INTRODUCTION

Noise is one of the most common causes of hearing loss, and one of the most common occupational illnesses. Repeated exposures to loud machinery may, over an extended period of time, present serious risks to human hearing.
• A good population has already suffered irreversible hearing damage from noise; many are exposed to hazardous noise levels each day.
• The risk and harmful effects of noise on hearing are often underestimated because the damage takes place so gradually.

How to prevent hearing loss.
Excessive noise exposure damages the delicate hair cells in the inner ear, not dissimilar to the effect of age on the ear (accelerated “wear and tear”). This damage often results in permanent, sensorineural hearing loss and tinnitus (ringing of the ears). Hazardous noise exposures can occur on the job, but also in common recreational activities. Hearing loss prevention thus requires diligence and sensitivity to situations where hearing can be put at risk:
• Beware of recreational sources of hazardous noise like firearms, firecrackers, power tools, music concerts, dance clubs, sporting events, motorcycles, motorboats, snowmobiles, powerboats, and “boom cars”.

• The risk for hearing loss due to exposure to noise is especially high among factory and heavy industry workers, transportation workers, military personnel, construction workers, miners, farmers, firefighters, police officers, musicians, and entertainment industry professionals.
If you have to raise your voice to shout over the noise to be heard by someone within an arm’s length away, that noise could be a serious risk to your hearing. You can prevent hearing loss by removing yourself from situations where noise is excessive or by using ear plugs to protect your ears.

WARNING SIGNS
Be alert to some of these warning signs, which could suggest that you’ve been exposed to hazardous noise:
• You hear ringing or buzzing (tinnitus) in your ears after exposure to noise.
• You notice that you can hear people talking, but you have difficulty understanding them, after exposure to noise.
• You experience “fullness” in your ears after leaving a noisy area.
Remember, even though you might have experienced these symptoms temporarily in the past, your hearing might not always “recover,” leaving you with a permanent and regrettable hearing problem.
WHAT YOU CAN DO TO PROTECT YOUR HEARING
• If you work in an at-risk occupation, check with your employer to make sure that your jobsite has an effective program to adequately protect your hearing.
• Wear hearing protection, such as earplugs or earmuffs, consistently when using loud equipment at work or at home.
• Limit exposure to noisy activities at home. Monitor your listening level and how long you are listening to personal listening devices. Encourage your children to use their headphones conservatively. Consider investing in higher quality earphones that block out background noise, to help you moderate your listening levels in noisier places. Note: being able to overhear your child’s headphones is not a good way to tell if they are listening too loud! If you can hear it, their music might be too loud, but just because you can’t hear it, that doesn’t mean the levels are ok.
• Buy quieter products (compare dB ratings and ask for low-noise products).
• Keep an “eye” on your hearing – see a hearing health professional routinely for hearing testing, or if offered through your employer, ensure you know your hearing test results and track it year-to-year.
AN OUNCE OF PREVENTION
Be alert to risks of hazardous noise in your life. Since prevention of hearing loss is so critical, make sure that your family (especially children), friends, and colleagues are aware of the hazards of noise and how they can protect themselves. Remember: One-third of permanent hearing loss is preventable with proper hearing loss prevention strategies.

Brian J. Fligor, Sc.D., Children’s Hospital Boston, Harvard Medical School, Boston, MA