“Prevention is better than cure.” – Desiderius Erasmus.
We know that prevention is the foundation of good health. So, our second goal is prevention because it is the most effective way to reduce hearing loss and tinnitus. Exposure to noise, whether prolonged or of short duration, is a major cause of approximately one-third of adult-onset hearing loss – this will be our focus. Hearing loss can also result from a range of preventable diseases, injury, solvents, and certain medications. Almost half the incidence of induced hearing loss can be avoided and prevented. We aim to strengthen hearing loss prevention campaigns and behavioural change in high-risk groups and in settings such as noisy recreation settings and workplaces.
People visiting nightclubs, bars, cinemas, restaurants, gyms and sporting and concert venues are at risk of ear damage and hearing loss. This recreational exposure also occurs through the increasingly widespread use of personal audio devices, in both noisy and quiet environments. Noise exposure can also be from environmental noise from airports, traffic, and gardening and DIY equipment. Other than causing hearing loss, loud noise is also associated with high blood pressure, coronary artery disease and stroke.
For children, the major causes of severe hearing loss are diseases such as measles, mumps, and meningitis, the majority of which can be prevented by vaccination. Other diseases and pathogens such as cytomegalovirus can also have serious impacts on children’s hearing. Middle ear infections are common in children and can cause some degree of hearing loss. Most infections are not covered by vaccination. Chronic ear infections during early childhood can cause developmental delay which in turn increases vulnerability on entering school, leading to poor education outcomes and contributing to high unemployment. This is particularly true for Aboriginal and Torres Strait Islander children, and more so for those living in remote regions. Strategies for prevention of ear disease and conductive hearing loss in children include immunisation, personal hygiene to prevent spread of infection, breast feeding, restrict pacifier use, avoidance of smoke exposure, and a healthy diet.
Teenagers and young people are widely recognised as vulnerable to hearing loss and tinnitus due to overuse of earphones, and working at or attending music concerts and venues that play loud music. The resulting impact on hearing can translate to educational, social and psychological impacts, and future employment and career choices can also be affected.
Occupational hearing loss represents a very significant social and economic burden for Australia. Nationally, an estimated 1 million employees in Australia may be potentially exposed to hazardous levels of noise at work. Noise exposure is the commonest preventable cause of occupational hearing loss. Noise-induced hearing loss occurs in a wide range of industries, particularly mining, manufacturing and construction, farming, recreation, hospitality and the Defence Force. Programs of work are underway to help reduce work related noise induced hearing loss in Australia, with various jurisdictions undertaking or planning a significant amount of work in inspections and auditing, targeting highest risk sectors.
Hearing loss, balance disorders, and tinnitus can result from ototoxic medications, such as aminoglycoside antibiotics, salicylates, platinum-based anti-cancer therapeutics, and the anti-malarial drug quinine. Many of these are necessary to treat severe chronic conditions or aggressive diseases. As such, baseline hearing testing and monitoring can either enable changes to the medications provided to prevent or reduce hearing loss, or can enable early audiologic intervention.
Industrial solvents, such as tolulene, styrene and carbon disulfide can be ototoxic, and the ototoxic effects of solvents can continue beyond the time of exposure. Yet ototoxic monitoring for workers exposed to these chemicals is limited.
Outcomes for better hearing in Australia.
- Preventable hearing loss is significantly reduced.
- Australians’ understanding, motivation and ability to prevent loss of their own and others’ hearing is substantially increased.
- Primary health care services are able to provide regular ear and hearing health checks that respond to the social and cultural needs of those receiving care.
- The process of implementing effective noise control and hearing loss prevention in Australian workplaces is completed.
- Strategies preventing hearing loss and its disabling effects are incorporated in urban design.
- Strategies to prevent hearing loss are included in wider public policy.
- Prevention activities specifically consider the needs and circumstances of vulnerable populations, particularly Aboriginal and Torres Strait Islander people, and are monitored and resourced accordingly.
Taken from Australia’s Roadmap for Hearing Health.