Noise-Induced Hearing Loss

Table of Contents

1. How Loud Sound Damages Hair Cells and Synapses
2. Hidden Hearing Loss and the Debate Around It
3. Temporary Shift Versus Permanent Loss
4. The Audiogram Notch at 4,000 Hz
5. How Common It Is
6. Decibels and Time: What the Agencies List
7. Personal Listening Devices and Concerts
8. Firearms and Impulse Noise
9. Sudden Acoustic Trauma and Hospital Steroid Studies
10. Hearing Protection and Workplace Programs
11. Nutrients and Antioxidants Tested in People
12. Drugs and Solvents That Add to Noise Damage
13. Tinnitus, Dementia and Heart Research
14. Hearing Aids and the Over-the-Counter Category
15. Cheap Home Measures as Reported
16. What Is Not Known
17. Key Research Papers
18. Connections
19. Featured Videos

How Loud Sound Damages Hair Cells and Synapses

The inner ear holds about 3,500 inner hair cells and 12,000 outer hair cells, and in mammals this tissue cannot replace cells once they are lost (Natarajan 2023). Outer hair cells act as an amplifier for quiet sounds. Inner hair cells pass the signal to the hearing nerve by releasing a chemical messenger called glutamate.

The same review lists four linked kinds of injury, drawn largely from animal research:

• Mechanical damage. Intense sound shears the tiny hair-like bundles on top of the cells, breaking their cores and the fine links between them.
• Oxidative stress and reduced blood flow. Noise trauma is followed by slowed blood flow in the inner ear and a rise in reactive molecules that can trigger cell death.
• Inflammation. Noise sets off an immune response inside the inner ear even without infection.
• Excess glutamate. Loud sound drives more glutamate release, and the nerve endings swell. Nerve cells can then be lost after a delay of several months, and the damage can progress over years.

Hair cell loss is what most people picture, but in mice and guinea pigs the connections between hair cells and nerve fibers are lost first. Exposures that caused only reversible hearing changes, with no hair cell loss, still caused permanent loss of more than 50% of those connections (Kujawa 2015).

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Hidden Hearing Loss and the Debate Around It

The term comes from a 2009 mouse study. Noise caused a moderate threshold rise that recovered completely, and the sensory cells survived, yet nerve endings were lost at once and the hearing nerve degenerated later (Kujawa 2009). A standard hearing test would miss this. The nerve fibers lost are the ones used for hearing in noisy rooms, so researchers proposed that this injury could explain trouble following speech in a crowd despite a normal audiogram (Liberman 2017).

Whether this happens in living people to a degree that matters is unsettled. It can only be confirmed by examining the inner ear after death, and studies in living people use indirect measures and conflict (Bramhall 2019).

Findings that support it:

• College students at high risk from noise had normal standard audiograms, but worse hearing at 10,000 to 16,000 Hz, a nerve-response pattern consistent with nerve loss, and worse word recognition in noise (Liberman 2016).
• Young veterans with normal audiograms and a significant history of noise exposure had smaller nerve responses than non-veterans with minimal exposure (Bramhall 2021).

Findings against it, or against it mattering:

• People with verified trouble hearing speech in noise but normal audiograms had no greater lifetime noise exposure and no nerve-response differences from matched controls (Guest 2018).
• Young adults with tinnitus and normal audiograms had more lifetime noise exposure, but no nerve-response signs of this injury (Guest 2017).
• Frequent attenders of loud music venues (31, against 30 who did not attend) showed one modest nerve-response difference and no measurable effect on hearing tasks or speech in noise (Grose 2017).
• Among 32 people tested around a loud recreational event, the authors found no permanent changes and concluded that their data do not support common recreational noise causing hidden hearing loss (Grinn 2017).

One proposed explanation for the mixed results is that risk may be lower with recreational noise than with work or military noise (Bramhall 2021). A separate question is aging. In 20 donated human inner ears from people with no history of ear disease, 7 of the 11 people over 60 had lost more than 60% of the nerve fibers measured, far more than their loss of inner hair cells (Wu 2019). That study addressed aging, not noise.

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Temporary Shift Versus Permanent Loss

After a loud event, hearing can seem muffled and the ears may ring. This is a temporary threshold shift, meaning the softest sound a person can hear has risen for a while. The 2023 review defines it as recovery within 24 to 48 hours. Hearing loss still present at 14 days points to a permanent shift, with 30 days as the upper limit for recovery. Both long exposure and a single very intense sound can cause permanent loss (Natarajan 2023).

A controlled experiment shows the temporary kind. Thirty-three adults with normal hearing listened to music through a digital player for 4 hours at levels from 93 to 102 dB. At the higher levels a shift was reliably seen, largest at 4,000 Hz, averaging 6.3 dB. Recovery was largely complete within 4 hours, and complete in everyone at one week (Le Prell 2012).

Three findings suggest that recovery on a hearing test does not settle the matter:

• In mice, exposures with full threshold recovery still cost nerve connections (Kujawa 2009).
• In mice exposed when young, nerve responses went on deteriorating long after the noise had ended, and the ears aged differently from unexposed ears (Kujawa 2006).
• In 203 older men from the Framingham Heart Study followed for 15 years, those with large noise notches lost more hearing at the neighboring frequency of 2,000 Hz. The authors suggest noise damage may keep having effects long after exposure stops (Gates 2000).

In workplace testing, the United States Occupational Safety and Health Administration uses a confirmed 10 dB average shift at 2,000, 3,000 and 4,000 Hz as its marker, called a standard threshold shift (Natarajan 2023).

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The Audiogram Notch at 4,000 Hz

An audiogram plots the softest sound heard at each pitch. The noise pattern is normal hearing at low and middle pitches, a sudden drop past 3,000 Hz that is deepest at 4,000 Hz, and slight recovery at higher pitches. The shape is credited partly to the length and volume of the ear canal, which amplifies sound in this range. With longer exposure the notch deepens and widens to neighboring pitches (Natarajan 2023). Age-related loss tends to affect the highest frequencies first, so the two patterns differ early but overlap later (Gates 2000).

The notch is a clue, not proof:

• In a United States survey of adults aged 20 to 69, 24% had notches, including almost one third of those reporting loud noise at work (Carroll 2017).
• Among workers exposed to noise, assessors found notches in 49%, but only the small group with notches at 4,000 Hz showed the expected link to noise, including an odds ratio of 4.25 for firearms. The larger group with notches at 6,000 Hz did not (McBride 2001).
• Among 2,348 United States teens, 16.6% had notches in both ears and 55.6% had a notch in at least one. In a computer simulation, 5.5% of perfectly flat audiograms were still counted as having notches in both ears, showing how readily this criterion gives false alarms (Bhatt 2017).
• A systematic review found it difficult to separate noise damage from age-related loss in one individual (Lie 2016).

Musicians often show the notch higher up, at 6,000 Hz (Jansen 2009; Phillips 2010). A guide to reading the rest of the chart is on the Hearing Loss page.

