A Complete Guide To Noise-Induced Tinnitus
Tinnitus is a chronic and abnormal ear noise that affects millions of people globally. The U.S. Centers for Disease Control has revealed that about 15 percent of the American population experience tinnitus.
Although Tinnitus symptoms are different for patients, the impact of this epidemic can be debilitating. While some hear low pitch sounds, others experience high pitch sounds that impair hearing and cause mental exhaustion.
These intrusive and annoying sounds take different forms and may happen frequently or at different intervals.
Noise-induced hearing loss is one of the most prevalent triggers of tinnitus. It typically occurs due to short and long-term exposure to occupational noise, recreational or leisure noise, and acoustic trauma.
Why is this epidemic a growing concern for medical experts and audiologists? Tinnitus is invisible, and there is no medical cure. So the increasing number of patients shows a troubling trend. Research has shown that over 30 million workers in the US are exposed to hazardous noise levels.
Beyond noise-induced tinnitus, there are other common causes of tinnitus, such as
- Age-related hearing loss (also known as presbycusis),
- Emotional trauma and stress
- Trauma due to concussion, head or neck injuries, and surgery
- Ear Obstruction caused by dirt or foreign objects, ear wax, etc.
This article will provide deep insights into noise-induced tinnitus, its causes, and recommended treatment methods.
Let's get to it.
Every day, we are exposed to sounds and noises from multiple sources such as vehicles, devices, human speech, traffic, music, etc. In most cases, these sounds may be at safe levels. But at other times, the noise levels may be unsafe and can potentially damage the ear.
Tinnitus is directly related to short and long-term exposure to unsafe noise levels. According to the World Health Organization, about 50 percent of people between the ages of 12 and 35 could be exposed to hazardous sound levels and frequencies from audio devices. Another research has shown that people with a positive history of work-related noise exposure have a 70 percent increased risk of experiencing tinnitus than people without a history of noise exposure.
You may experience tinnitus during a single traumatic experience. Even a short-term exposure of up to 15 minutes is enough to produce auditory fatigue, damage the auditory system, and cause hearing loss.
The hearing loss may sometimes be unilateral (one ear only) or unilateral (two ears) and prevents patients from hearing sound around the trauma’s frequency.
During diagnosis, it is not always possible to unequivocally identify the cause of the noise exposure associated with the individual's tinnitus. Albeit, work-related noise exposure, and recreational noise exposure result in more new tinnitus cases than all other etiologies combined.
What Causes Noise-Induced Tinnitus?
Noise-induced tinnitus is sensorineural and is triggered by loud noise exposure.
But how loud is too loud?
Experts believe that any sound that is above 85 decibels (dB) is harmful, especially when you are exposed to it for more extended periods.
Traumatic noise exposure can be work-related. However, the potential causes of non-work-related vulnerability are numerous, including
- Participating in sports like hunting,
- Listening to music and attending music concerts,
- Hobbies like flying airplanes and helicopters
Another potential source of tinnitus is noise exposure during active military service or accidents.
Recreational or Leisure Noise
Some leisure activities are dangerously loud, and people that engage in them face the risks of tinnitus. Here are typical examples we can relate to.
Shooting firearms may be work-related if you are in the military. But when used for hunting and target practice, it is purely recreational and a leading cause of noise-induced tinnitus and hearing loss.
The noise intensity for a round of most firearms exceeds 132db. And it is unreasonable for anyone to fire a single shot without wearing protective hearing equipment. Exposure to such sound levels can cause acoustic trauma and, in most cases, permanent hearing loss.
Sporting Events (Motor Sports)
Attending a Formula 1, NASCAR, or a MotoGP event may be an incredible and unforgettable experience. But the noise that comes from powerful engines and cheers from the crowd can affect your hearing.
Powerful engines from power bikes, sports cars, and jet skis generate sound in the range of 100 dBA and above. Although exposure to this sound level may not have an immediate impact, it may subject the ear to wear and tear and can cause tinnitus in the long run.
Music can be classified as both a recreational and work-related exposure to sound. The sound level of music on full volume via headsets falls between 100 to 110dB. And listening to loud music via earphones or headphones is a leading cause of noise-induced tinnitus.
Grammy, Emmy, Oscars, and Tony Award-winning American actress Whoopi Goldberg attributes her noise-induced hearing loss to "years and years of listening to music so loudly and so close to the delicate eardrum.”
Here are ways you can protect yourself,
- Turn down the volume of your music.
- Don't use earphones for long periods. Take breaks at frequent intervals.
- Use noise-canceling and quality headsets.
That's not all. Other recreational activities that can trigger noise-induced tinnitus include noise from movie theaters, video arcades, firecrackers, motorboats, etc.
