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Noise-Induced Hearing Loss On this page: What is noise-induced hearing loss? What sounds cause NIHL?

use NIHL? What are the effects of NIHL? What are the symptoms of NIHL? Who is affected by NIHL? Can NIHL be prevented? How we hear What research is being done for NIHL? Where can I get additional information?

What is noise-induced hearing loss? Every day we e!perience sound in our environment such as the sounds from television and radio household appliances and traffic" Normally we hear these sounds at safe levels that do not affect our hearing" However when we are e!posed to harmful noise#sounds that are too loud or loud sounds that last a long time#sensitive structures in our inner ear can be damaged causing noise-induced hearing loss $NIHL%" &hese sensitive structures called hair cells are small sensory cells in the inner ear that convert sound energy into electrical signals that travel to the brain" 'nce damaged our hair cells cannot grow bac(" )cientists once believed that the pure force of vibrations from loud sounds caused the damage to hair cells" Instead recent studies have shown that e!posure to harmful noise triggers the formation of molecules inside the ear that can damage or (ill hair cells" &op What sounds cause NIHL? NIHL can be caused by a one-time e!posure to an intense *impulse+ sound such as an e!plosion or by continuous e!posure to loud sounds over an e!tended period of time such as noise generated in a woodwor(ing shop" &he loudness of sound is measured in units called decibels" ,or e!ample the humming of a refrigerator is -. decibels normal conversation is appro!imately /. decibels and city traffic noise can be 01 decibels" )ources of noise that can cause NIHL include motorcycles firecrac(ers and small firearms all emitting sounds from 23. to 21. decibels" Long or repeated e!posure to sounds at or above 01 decibels can cause hearing loss" &he louder the sound the shorter the time period before NIHL can occur" )ounds of less than 41 decibels even after long e!posure are unli(ely to cause hearing loss"

5lthough being aware of decibel levels is an important factor in protecting one6s hearing distance from the source of the sound and duration of e!posure to the sound are e7ually important" 5 good rule of thumb is to avoid noises that are *too loud+ and *too close+ or that last *too long"+ &op What are the effects of NIHL? E!posure to harmful sounds causes damage to the hair cells as well as the auditory or hearing nerve $see figure%" Impulse sound can result in immediate hearing loss that may be permanent" &his (ind of hearing loss may be accompanied by tinnitus#a ringing bu88ing or roaring in the ears or head#which may subside over time" Hearing loss and tinnitus may be e!perienced in one or both ears and tinnitus may continue constantly or occasionally throughout a lifetime" Continuous e!posure to loud noise also can damage the structure of hair cells resulting in hearing loss and tinnitus although the process occurs more gradually than for impulse noise" E!posure to impulse and continuous noise may cause only a temporary hearing loss" If a person regains hearing the temporary hearing loss is called a temporary threshold shift" &he temporary threshold shift largely disappears 2/ to -0 hours after e!posure to loud noise" 9ou can prevent NIHL from both impulse and continuous noise by regularly using hearing protectors such as earplugs or earmuffs" &op What are the symptoms of NIHL? When a person is e!posed to loud noise over a long period of time symptoms of NIHL will increase gradually" 'ver time the sounds a person hears may become distorted or muffled and it may be difficult for the person to understand speech" )omeone with NIHL may not even be aware of the loss but it can be detected with a hearing test" &op Who is affected by NIHL? :eople of all ages including children teens young adults and older people can develop NIHL" 5ppro!imately ten percent of 5mericans between ages 3. and /;#or 33 million 5mericans#already may have suffered permanent damage to their hearing from e!cessive noise e!posure" E!posure occurs in the wor(place in recreational settings and at home" <ecreational activities that can put someone at ris( for NIHL include target shooting and hunting snowmobile riding woodwor(ing and other hobbies playing in a band and attending roc( concerts" Harmful noises at home may come from lawnmowers leafblowers and shop tools" &op Can NIHL be prevented? NIHL is 2.. percent preventable" 5ll individuals should understand the ha8ards of noise and how to practice good hearing health in everyday life" &o protect your hearing= >now which noises can cause damage $those at or above 01 decibels%" Wear earplugs or other hearing protective devices when involved in a loud activity $special earplugs and earmuffs are available at hardware and sporting goods stores%" ?e alert to ha8ardous noise in the environment"

