We often take our hearing for granted until it is affected. There are 38 million people in the United States who are partly or totally unable to hear sound in one or both ears. Hearing loss seems to be accepted as a part of aging, but the leading cause of hearing impairment is exposure to noise.

Adults, adolescents and children are commonly exposed to loud music through earbuds connected to iPods and MP3 players or while attending live concerts. Many of us also risk noise exposure in the workplace — firefighters, police officers, factory workers, farmers, construction workers, military personnel, heavy industry workers, airline ground maintenance crew, musicians, sound crew, recording engineers and entertainment professionals.

The human ear is fine-tuned for hearing. The outer ear collects sound waves and sends them through the ear canal that leads inside the ear. At the end of the ear canal, the eardrum (tympanic membrane) vibrates when sound waves strike it. It divides the outer ear from the middle ear and attaches to three tiny bones in the middle ear: the hammer (malleus), anvil (incus) and stirrup (stapes). The bones pass vibrations to the cochlea in the inner ear, a coiled structure like a snail shell. The inner ear is filled with a thin fluid that transmits pressure changes throughout the cochlea. Inside the cochlea, tiny hair cells pick up vibrations from the fluid and change sound into electric signals. The auditory nerve carries the message to the brain, which it interprets as sound. The inner ear’s tiny hairs are easily damaged by loud sounds, especially repeated exposure to loud noise and loud music over time.

Symptoms of hearing loss include certain sounds that seem too loud, voices that sound mumbled or slurred, difficulty following conversations when two or more people are talking, difficulty hearing in noisy areas, difficulty distinguishing high-pitched sounds (such as “s” or “th”) from one another and less trouble hearing men’s voices than women’s voices. Other symptoms include a feeling of being off-balance or dizzy, pressure in the ear (fluid behind the eardrum) or a ringing or buzzing sound in the ears (tinnitus).

If you experience any of these symptoms, contact your health care provider for a referral to an ear, nose and throat specialist. A hearing assessment may include a hearing test by an audiologist, a CT scan of the head or an MRI of the brain. The goal of treatment is to prevent further hearing loss, improve communication using any remaining hearing and develop coping skills such as lip reading. Hearing aids and cochlear implants have improved over the years, and most devices are not noticeable when worn.

Noise harms more than our ears. It is a significant source of annoyance that can cause fatigue and headaches, make us tense and stressed, and increase aggression. Studies correlate noise exposure with elevated blood pressure, cardiovascular changes, digestion disturbances (noise increases gastric emptying and esophageal contraction) and mental health issues including increased anxiety and sleep disturbances. Those with hearing loss may not hear the smoke detector or fire alarm go off or an ambulance while driving. Not being able to hear conversations can lead to social isolation and cause depression. Hearing loss may cause a person to avoid leaving home.

The decibel is a unit to measure the level of sound. The softest sound you can hear is 0 decibels. Normal speech ranges between 40 to 60 decibels. Sounds above 80 decibels may cause vibrations intense enough to damage the inner ear, especially if the sound continues for a long time. A rock concert measures between 110 to 120 decibels or as high as 140 decibels in front of the speakers. Headphones are 110 decibels. The risk of damage to your hearing when listening to music depends on how loud the music is, how close you are to the speakers, how long and how often you are exposed to loud music, headphone use and family history of hearing loss.

Generally, if you need to shout to be heard, the environmental sound is in the range that can damage hearing. The noise of a large truck five yards away is 90 decibels. Motorcycles, snowmobiles and similar engines range from 85 to 90 decibels. A jackhammer about three feet away is 120 decibels. A jet engine about 100 feet away exposes you to 130 decibels. In the United States, the maximum job noise exposure is regulated by law, considering both the length of exposure and the decibel level. If the sound is equal to or greater than the maximum levels recommended, protective measures are required.

Know which noises cause damage and protect your ears. Wear ear muffs, earplugs or other hearing protection devices when involved in a loud activity such as shooting a gun, operating machinery, driving snowmobiles, listening to music or attending a concert. Whenever possible, turn down the volume and limit exposure time to loud music. Decrease the amount of time you use headphones and turn down the volume; it is too loud if a person standing near you can hear the music. People not only have the right to peace and quiet, their health and hearing depend on it.

The content of this article is for informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition.