Photo credit: D Coetzee has dedicated this photo to the public domain
by Daniel Fink, MD, Chair, The Quiet Coalition
As I have written often, in public health prevention of disease is almost always cheaper and better than treating it after it affects someone. This is certainly true for noise-induced hearing loss, where the only current treatment is amplification using hearing aids or newer personal sound amplification products.
BioMed Central, one of the world’s leading open-access publishers of medical and scientific journals, published a recent blog post about public health interventions to prevent NIHL. A literature review found only eight studies on the subject, with effectiveness of public health interventions at encouraging use of earplugs before noise exposure being statistically significant in terms of effectiveness, but in my opinion not great enough to really protect the public.
Michael Loughran, the author of the blog post, concluded:
Overall the results tell us there are very few hearing protection interventions addressing recreational noise exposure, a global hearing health concern, and those that have tackled the issue have had mixed success. Further intervention studies should be conducted that employ randomized controlled designs, with use of systematic approaches to intervention development (e.g. the behavior change wheel), as this will help target specific behavior change techniques in an effort to increase hearing protection behaviors and raise effect sizes.
I’m a big believer in scientific research. There usually is no giant breakthrough from most research studies, but taken together they help provide useful information on which to base both public policy and personal behavior.
For prevention of NIHL, the science is clear and no further research is needed. Noise exposure causes hearing loss, which can be prevented by avoiding loud noise and prevented or reduced by wearing OSHA-rated hearing protection with a Noise Reduction Rating of 25 or greater.
More research on how best to encourage people to protect their hearing would be a good thing. But an even better thing would be for federal and state agencies to issue detailed guidelines for reducing noise exposure to prevent hearing loss, as it has been done for preventing skin cancer, and for federal, state, and local health agencies to issue regulations requiring quieter malls, stores, restaurants, concerts, sports events, vehicles, and aircraft.
