Tinnitus is an abnormal, chronic noise perceived in the ear that affects millions of people worldwide. The US Centers for Disease Control has reported that approximately 15% of the American population suffers from it.
Although the symptoms of tinnitus vary from patient to patient, the repercussions of this affliction can be debilitating. Some perceive low-pitched sounds, while others hear high-pitched sounds that hinder hearing and cause mental exhaustion.
These intrusive and distressing sounds take on many different forms and can occur frequently or intermittently.
Noise-induced hearing loss is one of the most common triggers for tinnitus. It usually results from brief or prolonged exposure to occupational noise, recreational noise, or acoustic trauma.
Why is this affliction increasingly worrying doctors and audiologists? Tinnitus is invisible, and there is no curative treatment. The rising number of patients therefore indicates a worrying trend. Studies have shown that over 30 million workers in the United States are exposed to dangerous noise levels.
Beyond noise-induced tinnitus, there are other common causes, such as:
Age-related hearing loss (also known as presbycusis),
Emotional trauma and stress,
Trauma due to concussion, head or neck injuries, and surgery,
Ear obstruction caused by dirt or foreign bodies, earwax, etc.
This article provides a comprehensive overview of noise-induced tinnitus, its causes, and recommended treatments.
Let's get straight to the point.
Noise-induced tinnitus
Every day, we are exposed to sounds and noises from multiple sources: vehicles, appliances, voices, traffic, music, etc. Most often, these sounds remain at safe levels. But sometimes, noise levels are excessive and can damage the ear.
Tinnitus is directly linked to brief or prolonged exposure to dangerous noise levels. According to the World Health Organization, approximately 50% of people aged 12 to 35 could be exposed to dangerous sound levels and frequencies through their audio devices. Another study showed that people with a history of occupational noise exposure have a 70% higher risk of tinnitus than those who have never been exposed.
Tinnitus can appear after a single traumatic episode. Even a brief exposure of just 15 minutes is enough to cause auditory fatigue, damage the auditory system, and lead to hearing loss.
This hearing loss can be unilateral (one ear) or bilateral (both ears) and prevents the patient from hearing sounds close to the frequency of the trauma.
During diagnosis, it is not always possible to definitively identify the source of noise exposure responsible for tinnitus. That said, occupational and recreational noise exposure alone generates more new cases of tinnitus than all other causes combined.
What causes noise-induced tinnitus?
Noise-induced tinnitus is neurosensory in origin and is triggered by exposure to sounds that are too loud.
But at what level does a sound become too loud?
Specialists estimate that any sound exceeding 85 decibels (dB) is harmful, especially with prolonged exposure.
Exposure to traumatic noise can be occupational. But there are many possible causes outside of work, including:
Sports such as hunting,
Listening to music and attending concerts,
Hobbies such as piloting planes and helicopters,
Another possible source of tinnitus is noise exposure during military service or accidents.
Recreational noise
Some recreational activities are dangerously noisy, and those who participate in them are at risk of developing tinnitus. Here are some common examples.
Firearms
Shooting can be a professional activity if you are in the military. But when it comes to hunting or sport shooting, it becomes purely recreational and is a major cause of noise-induced tinnitus and hearing loss.
The sound intensity of a gunshot exceeds 132 dB for most weapons. It is therefore unreasonable to fire even a single shot without hearing protection. Exposure to such sound levels can cause acoustic trauma and, most often, permanent hearing loss.
Sporting events (motorsports)
Attending a Formula 1 Grand Prix, a NASCAR race, or a MotoGP event can be an incredible and unforgettable experience. But the noise of powerful engines and the clamor of the crowd can damage your hearing.
The powerful engines of motorcycles, sports cars, and jet skis produce sounds in the range of 100 dBA and above. Even if exposure to this sound level does not have an immediate effect, it gradually wears down the ear and can cause long-term tinnitus.
Music
Music falls under both recreational and occupational exposure. The sound level of music at full volume in headphones is between 100 and 110 dB. Listening to music too loudly with earbuds or headphones is one of the main causes of noise-induced tinnitus.
American actress Whoopi Goldberg, a Grammy, Emmy, Oscar, and Tony Award winner, attributes her noise-induced hearing loss to "years and years of listening to music very loudly, very close to the very fragile eardrum."
Here's how to protect yourself:
Turn down the volume of your music.
Do not use headphones for long periods. Take regular breaks.
Use quality noise-canceling headphones.
That's not all. Other recreational activities can trigger noise-induced tinnitus: movie theaters, arcades, firecrackers, motorboats, etc.
