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Health Topics
Noise-Induced Hearing Loss
Promoting Hearing Health Among Youth
Introduction
Hearing plays an essential role in communication, speech and language development,
and learning. Even a small amount of hearing loss can have profound, negative effects on
speech, language comprehension, communication, classroom learning, and social development.
Studies indicate that without proper intervention, children with mild to moderate hearing
loss, on average, do not perform as well in school as children with no hearing loss. This
gap in academic achievement widens as students progress through school.1,2
An estimated 12.5% of children and adolescents aged 6� years (approximately 5.2 million)
and 17% of adults aged 20� years (approximately 26 million) have suffered permanent damage
to their hearing from excessive exposure to noise.3,4
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Hearing loss can result from damage to structures and/or nerve fibers
in the inner ear that respond to sound. This type of hearing loss, termed
搉oise-induced hearing loss,� is usually caused by exposure to excessively loud
sounds and cannot be medically or surgically corrected.
Noise-induced hearing loss can result from a one-time exposure
to a very loud sound, blast, impulse, or by listening to loud
sounds over an extended period. |
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Preventing Noise-Induced Hearing Loss
Hearing loss caused by exposure to loud sound is preventable.5
To reduce their risk of noise-induced hearing loss, adults and children can do the following:
- Understand that noise-induced hearing loss can lead to communication
difficulties, learning difficulties, tinnitus, distorted or muffled hearing,
and inability to hear some environmental sounds and warning signals.
- Identify sources of loud sounds (such as gas-powered lawnmowers, snowmobiles, power
tools, gunfire, or music) that can contribute to hearing loss.
- Adopt behaviors to protect their hearing:
- Avoid or limit exposure to excessively loud sounds;
- Turn down the volume of music systems;
- Move away from the source of loud sounds when possible; and
- Use hearing protection devices when it is not feasible to avoid exposure
to loud sounds or reduce them to a safe level.5
- Seek hearing evaluation by a licensed audiologist or other qualified professional,
especially if there is concern about potential hearing loss.
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Promoting Hearing Health in Schools
The following are some steps schools can take to prevent noise-induced hearing loss,
by limiting exposure to excessive noise on school property, screening for existing noise
induced hearing loss, and teaching students how to protect their hearing.
Establish Policies that Promote the Hearing Health of Students and Staff
School districts can adopt policies and procedures to minimize excessive noise during
the school day and protect the hearing of their students and staff. For example,
schools could
- Eliminate or reduce construction and maintenance activities during school hours.
- Set noise level standards for events such as school dances.
- Ensure that hearing protection devices are available to students, that students are
instructed on their proper use, and that these devices are required in classes or activities
where students are exposed to potentially unsafe noise levels, such as music classes, marching
band, industrial arts, and technology education classes.
- Implement policies consistent with
National Institute for Occupational Safety and
Health (NIOSH) recommendations to support hearing loss prevention programs for school
employees.6
Establish and Maintain Routine Hearing Screening for All Students
Many schools provide hearing screening as part of required student health assessments.
Hearing screening, especially at an early age, provides the opportunity to detect hearing
impairment or previously unrecognized hearing loss and intervene to limit further loss and
improve learning.7,8 According to the American Academy of Pediatrics (AAP), hearing screening
should be conducted
- At school entry for all children;
- At least once at ages 6, 8, and 10;
- At least once during middle school;
- At least once during high school;
- For any student entering a new school system without evidence of a previous hearing exam.
Screening might be required more often for students with other known health or learning
needs; speech, language, or developmental delays; or a family history of early hearing
loss.9-11
Hearing screening programs should be consistent with the AAP Criteria for Successful
Screening Programs in Schools7 to ensure that
- Screening tests are accurate and reliable.
- The school hearing screening site is suitable and appropriate.
- Persons who screen students' hearing are well-trained and qualified professionals.
- Community and healthcare provider referral mechanisms are in place so those with identified hearing loss can receive a more definitive evaluation and receive appropriate treatment if indicated.
- Student screening results are communicated effectively by the school to students, parents, and healthcare providers.
- Effective treatment and early intervention benefit those with identified hearing loss or impairment.
- Appropriate educational interventions are implemented to reduce the negative effects of hearing loss on student learning.
- The benefits of hearing screening outweigh the cost of implementing the screening program.
Screening programs might not capture all cases of noise-induced hearing loss.
Any student or school personnel reporting hearing difficulties or tinnitus (especially
after loud sound exposure) should be referred to an audiologist for further evaluation.
