U.S. Preventive Services Task Force recommendation, Part II

Photo Credit: Pennsylvania National Guard licensed under CC BY-NC-ND 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

As we reported, the U.S. Preventive Services Task Force recently posted a draft recommendation against recommending screening for hearing loss in adults.

Our colleagues at the Centers for Disease Control and Prevention sent us this email yesterday:


The U.S. Preventive Services Task Force has provided the attached communication toolkit to help inform partners and stakeholders about the public comment period of their draft recommendation and evidence review on Screening for Hearing Loss in Older Adults. The materials are available to use online and in newsletters and may be edited as needed.

Take Care and Be Well,

NCEH Noise Induced Hearing Loss Team

That draft recommendation can be accessed here, and public comments on the draft recommendation can be accessed here.

I will definitely be sending in comments. One of my main comments will be about the statements of USPSTF member Chien-Wien Tseng, MD, MPH, MSEE, in the USPSTF press release, who said, “Increasing age is the most important factor for hearing loss.” In so stating, Dr. Tseng perpetuates an inaccurate belief, not supported by scientific research.

Yes, the terms presbycusis or age-related hearing loss are in common usage, both implying that hearing loss is part of normal aging, but this is not the case.

There is age-related hearing loss, but it is caused by a lifetime of noise exposure. Noise exposure is the most important factor for hearing loss, not age. I spoke about this in Zurich in 2017 at the 12th Congress of the International Commission on the Biological Effects of Noise. My conclusion, based on a literature review going back to the 1960s when Dr. Samuel Rosen showed preserved hearing in older Mabaan people in the southern Sudan region, is now supported by the research of Wu et al. from Dr. Liberman’s laboratory at the Massachusetts Eye and Ear Infirmary. Age-related hearing loss in humans stems from hair cell death, not from normal aging or vascular damage. Hair cell death is caused by noise exposure.

In 2017 the CDC reported that about 25% of American adults age 20-69 had noise-induced hearing loss, with about 20% of those with hearing loss having had no significant occupational noise exposure. In addition, about 25% of those with hearing loss had no idea that they had any auditory problems.

The USPSTF press release also stated, “[i]f someone is concerned about their hearing [sic], they should talk to their clinician to get the care they need.” But the CDC publication also found that only 46% of those who knew they had hearing problems had seen any health care practitioner about this.

That’s something I will also comment on. I think the scientific evidence is pretty clear that treating hearing loss benefits those who can’t hear, and may encourage them to protect their hearing from further damage.

Because if something sounds loud, it is too loud, and hearing loss will likely eventually occur.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He 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. Dr Fink also is the interim chair of Quiet Communities’ Health Advisory Council, and he served on the board of the American Tinnitus Association from 2015-2018.

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