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How Common It Is

Workers

• Worldwide, 16% of disabling adult hearing loss was attributed to workplace noise in a 2005 burden estimate, ranging from 7% to 21% by region (Nelson 2005).
• About 22 million United States workers are exposed to hazardous noise. Around 33% of working-age adults with a history of workplace noise have audiogram evidence of damage, and 16% of noise-exposed workers have material hearing impairment (Themann 2019).
• Mining had the highest reported exposure, at 76% of workers, followed by lumber and wood products at 55% (Tak 2009).
• Audiograms from 1.4 million noise-exposed United States workers showed hearing loss in 19% overall, and 36% in forest nurseries and gathering of forest products (Masterson 2018).
• A systematic review of 187 studies reports that noise-related hearing loss at work is declining in most industrialized countries, probably because of prevention, and that most hearing loss is still related to age (Lie 2016).

Teens and Young Adults

• Hearing loss above 15 dB among United States 12- to 19-year-olds rose from 14.9% in 1988 to 1994 to 19.5% in 2005 to 2006 (Shargorodsky 2010).
• Adding later survey data changes that picture: 17.0% in 1988 to 1994, 22.5% in 2007 to 2008, and 15.2% in 2009 to 2010, with no significant overall trend. Reported noise exposure rose, yet noise was not consistently linked with hearing loss (Su 2017).
• A review of children and young adults found increased hearing levels in 9.6%. Most studies found no significant link between hearing thresholds and loud music, although high tinnitus rates and other changes suggest one (le Clercq 2016).
• Among German ninth graders, 41.9% were estimated to have hazardous noise exposure in their leisure time, yet no link with audiometric notches was detected (Dehnert 2015).

Music Players

• A review of 41 articles and 4,618 professional musicians found hearing loss in 38.6%: 63.5% of pop and rock players and 32.8% of classical players (Di Stadio 2018).
• Among 329 student musicians aged 18 to 25, 45% had a notch by the study's definition, and notches were more frequent in those practicing more than two hours a day (Phillips 2010).
• In five symphony orchestras, most musicians heard better than expected for their age. The most exposed ears, averaging above 90.4 dB for 41.7 years, had an additional 6.3 dB shift compared with the least exposed. Left ears were 2.5 dB worse than right ears (Schmidt 2014).

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Decibels and Time: What the Agencies List

Decibels (dB) are a logarithmic scale, so small changes in the number are large changes in sound energy. Workplace limits use a meter setting called A-weighting that matches how the ear responds. The limits below are listed by agencies, and they differ because they were set for different purposes.

United States Workplace Limits Per Day

The National Institute for Occupational Safety and Health issues a recommendation, with the allowed time cut in half for every 3 dB. The Occupational Safety and Health Administration issues the legal limit, with the time cut in half for every 5 dB. The 2023 review describes the first as clinically safe levels and the second as more liberal to allow for practical issues in industry (Natarajan 2023). On each line below, the first time is the National Institute for Occupational Safety and Health recommendation and the second is the Occupational Safety and Health Administration figure.

• 85 dB: 8 hours; 16 hours.
• 88 dB: 4 hours; 10 hours 36 minutes.
• 90 dB: 2 hours 31 minutes; 8 hours.
• 94 dB: 1 hour; 4 hours 36 minutes.
• 97 dB: 30 minutes; 3 hours.
• 100 dB: 15 minutes; 2 hours.
• 103 dB: 7 minutes 30 seconds; 1 hour 18 minutes.
• 106 dB: 3 minutes 45 seconds; 52 minutes 12 seconds.
• 110 dB: 1 minute 29 seconds; 30 minutes.
• 112 dB: 56 seconds; 22 minutes 48 seconds.
• 115 dB: 28 seconds; 15 minutes.

The federal noise regulation, 29 CFR 1910.95, sets 90 dB for 8 hours as the permissible limit. It states that impulse or impact noise should not exceed 140 dB peak. At an 8-hour average of 85 dB it requires employers to run a hearing conservation program that includes monitoring, with hearing tests and hearing protectors at no cost to the employee.

World Health Organization Safe-Listening Figures Per Week

The World Health Organization's safe-listening guidance counts time per week rather than per workday:

• 80 dB: 40 hours a week.
• 85 dB: 12 hours 30 minutes.
• 90 dB: 4 hours.
• 95 dB: 1 hour 15 minutes.
• 100 dB: 20 minutes.
• 105 dB: 8 minutes.
• 110 dB: 2.5 minutes.
• 120 dB: 12 seconds.

Examples on the same list: normal conversation 60 dB, heavy traffic heard inside a car 85 dB, shouted conversation 90 dB, motorcycle 95 dB, car horn at 5 meters 105 dB, standing near a siren 120 dB, jackhammer 130 dB, airplane taking off 140 dB, and firecrackers 150 dB. The organization lists 140 dB and above as having no safe listening time.

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Personal Listening Devices and Concerts

A meta-analysis of 33 studies and 19,046 people aged 12 to 34 estimated that 23.81% had unsafe listening habits from personal devices. For loud venues the data were less certain, and a fitted model gave 48.20%. The authors estimate that 0.67 to 1.35 billion young people could be at risk worldwide (Dillard 2022). This is an estimate of exposure, not of measured hearing loss.

• Across 26 studies, up to 58.2% of device users exceeded the full daily noise dose. Louder background noise went with higher chosen listening levels (Jiang 2016).
• Among 2,143 German students, 85% used music players. About one third of users exceeded 80 dB and one quarter exceeded 85 dB, converted to a 40-hour week. A notch was found in 2.3%, and it was not significantly linked with higher player exposure (Twardella 2017).

The concert evidence is clearer for the short term. In a randomized trial at an Amsterdam music festival, the average level over a 4.5-hour visit was 100 dB. A temporary shift at 3,000 and 4,000 Hz appeared in 8% of ears with earplugs and 42% without. New tinnitus appeared in 12% of those with earplugs and 40% of those without (Ramakers 2016). A systematic review the same year found that this was the only well-conducted trial of its kind (Kraaijenga 2016). Neither study followed people long enough to measure permanent loss.

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Firearms and Impulse Noise

A gunshot delivers its energy almost instantly. Measurements during small-firearm target practice found mean peak levels of 154 and 156 dB (Pawlaczyk-Luszczynska 2004), above the 140 dB peak figure in the federal regulation. A systematic review reports that impulse noise seems more harmful than continuous noise, that firearms may harm hearing, and that most other leisure noise seems less important (Lie 2016).