Work-Related Exposure to Noise
Work-related exposure to dangerous noise levels happens across a wide range of industries. And most industries that use loud equipment and power tools will most likely have workers suffering from noise-induced tinnitus and hearing loss. The National Institute for Occupational Safety and Health (NIOSH)reveals that about 22 million workers are yearly exposed to dangerous noise levels.
Power tools, chipping guns, drill motors, jackhammers, lawnmowers, etc., are all above 85 decibels. Jet and aircraft engines have noise levels between 110 and 140 decibels. So, when workers have increased exposure to these noise frequencies, it could rupture their eardrums and cause tinnitus.
Exposure during Military Service
Tinnitus and hearing loss is the most significant service-related disabilities and impairments among veterans and active service members. In 2012, 9.7 percent of veterans received disability benefits for tinnitus, while 5.8 percent received compensation for hearing loss.
It is no surprise as military personnel are frequently exposed to loud noise from weapons, explosives, gunfire, and heavy military equipment while in active service.
Higher noise levels are also found in aircraft and ship engine rooms. For instance, patrol vessels and ship tanks generate noise levels between 98 to 103 decibels. Missile gunboats generate about 120 decibels of noise. Carrier decks have dangerously loud noise that ranges between 130 to 160 dBA.
In such settings, long term exposure can stretch ear tissues beyond their elastic limits and cause permanent damage to the ear.
It is important to note that whether noise-induced tinnitus is recreational or work-related, the impact varies among patients. Some victims of tinnitus tolerate and manage their symptoms with less difficulty. Yet others suffer from a wide range of problems, including
- Stress, anxiety, depression, emotional trauma
- Hearing problems
- Insomnia, mental exhaustion, and lack of concentration
- Speech difficulties and lack of coordination
- General and work-related problems
- Inability to understand speech
Patients living with noise-induced tinnitus may also face work-related problems that may decrease productivity, such as
- Communication disorders
- Absenteeism and
- Increased risk of accidents.
Popular Cases of Noise-Induced Tinnitus
Entertainer's lives practically revolve around loud noises, so they face huge risks of noise-induced tinnitus.
Musicians are exposed to loud noises from speakers, musical instruments, and sound enhancers. Beyond stage performances, they attend practice and production sessions and listening parties.
Well, that's how they make their living.
Regardless of their genre of music, frequent noise exposure can induce tinnitus and hearing loss. About 35 percent of symphony orchestral musicians experienced tinnitus. And up to 19 percent of them report that tinnitus has a severe effect on their daily life.
Actors, movie directors, and stunt doubles are not left out. They perform stunts to create blockbuster movies that bring enjoyable and memorable experiences. While creating films for the big screens, they are exposed to loud noise from gunshots, explosions, special effects, and pyrotechnics.
Many of these celebrities, including actors and musicians, have spoken up and attributed their tinnitus diagnosis to loud noises.
Here's what some of them had to say.
"I have severe hearing damage. It's manifested itself as tinnitus, ringing in the ears at frequencies that I play guitar. It hurts, it's painful, and it's frustrating."
Pete Townshend of The WHO, Musician
"I've had tinnitus for about ten years, and since I started protecting my ears, it hasn't got any worse—touch wood. Unfortunately, looking after your ears is something you don't think about until there's a problem. I wish I'd thought about it earlier."
Chris Martin of Coldplay, Musician
"I suffer from permanent tinnitus . . . which means I've got this constant ringing in my ears, which has also made me somewhat deaf (or 'conveniently deaf,' as Sharon calls it). It's like this 'whee!' noise in my head all the time. Should have worn earplugs, I guess."
Ozzy Osbourne, Musician
"Tinnitus, big time. That's the price you pay for having a darn good time. Nothing's free!"
Tim Bogert, Musician
How Noises Damage our Hearing
Exposure to dangerously loud noises damages sensitive components of our auditory system. We cannot fully understand how these damages occur without understanding how we hear and how the brain process sounds.
We hear the sound because of a series of events that convert vibrations (sound waves) that reach our ear into electrical signals. Auditory nerves transmit these signals to the brain, allowing us to classify sounds into noise, music, or speech.
Sound waves that penetrate the outer ear travel through the ear canal. The ear canal is a narrow pathway that leads to the eardrum. The eardrum vibrates due to the incoming sound waves and automatically transmits these vibrations to three tiny bones (malleus, incus, and stapes) located in the middle ear.
These bones couple the sound vibrations and send them to the cochlea in the inner ear, which is snail-shaped and filled with fluids. These sound vibrations create waves that cause the cochlea to ripple and form a traveling wave along the basilar membrane.
As the waves form, they cause tiny hair cells that can detect sound to bend. Bending causes pore-like channels to open up, and when that happens, chemicals enter into the cells and create electrical signals. The auditory nerve transmits the electrical signals to the brain, and the brain translates the signals into sounds that we recognize and understand.
Now here's the point.