Occupational noise exposure
Exposure to dangerous noise levels at work affects a large number of sectors. Most industries that use noisy machinery and power tools have employees suffering from noise-induced tinnitus and hearing loss. The National Institute for Occupational Safety and Health (NIOSH) reports that approximately 22 million workers are exposed to dangerous noise levels each year.
Power tools, chipping hammers, drills, jackhammers, lawnmowers, etc., all exceed 85 decibels. Jet engines and aircraft engines reach sound levels between 110 and 140 decibels. When employees are repeatedly exposed to these sound frequencies, their eardrums can rupture, and tinnitus can develop.
Exposure during military service
Tinnitus and hearing loss are the primary service-related disabilities and sequelae among veterans and active military personnel. In 2012, 9.7% of veterans received disability benefits for tinnitus, and 5.8% received compensation for hearing loss.
This is not surprising: military personnel are frequently exposed to the noise of weapons, explosives, gunfire, and heavy military equipment during active duty.
High noise levels are also found in aircraft and ship engine rooms. For example, patrol boats and ship tanks generate sound levels between 98 and 103 decibels. Missile boats produce approximately 120 decibels. Aircraft carrier flight decks reach dangerous levels, between 130 and 160 dBA.
In such environments, prolonged exposure can stretch ear tissues beyond their elastic limit and cause irreversible damage.
It is important to note that, whether recreation-related or work-related, noise-induced tinnitus does not have the same consequences for all patients. Some people tolerate and manage their symptoms without too much difficulty. Others, however, suffer from various disorders, including:
Stress, anxiety, depression, emotional trauma,
Hearing disorders,
Insomnia, mental exhaustion, and lack of concentration,
Speech difficulties and lack of coordination,
General and professional problems,
Inability to understand speech.
Patients living with noise-induced tinnitus may also experience professional difficulties that reduce their productivity, such as:
Fatigue,
Communication disorders,
Absenteeism, and
An increased risk of accidents.
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Famous cases of noise-induced tinnitus
Artists' lives revolve almost entirely around noise, making them very high-risk for noise-induced tinnitus.
Musicians are exposed to the noise of speakers, instruments, and amplifiers. Beyond concerts, they endure endless rehearsals, recording sessions, and listening sessions.
This is how they make a living.
Regardless of their musical genre, frequent noise exposure can cause tinnitus and hearing loss. Approximately 35% of symphony orchestra musicians have suffered from tinnitus. And up to 19% of them report that tinnitus severely impacts their daily lives.
Actors, directors, and stunt performers are not spared. They perform stunts to create successful films and deliver memorable experiences. During big-screen productions, they are exposed to the noise of gunfire, explosions, special effects, and pyrotechnics.
Many of these celebrities, both actors and musicians, have spoken out to attribute their tinnitus to noise exposure.
Here's what some of them have said.
"I have severe hearing damage. It manifests as tinnitus, ringing in my ears on the frequencies I play on guitar. It hurts, it's painful, and it's frustrating."
Pete Townshend of The Who, musician
"I've had tinnitus for about ten years, and since I've been protecting my ears, it hasn't gotten worse — knock on wood. Unfortunately, you only think about protecting your ears when there's a problem. I wish I had thought of it sooner."
Chris Martin of Coldplay, musician
"I suffer from permanent tinnitus... which means I have this constant ringing in my ears, which has also made me a little deaf (or 'selectively deaf,' as Sharon says). It's like a 'whee!' in my head constantly. I should have worn earplugs, I suppose."
Ozzy Osbourne, musician
"Tinnitus, and not just a little bit. It's the price you pay for having fun. Nothing is free!"
Tim Bogert, musician
How noise damages our hearing
Exposure to dangerously loud noises damages the most sensitive elements of our auditory system. We cannot understand how this damage occurs without first understanding how we hear and how the brain processes sounds.
We hear thanks to a series of events that convert vibrations (sound waves) reaching our ear into electrical signals. The auditory nerves transmit these signals to the brain, allowing us to classify sounds as noise, music, or speech.
Sound waves entering the outer ear travel through the ear canal. The ear canal is a narrow passage leading to the eardrum. The eardrum vibrates from the incoming sound waves and automatically transmits these vibrations to three ossicles (the malleus, incus, and stapes) located in the middle ear.
These ossicles collect sound vibrations and transmit them to the cochlea in the inner ear: a snail-shaped, fluid-filled organ. These vibrations create waves that ripple through the cochlea and form a traveling wave along the basilar membrane.