• Hunters and target shooters. Among 1,538 men aged 48 and older, regular target shooting went with an odds ratio of 1.57 for marked high-frequency loss, and hunting raised the risk 7% per 5 years. Of those who shot in the past year, 38% of target shooters and 95% of hunters never wore protection (Nondahl 2000).
• Professional soldiers. Of 699 army officers, 68% had some hearing loss, including 26% of those under 30, and 32% had tinnitus (Ylikoski 1994).
• One ear worse. In seven right-handed soldiers with hearing impairment after firing unprotected, average thresholds were 6.5 dB on the right and 33.1 dB on the left, which the authors relate to head position during firing (Moon 2007).
• Suppressors. Three firearm suppressors cut the peak level at the ear by 17 to 24 dB, but the authors report that the cumulative exposure can still present a significant hearing risk (Murphy 2018).
• Protected shooters. Young firearm users, 91% of whom wore protection all or almost all the time, did not differ from non-users on any hearing or nerve measure (Grinn 2022).

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Sudden Acoustic Trauma and Hospital Steroid Studies

Acute acoustic trauma is hearing loss after a single intense sound such as a gunshot or blast. Time matters in nearly every series below.

Signs Hospitals Treat as Urgent

• Hearing that stays muffled or reduced after a blast, gunshot or explosion.
• Sudden hearing loss in one ear over minutes, hours or a few days, with or without an obvious cause.
• Hearing loss with spinning dizziness.
• Blood or fluid from the ear after a blast.

A blocked feeling alone cannot separate wax from inner-ear injury. A tuning-fork test or audiogram can. The Sudden Sensorineural Hearing Loss page covers the guideline and trial evidence for loss with no known cause.

What the Studies Report

Most of this work comes from military hospitals. No placebo-controlled trial was found. The 2023 review notes that high-quality long-term evidence in humans is lacking (Natarajan 2023).

• Oral steroids against no treatment. Among 263 Israeli military personnel, allocated non-randomly, 137 received prednisone at 1 mg per kilogram, up to 60 mg a day. Those treated within 24 hours at high dose for at least 7 days did significantly better. The steroid group improved 13 to 14 dB more in bone-conduction thresholds at 3,000 and 4,000 Hz, although overall averages did not differ (Zloczower 2022).
• Timing of steroids with piracetam. Among 52 soldiers, complete recovery occurred in 65% treated within an hour, 23.5% treated between 1 and 16 hours and 13.3% treated after 24 hours or more. There was no untreated group (Psillas 2008).
• Steroid course length. In a review of 29 patients, 60 mg of prednisolone a day for 10 days plus a 4-day taper gave more hearing gain than a 10-day course with 5 days at 60 mg (Choi 2019).
• Injection through the eardrum. In 19 patients, adding four injections to oral prednisolone gave about 11 dB more hearing gain in a regression model (Chang 2017).
• Hyperbaric oxygen. In Czech military records of 141 ears, 96% improved when treatment began within 24 hours, 74% within seven days and 53% after that. Overall improvement was 82% without hyperbaric oxygen and 77% with it, although the two groups were not randomized (Holy 2021). A Dutch military series reported better results at higher frequencies when hyperbaric oxygen was added (Bayoumy 2020). A series of 73 ears given both found no change in 78.4% of those treated within 10 days and 91.7% of those treated later (Salihoglu 2015).

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Hearing Protection and Workplace Programs

The main evidence summary is the 2017 Cochrane review of 29 studies, covering non-drug measures at work (Tikka 2017). Its findings are more modest than many readers expect:

• Hearing protectors reduced noise exposure by about 20 dB on average (low-quality evidence).
• Earplugs attenuated noise 8.59 dB better when workers received instruction on inserting them (moderate-quality evidence).
• Earmuffs and earplugs did not differ in long-term hearing loss (very low-quality evidence).
• Better use of hearing protection within a program lowered hearing loss risk, with an odds ratio of 0.40 (very low-quality evidence). Training and education components did not show a similar effect.
• Workers in programs still had 1.8 dB more loss at 4,000 Hz than non-exposed workers, a difference that was not statistically significant.
• Stricter mining legislation reduced the median noise dose by 27.7 percentage points, roughly 4.5 dB (very low-quality evidence).
• Case studies of quieter equipment and noise barriers reported immediate reductions of 11.1 to 19.7 dB, but no controlled field trials of such engineering measures exist.

The authors state that the absence of conclusive evidence is not evidence that these measures fail.

The gap between the label and real life is large. In a study of construction workers, protectors were worn less than one quarter of the time exposure exceeded 85 dB. Workers achieved more than half the rated attenuation on average, with wide variation, and overall effective protection came to less than 3 dB (Neitzel 2005). In United States survey data from 2014, 53% of noise-exposed workers used protection half the time or less (Green 2021). A 2019 review emphasizes controlling noise at the source over relying on protectors (Themann 2019).

A 2021 meta-analysis of 20 articles found that protectors significantly attenuated sound, with no significant effect on locating sounds or understanding speech (Kwak 2021).

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Nutrients and Antioxidants Tested in People

These trials are small, and most measured temporary shifts rather than permanent loss. Animal results have been stronger than human ones. No nutrient or drug is approved for this use (Natarajan 2023). The site's Tinnitus: N-acetylcysteine and Antioxidants page carries an evidence warning on some of these claims.

N-acetylcysteine

• Largest trial, null on its main outcome. Among 566 military personnel in weapons training, randomized and double-blind, the rate of threshold shifts did not differ significantly. A secondary outcome, the ear on the trigger-hand side, favored the drug: 27.14% against 34.98% on placebo. Adverse events occurred in 27.4% on the drug and 26.7% on placebo. The authors state that the design failed to confirm benefit (Kopke 2015).
• Noise-exposed workers. In a crossover trial, 53 men exposed to 88 to 89 dB took 1,200 mg a day for 14 days. Temporary shift fell overall, and the effect was significant only in men lacking two detoxifying genes (Lin 2010).
• Textile workers. Among 48 men, 1,200 mg a day or ginseng at 200 mg a day each reduced temporary shift compared with no supplement, with the larger effect from N-acetylcysteine. There was no placebo (Doosti 2014).
• Indoor shooting. Eleven officers given the drug after shooting were compared with a control group of 23. Changes in thresholds were small, and a measure of inner-ear function held steadier with the drug (Lindblad 2011).

Magnesium

• Military recruits. In a double-blind trial of 300 recruits who wore earplugs during training, those given 167 mg of magnesium a day as magnesium aspartate had fewer and less severe permanent shifts than those on placebo (Attias 1994). A report with overlapping authors, 320 recruits and the same dose found ears with shifts above 25 dB twice as often on placebo (Joachims 1993). These may describe the same study.
• Temporary shift. Twenty men had lower temporary shift during the magnesium phase of a double-blind study (Attias 2004).
• Blood levels. Among 68 soldiers, natural blood magnesium was not linked with hearing (Walden 2000).