:rotect the ears of children who are too young to protect their own" @a(e family friends and colleagues aware of the ha8ards of noise" If you suspect hearing loss have a medical e!amination by an otolaryngologist $a physician who speciali8es in diseases of the ears nose throat head and nec(% and a hearing test by an audiologist $a health professional trained to measure and help individuals deal with hearing loss%"

&op Ho We Hear Hearing depends on a series of events that change sound waves in the air into electrical signals that the auditory nerve carries to the brain" )ound waves enter the outer ear and travel through a narrow passageway called the ear canal which leads to the eardrum" &he eardrum vibrates from the incoming sound waves and sends these vibrations to three tiny bones in the middle ear" &hese bones are called the malleus incus and stapes" &he bones in the middle ear amplify or increase the sound and send the vibrations to the snail-shaped cochlea or inner ear" &he cochlea is a fluid-filled organ with an elastic membrane that runs down its length and divides the cochlea into an upper and lower part" &his membrane is called the *basilar+ membrane because it serves as the base or ground floor on which (ey hearing structures sit" &he vibrations cause the fluid inside the cochlea to ripple and a traveling wave forms along the basilar membrane" Hair cells#sensory cells sitting on top of the membrane#*ride the wave"+ &his motion causes bristly structures on top of the hair cells to bump up against an overlying membrane and deflect to one side" 5s the bristles or stereocilia move pore-li(e channels on their surface open up" &his allows certain chemicals to rush in that generate an electrical signal" &he auditory nerve carries the signal to the brain which translates it into a *sound+ that we recogni8e and understand" Hair cells near the base of the cochlea detect higher-pitched sounds such as a cell phone ringing" &hose nearer the ape! or centermost point detect lower-pitched sounds such as a large dog bar(ing"

&op What research about NIHL is being conducted? &he National Institute on Aeafness and 'ther Communication Aisorders $NIACA% researches the causes diagnosis treatment and prevention of hearing loss" @ost hearing loss is caused by damaged hair cells which do not grow bac( in humans and other mammals" NIACA-supported researchers have helped to identify some of the many genes important for ear development and hearing" 'ne gene has been found to regrow hair cells in guinea pigs" @ore important the treated animals were able to regain some of their lost hearing" &his e!periment is the first successful demonstration of gene therapy that improves hearing in formerly deaf animals" )cientists hope to one day use this type of gene therapy to restore hearing in humans" NIACA researchers also are investigating a potential way to prevent NIHL after noise e!posure" Noise e!posure triggers the formation of destructive molecules called free radicals that cause hair cell death" <esearchers initially had thought that antio!idants chemicals that protect against cell damage from free radicals might prevent NIHL only if the antio!idants were given before noise e!posure" In a recent study however the antio!idants in salicylate $aspirin% and

