What Young People Don't Know About Hearing Loss Can Hurt Them

That young patient sitting in your waiting room listening to his MP3 player may be damaging his hearing, and it's likely he doesn't even know it. But with the right approach, you might be able to help him make that connection.

According to survey results published in a spring 2005 issue of Pediatrics (abstract available free; full article available for a fee), only 8 percent of respondents completing an Internet survey that targeted adolescents and young adults defined hearing loss as a "very big problem." Respondents to the survey, which was hosted on the MTV.com Web site, ranked hearing loss well below other health issues, such as sexually transmitted disease (50 percent), drug and alcohol use (47 percent), depression (44 percent), and even acne (18 percent).

Yet despite the low percentage of respondents identifying hearing loss as a problem, more than 60 percent reported tinnitus after attending a concert or other loud music venue, and more than 40 percent reported temporary hearing impairment after such an event. Only 14 percent reported using earplugs in places where loud music was played, although 59 percent said they could be motivated to use ear protection if so advised by a medical professional.

Loud concerts and noisy nightclubs have long been recognized as auditory saboteurs, and the proliferation of iPods and other personal music devices has only increased the problem.

If turning down the volume is deemed "uncool" -- and there is a long line of hearing-impaired rock 'n' roll stars as proof -- then broaching the subject of turning down the volume must be handled delicately or physicians risk being ignored. Family physician Chris Patricoski, M.D., of Anchorage, Alaska, is the telemedicine clinical director for the Alaska Federal Health Care Access Network. He suggests trying to break the ice by finding a way to relate to these patients.

"What I try to do is share that interest and connect with patients about music," Patricoski said. "Ask what they like, where they download and share some of your interests. Get the conversation started about music in general, and then try to approach the subject of hearing loss."

Once the subject is broached, Patricoski recommends discussing how important the sense of hearing is throughout an individual's lifespan.

"We have to recognize that hearing is an important part of development, not only in childhood but adolescence and into adulthood. Often we take it for granted," Patricoski said. "If we can, we need to talk to patients -- adolescents or pre-adolescents -- and educate them that this is something we need to treasure and protect. These are the kind of messages to get across to the kids."

Parents may assume that if the music coming out of the headphones can be heard across the room, then it is too loud. That may no longer be enough. According to Brian Fligor, Sc.D., an audiologist at Boston Children's Hospital, just because parents can't hear the music coming from their child's headphones doesn't mean no hearing damage is occurring. Some headphones concentrate music solely in the ears, Fligor said. He recommends that listeners set their headphone volume control no higher than six (where 10 is the loudest) and limit listening to one hour a day.

Patricoski said the current swell of awareness about overexposure to MP3-induced noise may be a sign that taking care of one's hearing in musical or entertainment environments is starting to gain acceptance.

"To me, this is similar to what we saw in shooting and hunting," he said. "Twenty years ago you were a wimp if you wore hearing protection. Now it's accepted. Same thing at heavy machinery plants. It has become socially acceptable to protect your hearing."

Permanent hearing loss may occur after prolonged exposure to sound levels greater than 85 decibels -- about the intensity of an alarm clock going off, a blender whirling or a ringing telephone held an arm's length away from the ear. Here are some tips you can share to protect your music-loving patients' ears.