Others

• Ebselen, an experimental drug that mimics a natural antioxidant enzyme. In a phase 2 trial of 83 young adults funded by its developer, 400 mg twice daily reduced temporary shift at 4,000 Hz to 1.32 dB from 4.07 dB on placebo. The 200 mg and 600 mg doses did not reach significance (Kil 2017).
• Combined beta-carotene, vitamins C and E, and magnesium. A randomized placebo-controlled trial found no effect on music-induced temporary shift. Transient tinnitus was reported more often with the supplement (Le Prell 2016).
• Vitamin B12. Among 20 young volunteers, cyanocobalamin given at 1 mg daily for 7 days and 5 mg on the eighth day reduced temporary shift at 3,000 and 4,000 Hz (Quaranta 2004).
• Zinc. In 20 patients with noise-related hearing loss and tinnitus, two months of zinc improved tinnitus questionnaire scores from 38.3 to 30, with no change in hearing thresholds or in tinnitus loudness (Yeh 2019).
• Diet. In a Korean national survey, higher niacin and retinol and lower carbohydrate intake went with less noise-related hearing loss (Lee 2022). This is an association, not a trial. A 2019 review reports that healthy diet quality is linked with better hearing and that many questions remain open (Spankovich 2019).

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Drugs and Solvents That Add to Noise Damage

The drugs that can damage hearing on their own are listed on the Hearing Loss page. What matters here is how they combine with noise.

Drugs

• Aminoglycoside antibiotics. A review reports that combined noise and aminoglycoside exposure can cause more threshold loss than the two added together, particularly in newborn intensive care. An earlier sound exposure that causes no permanent change can still worsen the later drug effect, and low drug doses can worsen noise damage (Li 2009).
• Cisplatin. Among 488 male survivors of germ cell tumors, each added 100 mg per square meter of cisplatin went with 3.2 dB worse hearing from 4,000 to 12,000 Hz, 18% had severe to profound loss, and 40% had tinnitus. Noise damage, seen in 10%, was not related to the dose. The authors call for counseling these survivors about noise and other hearing hazards (Frisina 2016).

Solvents

Toluene, styrene, xylene, trichloroethylene and carbon disulfide are the solvents named in the early review of this subject (Morata 1994). The site also has pages on volatile organic compounds and benzene.

• Printing and paint workers. Adjusted risk of hearing loss was 4 times the unexposed level with noise, 11 times with noise and toluene, and 5 times with a solvent mixture (Morata 1993).
• Adhesive plant workers. Hearing loss of at least 25 dB was found in 86.2% with toluene and noise, 44.8% with noise only, and 5.0% of clerks. The toluene group's noise levels were actually lower (Chang 2006).
• Styrene. Exposure went with an odds ratio of 3.9 for hearing loss after adjusting for noise, and combined exposure gave odds two to three times higher than either alone (Sliwinska-Kowalska 2003).
• Dockyard workers. Odds of hearing loss were about 3 times higher with noise alone and almost 5 times higher with noise and solvents (Sliwinska-Kowalska 2004).
• United States general population. Blood benzene, ethylbenzene and toluene were linked with high-frequency loss, but no significant interaction with workplace noise was found (Staudt 2019). The evidence on whether the effect is additive or greater is not settled.
• Overlap. In Australia, over 80% of workers above the 85 dB limit were also exposed to at least one ear-damaging chemical (Lewkowski 2019).

Smoking appears to add to risk too. In 4,624 Japanese steel workers, the prevalence ratio for high-frequency loss was 1.57 for smoking alone, 1.77 for noise alone and 2.56 for both (Mizoue 2003). In Chinese workers exposed to noise, smokers had an odds ratio of 1.94 for high-frequency loss (Tao 2013).

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Tinnitus, Dementia and Heart Research

Tinnitus

Among 151 students, 73.5% reported ringing after leisure noise and 6.6% had chronic tinnitus (Degeest 2014). The link is less clear-cut in workers with normal hearing: in 752 workers, tinnitus was related to noise exposure only among those with hearing handicap (Rubak 2008). Young adults with tinnitus and normal audiograms still had more lifetime noise exposure (Guest 2017). Causes and treatments are on the Tinnitus page.

Dementia

Cohort studies link hearing loss with later dementia. A 2024 analysis of 50 studies and over 1.5 million people found a hazard ratio of 1.35, with 16% higher risk for each 10 dB of worse hearing (Yu 2024). These figures concern adult-onset hearing loss in general, not noise-caused loss specifically, and they show association.

The main trial, ACHIEVE, randomized 977 adults aged 70 to 84 to hearing aids with counseling or to health education. Overall 3-year cognitive change did not differ. The effect varied between the two populations in the trial, and the authors suggest a possible benefit in older adults at higher risk of decline (Lin 2023). The 2026 Cochrane update found the evidence very uncertain for working memory (Ferguson 2026). The Dementia page has more.

Road and rail noise is a separate question. In a study of nearly 2 million Danish adults, higher long-term home exposure went with higher Alzheimer's disease risk, with hazard ratios of 1.16 to 1.27 at levels well below the limits above (Cantuaria 2021). The report concerns noise at home, not measured hearing damage.

Heart and Blood Pressure

• Twelve prospective studies linked workplace noise with high blood pressure (hazard ratio 1.68) and cardiovascular disease (relative risk 1.34), with a small effect on cardiovascular death (hazard ratio 1.12) (Skogstad 2016).
• Another review of 24 studies found a pooled risk of 1.75 for high blood pressure at 80 dB or more, rising with dose (Bolm-Audorff 2020). A 2026 correction after a reanalysis slightly lowered the estimates, to 1.68 in studies at high risk of bias and 1.75 in those at low risk, and states that the dose-response finding stands (Bolm-Audorff 2026).
• In United States survey data, 58% of hearing difficulty, 14% of high blood pressure and 9% of high cholesterol among workers were attributed to workplace noise (Kerns 2018).
• In a cross-sectional survey of 6,307 workers, chronic noise exposure went with an odds ratio of 2.04 for coronary heart disease (Gan 2011).

These studies cannot rule out other features of noisy jobs, and the Skogstad review notes shortcomings in how exposure was measured.

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Hearing Aids and the Over-the-Counter Category

Lost hair cells do not come back, so management centers on protecting what remains and on amplification, with cochlear implants when loss becomes severe (Natarajan 2023). Device styles and buying details are on the Hearing Aids page.

The 2026 Cochrane update covered 16 randomized trials and 2,261 people with mild to moderate loss. Hearing aids likely produce a large improvement in hearing-related quality of life and listening ability, and may make little or no difference to loneliness. Among the six studies that monitored harms, covering 1,186 participants, none reported noise-induced hearing loss from the aids (Ferguson 2026).

The United States created an over-the-counter hearing aid category in 2022. Under 21 CFR 800.30 these devices are for people 18 or older with perceived mild to moderate impairment. Sale to anyone younger is prohibited. Output is capped at 111 dB, or 117 dB for devices with activated input-controlled compression.

In a randomized trial of 64 adults, a self-fitted over-the-counter aid with remote support and the same aid fitted by an audiologist showed no meaningful differences at 6 weeks. Fewer than 20% of United States adults with hearing loss use hearing aids (De Sousa 2023).

