Hearing loss is the third most common chronic physical condition in the United States. Approximately 40 million Americans report they have trouble hearing, including nearly half of people over 75. With so many lives affected, it’s important to understand the causes of hearing loss and what, if anything, can be done to reduce its negative impact on quality of life.
Aging
Age related hearing loss, also known as Presbycusis, often runs in families. Changes in the middle ear and complex changes along the nerve pathways between the ear and the brain play a role in its progression. Because the damage occurs over time, gradually worsening as we age, many of us don’t even realize the severity of our loss.
There are also a variety of conditions more common in older people, such as high blood pressure and diabetes that are associated with hearing loss. And while we don’t yet know how to prevent age-related hearing issues, there are steps you can take to catch it early or slow its progression –starting with an annual screening starting with a baseline test in your early fifties.
Exposure to loud noises
The ear is a highly sensitive organ and can be easily, and permanently, damaged by excessive noise within just a few minutes. Repeated exposure over time can significantly impact how quickly you might develop a hearing problem.
Normal conversation is measured at around 60 decibels (dB). Any sound over 70 dBs experienced over a period of time may start to affect hearing. This includes the sounds of traffic and even household appliances. The louder the noise the quicker the damage to the ear. Loud concerts and machinery are major culprits. Other situations that can affect hearing include close proximity to leaf blowers and lawnmowers, motorcycles, firearms, loud stereos, sirens or even people shouting. These sounds can reach 110 dB, or more, and result in hearing damage within two minutes or less.
Noise related hearing loss occurs when we damage the sensitive structures inside the ear. The average person has about 16,000 hair cells in their cochlea at birth. These cells send sound signals to the brain. Loud noises cause these hair cells to bend which results in temporary hearing loss. However, over a few days, the cells straighten again and return to normal. But with repeated exposure, these cells can die in the process resulting in permanent damage. This is why hearing protection is a must in any situation where loud noises occur.
Disease related hearing loss
There are a number of infectious diseases that may affect the auditory nerve or damage the sensitive hairs inside the ear. These include meningitis, mumps, chicken pox, STDs, COVID and cytomegalovirus. A virus can even cause hearing loss in unborn children, though the severity may not be detected until a child is tested at 6 to 12 months of age.
Localized hearing infections can also lead to hearing loss due to fluid buildup behind the ear drum. Fortunately, permanent hearing loss in this instance is rare and hearing usually returns to normal a few days after the infection clears.
Chronic health conditions such as high blood pressure, cardiovascular disease and elevated blood sugar levels from diabetes can also affect our hearing. As more and more comorbidities are associated with hearing loss, it’s important to make regular hearing tests an important part of your overall health care.
Medications
Some medications such as chloroquine and quinine, aminoglycosides, diuretics, and chemotherapy drugs have been associated with hearing loss or tinnitus (ringing in the ears). Theresult can be temporary or permanent hearing loss.
Surprisingly, common pain relievers including aspirin, naproxen and acetaminophen may also cause hearing loss. This can occur when high doses of these medications are taken for extended periods of time. When taken in normal doses this risk is very low.
Science is still learning about the connections between many of these medications and our hearing. All the more reason to consult with your physician when you take them and report any changes in your ability to hear.
Genetics
Of the babies born with hearing loss, 50-60% of the causes are genetic. This can be due to abnormalities in the formation of ossicles (tiny bones in the middle ear), malfunction of the cochlea or auditory nerve, or central dysfunction of the cranial nerve, auditory brainstem, or cerebral cortex.
Currently, there are more than 25 genes associated with genetic hearing loss. Prospective parents can choose to screen for congenital abnormalities or receive genetic counseling to determine the potential risks.
Ignoring your hearing health
Ongoing hearing care is important to hearing health and there are many steps you can take to protect it. Talking to your physician about the risks of hearing loss, possible lifestyle modifications, and medication compliance is a great place to start. Make sure a hearing screening is part of every annual exam. Protect your ears from prolonged exposure to loud noises. And, above all, don’t ignore even the slightest signs that your hearing isn’t what it used to be.
Early, and ongoing, attention to your hearing health can help you protect one of the most remarkable, and valuable, human traits – your ability to listen, communicate and enjoy all the wonderful sounds in the world around you.
