Noise-induced hearing loss: causes, prevention and what helps

RNID explains that noise-induced hearing loss is caused by being around very loud sounds. It can result from exposure to a single very loud sound, or from exposure to loud sounds over a long time, and the louder the sound is, the less time it takes for the damage to occur. Noisy situations include noisy workplaces, listening to loud music and loud bursts of sound such as gunshots or explosions.

The damage happens in the cochlea. The charity says loud noises can damage the sensitive hair cells in the cochlea, which leads to permanent hearing loss. Because the effect builds slowly it is easy to underestimate, and people often notice only years later.

RNID says that if hearing loss is caused by noise exposure there is first a dip in hearing in the high frequencies, meaning you cannot hear high-pitched sounds as well as lower pitches. If the exposure carries on, this dip spreads and affects both lower and high frequencies. You might then find it difficult to follow conversations over background noise, or hard to hear what someone is saying even in a quiet room.

Some people experience tinnitus as the first sign. The NHS describes tinnitus as hearing noises that do not come from an outside source, which can sound like ringing, buzzing, whooshing, humming, hissing, throbbing or music, in one or both ears or in the head. The NHS’s general hearing loss page lists difficulty hearing other people clearly, asking people to repeat themselves, turning up the volume and finding it hard to follow a conversation among the common signs.

• Difficulty hearing high-pitched sounds and speech clarity, especially in noisy places.

• Ringing or other noises in the ears (tinnitus), sometimes after loud events.

• Needing the TV or music louder than other people do.

• Feeling tired or stressed from the effort of listening.

RNID gives a practical test: in a real-life situation, you should be able to talk to someone 2 metres away (about 6.5 feet) without having to shout over background noise. If you cannot be heard over the background sound, noise levels could be hazardous. If you go somewhere where the sound level hurts your ears, you should leave.

The Health and Safety Executive (HSE) sets formal levels for work. Its description of the Control of Noise at Work Regulations 2005 says the level at which employers must provide hearing protection and hearing protection zones is 85 dB(A) (daily or weekly average exposure), the level at which employers must assess the risk to workers’ health and provide them with information and training is 80 dB(A), and there is an exposure limit value of 87 dB(A), taking account of any reduction provided by hearing protection, above which workers must not be exposed.

HSE says the aim of the Noise Regulations is to ensure workers’ hearing is protected from excessive noise at work, which could cause them to lose their hearing or suffer from tinnitus. It notes that the 2005 regulations require health surveillance (hearing checks) for workers regularly exposed above 85 dB(A), and that many thousands of people are exposed to loud noise at work that may be a risk to their hearing.

HSE adds that the regulations do not apply to members of the public exposed to noise from non-work activities, or when they make an informed choice to go to noisy places. If you believe your hearing is being put at risk at work, you can raise it with your employer or safety representative, and HSE publishes advice for workers.

The NHS says to see a GP if you think your hearing is getting gradually worse. It advises asking for an urgent GP appointment or contacting NHS 111 if you have sudden hearing loss in one or both ears, your hearing has got worse over the last few days or weeks, or you have hearing loss with other symptoms such as earache or discharge.

For tinnitus it advises seeing a GP if you have it regularly or constantly, it is getting worse or it is bothering you, and going to A&E or calling 999 if tinnitus follows a head injury or comes with sudden hearing loss, facial weakness or a spinning sensation. You can sometimes get a free hearing test at some pharmacies and opticians, the NHS says.

RNID says there is no cure for noise-induced hearing loss, but many people use hearing aids to hear better in everyday situations. The NHS says that for permanent hearing loss a specialist will often recommend hearing aids, which make sounds louder and clearer but do not make hearing perfect, and that some people need a hearing implant.

The NHS suggests ways to communicate better, such as reducing background noise, facing people when they speak and asking people to repeat themselves, and to avoid further damage by wearing ear protection when exposed to loud noise, not listening to music too loudly and not putting objects such as cotton buds in your ears. For tinnitus it lists relaxation, sleep routines, avoiding total silence and talking therapies such as CBT.

On the NHS a GP can examine your ears, check for treatable causes such as earwax, and refer you to a hearing specialist for tests and hearing aids. If your work exposed you to noise, your employer’s occupational health service may also arrange hearing checks.

Private audiologists and opticians offer hearing tests and hearing aids, and some people use them for quicker access. RNID offers a free online hearing check, and the NHS page points to it. Whichever route you take, tell your GP about the results.