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Cheap Home Measures as Reported

The World Health Organization's safe-listening guidance and the studies above list these low-cost measures:

• Volume setting. The organization lists device volume at no more than 60% of maximum, and an average below 80 dB when an app is used to monitor it.
• Less background noise. Listeners turn the volume up in noisy settings (Jiang 2016). The organization lists well-fitted, noise-cancelling headphones as one way to reduce the need to raise volume.
• Earplugs and correct insertion. Instruction alone added 8.59 dB of attenuation in the trials reviewed by Cochrane (Tikka 2017). In one study, simply handing young venue-goers free earplugs increased their use, with or without added health information (Beach 2016).
• Distance and breaks. The organization lists moving away from loudspeakers and noisy machinery, because sound drops with distance, and taking regular breaks.
• Phone sound meters. Accuracy varies. Of more than 130 apps on one platform, 10 met selection criteria, and four came within 2 dB of a reference (Kardous 2014). External calibrated microphones brought results within 1 dB (Kardous 2016). In another test most apps read high, and one stayed within 5 dB of a calibrated meter (Nast 2014).
• Hearing checks. The organization lists its own free hearWHO app for hearing screening in its hearing loss fact sheet.

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What Is Not Known

• Whether loss of nerve connections happens in living people at ordinary recreational exposure, and whether it causes real trouble hearing in noise (Bramhall 2019).
• Whether teen hearing loss is rising at all, given conflicting survey data, and how much of it comes from music (Su 2017; le Clercq 2016).
• How much a person's single audiogram can separate noise from aging (Lie 2016).
• Whether any pill prevents permanent loss. The largest trial missed its main outcome, and the review evidence is low-level (Kopke 2015; Natarajan 2023).
• Which steroid dose, route and time window works best for acute acoustic trauma, since placebo-controlled trials are lacking (Choi 2019).
• Whether long-term workplace programs fully protect hearing, because the evidence is of very low quality and controlled trials of quieter equipment have not been done (Tikka 2017).
• Whether treating noise-related hearing loss changes dementia risk. No trial reported here tested noise-caused loss specifically.
• How solvents and noise combine, since the available studies disagree on whether the effect is more than additive (Sliwinska-Kowalska 2004; Staudt 2019).