Implement Hearing Loss Prevention Education
Education about noise and its effects on
hearing, health, and learning can begin in elementary school.12 Studies have shown that
people who are educated about noise-induced hearing loss and hearing loss prevention
are more likely to use hearing protection devices in future occupational and recreational
settings.13,14 Comprehensive hearing loss prevention programs include instruction for
students on normal auditory function, types of hearing loss and their causes, noise and
its effects on hearing and quality of life, warning signs of noise-induced hearing loss,
and recommendations for preventing hearing loss.15-17
Hearing loss prevention education can be part of a school抯 health education curriculum
or integrated across curricula. School nurses, physicians, audiologists, speech-language
pathologists, or well-trained volunteers can help provide accurate information and
interactive activities. Teachers can be taught how to reduce loud sounds in the school
environment and model good hearing protection behavior and attitudes. Education also can
be provided for parents, encouraging them to practice hearing conservation at home and teach
it to their children.18
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Data and Statistics
School Health Policies and Programs Study (SHPPS)
The School Health Policies and Programs Study (SHPPS) is a national survey
periodically conducted to assess school health policies and practices at the state,
district, school, and classroom levels. SHPPS was most recently conducted in 2006;
the next SHPPS is planned for 2012. The 2006 SHPPS questionnaire contains three questions
that specifically address the subject of hearing screenings in schools and hearing loss
in health education:
- Has your state adopted a policy stating that districts or schools will screen
students for hearing problems?
- Has your state adopted a policy stating that a student抯 parents or guardians
will be notified when the student抯 hearing screening indicates a potential problem?
- Has your state adopted a policy stating that a student抯 teacher will be notified
when the student抯 hearing screening indicates a potential problem?
The findings from those and other health services and health education questions are described in the following reports:
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Science-based Strategies
Criteria for a Recommended Standard: Occupational Noise Exposure桼evised Criteria.
This publication contains NIOSH policy and recommendations regarding hazardous noise
and hearing loss prevention strategies. It provides recommendations for the management
of hearing loss prevention programs for workers whose noise exposures equal or exceed 85
dBA and includes recommendations for program evaluation.
Health Education Curriculum Analysis Tool (HECAT). The Health Education Curriculum
Analysis Tool (HECAT) can help school districts, schools, and others conduct a clear,
complete, and consistent analysis of health education curricula based on the National
Health Education Standards and CDC抯 Characteristics of Effective Health Education
Curricula. The HECAT results can help schools select or develop appropriate and
effective health education curricula and improve the delivery of health education
to address various health education topics, including hearing loss prevention.
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References
- American Speech-Language-Hearing Association.
Effects of Hearing Loss on Development*.
Rockville, MD: American Speech-Language-Hearing Association.
- Bess FH, Dodd-Murphy J, Parker RA. Children with minimal sensorineural
hearing loss: prevalence, educational performance, and functional status.
Ear and Hearing 1998;9:339�4.
- Niskar AS, Kieszak SM, Holmes AE, Esteban E, Rubin C, Brody DJ. Estimated prevalence of noise induced hearing threshold shifts among children 6 to 19 years of age: The third national health and nutritional examination survey. 1988-1994, United States.
Pediatrics 2001;108:40�.
- National Institute on Deafness and Other Communication Disorders.
Quick Statistics.
Bethesda, MD: U.S. Department of Health and Human Services; August 2008.
- National Institute on Deafness and Other Communication Disorders.
Noise Induced Hearing Loss. Bethesda, MD: April 2007. NIH Pub No. 97-4233.
- CDC/NIOSH.
Revised Criteria for a Recommended Standard: Occupational Noise Exposure (NIOSH Publication 98-126). Cincinnati: US Department of Health and Human Services; 1998.
- American Academy of Pediatrics, Committee on School Health. School
Health:Policy and Practice. 6th edition. Elk Grove, IL: American Academy of Pediatrics; 2004.
- American School Health Association.
Comprehensive Health Services
for Young Children* [pdf 160K].
- American Academy of Pediatrics, Committee on Practice and Ambulatory
Medicine, Bright Futures Steering Committee. Recommendations for preventive
pediatric health care. Pediatrics 2007;120:1376�78.
- American Speech-Language-Hearing Association.
Hearing Screening*.
Rockville, MD: American Speech-Language-Hearing Association.
- American Academy of Audiology. Position statement: identification of hearing loss and middle-ear dysfunction in preschool and school age children.
Audiology Today 1997;9(3):21�.
- National Association of School Nurses. Position Statement:
Noise Induced Hearing Loss* [pdf 210K]. Castle Rock, CO: National Association of School Nurses; 2003.
- Knobloch MJ, Broste SK. A hearing conservation program for youth working in agriculture.
Journal of School Health 1998;68(8):313�8.
- Ewigman B, Kivlahan C, Hosokawa M, Horman D. Efficacy of an intervention to promote use of hearing protection devices by firefighters.
Public Health Reports 1990;105(1):53�.
- Lass NJ, Woodford CM, Lundeen C, Lundeen DJ, Everly-Myers DS. The prevention of noise-induced hearing loss in the school-aged population: a school educational hearing conservation program.
Journal of Auditory Research 1986;26:247�4.
- Anderson KL. Hearing conservation in public schools revisited.
Seminars in Hearing 1991;12(4):340�4.
- Folmer RL, Griest SE, Martin WH. Hearing conservation education programs for children: a review. Journal of School Health 2002;72:51�.
- Folmer RL. The importance of hearing conservation instruction.
Journal of School Nursing 2003;19(3):140�8.
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