How we protect ourselves from noise – even with hearing aids or hearing implants

In the past, it was primarily occupational noise that caused hearing damage. Today, something like "affluence noise" is added to the mix: hours of listening to music, often through headphones and at unhealthy volumes, various other recreational noises, as well as the diverse ambient noises of our mobile industrial society.

Dr. Paul Martin Zwittag, as primary physician at the Department of Otolaryngology at the Kepler University Hospital in Linz, is confronted with the consequences: "Continuous exposure to noise damages the ear! But it also has a negative effect on the cardiovascular and vascular systems, hormonal systems, metabolism with the risk of type 2 diabetes, sleep quality, psychological well-being and cognitive performance." People who are profoundly deaf or hard of hearing are at higher risk for depression and up to five times more likely to develop dementia - both of which are partly a result of social withdrawal in response to hearing and communication problems.

Hearing silence is already so unfamiliar to many of us that it seems difficult to endure. Yet this silence is needed by the body and soul to recover from noise pollution. "Even though we can now take good care of most hearing impaired and even deaf people thanks to technologically advanced hearing aids and high-tech hearing implants, we need to give much more importance to noise hygiene." The hearing implant specialist warns, "Noise is an impairment that is not immediately noticeable. Decades later, however, you get presented with the bill!"

What is loud?

A normal conversation is heard at a distance of one meter at a volume of about 60 decibels. In an open-plan office, one reckons with 70 decibels of noise. The World Health Organization (WHO) defines noises above 65 decibels as noise pollution, and experts classify them as harmful above 75 decibels. A radio can quickly reach this volume, but so can an old dishwasher or the clothes dryer.

A lawn mower hums at around 85 decibels, as does traffic on a busy road. For the workplace, the law stipulates that hearing protection must be worn above 85 decibels. However, noise during breaks in the schoolyard often reaches 85 decibels, and it can be even louder in a busy restaurant!

Noise above 120 dB - the noise of a jackhammer, the thunder of a nearby thunderstorm, or the usual volume of music at a heavy metal concert - is painful to our unprotected ears.

Noise: limited in the workplace, hardly any in leisure time

Hearing is often significantly reduced after attending a concert, but can usually recover if the hearing is subsequently protected long enough from further noise exposure. Frequent or long-lasting noise, however, has a permanent effect on hearing.

The occupational safety and health legislation assumes that we also use the time off work as a rest break in the literal sense of the word. On the other hand, noise pollution is not only caused by car and air traffic and industrial noise; it is also becoming increasingly unhealthily loud during leisure time at events and in sports facilities.

Particularly in big cities, there is often a lack of suitable places to retreat. Young people are not the only ones countering this by shielding themselves from their surroundings with a kind of acoustic sound barrier: So-called in-ear headphones are used to listen to music so loudly that the surrounding noise is drowned out or at least faded out. Gradual hearing loss, tinnitus and other noise damage are imminent, even if they do not always become apparent in time.

Creeping noise damage often goes unnoticed

Our body reacts to noise exposure even if we are not aware of the volume - or are no longer aware of it as a result of habituation: constant noise from a nearby street triggers stress reactions, blood pressure and heart rate rise measurably; the now common continuous exposure to sound in shopping centers can also have a similar effect. Those affected often go unnoticed for a long time.

Noise-induced hearing loss also often remains undetected for a long time; even minor damage adds up over years in the hearing organ. Primar Zwittag advises all parents: "Point out the danger to your children at an early stage; ask them to turn down the music in their ears and to always take breaks from noise!"

As adults, we are required to model proper behavior: Even when mowing the lawn, riding a motorcycle or attending a concert, we should not forget appropriate hearing protection. When it comes to playing music, most professional musicians now set a good example. On a larger scale, urban development and landscaping, but also architecture, product design and many other areas are called upon to reduce noise emissions and create quiet spaces.

Allowing the ear to be in silence

Sensorineural hearing loss often becomes noticeable when the person affected thinks that the person they are talking to is speaking indistinctly. Conversations in larger groups or in noisy surroundings become tiring, and women's and children's voices are difficult to understand. Family members or neighbors complain that the TV or stereo system is too loud. Once the sensory cells in the inner ear are destroyed, this damage cannot be reversed. In the early stages, conventional hearing aids or suitable hearing implants can help.

Cochlear implants are used when the inner ear is so dysfunctional that speech understanding is no longer possible even with hearing aids. In this case, noise exposure may not cause permanent hearing damage, but even in CI users, hearing fatigue reduces hearing ability, at least temporarily. The physical stress reactions to noise also occur undiminished in CI users - up to and including vegetative and psychological damage.

In the early days with cochlear implants, many users appreciate a listening break during the day to relax from the initial strain of listening. For people without CIs, hearing breaks prevent noise damage and allow regeneration of a noise-stressed hearing. Primar Zwittag points to another effect: "Regular noise breaks are even part of burn-out prevention!"