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CDC Research on Non-Occupational NIHL

Carroll, Yulia MD, PhD; Eichwald, John MA

doi: 10.1097/01.HJ.0000515654.42611.16
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Dr. Carroll, left, is a senior medical officer and Mr. Eichwald is an audiologist at the Centers for Disease Control and Prevention's National Center for Environmental Health in Atlanta, GA. These opinions are the authors’ and do not necessarily represent the official position of the CDC or the Department of Health and Human Services.

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The Centers for Disease Control and Prevention (CDC) has conducted more than 40 years of research, providing guidelines to help reduce risks of noise-induced hearing loss in the workplace. In 2015, CDC received public and medical community inquiries on the topic of hearing loss related to noise in non-occupational settings. In 2016, the National Academies of Sciences report, “Hearing Health Care for Adults: Priorities for Improving Access and Affordability,” included a call to action for government agencies to strengthen efforts to collect, analyze, and disseminate population-based data on hearing loss in adults. In response to the information gap about the effect of noise in homes and communities, CDC instigated research efforts and participated in activities to raise awareness that excessive exposure to loud sounds outside of the working environment can cause permanent hearing damage, which can occur any time in life. Noise-induced hearing loss is a preventable health condition that can be avoided by using relatively easy measures.

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In 2014, data collected through CDC's National Health Interview Survey indicated 15 percent of American adults, aged 18 and over, reported some degree of trouble with hearing—about as much as the prevalence reported for both diabetes and cancer combined (Vital Health Stat 10. 2014;260:1 http://bit.ly/2lZlMX0). Hearing test results of 3,583 people (age 20-69), which were part of CDC's National Health and Nutrition Examination Survey during 2011 and 2012, revealed measurable hearing damage in one or both ears, suggestive of noise exposure in 24 percent of adults. Nearly 50 percent with this damage had reportedly not been exposed to loud noise at work (MMWR. 2017;66[5]:139 http://bit.ly/2lZxpNr). This suggests about 21 million American adults have hearing damage indicative of noise exposure that probably results from every day activities at home and in the community. About one in five young adults in their 20’s already exhibited this type of hearing damage, and one in four adults, apparently unaware of the damage, reported that their hearing was excellent or good.

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Many people may not recognize that loud noise from common activities, such as mowing the lawn or attending sporting events, can be as loud as the noise found in the workplace and is enough to damage hearing. As such, it is important to raise public awareness that the louder the noise and the longer the exposure, the more likely hearing damage will occur. Getting out preventive messages may be helpful. These messages include: avoiding or minimizing exposure to noisy environments whenever possible, using hearing protective devices like earplugs, and keeping the volume down. Health care providers can help their patients slow the progression of hearing loss from noise exposure. CDC encourages physicians and other clinicians to ask about loud noise exposure and hearing acuity as part of routine care and to refer their patients to hearing health professionals whenever there is a concern. At routine health care visits, providers can also explain how noise exposure can permanently damage hearing and teach patients how to protect their hearing (Vital Signs, 2017 http://bit.ly/2lZtTD3).

There are no federal guidelines on safe noise exposures. Because noise-induced hearing damage accumulates over time, there is a need for future research about noise exposure and prevention at younger ages. CDC is working with various organizations and continues to analyze national data to prioritize public health needs.

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