Management of Noise Induced Hearing Loss

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Answer

Reducing the risk of progression of this type of loss is among the primary concerns of the audiologist. As the diagnosis states, the cause of the loss has been established from at least one known source (occupational or recreational, traumatic or progressive). Regardless of the etiology or time line, communication complaints may also be a symptom.

Avoiding the source of the noise is the easiest way to reduce further changes in hearing. However, that may not be practical if the noise source has been identified as job-related. If the noise cannot be reduced at its source then the next logical step is to reduce the high intensity noise levels as they enter the ear using ear plugs/muffs. These devices are commonly referred to as noise filters or hearing protection devices (HPDs). HPDs are commercially available or can be custom made for consistency of the fit. Noise protection devices have a ''Noise Reduction Rating'' (NRR) on the packaging which serves as a guide as to how much protection (noise attenuation or reduction in decibels) the wearer might achieve in ideal situations. I tell my patients that the NRR should be as close to their age as possible (except teenagers when I recommend the highest number on the shelf over 25).

Finally, an annual audiometric evaluation will serve as the best measure to determine the effectiveness of any hearing protection device and hearing conservation program. Any changes in audiometric thresholds would indicate that a change in the type of protection selected may be in order or a need for further patient counseling concerning the long term effects of continuous noise exposure with improper or intermittent use of any hearing protection device. I tell my patients that properly worn hearing protection devices are significantly less expensive than hearing aids!

BIO
Robert M. DiSogra is NJ licensed audiologist and Director of Audiology Associates of Freehold (NJ). He also is an Instructor in the Graduate School of Audiology at the Pennsylvania College of Optometry. Bob has over 25 years experience in clinical, educational, research and industrial audiology. He has had several publications and has taught both undergraduate and graduate level courses at Rutgers University and Kean University. Bob was a cofounder of the NJ Academy of Audiology and served as its first President. He was the 1995 recipient of the award for Outstanding Clinical Achievement from the NJ Speech-Langauge-Hearing Association.