Hearing impairment is mainly a noise problem. We are rampant consumers of noise. Hearing aids can't fix the noise problem. Audiology theory urgently needs an update.
We have to talk about noise if we’re going to talk about hearing loss because today, persistent, ubiquitous environmental noise causes more than 90% of hearing loss. This type of hearing loss is permanent, often leads to tinnitus (brain noise), and is the #1 risk factor for dementia.
What we commonly call hearing loss is actually sensorineural hearing loss, or SNHL, which is caused by damage to the inner ear sensory nerves that convert sound waves into electrical signals and transmit them to the brain.
Noise induced hearing loss, often abbreviated NIHL, started becoming a public health issue at the beginning of the fossil fuel-driven Machine Age in the late 1800s, when factories and trains started burning coal, and gasoline-powered cars were invented.
The problem continued getting worse as the world population migrated to cities, and with recent inventions like digital sound processing technologies that allow very high sound pressure levels without distortion, capable of inflicting permanent hearing damage within a few minutes.
Noise regulations from public health authorities have mainly been limited to manufacturing environments, but noise regulations for public spaces are quite rare, so most citizens throughout the world are pretty much on their own to protect their hearing from noise damage. Public health authorities like the World Health Organization and the US CDC issue suggestions to avoid noise, wear ear plugs or muffs, and keep the volume down when listening to music. Clearly these suggestions aren’t working. Hearing loss and its consequences are major global health problems without cure. The data are sobering.
- Hearing impairment is the world’s second most common health disability.
- Total economic and social costs exceed $1T annually (The Lancet Global Burden of Disease Study).
- 70–85% of those with hearing loss also suffer tinnitus (CDC).
- About 12.5% of American children ages 6–19 already suffer permanent hearing damage from noise exposure (CDC). They are among the 1.1 billion young people ages 12-35 at early risk for hearing loss, mainly due to loud music and personal digital music systems (World Health Organization).
- Dementia is forecast to become the most burdensome disease globally within the next few decades.
- Hearing impairment is the most significant single risk factor for dementia, a disease without cure forecasted to overwhelm the coping capacity of the world healthcare system by mid-century.
Hearing aids can’t solve the hearing loss problem.
No doubt, bringing programmable hearing aids direct to consumers through retail stores will help many with mild to moderate hearing disability. Hearing aid makers and large electronics companies are making a safe bet that millions of those who already suffer with hearing impairment and who are reluctant to visit audiologists will pay thousands for hearing aids they can program themselves, sidestepping audiologists and creating a new stream of revenue from retailers, while shifting more of the financial burden of hearing loss onto those with the disability.
Isn’t it unfair to require the victims of public health policy shortcomings to pay for their injuries? Yet that seems to be what we’re doing with hearing aids. And what’s our plan for the kids and young adults who are at risk?
We must do better.
Audiology theory needs an update.
Audiology is defined as the branch of science and medicine concerned with the sense of hearing. The outdated mechanistic theory of audiology doesn’t touch the problem at the root of hearing loss. The theory is overdue for an update that incorporates what medical research has learned over the past several decades about the fundamental role of inner ear biology in preserving hearing health.
References
(Heather Cox Richardson – the idea to include sources is much appreciated)
Sensorineural Hearing Loss Wikipedia page
Noise induced hearing loss among Americans (CDC)
Hearing loss risk to young adults, globally ( WHO)
Hearing loss in children (CDC)
Loud noise and hearing loss correlations (CDC)
Dementia prevention, intervention and care (Lancet Commission 2020 report, free pdf)
