Photo credit: Christina Morillo
by Daniel Fink, MD, Chair, The Quiet Coalition
The World Health Organization’s Ear and Hearing Care Programme announced its new publication, Hearing Aid Service Delivery Approaches for Low- and Middle-Income Settings. As WHO has reported, only a minority of people worldwide who could benefit from hearing aids have been able to get them. This is certainly the case in the United States, where hearing loss is common in older people, but Medicare does not cover hearing aids. This is even more of a problem in developing countries, where there may not be a national health insurance program. And, these countries may have more pressing health and economic problems than providing hearing aids to their communities.
Even with newer and less expensive over-the-counter hearing aids for sale in the U.S., I don’t think providing hearing aids to everyone who needs them is the right approach to the problem of hearing loss. Prevention of disease is always better than treatment. Hearing aids don’t correct hearing loss, and they don’t provide an auditory correction like lenses provide a visual correction for those with vision loss. In addition, no country has yet been able to provide hearing aids to all who might benefit from them.
I believe that finding out what the safe noise exposure level is to prevent noise-induced auditory disorders — specifically noise-induced hearing loss, tinnitus and hyperacusis — and vaccinating infants and children against diseases causing hearing loss (including measles and meningitis) is better and more cost-effective than trying to provide hearing aids.
The exact noise exposure doses that cause tinnitus and hyperacusis are not yet known, but preventing noise-induced hearing loss will probably prevent those conditions as well. According to the Centers for Disease Control and Prevention, noise-induced hearing loss is the only type of hearing loss that is entirely preventable.
If it sounds loud, it’s too loud and one’s auditory health is at risk. Avoid loud noise exposure, leave the noisy environment or use hearing protection, and the need for hearing aids could be avoided.
