You're in a club, immersed in a band, and on stage the lead singer spouts something that makes everyone laugh — everyone but you, that is, because you couldn't hear what he said. At the office holiday party, you find yourself leaning in and repeating, "Sorry?" thanks to background chatter and music that make your co-workers sound like Charlie Brown's parents in Peanuts. You assume a kind of auditory denial and think, "OK, maybe I've lost a little hearing. It's just part of getting older."
That may be true — but hearing loss is happening to more of us, and sooner: A report in March from JAMA Otolaryngology predicted that the number of U.S. adults aged 20 or older with hearing loss will rise from 15 to 23 percent in the next 40 years. That's likely due to a constant assault of noise. We've become so accustomed to blaring sound — in traffic, at the gym, through our earbuds, while hitting blend on our green smoothies — that even our definition of what "loud" is has changed.
What we know: Twice as many people now have hearing loss as in the Eighties. Not coincidentally, that was the decade the Walkman entered our lives — and we're starting to see the impact on middle-aged Gen Xers: One in 14 grapples with hearing loss. The scarier stat? About 30 percent more teenagers have hearing loss now than when Reagan was president. A recent Brazilian study found that 28 percent of teenagers there had tinnitus (ringing in the ears) due to using earbuds and going to loud concerts and parties.
Age, of course, plays a role in losing hearing, and the fact that we're living longer adds to that. But age-related hearing loss is often caused by increasing exposure to moderately loud noise, explains Stanford professor and auditory expert Stefan Heller, "so aging and noise-caused hearing loss could be intertangled."
And that's where our ever-louder world is also to blame. "In the past, we were exposed to music and power tools, but we weren't exposed to so many combinations of things," says Heller. Medical professionals of all stripes, including those at the U.S. Department of Health & Human Services, agree that our ears shouldn't be subjected to any sound above the destructive threshold of 85 decibels — the volume of a blender. Anything higher can cause hearing loss. (It's important to note that decibel level is not a linear measure. Sound at 80dB is more than twice as loud as at 70dB, and 90dB is 10 times as loud.) Yet we're regularly bombarded with noise far louder than 85dB: motorcycles (95), subway rumble (100), rock shows (115), group cycling classes (117), and screeching kids' toys (up to 150). Movies, particularly, are more and more deafening (action movies have clocked in at 105), and they produce some of the longest exposure.
The fact that we seldom think about how we expose ourselves to these loud sounds is the heart of the problem. "Noise-induced hearing loss is more an issue because people underestimate it," says New York City audiologist Lisa McDevitt, who has seen a rise in this condition in her patients during the last decade. "Noise-induced loss takes place gradually — people aren't aware of it."
In Europe, regulations are in place to limit headphone volume and to protect bar employees from excessive noise in the workplace. So far, few of those preventative measures have made it to the U.S., where hearing loss isn't taken quite as seriously. "We haven't kept pace in terms of managing the change of sound exposure," says Deepa Sekhar, an associate professor of pediatrics at Penn State College of Medicine who has studied the connections between hearing loss and iron deficiency. "We've done a good job with seat belts and keeping pace with faster cars; we haven't done the same with hearing."
All of which raises the question, "Are we going to see people lose their hearing at an earlier age, and lose it more severely as time goes by?" asks Robert Jackler, chair of otolaryngology at Stanford, the U.S. institution leading hearing loss research, before emphatically answering, "Yes."
In other words, we're doing this to ourselves. And because permanent hearing loss means just that, our only recourse is awareness and prevention — as I was about to discover for myself.
My realization started simply. "Daddy, your phone," my daughter said to me as we were out walking a few years ago. I pulled out my cell, and sure enough, it was clanging. At the time, I chalked up my not noticing it to the cacophony of Manhattan street noise or the depth of my pockets. Given all the concerts I'd attended — I've been a music journalist for more than 30 years — and all the albums I'd pumped into my ears with headphones, I was bound to squander a little hearing. (Two decades ago, I had survived an intimate Guns N' Roses show so brutally assaultive that it left my ears still feeling clogged with cotton balls the next morning.)
But it would be my daughter, again, who pointed out the worsening problem: "Daddy, it's beeping," was her constant gripe when I stopped taking notice of the high-pitched timer on our microwave.
I dutifully sign up for physicals and dental checkups, but hearing exams? Not so much. I didn't subject myself to a hearing test as an adult until my late thirties, when I began noticing my ears would take longer to readjust after a deafening concert. Those results weren't alarming: The audiologist told me I'd suffered a degree of frequency loss, but it seemed so trivial I didn't even bother to write down the diagnosis.
It was now obviously time for an update, and I found myself sitting in a small, dark room wearing headphones. On the other side of glass, an audiologist spoke into an intercom, asking me to repeat words:
The audiologist, Lisa McDevitt, then asked me to raise my hand when I heard a sound. My arm shot up at a spooky-whistly Twilight Zone tone at various volume levels. Other times I heard nothing.
My results were sobering. My issue, she said, was sloping high-frequency loss. This is the way most of us lose hearing: First we stop hearing the high-pitched sounds, then the low. The condition explained why I was having trouble with clarity and deciphering consonants, softer sounds ("f," "th," "s"), and women and children's voices. It's easy to joke about that last one — ah, selective hearing! — but it's less amusing at dinners or parties, where I suddenly feel isolated, literally not in on the joke.