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Key Research Papers

1. Natarajan N, Batts S, Stankovic KM. Noise-Induced Hearing Loss. J Clin Med. 2023;12(6):10.3390/jcm12062347. PubMed PMID: 36983347
2. Carroll YI, Eichwald J, Scinicariello F, Hoffman HJ, Deitchman S, Radke MS, et al. Vital Signs: Noise-Induced Hearing Loss Among Adults - United States 2011-2012. MMWR Morb Mortal Wkly Rep. 2017;66(5):139-144. PubMed PMID: 28182600
3. Kujawa SG, Liberman MC. Synaptopathy in the noise-exposed and aging cochlea: Primary neural degeneration in acquired sensorineural hearing loss. Hear Res. 2015;330(Pt B):191-9. PubMed PMID: 25769437
4. Kujawa SG, Liberman MC. Adding insult to injury: cochlear nerve degeneration after "temporary" noise-induced hearing loss. J Neurosci. 2009;29(45):14077-85. PubMed PMID: 19906956
5. Liberman MC. Noise-induced and age-related hearing loss:  new perspectives and potential therapies. F1000Res. 2017;6:927. PubMed PMID: 28690836
6. Bramhall N, Beach EF, Epp B, Le Prell CG, Lopez-Poveda EA, Plack CJ, et al. The search for noise-induced cochlear synaptopathy in humans: Mission impossible? Hear Res. 2019;377:88-103. PubMed PMID: 30921644
7. Liberman MC, Epstein MJ, Cleveland SS, Wang H, Maison SF. Toward a Differential Diagnosis of Hidden Hearing Loss in Humans. PLoS One. 2016;11(9):e0162726. PubMed PMID: 27618300
8. Bramhall NF, McMillan GP, Kampel SD. Envelope following response measurements in young veterans are consistent with noise-induced cochlear synaptopathy. Hear Res. 2021;408:108310. PubMed PMID: 34293505
9. Guest H, Munro KJ, Prendergast G, Millman RE, Plack CJ. Impaired speech perception in noise with a normal audiogram: No evidence for cochlear synaptopathy and no relation to lifetime noise exposure. Hear Res. 2018;364:142-151. PubMed PMID: 29680183
10. Guest H, Munro KJ, Prendergast G, Howe S, Plack CJ. Tinnitus with a normal audiogram: Relation to noise exposure but no evidence for cochlear synaptopathy. Hear Res. 2017;344:265-274. PubMed PMID: 27964937
11. Grose JH, Buss E, Hall JW 3rd. Loud Music Exposure and Cochlear Synaptopathy in Young Adults: Isolated Auditory Brainstem Response Effects but No Perceptual Consequences. Trends Hear. 2017;21:2331216517737417. PubMed PMID: 29105620
12. Grinn SK, Wiseman KB, Baker JA, Le Prell CG. Hidden Hearing Loss? No Effect of Common Recreational Noise Exposure on Cochlear Nerve Response Amplitude in Humans. Front Neurosci. 2017;11:465. PubMed PMID: 28919848
13. Wu PZ, Liberman LD, Bennett K, de Gruttola V, O'Malley JT, Liberman MC. Primary Neural Degeneration in the Human Cochlea: Evidence for Hidden Hearing Loss in the Aging Ear. Neuroscience. 2019;407:8-20. PubMed PMID: 30099118
14. Le Prell CG, Dell S, Hensley B, Hall JW 3rd, Campbell KC, Antonelli PJ, et al. Digital music exposure reliably induces temporary threshold shift in normal-hearing human subjects. Ear Hear. 2012;33(6):e44-58. PubMed PMID: 22885407
15. Kujawa SG, Liberman MC. Acceleration of age-related hearing loss by early noise exposure: evidence of a misspent youth. J Neurosci. 2006;26(7):2115-23. PubMed PMID: 16481444
16. Gates GA, Schmid P, Kujawa SG, Nam B, D'Agostino R. Longitudinal threshold changes in older men with audiometric notches. Hear Res. 2000;141(1-2):220-8. PubMed PMID: 10713509
17. McBride DI, Williams S. Audiometric notch as a sign of noise induced hearing loss. Occup Environ Med. 2001;58(1):46-51. PubMed PMID: 11119634
18. Bhatt IS, Guthrie O. Analysis of audiometric notch as a noise-induced hearing loss phenotype in US youth: data from the National Health And Nutrition Examination Survey, 2005-2010. Int J Audiol. 2017;56(6):392-399. PubMed PMID: 28635495
19. Lie A, Skogstad M, Johannessen HA, Tynes T, Mehlum IS, Nordby KC, et al. Occupational noise exposure and hearing: a systematic review. Int Arch Occup Environ Health. 2016;89(3):351-72. PubMed PMID: 26249711
20. Jansen EJ, Helleman HW, Dreschler WA, de Laat JA. Noise induced hearing loss and other hearing complaints among musicians of symphony orchestras. Int Arch Occup Environ Health. 2009;82(2):153-64. PubMed PMID: 18404276
21. Phillips SL, Henrich VC, Mace ST. Prevalence of noise-induced hearing loss in student musicians. Int J Audiol. 2010;49(4):309-16. PubMed PMID: 20233141
22. Nelson DI, Nelson RY, Concha-Barrientos M, Fingerhut M. The global burden of occupational noise-induced hearing loss. Am J Ind Med. 2005;48(6):446-58. PubMed PMID: 16299704
23. Themann CL, Masterson EA. Occupational noise exposure: A review of its effects, epidemiology, and impact with recommendations for reducing its burden. J Acoust Soc Am. 2019;146(5):3879. PubMed PMID: 31795665
24. Tak S, Davis RR, Calvert GM. Exposure to hazardous workplace noise and use of hearing protection devices among US workers--NHANES, 1999-2004. Am J Ind Med. 2009;52(5):358-71. PubMed PMID: 19267354
25. Masterson EA, Themann CL, Calvert GM. Prevalence of hearing loss among noise-exposed workers within the agriculture, forestry, fishing, and hunting sector, 2003-2012. Am J Ind Med. 2018;61(1):42-50. PubMed PMID: 29152771
26. Shargorodsky J, Curhan SG, Curhan GC, Eavey R. Change in prevalence of hearing loss in US adolescents. JAMA. 2010;304(7):772-8. PubMed PMID: 20716740
27. Su BM, Chan DK. Prevalence of Hearing Loss in US Children and Adolescents: Findings From NHANES 1988-2010. JAMA Otolaryngol Head Neck Surg. 2017;143(9):920-927. PubMed PMID: 28750123
28. le Clercq CMP, van Ingen G, Ruytjens L, van der Schroeff MP. Music-induced Hearing Loss in Children, Adolescents, and Young Adults: A Systematic Review and Meta-analysis. Otol Neurotol. 2016;37(9):1208-16. PubMed PMID: 27466893
29. Dehnert K, Raab U, Perez-Alvarez C, Steffens T, Bolte G, Fromme H, et al. Total leisure noise exposure and its association with hearing loss among adolescents. Int J Audiol. 2015;54(10):665-73. PubMed PMID: 25906840
30. Di Stadio A, Dipietro L, Ricci G, Della Volpe A, Minni A, Greco A, et al. Hearing Loss, Tinnitus, Hyperacusis, and Diplacusis in Professional Musicians: A Systematic Review. Int J Environ Res Public Health. 2018;15(10):10.3390/ijerph15102120. PubMed PMID: 30261653
31. Schmidt JH, Pedersen ER, Paarup HM, Christensen-Dalsgaard J, Andersen T, Poulsen T, et al. Hearing loss in relation to sound exposure of professional symphony orchestra musicians. Ear Hear. 2014;35(4):448-60. PubMed PMID: 24603543
32. Dillard LK, Arunda MO, Lopez-Perez L, Martinez RX, Jiménez L, Chadha S. Prevalence and global estimates of unsafe listening practices in adolescents and young adults: a systematic review and meta-analysis. BMJ Glob Health. 2022;7(11):10.1136/bmjgh-2022-010501. PubMed PMID: 36379592
33. Jiang W, Zhao F, Guderley N, Manchaiah V. Daily music exposure dose and hearing problems using personal listening devices in adolescents and young adults: A systematic review. Int J Audiol. 2016;55(4):197-205. PubMed PMID: 26768911
34. Twardella D, Raab U, Perez-Alvarez C, Steffens T, Bolte G, Fromme H. Usage of personal music players in adolescents and its association with noise-induced hearing loss: A cross-sectional analysis of Ohrkan cohort study data. Int J Audiol. 2017;56(1):38-45. PubMed PMID: 27686245
