Tinnitus: What to do When Hearing Damage Escapes Prevention?

More than one million employees in Great Britain experience noise levels that put them at great risk for hearing loss and tinnitus, a “ringing in the ears” that can plague sufferers for a lifetime. The Labour Force Survey (LFS) estimates that the average number of cases of noise induced hearing loss (NIHL) caused or made worse by work between 2009/10 and 2011/12 was 19,000. (http://www.hse.gov.uk/statistics/causdis/deafness/). While hearing loss is perhaps the more common and better understood condition, tinnitus can be equally, if not more debilitating, leading to stress, anxiety, depression or difficulty sleeping or concentrating.

According to the Trades Union Congress (TUC), a basic guideline to assess potentially injurious noise exposure is whether two workers having a conversation several meters apart must shout above background noise. A normal conversation measures around 60 decibels (dB). According to the Health & Safety Executive’s Control of Noise at Work Regulations 2005, employers must prevent or reduce risks of constant loud noise in the environment, provide training and enforce hearing protection for workplace noise exceeding 85 dB, the volume of a vacuum cleaner.

Similarly, in the U.S., where 30 million workers are exposed to occupational noise each year, Occupational Safety and Health Administration (OSHA) requires implementation of hearing conservation programs for workers exposed to noise levels, also above 85 dB. Between 90 and 95 dB, hearing loss can occur if noise exposure is sustained. http://www.osha.gov/SLTC/noisehearingconservation/index.html

Aircraft workers are particularly susceptible to hearing loss and tinnitus. Individuals standing within 25 meters of a jet aircraft taking off experience noise levels above 160 dB. The sound is so jarring that over an extended period most people would find it unbearable. According to the U.S. Federal Aviation Administration (FAA), the aviation environment is rife with sources of high volume noise beyond take-off, including aircraft equipment power plants, jet efflux, propellers, rotors, pressurization systems, and the aerodynamic interaction between ambient air and aircraft surfaces.

International law exempts aircraft from noise regulation during landing, takeoff or flying. Nearby residents are subjected to the noise, even though engines today are typically 75 percent quieter than jets flown in the 1960s. However, employers must also follow noise at work regulations to prevent hearing loss among aircraft maintenance workers.

Options for hearing protection include off-the-shelf foam ear plugs or custom-made silicone ear plugs. For custom plugs, an audiologist makes an ear impression and orders them from a manufacturer. These can be standard ear protectors that block as much sound as possible or ear plugs which typically contain a filter and are designed to block out all frequencies equally to provide protection while maintaining sound quality. A high-end option would be an electronic earplug that passes soft sounds unaltered, and compresses louder sounds into the safe range without distortion.

Hearing Protection Still No Guarantee Against Tinnitus
Even with regulatory safeguards and improvements in preventive technologies, workers may still suffer noise damage and develop hearing loss and/or tinnitus, typically described as a ringing, buzzing, whooshing, or other noise in the ears.

According to the British Tinnitus Association, about 10 percent of the UK population has tinnitus all the time, and up to one percent of adults experience tinnitus so severely they can’t relax or sleep; they are truly debilitated. In fact, they must come to terms with the fact that they may never enjoy silence again. And since tinnitus is an invisible condition, most people do not comprehend the extent of the suffering.
Each instance of short-term tinnitus due to noise exposure likely causes a small amount of permanent hearing damage. Repeated damage can accumulate and hearing loss, tinnitus or both can become noticeable. Fortunately, advances in sound therapy can provide relief. In some instances, treatment allows sufferers to reach a point where they are no longer bothered by the sound.

Tinnitus has many possible causes, but most cases are related to noise damage to the auditory system. Many people have experienced this for a short time after exposure to loud sound—for example after attending a rock concert. Usually this resolves on its own. But for those with chronic persistent tinnitus, productivity and the overall quality of life can be diminished.

Tinnitus Can Be Treated and Managed
The best way to prevent tinnitus and hearing loss is by protecting your hearing. Continuous exposure to loud noise or even intermittent exposure to excessively loud bursts of sound can still cause auditory damage.
Those who are experiencing tinnitus should see a qualified audiologist. While primary physicians may be the first point of contact for seeking treatment, audiologists are better equipped to test and prescribe more advanced treatments for tinnitus. An audiologist can conduct both hearing and tinnitus evaluations and recommend the best course of action. Those with only mild tinnitus may benefit from a hearing aid or a tabletop masker that plays soft relaxing or distracting sounds.

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