A major new study shows hearing loss is decreasing in the US. This has surprised some experts who’ve feared greater use of ear buds would lead to greater hearing loss in young people. Experts discuss why hearing loss is declining and caution against complacency.

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  • Howard Hoffman, Program Director, Epidemiology and Statistics, National Institute on Deafness and Other Communication Disorders
  • Barbara Kelley, Executive Director, Hearing Loss Association of America

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The decrease in hearing loss

Nancy Benson: Hearing loss is a major disability around the world that’s closely associated with aging, but conventional wisdom has been that ear buds and loud music will unavoidably take a toll on the hearing of some young as well. So experts are pleasantly surprised at the results of an authoritative new study of the hearing of Americas adults, aged 20-69.

Howard Hoffman: The actual number of adults in the age range with hearing loss decreased from approximately 16%, circa the year 2000, to 14% in 2011/12 when the survey was conducted.

Benson: That’s study leader, Howard Hoffman, Program Director for Epidemiology and Statistics at the National Institute on Deafness and Other Communication Disorders, part of the National Institutes of Health. He says the raw number of people with hearing loss has declined slightly from 28M to 27.7M.

Hoffman: This decrease is in spite of the age trend during the decade in which more adults who are aged 50-59 and especially 60-69 that had occurred circa 2000. We also based on that and the fact that age is the most strongest risk factor for hearing loss we found, would normally have made us think there would be an increase in absolute numbers even though the prevalence for age and sex might decrease.

Benson: What’s more, in spite of the popularity of ear buds, the proportion of 20-29 year olds with hearing loss didn’t go up either. Does Hoffman find that surprising?

Hoffman: Not only surprising but in a way reassuring that it isn’t perhaps as bad as we worried about. But it doesn’t mean there is no risk, ear buds and headphones in themselves aren’t necessarily harmful, and it’s rather the volume and duration of listening to very loud extremely loud noise that leads to permanent hearing loss. There could still be, over time, affects that manifest but I think the issue is, the loudness may not be as universally big a problem because maybe the people aren’t listening to it as loud – doesn’t mean that individuals aren’t effected, but of course we’re very concerned.

Benson: The study in the Journal of JAMA Otolaryngology – Head & Neck Surgery, defined hearing loss as “being unable to hear sounds up to 25 decibels.” Hoffman says roughly someone whispering at arms length in a quiet room, more people can hear those sounds that in previous decades and medical advancements are one reason why.

Hoffman: Measles contributed a lot to adult hearing loss, I remember having a pretty severe case of measles but since then, there’ve been many innovations – antibiotics became more widely used to treat ear infection and chronic ear infections can also contribute partially to the burden of hearing loss. There are just so many health improvements that have the medical and the health of the U.S keeps increasing, so that’s part of it. I think of course there’ve been changes in occupational employment with many factory jobs are loud, jobs are moving elsewhere and I think general awareness of harmful effects that became greater in the 70s and 80s and on than it would’ve been in the 50s and 60s. Another thing is just farm workers, there’s many fewer than them these days – farm workers are exposed to a lot of noise.

Benson: However despite the good news there’s still plenty of room for concern. Barbara Kelley is Executive Director of the Hearing Loss Association of America.

Barbara Kelley: While the overall risk of hearing loss may be decreasing over time, the prevalence of hearing loss is expected to rise because of the aging population, especially the baby boomers who have had their hearing damaged through noise and although in recent years there’s a lot more education on noise induced hearing loss, which by the way is completely preventable and completely irreversible, while there has been some good public awareness campaigns about that, the generation of people in the baby boomers who might be effected by noise induced hearing loss that type of information wasn’t available.

Benson: People between 60 and 70 years old are all baby boomers and the survey found that nearly 40% of them have hearing loss. Overall men have twice the rate of hearing loss as women, men are more likely to pursue noisy leisure activities such as motorcycles and hunting, but Hoffman says that may not explain everything.

Hoffman: We can’t rule out the possibility of genetic or hormonal or physiological differences it could be, or even anatomical. However, it is pretty clear from the data that men have been exposed to more noise, both occupationally – from factory work and other occupation exposure, and also in leisure time activities they report more noise exposure. And there are other sources that say, when both men and women are exposed to noise – the level of the noise tends to be greater for men and probably longer. So all of that does, we think, increase the risk of hearing loss for men.

Benson: Genetics may also be the reason that African Americans consistently have less hearing loss than Whites and Hispanics. But while the results of the survey are promising, Kelley says there’s still millions and millions of people in the United States who have untreated hearing loss.

Kelley: It takes at least 7 to 10 years; from the time a person admits and realizes that they have a hearing loss, to the point when they do something about it. One of the reasons is cost, people hear how much hearing aids cost – up to $3,000 a year, and that’s going to stop them right there. Especially if someone has a mild or moderate hearing loss, they’re going to say “I’m just gonna put up with this.” The other thing is a barrier to care – it’s very difficult to get into the hearing healthcare system.

Benson: Until very recently, people have needed a medical evaluation to seek a hearing aid. Hearing aids also require a trip to an audiologist and Kelley says people with mild to moderate hearing loss may not be ready to do that. But some expert panels say it wouldn’t be hard to make hearing help easier and less expensive.

Kelley: One of the recommendations from the National Academies of Sciences was for the Food and Drug Administration to open up a new category of over the counter wearable hearing devices.

Benson: And then there’s the stigma of hearing aids; many people still feel that wearing one will make them look old even though many of todays “in ear” hearing aids are so tiny, that they’re nearly invisible. Hearing aids can also help prevent all kinds of other problem from falls to isolation, but we have to seek help first. You can find out more from the Hearing Loss Association of America at hearingloss.org. You can find out about all our guests on our website, RadioHealthJournal.net. Our production director is Sean Waldron. I’m Nancy Benson.

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