35. Ramakers GG, Kraaijenga VJ, Cattani G, van Zanten GA, Grolman W. Effectiveness of Earplugs in Preventing Recreational Noise-Induced Hearing Loss: A Randomized Clinical Trial. JAMA Otolaryngol Head Neck Surg. 2016;142(6):551-8. PubMed PMID: 27054284
36. Kraaijenga VJ, Ramakers GG, Grolman W. The Effect of Earplugs in Preventing Hearing Loss From Recreational Noise Exposure: A Systematic Review. JAMA Otolaryngol Head Neck Surg. 2016;142(4):389-94. PubMed PMID: 26940158
37. Pawlaczyk-Luszczyńska M, Dudarewicz A, Bak M, Fiszer M, Kotyło P, Sliwińska-Kowalska M. Temporary changes in hearing after exposure to shooting noise. Int J Occup Med Environ Health. 2004;17(2):285-93. PubMed PMID: 15387085
38. Nondahl DM, Cruickshanks KJ, Wiley TL, Klein R, Klein BE, Tweed TS. Recreational firearm use and hearing loss. Arch Fam Med. 2000;9(4):352-7. PubMed PMID: 10776364
39. Ylikoski ME, Ylikoski JS. Hearing loss and handicap of professional soldiers exposed to gunfire noise. Scand J Work Environ Health. 1994;20(2):93-100. PubMed PMID: 8079140
40. Moon IS. Noise-induced hearing loss caused by gunshot in South Korean military service. Mil Med. 2007;172(4):421-5. PubMed PMID: 17484317
41. Murphy WJ, Flamme GA, Campbell AR, Zechmann EL, Tasko SM, Lankford JE, et al. The reduction of gunshot noise and auditory risk through the use of firearm suppressors and low-velocity ammunition. Int J Audiol. 2018;57(sup1):S28-S41. PubMed PMID: 29299940
42. Grinn SK, Le Prell CG. Evaluation of hidden hearing loss in normal-hearing firearm users. Front Neurosci. 2022;16:1005148. PubMed PMID: 36389238
43. Zloczower E, Tsur N, Hershkovich S, Fink N, Marom T. Efficacy of Oral Steroids for Acute Acoustic Trauma. Audiol Neurootol. 2022;27(4):312-320. PubMed PMID: 35231916
44. Psillas G, Pavlidis P, Karvelis I, Kekes G, Vital V, Constantinidis J. Potential efficacy of early treatment of acute acoustic trauma with steroids and piracetam after gunshot noise. Eur Arch Otorhinolaryngol. 2008;265(12):1465-9. PubMed PMID: 18463885
45. Choi N, Kim JS, Chang YS. Comparison of oral steroid regimens for acute acoustic trauma caused by gunshot noise exposure. J Laryngol Otol. 2019;133(7):566-570. PubMed PMID: 31182177
46. Chang YS, Bang KH, Jeong B, Lee GG. Effects of early intratympanic steroid injection in patients with acoustic trauma caused by gunshot noise. Acta Otolaryngol. 2017;137(7):716-719. PubMed PMID: 28125313
47. Holy R, Zavazalova S, Prochazkova K, Kalfert D, Younus T, Dosel P, et al. The Use of Hyperbaric Oxygen Therapy and Corticosteroid Therapy in Acute Acoustic Trauma: 15 Years' Experience at the Czech Military Health Service. Int J Environ Res Public Health. 2021;18(9):10.3390/ijerph18094460. PubMed PMID: 33922296
48. Bayoumy AB, van der Veen EL, van Ooij PAM, Besseling-Hansen FS, Koch DAA, Stegeman I, et al. Effect of hyperbaric oxygen therapy and corticosteroid therapy in military personnel with acute acoustic trauma. BMJ Mil Health. 2020;166(4):243-248. PubMed PMID: 30612101
49. Salihoğlu M, Ay H, Cincik H, Cekin E, Cesmeci E, Memis A, et al. Efficiency of hyperbaric oxygen and steroid therapy in treatment of hearing loss following acoustic trauma. Undersea Hyperb Med. 2015;42(6):539-46. PubMed PMID: 26742254
50. Tikka C, Verbeek JH, Kateman E, Morata TC, Dreschler WA, Ferrite S. Interventions to prevent occupational noise-induced hearing loss. Cochrane Database Syst Rev. 2017;7(7):CD006396. PubMed PMID: 28685503
51. Neitzel R, Seixas N. The effectiveness of hearing protection among construction workers. J Occup Environ Hyg. 2005;2(4):227-38. PubMed PMID: 15788384
52. Green DR, Masterson EA, Themann CL. Prevalence of hearing protection device non-use among noise-exposed US workers in 2007 and 2014. Am J Ind Med. 2021;64(12):1002-1017. PubMed PMID: 34597431
53. Kwak C, Han W. The Effectiveness of Hearing Protection Devices: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2021;18(21):10.3390/ijerph182111693. PubMed PMID: 34770206
54. Kopke R, Slade MD, Jackson R, Hammill T, Fausti S, Lonsbury-Martin B, et al. Efficacy and safety of N-acetylcysteine in prevention of noise induced hearing loss: a randomized clinical trial. Hear Res. 2015;323:40-50. PubMed PMID: 25620313
55. Lin CY, Wu JL, Shih TS, Tsai PJ, Sun YM, Ma MC, et al. N-Acetyl-cysteine against noise-induced temporary threshold shift in male workers. Hear Res. 2010;269(1-2):42-7. PubMed PMID: 20638463
56. Doosti A, Lotfi Y, Moossavi A, Bakhshi E, Talasaz AH, Hoorzad A. Comparison of the effects of N-acetyl-cysteine and ginseng in prevention of noise induced hearing loss in male textile workers. Noise Health. 2014;16(71):223-7. PubMed PMID: 25033789
57. Lindblad AC, Rosenhall U, Olofsson A, Hagerman B. The efficacy of N-acetylcysteine to protect the human cochlea from subclinical hearing loss caused by impulse noise: a controlled trial. Noise Health. 2011;13(55):392-401. PubMed PMID: 22122955
58. Attias J, Weisz G, Almog S, Shahar A, Wiener M, Joachims Z, et al. Oral magnesium intake reduces permanent hearing loss induced by noise exposure. Am J Otolaryngol. 1994;15(1):26-32. PubMed PMID: 8135325
59. Joachims Z, Netzer A, Ising H, Rebentisch E, Attias J, Weisz G, et al. Oral magnesium supplementation as prophylaxis for noise-induced hearing loss: results of a double blind field study. Schriftenr Ver Wasser Boden Lufthyg. 1993;88:503-16. PubMed PMID: 8460390
60. Attias J, Sapir S, Bresloff I, Reshef-Haran I, Ising H. Reduction in noise-induced temporary threshold shift in humans following oral magnesium intake. Clin Otolaryngol Allied Sci. 2004;29(6):635-41. PubMed PMID: 15533151
61. Walden BE, Henselman LW, Morris ER. The role of magnesium in the susceptibility of soldiers to noise-induced hearing loss. J Acoust Soc Am. 2000;108(1):453-6. PubMed PMID: 10923909
62. Kil J, Lobarinas E, Spankovich C, Griffiths SK, Antonelli PJ, Lynch ED, et al. Safety and efficacy of ebselen for the prevention of noise-induced hearing loss: a randomised, double-blind, placebo-controlled, phase 2 trial. Lancet. 2017;390(10098):969-979. PubMed PMID: 28716314
63. Le Prell CG, Fulbright A, Spankovich C, Griffiths SK, Lobarinas E, Campbell KC, et al. Dietary supplement comprised of β-carotene, vitamin C, vitamin E, and magnesium: failure to prevent music-induced temporary threshold shift. Audiol Neurotol Extra. 2016;6(2):20-39. PubMed PMID: 27990155
64. Quaranta A, Scaringi A, Bartoli R, Margarito MA, Quaranta N. The effects of 'supra-physiological' vitamin B12 administration on temporary threshold shift. Int J Audiol. 2004;43(3):162-5. PubMed PMID: 15198380
65. Yeh CW, Tseng LH, Yang CH, Hwang CF. Effects of oral zinc supplementation on patients with noise-induced hearing loss associated tinnitus: A clinical trial. Biomed J. 2019;42(1):46-52. PubMed PMID: 30987704
66. Lee HJ, Lee J, Yoon C, Park Y, Joo YH, Park JO, et al. Association of dietary factors with noise-induced hearing loss in Korean population: A 3-year national cohort study. PLoS One. 2022;17(12):e0279884. PubMed PMID: 36584228
