Noise-Induced Hearing Loss (NIHL)

Noise-induced hearing loss (NIHL) may happen if you’re exposed to loud noise. It’s a common condition that affects children and adults of all ages.

Unlike age-related hearing loss, you can prevent NIHL. If you already have NIHL, there are options to manage it.

Types of noise-induced hearing loss

The two types are:

• Acoustic trauma: This is instant hearing loss that happens after a single exposure to a very loud, forceful sound (like a gunshot or firecracker). In these instances, hearing loss can be immediate and permanent.
• Chronic NIHL: This is gradual hearing loss from exposure to loud sounds. This can happen if you use earbuds or headphones to listen to music, audiobooks or podcasts at an unsafe volume. Working in a very noisy environment can also affect your hearing. This type is much more common than acoustic trauma.

Symptoms of NIHL

You may have symptoms right after you’re exposed to a loud noise, or your symptoms may happen over time. Some common symptoms are:

• A feeling of fullness or pressure in your ear
• Inability to hear high-pitched sounds, like birds singing
• Speech that sounds muffled or distorted
• Ringing in your ears, also known as tinnitus

Your symptoms may go away quickly or last for hours or days.

NIHL causes

This condition happens when loud noises damage tiny sensory hair cells in your inner ear. The cells change the sounds you hear into signals that are sent to your brain. Once damaged, they can’t heal or regenerate (grow back).

Experts measure noise by decibel level. A decibel is a unit that measures sound in terms of loudness and intensity. Sounds that measure 85 decibels (dB) and above can damage your hearing over time, depending on how long you're exposed to the noise. The louder the noise in decibels, the higher the risk for hearing loss. A single loud noise at or above 120 decibels (dB) can cause immediate hearing loss.

Examples of sounds that can cause noise-induced hearing loss include:

Decibel levels are one way to check whether loud sounds put your hearing at risk. But sounds may be too loud if you:

• Have to shout for people to hear you
• Can’t hear or understand someone talking when they’re 3 feet away from you
• Have ringing in your ears, or the sound is so loud it makes your ears hurt
• Can’t hear sounds or they seem muffled several hours after being exposed to loud sounds

Risk factors

People who spend time in noisy environments have an increased risk of this condition. Jobs and industries with the highest risk of occupational hearing loss include:

• Agriculture
• Carpentry
• Construction
• Military
• Mining
• Oil or gas extraction

Complications of noise-induced hearing loss

Hearing loss can affect your quality of life. Struggling to hear can be exhausting and frustrating. You may feel self-conscious about your hearing loss, so you spend less time with other people. Specific complications include:

• Anxiety
• Depression
• Fatigue
• High blood pressure
• Increased heart rate
• Insomnia
• Irritability
• Stress
• Tinnitus (ringing in your ears)

How doctors diagnose noise-induced hearing loss

An audiologist may do the following tests:

• Pure-tone testing finds the quietest volume you can hear at different pitches.
• Speech audiometry determines how loud speech needs to be for you to hear it, and how clearly you can understand spoken words.
• Auditory brainstem response (ABR) checks how your brain and hearing nerves respond to different sounds.
• Speech in noise testing determines how well you can hear someone speaking in quiet surroundings versus environments with background noise.
• Otoacoustic emissions measures hair cell function in your inner ear.
• Tympanometry measures how your eardrum moves and how well your middle ear works.

How is this condition treated?

Hearing aids are the go-to NIHL management option for permanent hearing loss. Sometimes, hearing aids aren’t enough. In that case, surgical options, like cochlear implants, may be more appropriate.

Your healthcare provider may prescribe steroids in an effort to restore your hearing if acoustic trauma causes NIHL.

When should I see my healthcare provider?

Talk to a provider if it’s hard to hear or you have ringing in your ears. Hearing loss typically worsens gradually. Early diagnosis and treatment may help preserve your hearing.

What can I expect if I have noise-induced hearing loss?

NIHL can happen suddenly or over time. Either way, management options, like hearing aids, can help improve your hearing and quality of life.

How can I prevent noise-induced hearing loss?

Following these guidelines can help:

• Protect your ears. Wear earplugs or earmuffs when you’re around loud sounds, like if you're at a concert or going hunting.
• Turn the sound down. That includes any time you use earbuds or headphones. The World Health Organization recommends keeping the volume on personal devices at 80 dB for adults and 75 dB for kids.
• Walk away. If you can, move away from the source of the sound.