&rolo! $vitamin E% were given to guinea pigs as long as three days after noise e!posure and still significantly reduced hearing loss" &hese results suggest that there is a window of opportunity in which it is possible to rescue hearing from noise trauma" )cientists hope to begin clinical trials with humans with the goal of reducing NIHL" Noise-Induced Hearing Loss !act "heet Editor= WeBve been hearing more and more lately about the dangers of our increasingly noisy world" ,or some specifics and recommendations see the following Noise-Induced Hearing Loss ,act )heet provided by the House Ear Institute" CCCCCCCCCCCCCCCCCCC AE)C<I:&I'N ', NIHL When an individual is over-e!posed to e!cessive sound sensitive structures of the inner ear can be damaged causing noise-induced hearing loss $NIHL%" &hese structures can be inDured by e!posure to an intense brief impulse of noise such as an e!plosion or from continuous e!posure to loud sounds over time" Noise-induced hearing loss is cumulative and permanent" However both forms of NIHL can be prevented through the control of sound levels or regular use of hearing protectors such as earplugs or earmuffs" @E5)E<E@EN&) &H5& AE&E<@INE WHICH )'ENA) C5E)E NIHL= )ound pitch or fre7uency is measured in Hert8 $H8%" 5lthough the human ear collects sounds ranging from 2..-3. ... H8 it amplifies the 3-1 (H8 fre7uency range where much of the important speech information registers" &he intensity of sound or sound pressure level $):L% is measured in decibels $d?%" ,or e!ample normal conversation is measured at a moderate noise level of 1.-4. decibels $d?% while the e!treme noise level of a roc( concert might be measured at 22.2F. decibels $d?%" ?ecause the auditory system does not have a limiting mechanism to prevent dangerous amounts of acoustic energy from being transmitted to the inner ear over-e!posure to high intensity sound is a leading cause of damage to nerve cells" )ounds above 01 d? may cause permanent hearing loss" )ome e!amples of loud noises that can cause NIHL are= @otorcycleGHair dryerGLawn mowerGLeaf blower - 01-;. d? Wood shopGChainsawG,irecrac(ers $small% - 2..-22. d? <oc( concerts - 22.-2F. d? :neumatic drillG5mbulance )irenGHet ta(e off - 22;-2-. d? E,,EC&) ', NIHL= When damage first occurs it usually affects the part of the ear corresponding to the higher fre7uencies of the voice range at - (H8 creating a Inoise notch"I &hese fre7uencies respond to many of the consonant sounds and a person with this type of hearing loss may have trouble understanding speech" Hearing loss may be accompanied by tinnitus a ringing bu88ing or fluttering in one or both of the ears" )ometimes e!posure to impulse or continuous noise may cause only temporary hearing loss" &emporary hearing loss is called a temporary threshold shift" &he temporary threshold shift usually disappears within 2/ hours after e!posure to loud noise" W5<NINJ )IJN)= &emporary threshold shift Ear discomfort after e!posure <inging or bu88ing in ears Aifficulty hearing in noise EKIAENCE ', 'KE<-EL:')E<E=

&innitus or head noise Hypersensitivity Loss of sensitivity High fre7uency hearing loss WHEN N'I)E ?EC'@E) 5 H5M5<A= :rolonged duration of e!posure Intensity of signal <epeated e!posure Individual susceptibility &I:) ,'< :<EKEN&INJ NIHL= 5void ha8ardous sound environments Ese hearing protection whenever possible @onitor sound at ;. d? &a(e 21-minute I7uietI brea(s every few hours @ove away from electronic spea(ers )5,E )'ENA LEKEL)= &he 'ccupational )afety and Health 5dministration $')H5% has set guidelines for the ma!imum length of time a person can be e!posed to continuous sound levels beginning at ;. d? and not e!ceeding 2.1 d?" )ound Level Auration per Aay ;. d? " " " " " " " " " " " " " " " " " " " " " 0 hours ;2"1 d? " " " " " " " " " " " " " " " " " " " "/ hours ;F d? " " " " " " " " " " " " " " " " " " " " " - hours ;-"1 d? " " " " " " " " " " " " " " " " " " " "F hours ;/ d? " " " " " " " " " " " " " " " " " " " " " 3 hours ;4"1 d? " " " " " " " " " " " " " " " " " "2 2G3 hours ;; d? " " " " " " " " " " " " " " " " " " " " " 2 hour 2.3 d? " " " " " " " " " " " " " " " " " " " "2G3 hour 2.1 d? " " " " " " " " " " " " " " " " " " " "2G- hour or less 2.1Nd? " " " " " " " " " " " " " " " " " " " " " e!treme ris( :E?LIC 5W5<ENE)) ', NIHL= @ore than 3. million 5mericans of all ages are e!posed to dangerous environmental noise and sound levels on a regular basis" E!posure to loud noise occurs in the wor(place the home and recreational areas" We can damage our ears while attending movies concerts bars and health clubs where music and sound are amplified" Even wearing earphones can be dangerous if the volume is too loud" 'f the 30 million 5mericans who have some degree of hearing loss about one- third have been affected by noise" Noise-Induced Hearing Loss Noise and hearing loss: When the ears are e!posed to e!tremely loud noises or to prolonged loud noises inner ear structures can be damaged leading to noise-induced hearing loss" Noise-induced hearing loss is 7uite common affecting about onethird of the nearly F. million 5mericans who suffer from hearing loss"

