Noise-Induced Hearing Loss (NIHL)

What is noise-induced hearing loss?

Noise-induced hearing loss (NIHL) occurs when loud noises damage the structures in your inner ear. Most of the time, the sounds in our everyday environment — like TV, traffic and ambient conversations — are at a safe level. But there are times when sounds become too loud (explosions) or last for too long (on-the-job machinery). This can lead to noise-induced hearing loss.

Depending on the type and extent of damage, noise-induced hearing loss can be temporary or permanent. Unlike other types of hearing loss, NIHL is preventable.

How common is noise-induced hearing loss?

Noise-induced hearing loss is common. According to research, NIHL affects:

• 5.2 million children and teens between the ages of 6 and 19.
• 26 million adults between the ages of 20 and 69.

What are the symptoms of noise-induced hearing loss?

There are a few things that could mean you’re losing your hearing from loud noise. Depending on the cause of NIHL, symptoms may be immediate or you may develop them over time. Some of the most common symptoms of NIHL include:

• A feeling of fullness or pressure in your ear.
• Inability to hear high-pitched sounds, like birds singing.
• Muffled or distorted speech.

Symptoms can last minutes, hours or days after noise exposure ends. Your hearing may return to normal, but you still have damage. Your hearing may eventually come back, but continued exposure to loud noises can further damage your hearing and make hearing loss permanent.

What causes noise-induced hearing loss?

Noise-induced hearing loss occurs when loud sounds damage the hair cells in your inner ear. Once damaged, these cells can’t heal or regenerate (grow back).

Types of NIHL

The extent of hearing loss depends on what caused NIHL.

There are two types of NIHL:

• Acoustic trauma: Instant hearing loss that happens after a single exposure to a loud, forceful sound (like a gunshot or firecracker). In these instances, hearing loss can be immediate and permanent.
• Chronic NIHL: Gradual exposure to less forceful noise over time (like hearing damage from listening through headphones). You may go for weeks, months or even years before noticing symptoms.

What decibel level causes noise-induced hearing loss?

A decibel is a unit used to measure the degree of loudness or the intensity of a sound. Noises at or above 85 decibels (dB) can damage your hearing over time. A single loud noise at or above 120 decibels (dB) can cause immediate hearing loss.

Here are some examples of everyday noises and their sound levels measured in decibels:

NIHL risk factors

Anyone can develop noise-induced hearing loss. But wearing hearing protection like ear plugs or earmuffs significantly reduces your risk. You don’t have to miss out on concerts, fireworks and other things you love. Just be sure to give your ears a little TLC.

People who have jobs in noisy environments are particularly vulnerable to NIHL. Jobs and industries with the highest risk of occupational hearing loss include:

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

What are the complications of noise-induced hearing loss?

When you can’t hear as well as you used to, it can have a noticeable impact on your quality of life. You might feel less sociable or more frustrated in general. Or you might feel tired all the time from straining to hear things in your surroundings.

In addition to hearing loss, NIHL can cause:

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

How is noise-induced hearing loss diagnosed?

If you think you might have NIHL, talk to your primary care physician or a healthcare provider. They can refer you to an audiologist or otolaryngologist for hearing tests.

Specialists use multiple hearing tests to diagnose NIHL. This helps them determine whether additional factors could contribute to your hearing loss.

What tests will be done to diagnose NIHL?

A healthcare provider will run several tests to diagnose noise-induced hearing loss, which may include:

• 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.

They may run additional tests, including:

• 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 noise-induced hearing loss treated?

Hearing aids are the go-to NIHL treatment. But if noise-induced hearing loss worsens over time, hearing aids may not give you enough benefit. In these cases, your provider might recommend other options like cochlear implants.

In some cases, your provider might try corticosteroids to ease your symptoms. These medications can reduce inflammation in cases of acoustic trauma.

Can noise-induced hearing loss be prevented?

While you can’t reverse existing damage, you can reduce your risk for future deterioration.

Following these guidelines can help you prevent noise-induced hearing loss:

• Wear hearing protection when participating in loud activities. (You can even buy high-fidelity earplugs for concerts. These allow you to fully immerse yourself in the musical experience without damaging your hearing.)
• Move far away from loud noise if you’re unable to protect your ears.
• Help young children protect their ears until they’re old enough to do so themselves.

A research study in Austria found that it’s possible to determine your susceptibility to NIHL by measuring temporary hearing loss, also known as temporary threshold shift (TTS). This test can tell you how quickly the cells in your inner ear recover after noise exposure, which can be beneficial for preventing NIHL.

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

If you have noise-induced hearing loss, start protecting your ears now. Consider carrying earplugs with you, especially if you frequently go to concerts, gun ranges or other loud environments.

Can noise-induced hearing loss be cured?

While healthcare providers can’t cure NIHL, there are treatments that can help improve your hearing. If you think you have noise-induced hearing loss, schedule an appointment with a healthcare provider.

When should I see my healthcare provider?

You should tell your healthcare provider if you:

• Have a history of noise exposure.
• Develop tinnitus (ear ringing) after a loud noise.
• Notice any changes in your hearing.
• Experience sudden or quickly worsening hearing loss.
• Have loved ones who say you have difficulty hearing them.

Are there other harmful effects regarding noise pollution?

Yes. Hearing loss can severely impact your quality of life. In addition to damaging your hearing, harmful noise has been linked to:

• Anxiety.
• Stress.
• High blood pressure (hypertension).
• Insomnia.
• Increased heart rate.
• Isolation.
• Depression.

A note from Cleveland Clinic

Noise-induced hearing loss can have a significant negative impact on your quality of life. You may have difficulty following conversation or communicating with friends and family. This can ultimately lead to an avoidance of social situations. Fortunately, noise-induced hearing loss can often be successfully managed with hearing aids or implants.