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Measuring the Impact of Hearing Loss on Quality of Life

Posted on by Elizabeth Masterson, PhD, CPH, COHC

 

Hearing loss is common in the United States. More people have hearing loss than diabetes, cancer or vision trouble. Occupational hearing loss, which is caused by exposure at work to loud noise or chemicals that damage hearing, is the most common work-related illness. It is also permanent.

Hearing loss can have a profound impact on quality of life. The effects begin small and progress as hearing loss worsens. For most individuals, it starts with others sounding like they are mumbling because some sounds cannot be heard well. The individual often has to ask others to repeat themselves, and this becomes frustrating for both parties. Both begin limiting the length and depth of conversations. As hearing loss progresses, it becomes increasingly difficult to hear others in the presence of background noise. Social gatherings and even dinner at a restaurant become isolating activities because of the inability to understand what people are saying and individuals can’t contribute to the conversation. Over time, these barriers to communication can lead to strained marriages, diminished or lost friendships and limited interactions with coworkers and supervisors.

There are other effects, such as loss of enjoyment. Music…forest sounds…a grandchild’s voice…all of the sounds we want to hear become muted and lack quality. Even a person with mild hearing loss has trouble hearing softer sounds, has difficulty differentiating between the softest sounds and the loudest sounds, and has more listening fatigue. To compensate for this loss of hearing sensitivity, people with hearing loss will need to ”turn it up” whenever possible. Having the TV and radio at high volume can be annoying to others and a spouse or roommate may choose to watch TV in another room, again turning a group activity into a solo activity.

Safety can also be compromised. The sounds of a tea kettle, the warning beep as a fork lift backs up, and the engine of an oncoming car may be missed. There can be a general loss of situational awareness. It is also well known that workers with hearing loss are more likely to get injured on the job.

Not surprisingly, all of these challenges can affect a person’s mental health. Hearing loss is strongly associated with depression. Depressed people are also less likely to participate in activities with others, so the effects of hearing loss and depression compound and intensify isolation. Hearing loss is also associated with cognitive decline, which includes loss of memory and thinking skills. As people lose their ability to hear, they don’t use the hearing-related parts of their brains as much and these parts start to break down. It is a case of “use it or lose it”.

Often those with hearing loss also have ‘ringing in the ears’ (tinnitus). It can be an annoying buzzing, rushing or ringing noise in the ears or in the head. For some people, tinnitus is more than annoying and can disrupt sleep and concentration, increasing fatigue and affecting alertness. The symptoms can be intermittent or continuous. Like hearing loss, tinnitus can also impact mental health and is associated with depression and anxiety.

 

How does one assign a number to, or quantify the impact of hearing loss on these critical intangibles, such as communication and mental health?

One way to measure this impact is to calculate disability-adjusted life years (DALYs). These are the number of healthy years lost due to a disease or other health condition. For a condition like hearing loss, it doesn’t mean that a person dies younger, but rather that a person has fewer years of good health. The DALYs calculation takes into account life limitations caused by hearing loss as a lost portion of a healthy year of life, and we end up with the number of healthy years lost by a group of people over a specific time period.

NIOSH recently used DALYs to estimate the impact of hearing loss on quality of life in a CDC Morbidity and Mortality Weekly Report article titled “Hearing Impairment Among Noise-Exposed Workers in the United States, 2003-2012.” We examined noise-exposed workers because they have a higher risk of hearing loss. In our paper, we estimated the number of healthy years lost for every 1,000 workers each year. We also looked at each industry sector separately.

We found that 2.5 healthy years were lost each year for every 1,000 noise-exposed U.S. workers because of hearing impairment (hearing loss that impacts day-to-day activities). These lost years were shared among the 13% of workers with hearing impairment (about 130 workers out of each 1,000 workers). Mining, Construction and Manufacturing workers lost more healthy years than workers in other industry sectors; specifically and respectively in those sectors, 3.5, 3.1 and 2.7 healthy years were lost each year for every 1,000 workers.

Fortunately, no worker needs to lose years of good health because his or her hearing was damaged on the job. Occupational hearing loss can be entirely prevented with today’s hearing loss prevention strategies and technology. Visit our web site for more information on occupational hearing loss surveillance and links to resources to protect worker hearing.

 

Elizabeth Masterson, PhD, CPH, COHC

Dr. Masterson is an epidemiologist in the NIOSH Division of Surveillance, Hazard Evaluations and Field Studies

Posted on by Elizabeth Masterson, PhD, CPH, COHC

11 comments on “Measuring the Impact of Hearing Loss on Quality of Life”

Comments listed below are posted by individuals not associated with CDC, unless otherwise stated. These comments do not represent the official views of CDC, and CDC does not guarantee that any information posted by individuals on this site is correct, and disclaims any liability for any loss or damage resulting from reliance on any such information. Read more about our comment policy ».

