Listening to loudness adds up in time

Noise-related deafness can happen suddenly, over time or years later. Someone who finds their hearing is a bit muffled when they come out of a concert might be OK the next morning - but that might be a sign of problems to come. Some people go to a concert and do not recover.

Damage to the hair cells in the inner ear is called sensorineural hearing loss or "cochlear concussion". In most people it's age-related, starting after 60. But I see patients in their 30s, 40s or 50s who have noise-induced high frequency hearing loss. They are usually fine one to one but find conversation difficult to follow when there's background noise - for instance, in a restaurant.

There's a cumulative effect - more noise for longer is more likely to damage your hearing. That could be noise from playing or listening to music, iPods, shooting or a job somewhere noisy like a printing works. It could be the guy on a train whose music you can hear from the other end of the carriage. If he continues to listen that loudly for a long time, then he's got an ever-increasing chance of noise-induced hearing loss.

There's a genetic susceptibility to noise exposure. Some people are luckier than others. But with noise the only thing you can do to protect your ears is to limit your exposure by putting something in your ears, like ear protectors, or not doing noisy stuff to start with, like clubbing.

Some people recover from sensorineural hearing loss, but not many. And, it's rarely something that can be operated on. The only solution is to wear a hearing aid. But many people think that makes them look old or a bit naff or vulnerable. Now hearing aids are getting better and smaller. Some people who need them don't get them and some people who need them don't want them.

The best thing is not to lose your hearing in the first place. Everyone should limit their risk and wear ear defenders or earplugs, even if they're doing DIY with power tools. Clubbers should take regular breaks from the dance floor, stand away from the speakers and wear earplugs.

(China Daily 06/11/2008 page19)