National Disability Prevention Day | Protect your hearing and don’t let your life be muted

Hearing impairment is the fourth leading cause of life expectancy among people with disabilities worldwide, affecting 6% to 8% of the global population. In recent years, as life expectancy has increased and society has changed, hearing loss due to excessive noise exposure and ototoxic medications has become more common. Recent estimates from the World Health Organization (WHO) indicate that 1.5 billion people worldwide now suffer from disabling hearing loss, and nearly 750,000 babies are born with severe hearing problems each year.

In early childhood, hearing impairment may hinder language acquisition and affect academic performance. Studies have shown that even adolescents and young adults with only mild hearing loss are more likely to drop out of school early or become unemployed. In the adult population, people with hearing impairment may be considered to have reduced cognitive ability, decreased ability, and poor social skills, which may lead to social problems such as low income, underemployment or unemployment in the hearing-impaired group. [1] Therefore, hearing impairment can seriously affect people's quality of life and should be taken seriously.

1. How to determine the severity of hearing impairment?

Hearing impairment, commonly known as deafness, refers to various reasons that lead to hearing difficulties, inability to hear or unclear environmental sounds and speech. The World Health Organization divides the severity of hearing impairment into the following levels according to the hearing threshold (the minimum amount of sound stimulation that can just cause an auditory response in the human ear) [2]:

Disabling hearing loss is defined as a hearing threshold of more than 40 decibels in the better hearing ear of an adult or more than 30 decibels in the better hearing ear of a child.

2. Factors that may cause hearing impairment

01 Congenital hearing loss

Its mechanism includes genetic and environmental factors. In addition to hearing loss, children may also have craniofacial abnormalities (Treacher-Collins syndrome), goiter (Pendred syndrome), decreased vision (Usher syndrome) and other complications, so it is easier to be identified early. Although congenital hearing loss is not as common as acquired hearing loss, since most of them are gene-related diseases, the consequences can be devastating for children. Therefore, preventive screening is extremely important.

02 Infection factors

It is reported that the most common cause of hearing impairment in the general population is middle ear disease (accounting for 36% of hearing loss patients). In addition to otitis media, measles, mumps, cerebral malaria and meningitis are important pathogenic factors. When pregnant women are infected with certain pathogens, it may cause hearing loss in the fetus (such as: giant cell infection, rubella, etc.).

03 Noise Exposure

Regular exposure to noise can also lead to hearing loss. As the world becomes more industrialized, the number of people exposed to excessive noise is also increasing. Possible exposure environments include occupational noise environments, road noise, prolonged use of headphones, etc. Just one or a few exposures can cause irreversible damage to a person's inner ear.

04 Drug factors

Some antibiotics, antimalarials, and chemotherapy drugs are ototoxic and can cause severe hearing loss. However, sometimes patients have to take the risk of hearing loss to use them to treat other more serious diseases, such as chloroquine for malaria, gentamicin for neonatal sepsis, and multidrug regimens for drug-resistant tuberculosis. Doctors should be fully aware of their ototoxicity and use appropriate doses and durations to minimize the risk of hearing loss.

05 Presbycusis

Another factor contributing to the increasing prevalence of hearing loss worldwide is age-related hearing loss resulting from increased life expectancy in many parts of the world.

06 Traumatic hearing loss

Damage to the auditory anatomy due to trauma, such as road traffic accidents, can affect hearing, such as temporal bone fracture involving the otic capsule.

07 Immune diseases

Many autoimmune diseases also affect hearing in children and adults, including Cogan syndrome, lupus, ulcerative colitis, and rheumatoid arthritis.

3. How to prevent hearing impairment?

01 Preventing fetal hearing impairment

Strengthen pre-pregnancy examinations: Couples with a family history of deafness, or couples who have given birth to children with hearing impairments, should undergo genetic counseling and related testing before pregnancy to reduce the occurrence of hereditary hearing loss.

Prevent infections in early pregnancy: such as rubella, cytomegalovirus, herpes simplex and other viral infections.

Avoid the use of ototoxic drugs during pregnancy: The use of medications during pregnancy should be discussed with the obstetrician and gynecologist to avoid the use of drugs that may affect the hearing of the fetus.

02 Preventing hearing impairment in children

Prevention and treatment of otitis media: Preventing infants from choking on milk and preventing water from entering the outer ear during bathing can reduce the incidence of otitis media; early identification and treatment of otitis media may help slow the progression of hearing loss or prevent it altogether

Avoid head trauma in children: Traumatic brain injury is associated with a higher incidence of long-term hearing loss.

Use ototoxic drugs with caution: When using ototoxic drugs in children, you should also try to avoid using them. If you must use them, be sure to follow the doctor's orders.

03 Prevent noise-induced hearing loss

When using headphones, follow the "3 60s" principle: use headphones for no more than 60 minutes each time; the volume should not exceed 60% of the maximum volume; when the ambient sound exceeds 60dB, try not to use headphones. If you cannot avoid being in a noisy environment, you should wear professional earplugs before being exposed to noise.