67. Spankovich C, Le Prell CG. The role of diet in vulnerability to noise-induced cochlear injury and hearing loss. J Acoust Soc Am. 2019;146(5):4033. PubMed PMID: 31795697
68. Li H, Steyger PS. Synergistic ototoxicity due to noise exposure and aminoglycoside antibiotics. Noise Health. 2009;11(42):26-32. PubMed PMID: 19265251
69. Frisina RD, Wheeler HE, Fossa SD, Kerns SL, Fung C, Sesso HD, et al. Comprehensive Audiometric Analysis of Hearing Impairment and Tinnitus After Cisplatin-Based Chemotherapy in Survivors of Adult-Onset Cancer. J Clin Oncol. 2016;34(23):2712-20. PubMed PMID: 27354478
70. Morata TC, Dunn DE, Sieber WK. Occupational exposure to noise and ototoxic organic solvents. Arch Environ Health. 1994;49(5):359-65. PubMed PMID: 7944568
71. Morata TC, Dunn DE, Kretschmer LW, Lemasters GK, Keith RW. Effects of occupational exposure to organic solvents and noise on hearing. Scand J Work Environ Health. 1993;19(4):245-54. PubMed PMID: 8235513
72. Chang SJ, Chen CJ, Lien CH, Sung FC. Hearing loss in workers exposed to toluene and noise. Environ Health Perspect. 2006;114(8):1283-6. PubMed PMID: 16882540
73. Sliwińska-Kowalska M, Zamyslowska-Szmytke E, Szymczak W, Kotylo P, Fiszer M, Wesolowski W, et al. Ototoxic effects of occupational exposure to styrene and co-exposure to styrene and noise. J Occup Environ Med. 2003;45(1):15-24. PubMed PMID: 12553175
74. Sliwinska-Kowalska M, Zamyslowska-Szmytke E, Szymczak W, Kotylo P, Fiszer M, Wesolowski W, et al. Effects of coexposure to noise and mixture of organic solvents on hearing in dockyard workers. J Occup Environ Med. 2004;46(1):30-8. PubMed PMID: 14724476
75. Staudt AM, Whitworth KW, Chien LC, Whitehead LW, Gimeno Ruiz de Porras D. Association of organic solvents and occupational noise on hearing loss and tinnitus among adults in the U.S., 1999-2004. Int Arch Occup Environ Health. 2019;92(3):403-413. PubMed PMID: 30806784
76. Lewkowski K, Heyworth JS, Li IW, Williams W, McCausland K, Gray C, et al. Exposure to noise and ototoxic chemicals in the Australian workforce. Occup Environ Med. 2019;76(5):341-348. PubMed PMID: 30683670
77. Mizoue T, Miyamoto T, Shimizu T. Combined effect of smoking and occupational exposure to noise on hearing loss in steel factory workers. Occup Environ Med. 2003;60(1):56-9. PubMed PMID: 12499458
78. Tao L, Davis R, Heyer N, Yang Q, Qiu W, Zhu L, et al. Effect of cigarette smoking on noise-induced hearing loss in workers exposed to occupational noise in China. Noise Health. 2013;15(62):67-72. PubMed PMID: 23412581
79. Degeest S, Corthals P, Vinck B, Keppler H. Prevalence and characteristics of tinnitus after leisure noise exposure in young adults. Noise Health. 2014;16(68):26-33. PubMed PMID: 24583677
80. Rubak T, Kock S, Koefoed-Nielsen B, Lund SP, Bonde JP, Kolstad HA. The risk of tinnitus following occupational noise exposure in workers with hearing loss or normal hearing. Int J Audiol. 2008;47(3):109-14. PubMed PMID: 18307090
81. Yu RC, Proctor D, Soni J, Pikett L, Livingston G, Lewis G, et al. Adult-onset hearing loss and incident cognitive impairment and dementia - A systematic review and meta-analysis of cohort studies. Ageing Res Rev. 2024;98:102346. PubMed PMID: 38788800
82. Lin FR, Pike JR, Albert MS, Arnold M, Burgard S, Chisolm T, et al. Hearing intervention versus health education control to reduce cognitive decline in older adults with hearing loss in the USA (ACHIEVE): a multicentre, randomised controlled trial. Lancet. 2023;402(10404):786-797. PubMed PMID: 37478886
83. Ferguson MA, Sarant JZ, Bennett RJ, McIlhiney P, Badcock N, Bothe E. Hearing aids for mild to moderate hearing loss in adults. Cochrane Database Syst Rev. 2026;8(8):CD012023. PubMed PMID: 42644645
84. Cantuaria ML, Waldorff FB, Wermuth L, Pedersen ER, Poulsen AH, Thacher JD, et al. Residential exposure to transportation noise in Denmark and incidence of dementia: national cohort study. BMJ. 2021;374:n1954. PubMed PMID: 34497091
85. Skogstad M, Johannessen HA, Tynes T, Mehlum IS, Nordby KC, Lie A. Systematic review of the cardiovascular effects of occupational noise. Occup Med (Lond). 2016;66(1):10-6. PubMed PMID: 26732793
86. Bolm-Audorff U, Hegewald J, Pretzsch A, Freiberg A, Nienhaus A, Seidler A. Occupational Noise and Hypertension Risk: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2020;17(17):10.3390/ijerph17176281. PubMed PMID: 32872306
87. Bolm-Audorff U, Hegewald J, Pretzsch A, Freiberg A, Nienhaus A, Seidler A. Correction: Bolm-Audorff et al. Occupational Noise and Hypertension Risk: A Systematic Review and Meta-Analysis. Int. J. Environ. Res. Public Health 2020, 17, 6281. Int J Environ Res Public Health. 2026;23(7):10.3390/ijerph23070855. PubMed PMID: 42512247
88. Kerns E, Masterson EA, Themann CL, Calvert GM. Cardiovascular conditions, hearing difficulty, and occupational noise exposure within US industries and occupations. Am J Ind Med. 2018;61(6):477-491. PubMed PMID: 29537072
89. Gan WQ, Davies HW, Demers PA. Exposure to occupational noise and cardiovascular disease in the United States: the National Health and Nutrition Examination Survey 1999-2004. Occup Environ Med. 2011;68(3):183-90. PubMed PMID: 20924023
90. De Sousa KC, Manchaiah V, Moore DR, Graham MA, Swanepoel W. Effectiveness of an Over-the-Counter Self-fitting Hearing Aid Compared With an Audiologist-Fitted Hearing Aid: A Randomized Clinical Trial. JAMA Otolaryngol Head Neck Surg. 2023;149(6):522-530. PubMed PMID: 37052929
91. Beach EF, Nielsen L, Gilliver M. Providing earplugs to young adults at risk encourages protective behaviour in music venues. Glob Health Promot. 2016;23(2):45-56. PubMed PMID: 25662567
92. Kardous CA, Shaw PB. Evaluation of smartphone sound measurement applications. J Acoust Soc Am. 2014;135(4):EL186-92. PubMed PMID: 25236152
93. Kardous CA, Shaw PB. Evaluation of smartphone sound measurement applications (apps) using external microphones-A follow-up study. J Acoust Soc Am. 2016;140(4):EL327. PubMed PMID: 27794313
94. Nast DR, Speer WS, Le Prell CG. Sound level measurements using smartphone "apps": useful or inaccurate? Noise Health. 2014;16(72):251-6. PubMed PMID: 25209033

PubMed Topic Searches

1. PubMed: noise-induced hearing loss reviews
2. PubMed: cochlear synaptopathy in humans
3. PubMed: acute acoustic trauma and steroids
4. PubMed: N-acetylcysteine and noise in trials
5. PubMed: workplace noise and solvents
6. PubMed: unsafe listening and personal devices

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Connections

• Ear, Nose and Throat — the parent category
• Hearing Loss — types of loss, testing and treatment
• Tinnitus — ringing in the ears, causes and care
• Sudden Sensorineural Hearing Loss — urgent loss with no known cause
• Hearing Aids — device styles and categories
• Tinnitus: N-acetylcysteine and Antioxidants — the inner-ear oxidative stress story
• N-Acetylcysteine — the drug's main page
• Volatile Organic Compounds — solvents and their exposure
• Dementia — hearing loss among other risk factors

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