Hearing loss from noise is a serious public health problem:
More than 26 million U.S. adults have noise-induced hearing loss from work or
recreational activities, and research shows evidence of early noise-induced
hearing losses among teens.
And yet—noise-induced hearing loss is nearly always
Protecting people from noise-induced hearing loss is one of
the most important things ASHA members can do. We should not leave hearing loss
prevention up to the relatively small group of audiologists who specialize in
this area. We need everyone's help!
ASHA and other professional organizations list hearing loss
prevention among an audiologist's primary responsibilities. Audiologists are uniquely qualified to raise awareness about hearing risks, organize public health campaigns, promote healthy hearing behaviors, implement intervention programs and monitor progress in prevention. We can help shape people's knowledge, attitudes, beliefs and behaviors related to safe hearing practices.
But don't panic—many of these activities can be incorporated into work that we already do every day.
- Raise awareness of noise risks. Make sure your patient
history form includes questions about modifiable risks to hearing: workplace
exposures, noisy hobbies and music habits, for example.
- Make it real. Keep a few inexpensive sound level meters on
hand (a quick Internet search will identify several models in the $25–$80 price
range) to lend to clients to measure the sound levels of their daily
activities. Or download smartphone apps that measure noise. The National
Institute of Occupational Safety and Health and others are studying the
accuracy of these apps, but they are sufficient for raising awareness. Discuss
potential noise risks with clients when they return the meters, and recommend
appropriate hearing protection as needed.
- Learn about protection. Become familiar with the various
types of hearing protection available, including basic devices such as earmuffs
and earplugs, as well as more sophisticated protectors such as flat attenuation
devices (great for musicians) and non-linear devices (useful for hunters).
- Match protection to the user. When you recommend hearing
protectors for a client, use the same individual considerations that factor
into hearing aid recommendations. Consider the labeled noise reduction rating
(which generally overestimates the level of protection obtained by an average
user) as well as other issues such as comfort, convenience, communication needs
and cost. Most noisy environments require only a moderate amount of attenuation
to reduce exposures to safe levels.
- Give appropriate instruction. Individual training in the use
and fit of the devices is usually more important for obtaining adequate
protection than the labeled attenuation rating. Take just a few minutes to give
practical instructions—this essential service can be very effective at
preventing noise-induced hearing loss.
- Verify hearing proctor fit, just as you would verify hearing
aid fit. Several field attenuation estimation system products are available,
including Fit-Check, Ear Fit, VeriPro, WellFit and Safety Check. These portable
systems are priced within the budget of most audiology practices. The devices
provide immediate feedback on the user's level of protection, making them helpful to audiologists fitting the protection and to clients learning to use it. There is a billing code for hearing protector fit-testing (CPT 92596; Common Procedural Terminology © American Medical Association), though insurance coverage varies.
If you have time to stretch outside your usual practice,
consider doing public health outreach. Simple activities—distributing earplugs
at noisy sporting or entertainment events, writing letters to newspapers or
public officials about community noise, or blogging about promoting healthy
hearing behaviors—can make a big impact on public awareness about noise and its
Be proactive about identifying community events that may
involve hazardous exposures and propose strategies to minimize risks to
hearing. You can even use these activities as an alternative to marketing or
advertising by providing visibility for your audiology practice at the same
Also consider presentations to local schools or community
groups about noise hazards and hearing loss prevention. Many organizations have
ready-made materials for such efforts. For example, Dangerous Decibels has developed a classroom program and supplemental
activities to educate children about protecting their hearing. ASHA has the
"Listen to Your Buds" campaign and the National Institute on Deafness and Other Communication Disorders has the "Wise Ears" campaign. You can tailor ideas and information from these initiatives for specific audiences. You may even be able to obtain
funding from local businesses or charities to support these efforts.
Hearing professionals have an obligation to promote the
prevention message. With at least 20 percent of Americans having some degree of
hearing loss, and many more affected by the hearing loss of family and friends,
we have the opportunity to break this cycle and eliminate at least some of the
preventable hearing losses.