By Ellen Lafargue, AuD, CCC-A
In honor of International Noise Awareness Day (4/24/19), I thought I’d share my thoughts on noise and hearing loss. I hope it inspires greater awareness of the dangers of noise and motivates people to protect their hearing so they can enjoy a lifetime of healthy hearing.
Noise protection for a lifetime of healthy hearing

Ellen Lafargue, AuD, CCC-A
Talking with a colleague in preparation for writing this article, I was struck by the irony of his statement that the effects of noise on hearing is the message that isn’t being heard. I found this to be really interesting. Why are we not paying attention to the fact that noise can damage our hearing? Part of the problem may lie in our definition of noise. Screeching wheels of a subway car, jackhammers and ambulance sirens are all obvious sources of noise. But the beautiful sounds of tympani drums playing or the bells on children’s toys, if loud enough and close enough to your ear, are also sources of noise.
Hearing loss due to noise: permanent yet preventable
There have been hundreds, if not thousands, of research projects that document the damage caused by excessive noise to the delicate hair (or nerve) cells in the inner ear. The repeated pounding of sound pressure against the nerve fibers may cause temporary damage at first, and eventually permanent damage. Damage to these cells causes permanent hearing loss. The issue that so many people ignore is that hearing loss due to noise exposure is completely preventable. If you use adequate hearing protection or avoid environments that are too noisy, you won’t develop a noise-induced hearing loss (NIHL).

Figure 1 – Typical NIHL audiogram
A man in his 40s recently came into my office. He had noticed some trouble communicating in noisy environments over the last year. He works as a wedding photographer and is in noisy environments at least twice a week for five or more hours at a stretch. Hearing testing showed that he had indeed developed a sensorineural hearing loss (loss that is caused by damage to the inner ear) in the classic configuration of a NIHL—that is a hearing loss that is centered around the high frequency (treble) sounds, while leaving the low, mid, and very high frequency sounds intact (see figure 1).

Ear muffs hearing protection
The effects on communication of this hearing loss are difficulty hearing words that contain the sounds “s”, “t”, “k”, “f”, “sh”, “h”, and “ch” and “p”. For example, if you are asked to meet at the restaurant at 53rd Street and Sixth Avenue, you may very well be waiting at the corner of 63rd Street and Fifth Avenue as, acoustically, “f” and “s” are high frequency sounds, and the ear that has experienced noise damage will not be able to discriminate these fine differences.
Noise protection can make all the difference
The very important question that my client asked was would his hearing loss get worse? While no one has the power to predict these things with certainty, if he continues to be in the same environments that caused the hearing loss, it is likely that the hearing loss will get worse. However, one can protect one’s hearing by wearing noise protection. There are a number of different products available that can be worn when in noisy environments. Single-use earplugs, custom earplugs, headphones, and noise-cancelling devices are among the options. An audiologist can suggest a solution that would best meet your listening and communication needs.
Noise increases risk of tinnitus, too
Loud-noise exposure can also cause tinnitus – a ringing, buzzing, or roaring in the ears or head. It’s a phantom auditory perception when no external sound is present. Tinnitus may subside over time but sometimes can continue as an intermittent or constant symptom throughout a person’s lifetime. CHC’s resident tinnitus expert, audiologist Susan Adams, shares this additional perspective:
Noise is one of the leading causes of tinnitus. Concerts, weddings and MRIs are some of the more common situations that have triggered tinnitus symptoms for many of my clients. Sometimes the condition is the result of a single, very loud event, while other times it’s the result of a series of exposures.
The first step to take when you experience tinnitus is to seek a thorough examination by an ENT and discuss possible treatment options. For CHC clients with mild symptoms, it can be helpful to have a white noise machine running in the background to mix in with the tinnitus. For more significant symptoms, we recommend Tinnitus Retraining Therapy (TRT), a therapy program at CHC with a success rate of 80%. Of course the best action is to use appropriate hearing protection in noisy situations to prevent tinnitus from occurring in the first place.
Enjoy the sounds of life…but safely
When entering a situation that is loud, whether it is the street where you live, a concert, a noisy club or a basketball game…enjoy it! But enjoy it safely. Think about your environment and take the necessary steps to protect your hearing as much as possible. I think we’d all agree hearing is a very precious resource.
Happy International Noise Awareness Day, everyone!
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3 responses to “Noise and its damaging effects on hearing”
“…the effects of noise on hearing is not being heard.”
Of concern to me are the retail stores with sound systems capable of filling their space with “music” that when combined with the normal ambient sound, are clearly raising overall sound.
Over the past 50 years or so, retailers have moved from a “Muzak” subliminal sound to a club sound. Amazingly, the general public is seemingly unaware of the increased sound levels.
I have been advocating for lower sound levels for years at the retail store where I work, mostly with little effect. My observation is that loud music typically is loud for the employees and managers to enjoy, certainly not for customers. There is a perception that a low sound level equates to a “dead” store.
An opportunity exists for research on consistent day to day ambient sound levels in the 70 to low 80 dB range in a the retail environment for hearing loss and elicited stress levels for both customers and employees and the effects long term on health.
How ironic the perception that a low sound level equates to a “dead” store. On the contrary, I avoid retail stores and even restaurants, sports events and certainly rock concerts and Broadway musicals with loud music. I wear custom made ear plugs and always carry a spare when I know I must go to some place loud. I preached the facts to my dear family and friends but to no avail. They complain about the noise levels at special events but still stay or hopefully leave early. I serve on the Board of Ear Peace in the Miami area and even ran lectures in the Herbert Wertheim College of Medicine at Florida International University on Noise Induced Hearing Loss. I believe that the message was heard by the medical students and that they will guard their hearing and the hearing of their patients. Like many things in life, we need to take responsibility for our hearing health.
My name is Emilio Cortez, Ed.D. For the past 3 years, I have been giving talks on the dangers of Noise-induced Hearing Loss on behalf of the Hearing Loss Association of America. The name of my committee is: “Turn Down the Volume.” At this point, I have spoken to at least 1,000 people about this topic so I understand Ms. Joan Peven Smith’s frustration when she informs family and friends about dangerous decibels, “but to no avail.” The public responds more to poison ivy than taking measures to preserve their hearing. Thus is the insidious nature of NIHL. I have come to the conclusion there are three types of people: 1) those who are informed and take action 2) those who blatantly don’t care and do nothing, and 3) those who would do something but are not informed. So in essence dealing with the latter group is where meaningful learning can take place. I feel good just because I can provide salient information for people to make informed decisions. As Ms. Smith points out “we need to take responsibility for our hearing health.”
The truth is that folks will do what they want to do. Feel good about the fact that you have tried. Actually, the most success I can point to is the time I taught children about Noise-induced hearing loss–the young, verdant mind is a beautiful thing.
I have written a two-page information sheet which I disseminate at my talks. Feel free to use it as one more way to promote hearing health. You will find it on-line.
Go to hlaamcc.org click on “links” and scroll down to “Noise-induced Hearing Loss Information Sheet” –my professional email address is at the bottom of page 2.
Kudos to Dr, Larfargue for her article.
Sincerely,
Emilio Cortez, Ed.D