Now, Hear This! - All About Hearing Loss
In today’s jarringly noisy world more than a million Canadians report having trouble hearing. Here’s what you can do to stop it.

BY CLAUDIA CORNWALL

Sébastien lafontaine, a 36-year-old Montrealer, is a big music fan. He says, “I went to hundreds of shows, after-hours parties and raves where you dance for 12 hours with your head two steps away from the speakers.” Recently he consulted a specialist because he was starting to notice an irritating vibration in his left ear whenever he heard something loud—like his young daughters shouting. A test showed that Lafontaine had already begun to lose some of his hearing.

It’s a noisy world out there for the iPod generation, and the constant barrage is starting to take its toll. A March 2006 poll for the American Speech-Language-Hearing Association showed that high-school students are more likely than adults to have symptoms of hearing loss: turning up the volume on their television or radio; saying “what” or “huh” during normal conversation; or having tinnitus, or ringing in the ears. In British Columbia a 2004 Workman’s Compensation Board study found that just over 20 percent of young workers (average age 21) had hearing loss because of overexposure to noise.

Statistics Canada reports that over a million of us are having trouble hearing. And too much noise accounts for one third (33.7 percent) of these difficulties, according to the Hearing Foundation of Canada. After that, come aging (28 percent), infection or injury (17.1 percent) and genetics (4.4 percent). Other causes are not identified. Hearing loss is the third most common chronic disability after hypertension and arthritis. It hits both young and old: One out of four affected are under age 40.

When we hear properly, our outer ear captures a sound wave and funnels it down the ear canal to the eardrum in the middle ear. The eardrum vibrates, and the sound is amplified and transmitted to the cochlea, or inner ear. In this tube filled with fluid, thousands of tiny hair cells flex and bend in response to vibrations. They generate electrical impulses that travel along the auditory nerve to the brain, which then translates them into sound information. A glitch anywhere along the route can cause problems.

If sound can’t pass through your middle ear, you have what is called conductive hearing loss. It can result from a wide variety of diseases and conditions such as wax buildup or bacterial infection and it usually doesn’t last. Treatments are normally successful, and only occasionally does scarring cause permanent damage.

Inner ear injury, called sensorineural hearing loss, on the other hand, is more likely to be permanent. Jean Paterson, professor of anatomy at the University of Manitoba, says the tiny hair, or sensory cells, in our inner ears (which are actually slender processes and not really hair cells) are very complicated structures containing proteins found nowhere else in the body. Healthy “hairs” stand up, but when damaged they flop down and eventually disappear.

Dr. Lorne Parnes, professor of otolaryngology and clinical neurological sciences at the University of Western Ontario, says, “Noise is the No. 1 preventable cause of hearing loss.” Usually it doesn’t completely destroy a person’s hearing, but it can damage enough of the hair cells to make ordinary conversations difficult. While many workers in loud environments now wear earmuffs or plugs for protection, people often don’t worry about leisure-time noise.

To preserve our hearing, we need to pay attention to how loud a sound is and how long it lasts. Any kind of sound—a rap song, a symphony or the grinding of machinery—can cause trouble. The amount of damage depends on the total exposure. Margaret Cheesman, an associate professor of communication sciences and disorders in the National Centre of Audiology at the University of Western Ontario, explains: “It all adds together. If I wear my iPod going home on the bus, and then I go and use a dirt bike, that’s more noise. If I go to a rock concert or to a club for dancing, that adds more noise. If I work in a noisy factory, that’s still more.”

Washing machines make a sound that is around 75 decibels loud. You can listen to this as long as you like. But if you get up to 85 decibels—the sound of an electric razor, for instance—you need to limit your exposure to eight hours a day to be safe.

Loud sounds can cause damage surprisingly quickly, as Lasha Durza found out. She wrecked her hearing one summer 20 years ago when she was driving to Toronto three times a week from her home in London, Ont. She drove the two-hour stint each way with the windows open. To listen to her favourite pop songs over the traffic, she borrowed a friend’s headset and cranked up the volume. By the end of the summer, she couldn’t hear her phone ring.

Today she can’t hear any high-pitched sounds such as sirens, alarms and smoke detectors. At 51, she wears a hearing aid, but it doesn’t compensate perfectly for the loss. She says, “Music is a wonderful part of life. It’s okay to listen but be really aware that, especially if you’re wearing something on your ears, they are fragile and delicate. They can only withstand so much. Damage can be permanent.”

Most of us don’t walk around with a decibel meter, so Cheesman offers this rule of thumb: if you can’t talk to someone who is about a metre away without shouting because of the background noise, it’s too loud. Another handy tip comes from Marshall Chasin, an audiologist with the Musicians’ Clinics of Canada. He points out that humming causes a small muscle in the middle ear to contract, and helps to lessen the effects of a loud noise. Chasin says, “If a musician is about to hit a rim shot on the drums, humming very quietly, almost inaudibly, can give 15 to 20 decibels of protection.” This is something to remember during takeoff on your next flight!