    Dear Dr Elizabeth Masterson,

    I read your NIOSH science blog about “Measuring the Impact of Hearing Loss on Quality of Life”.
    I was interested in your paper.
    I can’t get the informations about the prevention method of Hearing Loss at the workplaces. I think at the workplaces, workers must wear the hearing prodection devices. But, during wearing the hearing protection devices on thier ears, they don’t listen the voice or some other audio informations at that time.
    So, how do you prevent the hearing loss at these situations? I wanted to know about this from your papers and NISOH publications. But, I couln’t get it.
    Can you teach me your considerations about this?

    Professor Setsuo Maeda, Dr.Eng., Dr.Med.Sci.
    Human Response to Vibration Research Laboratory
    Department of Applied Sociology
    Faculty of Applied Sociology
    Kinki University
    228-3 Shinkamikosaka, Higashiosaka
    577-0813, Osaka, Japan
    Tel:+81-(0)6-4307-4191
    Fax:+81-(0)6-6721-2512
    E-Mail:maeda@socio.kindai.ac.jp

    Thank you for your comment, which touches on a common objection to hearing protectors. Sometimes hearing protectors can block too much sound or “over-protect,” making it hard to hear conversation. Choosing an ear plug which blocks less sound (lower attenuation) could be a solution. If a worker already has some hearing loss, using a ‘flat attenuation’ ear plug can make speech more understandable. Either type of ear plug can be purchased from most safety suppliers. Information on how to choose the best protection is available on the NIOSH topic page on “Hearing Protector Devices” at http://www.cdc.gov/niosh/topics/noise/hpdcomp/. There is also additional information in the NIOSH Practical Guide for Preventing Occupational Hearing Loss at http://www.cdc.gov/niosh/docs/96-110/.

    Dr. Masterson,
    Excellent subject matter. I often reflect back to the times when I had better hearing. Now, after experiences in the aircraft industry (jet engine run-up ~ 120+ dB), and oil and gas (compressor stations 100+ dB with a high frequency impact to bone and vibration conduction) I’ve lost about 20% of my hearing.

    Ok so I’m no spring chicken anymore either. Even as an industrial hygienist who routinely pitches hearing protection and wore some form of ear plug or muff routinely I have lost the ability to hear my grandson talking from the backseat.

    So where am I going with this comment? It’s not about the sly looks when one tries to convince workers to wear hearing protection properly, even though the DALYs calculation is new to me and I intend to add it to my tool box. I note your comment about validating hearing protection efficacy and avoiding over protection. This is a promising approach to getting worker acceptance.

    I worked with one a hearing protection manufacturer last year who manufactures a software that tests and describes hearing fit as ‘personal attenuation rating’. I found the software useful as a training tool to describe proper fit and adequate protection especially in concert with audiometric testing. What are your thoughts on the matter of using this or other similar software programs for checking hearing protection fit?

    Thank you for this. Got hearing aids at age 61. I was finally able to stop saying “huh?” Contributing factors: continual ear infections as a child; lifeguard for five years during college break (many evenings ears would not clear); sales job for seven years requiring almost weekly airplane travel (sometimes ears would not pop when landing. oh brother); and twenty years of mowing the lawn with no ear muffs (wised up when I started working for NIOSH). Seven years go I had permanent tubes put in, under anesthesia. This finally did me in. No more tubes for me.

    Hi Calypso, I am just now reading this article/responses. I’ve suffered sudden hearing loss due to airbag deployment six months ago. In an attempt to regenerate hearing, the ENT put a ventilation tube in my ear for use in steroid injections. Six months later and the tube hasn’t fallen out. I haven’t really recovered my hearing in the affected ear and I’m wondering if having the ventilation tube still in my ear could be contributing to it. Did the tubes cause you to have more hearing loss? If so, did you regain any of it by having them removed?

    I woke up one morning about 5 years ago to realize that I had lost most of my normal hearing overnight in my right ear. The cause was never determined. It has significantly affected the quality of my personal and work life. I have experienced the cognitive / mental decline that Dr. Masterson discusses – it is REAL. Bob Allen

    A great article that touches on all areas of hearing loss. I don’t work in an industry where hearing protection is needed, but certainly can identify with having hearing loss and trying to work. it can be exhausting and the impact of untreated hearing loss on our health is proving to be more substantial than was previously realized. Treat your hearing loss. it’s worth the investment and there are implantable options as well.

    Dr. Masterson,

    I am a design student at the University of Cincinnati working with students in nursing and NIOSH to investigate potential solutions for reducing Occupational Hearing Loss. If it is not too much to ask we love to get your input on the subject. Please let me know if you would be willing to have a short meeting or respond to email questions.

    Thanx,
    Ade

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