Who should get their hearing checked? Everyone!

By Daniel Fink, MD, Chair, The Quiet Coalition

This local television anchor recommends that everyone get his or her hearing checked.

But this isn’t what the experts at the U.S. Preventive Services Task Force recommend. They reviewed the published medical literature on screening for hearing loss and concluded that, based on the literature, there is no proven benefit to screening for hearing loss in adults. People who complain of not being able to hear should be checked, they cautioned, but they found no benefit in looking for hearing loss is those who don’t have an obvious problem.

Maybe it’s time to rethink that recommendation. A recent report from the Centers for Disease Control and Prevention (CDC), Vital Signs: Noise-Induced Hearing Loss Among Adults, found the following based on recent data from the National Health and Nutrition Survey:

Results: Nearly one in four adults (24%) had audiometric notches, suggesting a high prevalence of noise-induced hearing loss. The prevalence of notches was higher among males. Almost one in four U.S. adults who reported excellent or good hearing had audiometric notches (5.5% bilateral and 18.0% unilateral). Among participants who reported exposure to loud noise at work, almost one third had a notch.

Conclusions and Implications for Public Health Practice: Noise-induced hearing loss is a signficant, often unrecognized health problem among U.S. adults. Discussions between patients and personal health care providers about hearing loss symptoms, tests, and ways to protect hearing might help with early diagnosis of hearing loss and provide opportunities to prevent harmful noise exposures. Avoiding prolonged exposure to loud environments and using personal hearing protection devices can prevent noise-induced hearing loss.

Audiometric notch is the hallmark of noise induced hearing loss.

The CDC information that a quarter of American adults have hearing loss but don’t know it–including those who rate their hearing as good or excellent–indicates a major problem. Experts recommend checking blood pressure at every doctor visit and cholesterol at varying intervals, depending on risk factors, beginning in childhood. Screening for auditory disorders is recommended for children but not for adults. But hearing loss is like high blood pressure or high cholesterol–it is painless and asymptomatic, and unless someone checks, the patient doesn’t know that he or she has it.

Why does this matter? Most Americans, including most doctors and audiologists, don’t know that the only safe noise exposure level to prevent hearing loss is only 70 decibels time weighted average for 24 hours with the real safe noise exposure level probably even lower than that. Most Americans don’t know that we are exposed to dangerous levels of noise every day, which probably explains the recent CDC findings. If people know that they have hearing loss, perhaps they will do more to protect their ears.

Significant hearing loss with age is probably not part of normal physiological aging, but represents noise-induced hearing loss. (I will be presenting a paper on that topic at the 12th Congress of the International Commission on the Biological Effects of Noise.)  Regular hearing testing could prevent current and future generations from losing their hearing.  Why? Because noise-induced hearing loss is 100% preventable, and regular tests would let people know whether and to what degree their hearing is compromised, allowing–and encouraging–them to take action today to avoid significant hearing loss tomorrow.¹

Take the initiative with regard to your hearing health, and have your hearing tested regularly as part of a preventive health plan.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area.  He serves on the board of the American Tinnitus Association, is the interim chair of Quiet Communities’s Health Advisory Council, and is the founding chair of The Quiet Coalition, an organization of science, health, and legal professionals concerned about the impacts of noise on health, environment, learning, productivity, and quality of life in America.

¹ For those who are concerned about establishing the diagnosis of hearing loss as a pre-existing condition which might increase their insurance rates or exclude coverage for future hearing health care, they should not be worried for two reasons: (1) Medicare and Medicaid don’t have a pre-existing condition exclusion, and (2) federal and commercial insurance plans do not cover audiology services and hearing aids. Which is more important? Not establishing a pre-existing condition for something not covered by insurance, or finding out that your hearing is already being damaged and having the chance to take steps to protect your ears?

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