon Hearing Research Center at the Oregon Health and Science University in Portland. "Today's devices [iPods, iPhones, MP3 players, etc.] have longer battery
lives and greater music storage than ever before, so many kids listen for several hours a day," says McCormack. The longer exposure increases the risk of hearing loss, she says.
In a 2010 study published in the Journal of the American Medical Association, researchers found a 31 percent increase in teenage hearing loss. The study compared teens in 2005 and 2006 to teens tested from 1988 to 1994. According to the research, called the Third National Health and Nutrition Examination Survey, the results show that "one in five U.S. adolescents 12 to 19 years old demonstrated hearing loss."
That means 6.5 million teens now have hearing loss. Much of that hearing loss was slight, but the trend is troubling because it can be indicative of a more profound hearing loss later in life. "Clearly the increased use of personal listening devices has contributed to this unprecedented rise," McCormack says.
Protect Your Ears
Consider these survey results reported by the House Research Institute, a nonprofit organization based in Los Angeles:
About 80 percent of teens had never received information about noise-induced hearing loss.
Nearly 200 teens reported their typical listening volume levels as "medium to high" because they like the sensation of tuning out the world via total immersion in music.
More than half of U.S. high school students report having at least one symptom of hearing loss.
The National Institute on Deafness and Other Communication Disorders (NIDCD), part of the National Institutes of Health in Bethesda, Md., is working to reverse the trend of increased hearing loss in teens. Gordon B. Hughes, M.D., the program director of NIDCD's Clinical Trials Division of Scientific Programs, suggests teens follow these three steps in this order to protect their hearing:
First, turn down the noise at the source. Second, remove yourself from the source. And third, wear ear protection.
Ear protection should be adequate for the noise intensity, comfortable enough to encourage routine use, and available instantly when needed. In ascending order of protection from mild noise to loud noise, protection includes earplugs, custom-fitted ear molds, and earmuffs (headphones). Earplugs can be free-form foam, putty, rubber, or custom-fitted. (See sidebar, "Earplugs 101," page 17.)
Noise from motorcycles, loud car stereos, target practice, video games, hair dryers, power tools, loud machinery, and even the noise from crowds at sporting events can cause possible ear damage without protection.
Wearing hearing protection is recommended in any loud, noisy environment, and also when loud music is present, such as at a dance or live concert; from marching bands and amplifiers; or at band practice.
When Loud Is Too Loud
High school junior Denny Cha, of La Crescenta, Calif., was thankful for having hearing protection when he worked as a volunteer during the 2010 World Cup season at the Los Angeles Korean Radio Center.
"The place was full of loud music and screams," Cha says. He says the volume hurt his ears, but when he took out his earplugswhich he carries all the timeand put them on, he felt better immediately and wasn't bothered by the noise, unlike some other volunteers who didn't have hearing protection.
A good rule of thumb is that if the decibel level is above 85 decibels (dB), wear hearing protection. How do you know what is above 85 dB? If you can hear the music from someone else's headphones or if you have to shout to be heard, then it's probably too loud.
But because different types of earplugs and headphones convey sound differently, the converse is not true. Just because you can't hear music the same distance away does not mean that it is definitely at a safe level. Another test is whether the person listening to music can easily hear a conversation over the music coming from the headphones. If not, the music is probably too loud.
The risk of damage to hearing depends on the duration and intensity of the exposure. For example, someone exposed to a gas-engine lawn mower (85 dB) for eight hours may be equally at risk as someone using a chainsaw (110 dB) for only a few minutes. "Both should use hearing protection," McCormack says.
After exposure to high decibel levels, hearing loss initially may only be temporary, with hearing returning to normal after several hours or days. If exposure occurs repeatedly, the ears will eventually lose their ability to bounce back, resulting in permanent hearing degeneration, explains Kathy Peck, the executive director of Hearing Education & Awareness for Rockers (HEAR), based in San Francisco. Founded in 1988, the organization is dedicated to the prevention of hearing loss and
tinnitus among musicians and music fans through education and grassroots advocacy.
