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Week of 27 February 1998

Vol. I, No. 22

Health Matters

Loud music and noise be deafening -- permanently

My teenage son often listens to music at very high volume. Should I be worried about his hearing?

"Absolutely," says Bruce MacDonald, M.D. "He should be concerned with losing his hearing and also a second condition known as tinnitus, or ringing in the ears. If people damage their ears enough, the tinnitus can be permanent."

MacDonald, who is a professor of medicine at the Boston University School of Medicine, distinguishes between two types of hearing loss: chronic loss and traumatic loss. Chronic hearing loss generally occurs from exposure to a noisy environment over months or years. Construction workers are at a high risk, as are those who practice shooting at firing ranges. Playing stereos too loud (especially in closed areas, such as small rooms and cars) and frequenting noisy concerts without ear protection puts the rock-music fan in danger as well.

Chronic hearing loss characteristically affects one's high-frequency hearing range. Exposure to sustained loud noise damages or kills the nerve cells in the inner ear, or cochlea. Listeners experience a "threshold shift," and their hearing is altered temporarily. Over time, more nerve cells are killed and high-frequency hearing loss becomes pronounced. Since nerve cells cannot regenerate, this hearing loss is permanent.

Parents and children should also be concerned about traumatic loss, cautions MacDonald. Traumatic hearing loss involves a one-time exposure to a noise so loud that the damage to the ear is irreversible. Unlike sufferers of chronic hearing loss, people who experience traumatic hearing loss may lose hearing at all frequencies. Typically, a trauma like this occurs when someone is in an enclosed space when a tremendous noise occurs, as when a gun fires in a room or one is standing right next to an amplifier during a loud rock concert. Children playing with firecrackers are also at risk, especially if a firecracker explodes near a child's ear.

The result of either type of loss can be tinnitus. Although researchers do not know the exact mechanism responsible for tinnitus, it is the hearing equivalent of the "ghost pains" that some people with severed limbs experience. Sometimes the ringing people sense is minor, but it can often be distracting and annoying. In fact, tinnitus can become so annoying as to induce insomnia, anxiety disorder, and depression.

Tinnitus can be treated by "masking units," which look like hearing aids and mask the internal ringing sound with a more pleasant external sound; the same effect can be achieved by playing a recording of ocean sounds. People with tinnitus should definitely avoid loud noises, because this exacerbates the ringing.

"In general, a hearing aid can help alleviate hearing loss, but the best course is to avoid damaging the ears if possible," says MacDonald. Answering yes to these simple questions can help you determine if you are at risk:

  1. Are your headphones on at full volume with fresh batteries? Can the person next to you clearly hear the music in your headphones?
  2. Is the music so loud at parties or rock concerts that you feel uncomfortable?
  3. After you listen to music, do you have ringing in your ears?

MacDonald recommends these preventive measures if people do listen to loud music or often spend time around loud noises:

  • Always wear earplugs at concerts. They can be purchased at most drugstores for only a few dollars, and many brands are skin-colored and inconspicuous.
  • Those who shoot at firing ranges should buy larger, more protective earmuffs, which are available at sporting goods stores.
  • Those who play amplified instruments (electric guitars, keyboards) can purchase special earplugs that do not distort the sound they hear. These are much more expensive than drugstore-variety earplugs and can be obtained from an otologist, otolaryngologist, or a hearing-aid dispenser.

If these measures are taken, the risk of hearing loss should be dramatically reduced.

"Health Matters" is written in cooperation with staff members of Boston Medical Center. For more information about hearing loss or other health matters, call 617-638-6767.