As these waves propagate, they bend tiny hair cells capable of detecting sound. This movement opens pore-like channels: chemicals then enter the cells and create electrical signals. The auditory nerve transmits these electrical signals to the brain, which translates them into sounds that we recognize and understand.
And here's the key point.
A human being has an average of about 16,000 hair cells in the cochlea, and without them, the brain cannot detect sounds. Noise-induced hearing loss occurs when your hair cells are damaged or destroyed. Unfortunately, human hair cells do not regenerate and cannot be repaired.
In most cases, the patient does not directly notice their hearing loss or the frequencies they have lost. This does not mean that no damage has occurred. A trained hearing professional or audiologist can perform several audiological tests to measure the true extent of hearing impairment.
Treatment and recovery for noise-induced tinnitus
Noise-induced tinnitus is generally permanent. Unfortunately, science has not yet found a curative treatment. While waiting for research advances, it is essential to take precautionary measures to protect your ears.
That said, if you suffer from noise-induced tinnitus, there are solutions to help you manage your condition and improve your health and mental well-being.
Prevention measures
Here are several ways to avoid exposure to loud noises and the resulting tinnitus.
Avoid dangerously loud noises
Do your best to stay away from loud noises. If the noise hurts your ears, if you can't hear what others are saying, and if you have to raise your voice to respond, the sound level is sufficient to cause tinnitus.
Protect your ears during noisy activities or events
If you cannot avoid noisy places, you must protect your hearing during noisy events or recreational activities: nightclubs, sporting events, or concerts.
These solutions can help you:
Stay away from major noise sources, such as speakers.
Take regular breaks away from the noise.
Wear earplugs that reduce sound intensity.
Use your headphones carefully
When listening to music with headphones, you can:
Turn down the volume.
Use quality, noise-canceling headphones.
Remove your headphones from time to time.
Follow workplace safety instructions
If you are exposed to loud noise at work, you should:
Ensure you are not exposed to noise for a long period.
Switch to less noisy equipment, if possible.
Wear hearing protection, such as earplugs and earmuffs.
Have your hearing checked regularly
Consult an audiologist for a hearing check-up as often as possible, especially if you are at high risk of noise-induced tinnitus: for example, if you work in a noisy environment or are a musician.
Comprehensive hearing tests establish a baseline of your hearing, track its evolution, and identify abnormalities.
Treatment
Many therapeutic options can reduce the impact of chronic and severe noise-induced tinnitus. Here are a few.
Wearing hearing aids
Hearing aids are electronic sound amplification devices worn in the ear to improve hearing and communication.
According to a 2007 survey of 230 hearing professionals, 22% of patients experience significant relief from their tinnitus with hearing aids. Approximately 60% experience slight to significant relief.
Here's why hearing aids are effective in alleviating the burden of tinnitus:
Sound masking
The intrusive noise of tinnitus can prevent patients from concentrating. Hearing aids cover the sound of tinnitus by increasing the intensity of external sounds. They re-accustom the brain to focus on environmental sounds.
Improved communication
Intense tinnitus disrupts the normal course of communication. It makes it almost impossible to participate in professional or social activities. With hearing aids, patients communicate better and cope better with their tinnitus.
Sound therapies
Sound therapies also use external sounds to counteract tinnitus. This term covers a wide range of methods that modify a patient's reaction to noise-induced tinnitus, including:
Masking
Habituation
Distraction
Neuromodulation
Habituation helps the human brain reclassify tinnitus as insignificant sounds.
Distraction uses external sound sources to divert your attention from the noise of tinnitus.
Neuromodulation uses specific sounds to reduce brain hyperactivity.
There are several medical-grade devices and connected devices used to mask sound, such as:
Modified sound devices
Notch-filtered music players
Combined devices
Sound and sleep apps, etc.
Adopting a healthy lifestyle
The burden of tinnitus can be mentally and emotionally draining. Stress, anxiety, and trauma can further exacerbate its impact. It is, therefore, essential to practice activities that improve your mental and emotional well-being.
Here are some recommended activities that can greatly help:
Physical activities like sports, yoga, etc.
Social activities like networking, volunteering, community service.
Hypnotherapy and meditation
Leisure activities.
In summary
The way we communicate and interact with our environment makes exposure to loud noises inevitable.
However, prolonged exposure to dangerous noise levels can cause tinnitus. Tinnitus affects the mental and emotional well-being of patients, and those who suffer from it endure a lot.
Whether recreational or work-related, noise-induced tinnitus can be prevented. You can reduce your exposure by wearing hearing protection or simply avoiding intense noise sources.
If you suffer from tinnitus, consult an audiologist or hearing professional. They will assess your situation and recommend the most suitable treatments.