During educational visits with people in the music business, Pecka former punk musician whose hearing was damagedscreens the "rockumentary"
"Listen Smart: Safely Handling the Power of Sound." The 15-minute DVD features interviews with some of today's most popular musicians across a range of genres (including Ozzy Osbourne, Metallica, Wyclef Jean, Blondie, and Moby) along with hearing health experts as they talk about the kinds of long-term hearing damage that can occur when music and other sounds are played too loudly.
The NIDCD is also committed to providing information on healthy hearing habits. In October 2008, NIDCD launched "It's a Noisy Planet: Protect Their Hearing," an educational campaign targeted at "tweens," or children ages 8 to 12. (Deafness Research Foundation [DRF], publisher of this magazine, is a partner in the campaign.) The campaign aims to increase awareness of the causes and prevention of noise-induced hearing loss. Tweens are the focus because children at this age are becoming more independent and developing their own attitudes about health, listening, leisure, and work habits. (Recognizing the importance of directly reaching pre-teens, DRF will be launching an education program in New York City this fall called Safe and Sound. To learn more, see page 6.)
How Hearing Loss Happens
Each inner ear has roughly 30,000 tiny hair cells arranged by frequency or pitch, like on a piano keyboard, to help you hear the nuances of sound. Very loud sound causes physical and metabolic changes that literally bend or break these hair cells. They do not repair themselves. This causes sensorineural or "nerve" hearing loss.
Usually the hair cells that respond to soft high frequency sounds are damaged first. This has a tremendous impact on listening to words because many consonant sounds are soft and high pitched, like the sound of /s/ or /sh/. This occurs when people say they can "hear but not understand" because sounds are missing. This also results in complaints of difficulty hearing in a crowd or background noise, says McCormack. Currently there is no treatment to reverse noise-induced hearing loss, but
research (funded in part by DRF) that focuses on regenerating hair cells shows promise and is under way.
The first sign of hearing damage is usually tinnitus. "If your teen comes home from band practice or a school dance complaining that his or her ears ring, you should have their hearing checked," McCormack says. If a teen is doing poorly in school or asking 'What?' frequently, it makes sense to see a hearing healthcare professional for a hearing test and education about using hearing protection, she adds.
According to NIDCD's Hughes, other signs that hearing damage may have occurred are feelings of new pressure or pain in the ear, a perceived drop in hearing ability when removed from a noisy area, and new, measurable, nervetype hearing loss that affects the ability to hear high tones.
The NIDCD estimates that approximately 15 percent, or 26 million, of Americans between the ages of 20 and 69 have high-frequency hearing loss due to exposure
to loud sounds, noise at work, or in leisure activities. HEAR's Peck says that hearing loss in adolescents may also result from head injuries and certain infections, such as meningitis or otitis media, a middle-ear infection common in young children.
Volume Control
Researchers and sound engineers have measured the average loudness of iPods at different volume levels. Listening at 50 percent of the volume generally measures under 85 dB and is considered safe for an unlimited time. Increasing the volume to 80 percent averages 98 dB and about 90 minutes daily would be considered a safe daily noise dose (provided there hasn't been exposure to any other noises over 85 dB that day).
Listening at full volume is not safe for any length of time. "We don't want to limit anyone's time enjoying music, we just want to limit the volume," McCormack says. Peck advises taking a five-minute break every 15 minutes.
While improvements in technology have added to the problem of hearing loss, they are also helping to protect hearing. In 2006, iPod maker Apple released a software update to allow parents to set a maximum volume on iPods and lock them with a pass code. This measure was taken in response to a lawsuit alleging potential hearing loss from iPod use. The European Union recently updated its restrictions for music players, limiting the maximum volume to 80 dB.
There are several applications for the iPhone, such as Studio Six Digital's SPL, that measure sound levels. "I have used my iPhone to measure sound levels and help instructors adjust music levels at the exercise classes at my gym," McCormack says.
Teens are notorious for taking the short view, a "who, me, worry?" stance toward long-term health problems. Some teens who have contacted HEAR already think their ears are shot, so they question why they should start wearing hearing protection. HEAR's Peck says she tells them, "To save what's left, hopefully. Even if your ears are fine it is always wise to protect your ears to help ensure the longevity and the quality of your hearing."
