Noise Induced Hearing Loss

Loud Noise and Hearing Loss

Roughly 10 million cases of hearing loss can be attributed to noise exposure. Noise induced hearing loss (NIHL) is characterized by a gradual, progressive loss of high frequency hearing sensitivity that usually presents as a “notch” that occurs at or around 4000 Hz.

NIHL can occur from a one-time exposure to loud noises or from extended exposure to harmful levels of sound. Sound levels are measured in decibels (dB). Normal conversations typically occur between 50-60 dB SPL, which is not loud enough to cause damage to your hearing. Exposure to sound levels 85 dB and higher over an extended period of time can cause permanent damage to your hearing. The softer the sound, the longer period of time it is safe to listen to the sound. The graphic below, created by the Dangerous Decibels public health campaign, outlines guidelines based on NIOSH and CDC recommendations for maximum time exposure allowed in various levels of sound.

Ways To Protect Your Hearing

There are many ways to prevent NIHL, such as:

  • Avoid or limit exposure to dangerously loud sounds
  • Decrease the volume of music systems
  • Move away from loud sound sources when possible
  • If you must be around loud sounds, use appropriate hearing protection.

Hearing Protection Devices

At The Hearing Center, we offer a variety of hearing protection devices. Common devices include:

  • Swim plugs are designed to prevent moisture from entering the ear canal during swimming, showering and water sports
  • Shooter’s protection is designed to protect hunters/shooters from impulse noises up to 160 dB peak SPL. These devices can be made with special acoustic filters that allow for awareness of conversation and the ability to track animals.
  • Industrial noise protection- Some work places require workers to wear custom hearing protection due to exposure to dangerous sound levels. Employees who work in industrial factories, construction sites and around aircraft equipment are likely to be required to wear hearing protection. Specialized devices can be made that can connect to radios for those who work in jobs that require radio use.
  • Musician earpieces provide hearing protection for musicians who practice and perform in a variety of settings. Depending on the source and location of the sound, different levels of attenuators can be used in the earpieces to allow for optimal hearing protection.
  • Motorcyclist’s protection is designed to help eliminate wind noise under a helmet.
  • Custom sleep plugs can be used to promote interrupted sleep.
  • Custom fit ear tips for mp3 players or other headphones are designed to have standard earphones fit into a custom fit ear tip. These earplugs help block excessive environmental noise and allow the listener to turn down the music volume.

How Much Hearing Protection Is Enough?

Custom hearing protection is rated by a system known as the Noise Reduction Rating (NRR). The NRR is used to determine the ability of hearing protection devices to decrease sound exposure within an environment. The higher the NRR number assigned to the hearing protection, the greater potential for noise reduction. It is important to remember that the NRR number is not simply subtracted from the loudness of sound. To compute how much hearing protection is provided by an earplug, take the NRR number (in dB), subtract 7, and then divide by 2. If an earplug has a NRR of 29 dB, the equation would be (29-7)/2=11. This mean if you were at a concert were the level of noise exposure was 100 dB and your hearing protection had a NRR of 29 dB, your actual noise exposure level would be 89 dB. If you are wearing hearing protection in combination, you do not add the NRR of both devices together to find the amount of protection. Instead, you would add 5 dB to the higher NRR to find the combined hearing protection. For example, if you were wearing earplugs with an NRR of 17 dB and earmuffs with a NRR of 24 dB, your combined NRR would be 29 dB.

If you believe you are at risk for noise induced hearing loss, make an appointment with your JHBI audiologist to discuss a custom hearing protection option that is suitable for your needs!

Earwax and Cleaning Your Ears

What Is Earwax?

Cerumen, more commonly known as earwax, is healthy for your ears in normal amounts. Glands in the ear canal produce earwax, which helps trap dust and dirt particles from making its way to the eardrum. It serves as a self-cleaning agent that can protect and lubricate the ear canal. Without earwax, the ear canal may be dry and itchy. While everyone produces earwax, the amount can vary greatly. For most people, earwax naturally works its way out of the ear. It is transported by jaw motion from the ear canal to the outer ear where it dries and falls out.

Should I Use Q-Tips To Clean My Earwax?

Earwax is formed in the outer 1/3 of the ear canal. When cerumen impaction occurs deep in the ear canal at the eardrum, it is often the result of the individual pushing the wax deeper with things such as q-tips or bobby pins. You should never probe into your ear canal to remove wax. Injury to your eardrum can occur as a result of probing in the ear canal. Some medications, stress and exercise can cause the body to process excessive earwax. Symptoms of earwax impaction can include decreased hearing, ear pain, plugged or fullness sensation, tinnitus, itching or dizziness.


How Should I Keep My Ears Clean?

If you notice earwax buildup in your ears, there are safe, at home ways to soften the wax. Patients can place a few drops of mineral oil, commercial cerumen softening drops or a mixture of hydrogen peroxide and water drops in the ear over the course of a few days. If deep impaction has occurred, softening the wax alone will most likely not remove all of the wax. A person who has an eardrum perforation should not use eardrops to soften their earwax.

Many licensed medical providers have the ability to manually remove earwax. Different methods include suction, water irrigation, or curette removal. The method used varies from person to person depending on the condition of their ear. Consult a physician if you are unsure if you have cerumen impaction. Ear candles are not a safe option to remove earwax. The U.S. Food and Drug Administration (FDA) do not approve use of these products.

There is no way to prevent excessive earwax. Individuals who are prone to cerumen impaction should see a doctor at regular intervals to have routine ear cleanings. If you believe you may have cerumen impaction in either ear, contact Jacksonville Hearing and Balance Institute to set up an appointment for removal by our physician or physician’s assistant.

Unilateral Hearing Loss: CROS and BiCROS Hearing Aids

CROS and BiCROS Hearing Aids

In a previous blog entry, we spoke about the benefits of two hearing aids for users with bilateral hearing loss. However, you might wonder what some options are for a person with hearing loss in only one ear or hearing loss that is worse in one ear than the other.

One option for consideration is referred to as a CROS or BiCROS system. CROS systems are for users with normal hearing in one ear and deafness in the other ear. BiCROS systems are for individuals with hearing loss in one ear and deafness in the other ear. In both systems, the user will need to wear a hearing aid device in both ears; however the style of the device can be flexible depending on the manufacturer and the user’s individual hearing loss. A microphone will be used on the poorer hearing ear to pick up sounds and transmit them wirelessly to a receiving device worn on the opposite ear. With a CROS device, no amplification is present in the signal. It is simply sent from one side of the head to the other. With a BiCROS device, the transmitted signal is amplified to fit the hearing loss in the better hearing ear for optimized listening.


CROS (left) BiCROS (right)


BiCROS and CROS hearing aids are designed for users who receive no benefit from traditional amplification on their poorer hearing side. In that situation, these systems can give individuals back their awareness to sounds coming from their poorer hearing side. This is an important benefit for safety, communication and quality of life. If you currently have single sided deafness or asymmetrical hearing loss and you think a BiCROS or CROS system might be right for you, please consider making an appointment with one of our audiologists for a hearing aid consult to discuss your options further.