Protect it or lose it – Now is the time for change!

As a clinical audiologist working in the UK for nearly 40 years, I have watched how our profession has adapted to accommodate the advances in technology and demands on our services.

However, audiology has remained predominantly reactive; we assist in diagnosis, treatment, and rehabilitation of individuals with a range of acquired auditory or vestibular disorders.

From the beginning of my career, I found it increasingly frustrating that many of the patients we see, have conditions that could have been avoided:

Induced auditory conditions that are a result of sound exposure, such as Sound-Induced Hearing Loss (SIHL) and induced tinnitus, are often preventable, yet are irreversible. Consequently, I have devoted much of time in considering effective auditory health conservation programs.

Why we should be proactive, not reactive

Audiologists react to those who have already acquired injury as a result of exposure. The question then is, can and should audiologists have a greater impact by being proactive in their practice to prevent disorders?

I believe the answer is, yes. Here are 3 reasons:

1. Consequences of SIHL can be devastating.  
   We have become increasingly aware of the increased risk of secondary health concerns linked to hearing loss and noise exposure. Dementia, cardiovascular disease, and other serious illnesses, in addition to acquired auditory conditions commonly dealt with by audiologists, strengthen the vital need for developing an effective preventative approach.
   
   
2. If we don’t work to prevent SIHL, more than 1 billion young people are at risk.
   In published reports from around the world including the World Health Organization’s (WHO) World Report on Hearing 2021¹, developing strategies for the prevention of hearing loss have been clearly highlighted as key objectives. However, despite improving awareness on the consequences of exposure, the prevalence of SIHL still continues unchecked. It could be argued that exposure to sound is the greatest cause of hearing loss in many societies around the world.
   
   The WHO tells us that more than 1.1 billion of young people aged 12-35 are set to suffer from SIHL, not from exposure to industrial noise but from everyday louder sound including listening to music.¹
   
   
3. Preventative audiology could help develop our profession.
   The role of the Audiologist is being unavoidably impacted by external forces. With the advent of OTC hearing aids, online sales and AQPs, etc., rightly, or wrongly our rehabilitative influence is already transforming.
   
   Whilst for the moment much of the diagnostic work remains within our remit, the changing landscape and challenges that healthcare systems worldwide are facing, means that we should be looking ahead in how audiologists should consider their role. Embracing and implementing preventative audiology offers us the opportunity to develop the profession and contribute to a healthier future for all.
   
   

What can we do to prevent sound-induced hearing loss?

The audiological profession could, and should, do more to encourage healthy hearing behaviors across a person’s life course and not just in the elderly. We already possess the experience, knowledge, and skillset to become instrumental in developing and implementing strategies for improved prevention of SIHL.

• Make an effort to engage with those at risk – Our practices could allow us to create touch points and opportunities to engage with those at risk, and we are able capitalize on our clinical skills to prevent these disorders and not just test and treat them once acquired.
  
• Address younger people and everyday sound exposure – Historically the only approach in protection of injury to hearing has been in the workplace, so exposure to potentially equally hazardous environmental or leisure sound has not been considered, consequently younger people have not been included in any program to conserve hearing health.
  
  Only workers in noisy environments will have had any consideration of their hearing and the procedures employed in regulatory noise at work programs will likely not have changed for decades, and may not be effective. We must engage younger people and discuss everyday sources of sound, like listening to loud music.
  
• Encourage use of health protection products in and beyond industrial settings – Types of hearing protectors and means to reduce exposure have evolved over the years so that suitable methods can be encouraged to reduce the risk of injury in all at risk environments.
  
  This could include:
  • using personal protective equipment (PPE) specifically designed for musicians
  • being aware and limiting the levels we listen to music on our headphones
  • using noise canceling headphones on a loud train journey
  • employing Smart PPE that will intuitively provide the appropriate level of protection for noise levels that change throughout the day, allowing safe listening in the workplace and unhindered communication (at the same time collecting comprehensive on-site noise level and compliance data)
    

Now is the time for change, as there is a better way

It is understandable that political appetite for this subject over the years has been limited as it does not demand the high profile, eye-catching headlines that other acute health issues may. Prevention is the Long Game and often decision makers are more involved with seeking immediate results in healthcare.

However, as the socio-economic burden and personal impact on health caused by all these induced illnesses is huge, promoting and supporting healthy hearing behaviors across a person’s lifespan should become a much greater priority in public health initiatives.  

We must re-consider all aspects of sound exposure; risk, protection, education and the methods used to gauge if those preventative elements have been effective, including suitable measurement of auditory status. Health Surveillance should provide a leading indicator of exposure, proactive prevention of injury, and evaluation on the efficacy of any auditory health conservation program, if it fails to do this then consider more effective alternatives.

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Example of successful auditory health conservation in action
Significant developments in hearing conservation have been made and are already being implemented. One sector that has already recognized these initiatives as Best Practice is musicians and the performance industry.

See Best Practice Guidelines for UK Performers downloadable from the BAPAM website here.

To learn about Serenity Choice™ Hearing Protection Products from Phonak, please visit our Overview of Serenity Choice™.

Reference:

World Health Organization (2021). World Report on Hearing. Retrieved from https://www.who.int/publications/i/item/world-report-on-hearing, accessed June, 2022.