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While sheltering in place is helping protect people from COVID-19, it may be raising their risk of noise-induced hearing loss as families turn the volume up on their devices to escape the news or conduct their business via loud conference calls. 

That makes Michigan Medicine audiologist Allie Heckman, AuD, long for the days when she only had to prepare her 3-year-old for noise overload at sporting events or loud restaurants, using traditional, over the ears, headphones to protect her.

"It's never too early for a child to wear it because we live in a noisier world than we realize," Heckman says.

In this age of abundant earbud and headphone use, it's a message that needs to be heeded more, particularly during an unprecedented time of media usage. And Michigan Medicine hearing experts are seeing an uptick in patients experiencing hearing loss at a younger age.

"Many of them are teenagers, but yet, noise induced hearing loss is 100% completely preventable," Heckman says.

And adults are impacted as well. According to a 2017 study conducted by the Center for Disease Control and Prevention (CDC), nearly one in four of U.S. adults aged 20 to 69 years old has noise induced hearing loss, which means 48 million U.S. residents have trouble hearing.

So how much noise is too much? Well, you know that ringing or hollow sound that follows after a concert? That's actually an indication that some damage has already occurred to the ear's hair cells.

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Prolonged exposure to noise above 85 decibels – or the sound of a running lawnmower – for more than eight hours a day, causes gradual hearing loss, while explosive noises like fireworks, louder than 140 decibels, can cause immediate damage. Rock concerts or nightclub music hit the 95 to 115 decibel range.

Before the shelter-in-place order, the Michigan Medicine audiology team was bringing awareness to high risk population groups, like U-M's School of Music, Theatre and Dance and the university's marching band, to help meet the unique demands of these performing artists. With many being exposed to hazardous sound levels due to the nature of their work, this wellness initiative was helping to prevent them from acquiring long term hearing disorders like tinnitus, a sensation of ringing in the ear.

"Our goal is to be proactive, instead of helping young people, faculty and staff when they've already got hearing loss. We want to try to avoid that and prevent the damage," Edwards explains. And of course, if there already was damage, the team was able to help.

Although troubling, U-M audiologists recommend the following five prevention strategies:

1. Be wary of sound

The best prevention for hearing loss is first to become aware of it, believes Bruce Edwards, AuD, a Michigan Medicine audiologist.  

How loud is too loud? Are certain noises more harmful than others? Are repeated noise exposures harmful over time? Once people become cognizant of it, they start taking steps to protect themselves.

If you're unsure how different noises rate on the scale of quiet to loud, then check the National Institutes of Health's interactive infographic called "Listen Up! Protect Your Hearing."

"It's never too late to start protecting your hearing," Edwards says. "Continuous exposure can increase damage to your hearing, so you want to minimize it." 

2. To hear, first listen

There's an education element to being proactive. The team offered more information about hearing loss by hosting classes and lectures for students to help them minimize their risks in both their performances and their everyday life. Knowledge is power if it's followed, Edwards and Heckman believe.

3. Beware of the earbuds

Earbuds are prevalent in today's culture of smart phones and laptops. If used at high volume, it causes more damage than previous generation's boom boxes or Walkmans, Edwards notes.

"The closer you get that sound to the ear drum, the louder it is because it's trapped in and it's tighter and that increases the level of the sound, which increases their risk for damaging their hearing."

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His advice, especially as people have more time on their hands during social distancing: Turn the volume down and only use them for brief periods, as length of exposure to loud sounds contributes to long term damage. Setting limits is key.

4. Embrace well-fitting ear protection

Because the world is loud, everyone should invest in ear protection headphones or in-ear foam plugs, Heckman adds, with one caveat: Make sure they fit well.

Learning an instrument during social distancing? Heckman says protection is key in preventing hearing loss.

For the unique needs of musicians and performers, though, Heckman says to consider custom fitted earplugs. To make, an audiologist takes an impression of each ear, creating plugs that offer the most secure fit. These include various filters which help reduce frequencies while preserving sound quality essential for musicians who need to hear the nuances of each note, just not at a damaging level.

Although non-customized earplugs with filters work well, too, Heckman suggests working with a hearing expert to select the appropriate attenuation characteristics, as well as to ensure an appropriate fit.

5. Take action to ensure a healthy future

As if COVID-19 wasn't enough to worry about, ignoring hearing advice could come with a cognitive risk, Heckman explains.

"Leaving hearing loss untreated can increase our risk for developing problems like dementia or Alzheimer's down the road," she says. 

Picking up fewer sounds severely cuts down the number of signals to the brain the ear nerves send. With less stimulation, the brain declines. Also, the brain works harder when it's trying to process sound with a hearing impairment. That strain stresses the brain, creating further neurological decline.

It may also bring on relationship discord as couples may not communicate often because "having to work so hard to listen is physically and mentally draining", so they shut down. Social withdrawal may be a part of the equation as well, along with depression and anxiety because of feelings of isolation.

Overall, better hearing will promote a happier lifestyle down the road, says Heckman.

To schedule an appointment for treatment of hearing loss, call Michigan Medicine's audiology team at 734-936-8051. Insurance benefits may be used for an audiological assessment as long as a person has a referral for it from their primary care physician in advance of the appointment