Hearing – protecting it, and what to do when it goes

Loud noise destroys the hair cells in the inner ear that convert sound into signals. Those cells do not grow back. Every exposure adds to a total that only ever goes up, which is why hearing loss from noise appears decades after the noise that caused it.

Both loudness and duration count. Very loud noise causes damage in minutes; moderately loud noise causes it over hours, repeated across years.

• Wear hearing protection for power tools, grinders, chainsaws, firearms, and in mining, construction and manufacturing. Employers are required to provide it; wearing it is the part that gets skipped.
• Foam plugs work well when inserted properly — rolled thin, pushed in, and allowed to expand. Half-inserted plugs do very little.
• At loud events, move away from speakers and take breaks in quieter areas.
• With headphones, follow the sixty-sixty idea: no more than about sixty percent volume for no more than about sixty minutes at a stretch. Noise-cancelling headphones help because people turn the volume down when there is less background to compete with.
• Never put cotton buds, matches or anything else into the ear canal. This is a leading cause of perforated eardrums and pushed-in wax.

• Asking people to repeat themselves often, or finding others seem to mumble.
• Struggling in a noisy room, restaurant or taxi — usually the first thing to go.
• Turning the television up beyond what others find comfortable.
• Missing a phone or doorbell others hear.
• Ringing, buzzing or hissing in the ears.
• In a child: not responding to their name, delayed speech, or falling behind at school. Untreated hearing loss in a child is frequently mistaken for inattention or a behaviour problem.

Untreated hearing loss is one of the larger modifiable risk factors for dementia, and it drives social withdrawal, isolation and depression — people stop going to the places where they cannot follow the conversation.

Hearing aids are commonly delayed for years out of cost or self-consciousness. Public sector audiology services exist and clinics can refer; medical aids often cover a device at an interval. Getting assessed costs nothing but time, and the assessment also finds the causes that are simply fixable — wax, infection, or fluid behind the eardrum.