You don’t always notice the effects of noise damage immediately. Dr. Brian Blakley, chair of the Department of Otolaryngology at the University of Manitoba in Winnipeg, says, “When you are 20 and you do a little bit of damage to your ears, sometimes it doesn’t become obvious until 30 years later, when the effects of aging also kick in.”

This is what happened to Jean Deslauriers, now in his 70s and living in Laval West, Que., who served in the Canadian Navy during the 1950s as a gun loader. “I was right on top of the artillery when the guns were fired, and the blasts were bound to have an effect on my ears,” he says. He was young at the time and didn’t notice that there was anything wrong with his hearing. But as he grew older, he began to experience hearing loss.

“I have to turn the volume up on the TV and telephone, and I keep having to make my wife repeat what she says or I miss half the sentence,” he says.

Sometimes people suddenly lose their hearing in one or (rarely) both ears. Sudden sensorineural hearing loss is not well understood but it affects about 3,000 people every year in Canada. Says Parnes, “There are different theories about the causes. It could be a viral infection, an inflammatory problem, a little stroke in the inner ear or a rupture of delicate membranes.” Parnes says the important thing to remember is that “this is an emergency. If we can see patients early, putting them on steroids is beneficial. But after a month, it’s too late.”

If you do have a hearing problem, there is a lot of help out there, although not everyone is taking advantage of it. According to the Canadian Hearing Society, one in five people with hearing loss would rather struggle than get a hearing aid. This may be because they have only tried older hearing aids, which were difficult to use as they amplified all the sound. Newer digital hearing aids, costing between $1,000 and $4,000 per ear, have built-in smarts that allow them to do a better job of figuring out which sounds you want amplified.

Mark Betuzzi, in his mid-50s from Kamloops, B.C., suffered hearing loss because of noise at work and because of childhood ear infections. “The new hearing aids,” he says, “are phenomenal at knocking out the background noise.” His hearing aid has three settings: one for normal listening, one for noisy places such as restaurants and one for playing music. It’s good enough for Betuzzi to play second trumpet with the Kamloops Symphony Orchestra and principal trumpet with the Thompson Valley Community Orchestra in Kamloops.

A device called a Bone Anchored Hearing Aid (BAHA) can be implanted in a bone behind one ear during day surgery. The BAHA was first used by people who could not wear standard hearing aids because of chronic ear infections or because they had deformities of the ear canal. It bypasses a damaged middle ear by vibrating the skull. More recently, the BAHA was found to be helpful for people who are deaf in just one ear as it can send sound through the skull from a bad ear to a good one. Kathryn Deacon, 68, of Delta, B.C., lost all her hearing in one ear after a stroke. She now has a BAHA and thinks the device, which cost her $3,800, is worth every penny. “It’s marvellous. What amazes me is that I can totally plug my good ear and still hear.” The cost of a BAHA is covered to varying degrees by provincial health plans.

Hearing aids can also be supplemented by a variety of other devices. Leo Bellemare, 54, of Barrie, Ont., calls himself the “poster boy for people in denial.” He would often ask people to repeat what they had said, thinking many of them mumbled. For a long time he didn’t admit that he was hard of hearing. However, about three years ago, he tried a hearing aid that allowed a person wearing a small microphone to transmit directly to him via a wireless radio contact. Called an FM system, it is ideal wherever there is a lot of background noise. To test it, Bellemare and his wife went to a favourite restaurant where he normally would not be able to understand what she was saying. Bellemare says, “I could not believe the difference. I heard every word she said.”

Nowadays FM systems are often found in churches, schools, concert halls and conference rooms. Radios, TVs and phones can all be amplified for the hard of hearing.

Even more innovative solutions may be just around the corner. Donald Henderson, a professor at the Centre for Hearing and Deafness at the State University of New York at Buffalo, helped in the development of a pill that counteracts the effects of noise. In tests by the U.S. military, it was able to reduce hearing loss in deafening battle conditions. Other researchers are looking for ways to regenerate the hair cells of the inner ear. But so far “it’s very experimental,” says Dr. Jamie Rappaport, chief of otology and neurotology at the Jewish General Hospital in Montreal.

When it comes to noise, avoidance is still the safest course. Rappaport says, “I’m a big believer in the prevention of hearing loss. I trained at Harvard as an otologist, but when some- one comes in with nerve damage from noise, I can’t really do anything. I can fit them with a hearing aid, which may or may not be helpful. That’s why I give talks all the time—counselling hearing protection from noise—to family doctors, my residents, medi- cal students and the general public. We live in a noisier environment than ever before. Noise-induced hearing loss is an epidemic. But the problem is preventable.”