The average human has about 16,000 hair cells within the cochlea, and without these hair cells, the brain cannot detect sounds. So, noise-induced hearing loss occurs when your hair cells are damaged or dead. Unfortunately, human hair cells do not regenerate and cannot be repaired.
In most cases, the patient may not directly observe the hearing loss or lost frequencies. But this doesn't mean that the damage has not occurred. A hearing health professional or trained audiologist can perform several audiometric tests to measure hearing impairment’s true extent.
Noise-Induced Tinnitus Treatment and Recovery
Noise-induced tinnitus is usually permanent. Unfortunately, the cure for this condition has eluded scientific understanding. So, while progress is being made in finding a cure, it's critical to take precautionary measures to protect your ears.
However, if you experience noise-induced tinnitus, there are treatment options that can help you manage your condition, improve your health and mental well-being.
Here are some of the ways you can avoid exposure to noise loud noise and noise-induced tinnitus.
- Avoid dangerously loud noises
Do your best to keep away from loud noise. If the noise hurts your ears, or you can't hear what others say, and you have to raise your voice while responding, the noise is loud enough to induce tinnitus.
- Protect your ear during loud activities or events
If you cannot avoid places with a loud noise, you need to protect your hearing during loud events or recreational activities such as nightclubs, sports events, or concerts.
These options might help.
- Move away or far from the primary sources of loud noises such as speakers.
- Take a break from the noise at intervals.
- Wear earplugs that reduce the intensity of sound.
- Use your headphones with caution
When listening to music via your headphones, you can
- Turn down the volume.
- Use quality noise-canceling headsets.
- Remove the earphones at intervals.
- Adhere to safety precautions at work
If you're exposed to loud noise during work, you may need to
- Ensure you aren't exposed to the noise for an extended period
- Switch to less noisy equipment, if possible
- Wear ear protective gears, like earplugs and earmuffs.
- Get frequent hearing checks
Visit the audiologist for hearing checks as frequently as possible, especially if you're facing a higher risk of noise-induced tinnitus. For example, if you work in a noisy place or you're a musician.
Extensive hearing examinations can provide baseline reports about your hearing status, track changes, and flag abnormalities.
Numerous treatment options can help you reduce the impact of chronic and severe noise-based tinnitus. Let's take a look at some of them.
Use of Hearing Aids
Hearing aids are electronic sound amplification devices that are worn in the ear to improve hearing and communication.
According to a 2007 survey of 230 hearing care professionals, respondents agreed that 22 percent of patients experience significant tinnitus relief when using hearing aids. About 60 percent enjoy minor to considerable relief.
Here's why hearing aids are effective in minimizing the burden of tinnitus.
The intrusive noise from tinnitus can make it difficult for patients to concentrate. But hearing aids cover the sound of tinnitus by increasing the intensity of sound from external sources. Hearing aids recalibrate the brain to focus on external sounds.
Loud tinnitus negatively impacts normal communication flow. The condition makes it almost impossible for patients to engage in work or social activities. With hearing aids, patients can enjoy improved communication and cope better with tinnitus.
Sound therapies also involve the use of external noise to counter sounds from tinnitus. The term represents a wide range of different methods that help to alter a patient's reaction to noise-induced tinnitus, including
Habituation helps the human brain to recategorize tinnitus as an insignificant sound.
Distraction uses external sound sources to divert your focus from the sound of tinnitus.
Neuromodulation utilizes unique sounds to minimize hyperactivity in the brain.
There are a couple of medical-grade and technology-enabled devices that are used to mask sound, such as
- Modified sound devices
- Special notched music devices
- Combination devices
- Sound and sleep apps etc.
Maintaining a Healthy Lifestyle
The burden of tinnitus can be mentally and emotionally draining. And stress, anxieties, and trauma can further aggravate its impact. So, it is essential to engage in activities that improve your mental and emotional well-being.
Here are some recommended activities that may help a great deal
- Physical activities like exercises, yoga, etc
- Social activities like networking, volunteering, community service.
- Hypnotherapy and meditation
- Recreational activities.
The dynamics of human communication and interaction with our physical environment makes it inevitable for us to face exposure to loud noises.
Albeit exposure to dangerous noise levels over a long period can cause tinnitus. Tinnitus hurts the mental and emotional well-being of patients. And people that experience this condition suffer a great deal.
Whether it's recreational or work-related noise, noise-induced tinnitus can be prevented. You can reduce your exposure by wearing hearing protective devices or simply avoiding loud noise sources.
If you experience tinnitus, consult an audiologist or hearing professionals. They will evaluate your condition and recommend the best treatment methods that will help you.
Drew Sutton M.D.
Drew Sutton, MD is a board-certified otolaryngologist. He has extensive experience and training in sinus and respiratory diseases, ear and skull base surgery, and pulmonary disorders. He has served as a Clinical Instructor at Grady Hospital Emory University for more than 12 years.