The physiological reason why this was happening, to me and millions of others, is simple. When we hear, a sound makes its way past the ear canal and ear drum to the inner ear, home to the cochlea, a snail-shaped part of the ear lined with microscopic hair cells, or stereocilia. To picture them, imagine incredibly fragile and small cylinders sticking up.
Those hair cells are able to detect extremely soft sounds and handle loud ones. They can be flattened or destroyed by way of one catastrophic sound, like a firecracker exploding near you. But decades of headphone usage or ear-piercing concerts or blaring SoulCycle classes can add up to permanent loss through gradual wear and tear, too. Once wrecked, the hair cells, which can number 15,000 per ear, are gone for good. And because hearing loss doesn't have tangible symptoms, like bleeding or bruising, you don't know you're a victim until the damage is done.
The goal for me — for anyone who has suffered hearing loss — is to prevent further damage. McDevitt suggests two courses of action: The first is shelling out for custom-molded earplugs to wear to concerts and other eardrum-battering events. You can get those from any reputable audiologist, and they'll run about $250. (Wearing these plugs, you can still hear what's going on around you, but the sound isn't as sharp — or destructive.) The second recommendation is harder to digest: McDevitt says I should consider hearing aids.
This is depressing news — I didn't think my hearing was that bad. But it's doubly chilling, because I know this diagnosis well.
For as long as I knew him, my father wore a hearing aid, one of those clunky, hard-to-miss devices, so sensitive that it made a whistling noise when he touched it. Maybe it was a coincidence, but in his fifties, he took a job working the night shift in an office building, overseeing the heat and electricity. There, he didn't need to talk to people or admit his affliction, something he was loath to do.
Hearing loss, the more I looked into it, has a profound and unsettling impact in the workplace, starting with money. According to a 2010 study by the D.C.-based Better Hearing Institute, people with hearing issues can make as much as $30,000 a year less than those without them. The reasons for that are direct or indirect repercussions of not being able to hear what's going on — a failure to chime in and offer suggestions, making "mistakes on the job," coping with anxiety and related issues that may damage job performance, and underemployment (or unemployment altogether).
The psychological impact of hearing loss can be even more debilitating, leading to isolation and depression, and it's still a largely unspoken ailment. Like my dad, subsequent generations are also unwilling to admit to hearing issues, which suggests a larger social stigma at play. Only 20 percent of older people diagnosed with a hearing handicap do anything about it, and even then, people stall — those who purchase a hearing aid wait, on average, 10 years to do so. It's not hard to imagine why. "If you need something for vision, you put this piece of glass in front of your face and you look smart," says Jackler. "Stick a putty-colored thing behind your ear, and you're old and dumb."
At about two dozen labs around the world, scientists and researchers are trying to figure out how to regenerate inner-ear hair cells. As few as 10 percent of those hairs would need to be reconstructed to restore a degree of hearing, but it's a complex problem. Drugs and surgery are options, but effective medication may not be available for another five to 10 years; meanwhile, surgical procedures on the inner ear require inordinate delicacy: Unlike operating on the human eye, it's hard to navigate inside the inner ear without damaging it.
But Jackler offers hope for reversing permanent loss. "If you had asked me 10 years ago, I would have said we'd have a cure 'someday,' " he says. "Now I believe we can regenerate the inner ear, and I'm hoping we'll be in serious trials for a strategy in a decade."
In the meantime, a thriving cottage industry has sprung up to deal with our audio deficiencies. You can now buy headphones that alert you when the volume hits 85dB, a Dyson hair dryer that's more faint to the human ear, and apps that measure the decibel level in your vicinity.
For now, I've ponied up for those personalized earplugs. I've started making a determined effort to avoid restaurants and public spaces where I know the music, conversation, and clattering of dishes will be overpowering. And I find myself utilizing the same closed-captioning feature my father favored, but via my smart TV, with a sometimes comical effect: Watching house band the Roots cue up The Tonight Show, I'll see "loud rock music plays" at the bottom of the screen. After decades of experiencing it firsthand, that's an amusing line to read. But it's all less funny when I watch my daughter, sitting beside me, clamp on her headphones, and crank up her phone's volume.
Protect What You've Got
Five ways to ward off hearing loss.
Download a noise-measuring app. Companies like Decibel Meter Pro offer an instant way to measure the decibel levels around you, so you know exactly how loud it is at a concert or sporting event.
Get earplugs. "If your ears ring and feel hollow after a show, that means it hit your inner ear hard and harmed your hair cells," says Jackler. "Most people recover, but not everyone." At a loud event, even cheap foam plugs will help protect your ears. Custom-molded plugs from an audiologist are pricier, ranging from $75 to $250, but far more effective.
Check volume. Resist the urge to crank up the volume in your car with the windows down, or while wearing headphones on the street. Outside noise prompts you to turn up music dangerously high to drown out the ambient sound. (A simple way to monitor headphone volume? Take out one earbud and listen to how loud the music seems.)
Test iron levels. The nutrient helps carry blood to the ear, and studies have linked deficiencies to hearing issues. Get your iron levels tested at your next checkup.
Be wary of painkillers. Over-the-counter drugs like ibuprofen can reduce blood flow to the cochlea and damage the inner ear. Taking these painkillers just twice a week can increase hearing loss risk by 24 percent, a recent study found.