What constitutes a loud noise? Noise or sound intensity is measured in decibels" Normal conversation levels occur at about /. decibels" 5nything above 23. decibels can harm the ears and lead to hearing loss" E!amples of noises that reach 23. decibels or above include firecrac(ers gunshots and motorcycles" 5ccording to the 5merican 5cademy of 'tolaryngology noise is damaging if= you have to shout to be heard" your ears hurt" your ears ring" you have difficulty hearing for a couple of hours after the e!posure"

What is pitch? 5nother measurement of noise pitch is the fre7uency of sound vibrations per second" &he lower the pitch $deeper sound% the fewer vibrations per second" :itch is measured in Hert8 $H8% which means cycles per second" )mall children tend to have better hearing than adults and can hear sounds as low as 3. H8 $a large pipe organ% or as high as 3. ... H8 $a special dog whistle that most humans cannot hear%" When hearing loss begins a person will generally first have trouble hearing high-pitched noises" Ho does a loud noise cause hearing loss? Loud noises can cause damage to the hair cells in the inner ear and to the hearing nerve called sensorineural hearing loss or nerve deafness" $)ensorineural hearing loss also can be caused by infection head inDury aging certain medications birth defects tumors problems with blood circulation or high blood pressure and stro(e"% Aamage can occur from a brief intense noise such as an e!plosion or from continuous loud noises such as noises in a loud wor( environment" Hearing loss from loud noises may be immediate or occur slowly over years of continuous e!posure" Immediate hearing loss is often accompanied by tinnitus or ringing in the ears or head" Immediate hearing loss can occur in one or both ears and often involves severe damage to the inner ear structure" :rolonged e!posure to noise can actually change the structure of the hair cells in the inner ear resulting in hearing loss" &innitus which is the sound of ringing roaring bu88ing or clic(ing inside the head often occurs with prolonged noise e!posure damage as well" Hearing loss from noise can be permanent or temporary" If the hearing loss is temporary hearing usually recovers within 2/ hours of loud noise e!posure" Noises that cause hearing loss: Hearing loss can occur after a one-time e!posure to a loud noise or after repeated e!posure to varying loud noises" E!posure to loud noises can occur at wor( at home or at play" E!amples of noises that can cause hearing loss either immediately or over time include= #ecreational activities firing guns and other weapons snowmobiles go-carts motorcycles

$t home $t or%

power horns model airplanes cap guns

garbage disposal vacuum cleaner lawn mower leaf blower shop tools

woodwor(ing e7uipment chain saws sandblasting heavy construction Det engine other noisy machinery

'id you %no ? Jradual hearing loss may occur after prolonged e!posure to ;. decibels or above" E!posure to 2.. decibels for more than 21 minutes can cause hearing loss" E!posure to 22. decibels for more than a minute can cause permanent hearing loss" &reventing noise-induced hearing loss: When you (now you will be e!posed to loud noises either temporarily or over a longer period using ear plugs or ear muffs can help prevent hearing loss" Ear plugs which fit into the outer ear canal and ear muffs which fit over the entire outside of the ear decrease the intensity of the sound that reaches the eardrum" :roperly fitted ear plugs and ear muffs can reduce noise by 21 to F. decibels" 'ther preventive measures include= :rotect small children from loud noises" ?e aware of ha8ardous noises in your environment" >now which noises are too loud and can cause damage" Endergo a medical e!amination to measure hearing"

In addition the 'ccupational )afety and Health 5dministration $')H5% re7uires hearing conservation programs in noisy wor( environments" Wor(ers e!posed to 01 decibels or more each day are re7uired to have an annual hearing

test" If more than 2. decibels of hearing loss are indicated by the annual hearing test the employee must be informed and is re7uired to wear some type of hearing protectors" Which noises can affect hearing? Level of safety 'anger: &ermanent hearing loss may occur 2-. 23. 22. 2.. Warning: ,radual hearing loss may occur over time "afe ;. 0. /. -. 3. Source: National Institute on Deafness and other Communication Disorders 'ecibels ($ppro)imately* +ype of noise ,irecrac(ersO roc( concert )nowmobiles Chain saw Wood shop LawnmowerO motorcycle &raffic noise Normal conversations <efrigerator humming Whispering