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Noise-Induced Hearing Loss

CDC Addresses Non-Occupational Noise-Induced Hearing Loss

Eichwald, John MA; Benet, Lauren

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doi: 10.1097/01.HJ.0000719788.78887.02
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For nearly five decades, the Centers for Disease Control and Prevention (CDC) has researched noise-induced hearing loss (NIHL) in the workplace and disseminated that research through the National Institute for Occupational Safety and Health (NIOSH) to prevent occupational hearing loss. In 2015, CDC received inquiries from the public and medical community about NIHL in non-workplace settings. To address the issues of non-occupational NIHL, CDC formed an intra-agency workgroup within the National Center for Environmental Health (NCEH). This small workgroup, comprised of audiologists, scientists, and health educators from NCEH, NIOSH, and the National Center on Birth Defects and Development Disorders, gathers evidence and educational resources to increase awareness and promote the prevention of NIHL from exposures at home and in the community.

Figure 1
Figure 1:
How Loud is Too Loud?” part of the CDC Healthy Schools “Ask a Scientist” comic series. Public health, noise, hearing loss, CDC.
Figure 2
Figure 2:
interactive infographic. Collaborative NCEH/NIOSH. Public health, noise, hearing loss, CDC.
Figure 3
Figure 3:
PSA quiz developed for the NFL, NBA, NHL, and mo-torsports races. Public health, noise, hearing loss, CDC.
Figure 4
Figure 4:
YouTube video “Roll, Pull, and Hold. How to Wear Soft Foam Earplugs.” Public health, noise, hearing loss, CDC.

In February 2017, the CDC NIHL workgroup launched its hearing loss campaign with a special edition of the Morbidity and Mortality Weekly Report (MMWR): “Vital Signs: Noise-Induced Hearing Loss Among Adults.”1 The launch included a website with infographics, videos, and other sharable media, most of which are available in English and Spanish. In April, The Hearing Journal published “CDC Research on Non-Occupational NIHL.”2 The June 2017 CDC Public Health Grand Rounds topic followed with “It's Loud Out There: Hearing Health Across the Lifespan” and included presentations from NCEH, NIOSH, Dangerous Decibels®, and the World Health Organization.3,4

In 2018, the workgroup developed an interactive infographic, partner advisories, social media content, videos, and factsheets in recognition of World Hearing Day, Better Hearing and Speech Month, and Protect Your Hearing Month. Workgroup members made related presentations at meetings of the Acoustical Society of America; the International Society for Environmental Epidemiology; the National Hearing Conservation Association; and the National Conference on Health Communication, Marketing, and Media. In April, the Journal of Environmental Health published “Loud Noise: Too Loud, Too Long!” authored by two NCEH workgroup members.5 In recognition of the 2018 Protect Your Hearing Month, the CDC published the MMWR “Use of Personal Hearing Protection Devices at Loud Athletic or Entertainment Events among Adults,” which was selected for an online MMWR/Medscape professional continuing education activity.6

In 2019, the workgroup ran full-page color public service announcements in the program books for Super Bowl LIII, the NFL Pro Bowl, the NHL All-Star Game, the NBA All-Star Game, multiple NASCAR Motorsports races, and the Indianapolis 500. Each contained a QR code and link to a six-question quiz entitled “How much sound can your ears safely take? And for how long?” The correct answers for duration without wearing hearing protection were based upon the 24-hour daily sound allowance of 70 dB7,8 rather than the widely cited eight-hour 85 dB Recommended Exposure Limit for occupational noise exposure.

In October 2019, for National Protect Your Hearing Month (#NPYHM), the workgroup promoted multiple social media materials on Facebook, Twitter, Instagram, and LinkedIn. One of the Instagram posts (“Musicians wear earplugs, so why don't you?”) generated more than 1,400 “likes” within 24 hours. “Roll, Pull and Hold,” a 30-second animated video demonstrating foam earplug use, generated over 6.5K Instagram views. A 60-second version posted on YouTube ( has been viewed over 3,000 times and counting.

During the weeks around Thanksgiving (11/25/19–12/02/19) and New Years’ (12/24/19–12/31/19), clips from the #NPYHM animated video were projected onto the electronic billboards in New York City's Times Square. Twenty hours per day, four 15-second spots per hour were projected onto the screens of the 10,080 square foot, seven-story tall NASDAQ Tower (Broadway and 43rd St), and the 7,691-square foot, 22-story tall Thompson Reuters building (7th Ave and 43rd St). These generated an estimated three million impressions each day.

In July 2020, the workgroup launched a new animated, narrated video in recognition of National Fireworks Safety Month to inform families about NIHL and demonstrate the preventative actions for hearing protection. During that month, the video was viewed nearly 2,000 times on YouTube ( The CDC Environment Twitter account (@CDCEnvironment) added another 15.7K views.

The workgroup created a 10-page Steampunk-themed graphic novel/comic book entitled How Loud is Too Loud? as part of the CDC Healthy Schools “Ask a Scientist” comic series (access these shareable resources here: CDC graphic designers, the Office of Laboratory Science and Safety, and the School Health Branch within the CDC's National Center for Chronic Disease Prevention and Health Promotion collaborated on the novel. This project was designed to increase students’ knowledge about hearing anatomy, NIHL, tinnitus, and prevention in a fun and engaging way. To further engage educators, 11,871 hard copies of the comic book were distributed with the April 2020 edition of Scholastic's SuperScience magazine to teachers of grades 3–6 in all 50 states, DC, Guam, and the Armed Forces Europe/Armed Forces Pacific. Included with this edition was a four-page standards-based teacher's guide with lesson plans on the science of sound, including hearing protection and related student activities.

As the nation's premier health protection agency, CDC provides evidence and education/health communication to promote an increased awareness and behavioral changes to prevent noise-related hearing loss at home and in the community.

Editor's note: 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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