Unnaturally quiet

All newborns in the Greater Washington area are required by law to have their hearing tested before leaving the hospital. From then on, in most cases, a person is responsible for his own ear health — an increasingly difficult assignment in today’s noisy society.

According to the Rockville-based American Speech-Language-Hearing Association, an estimated 28 million Americans have some degree of hearing loss and up to 50 million are affected with some degree of tinnitus, a ringing sensation in the ears.

A number of issues are involved, as audiologists well know. They are the professionals who measure hearing loss, tinnitus, balance and related disorders and recommend treatment for them. If a hearing aid is recommended, audiologists fit the device and give the necessary counseling.

Insurance usually covers the screening but not the expense of a hearing aid.

The McLean-based American Academy of Audiology has a lower estimate of the number who need help. It says 24 million Americans have hearing loss — nearly one-half of them younger than 65. Hearing usually decreases with age, but many other causes are at work.

“It has gotten worse. We are definitely a noisy society,” says audiologist Teri Wilson-Bridges, director of Washington Hospital Center’s Hearing and Speech Center.

“Everything is bigger and louder. Toys are louder. Television sets are humongous, and they are loud. And all those Walkman radios and CD players. That is the worst because the sound is right at your ear. If I am sitting next to you wearing one and you hear it, it is too loud. Over time, it definitely can cause some hearing loss, and people aren’t aware of it.”

An audiogram is a test that shows the profile of a person’s condition. Even people who do not suspect they have a hearing problem would benefit from undergoing the test, audiologists say, because results establish a baseline for the future.

The tests are required by the U.S Department of Labor for people surrounded by continuous loud noises on their jobs, such as construction workers who operate jackhammers. Medical doctors — usually ear, nose and throat specialists, known as otolaryngologists — will send patients for testing when they suspect a problem and need help with a diagnosis.

The District of Columbia and 32 states, including Maryland and Virginia, mandate screening for newborns. “The problem was that a lot of kids were being identified at age 3 or 4 when they have missed a lot of language,” says Mrs. Wilson-Bridges. “We started it at Washington Hospital Center in 2001, a year before the District required it, and it was definitely a big undertaking because we have about 5,800 births a year.”

Usually the baby is asleep and unaware of the test, which is given at least 12 hours after birth because, she explains, before then there could be debris in the ear. A tiny plug that gives off a very soft clicking sound is put into the ear to see whether it registers an echo. A normal baby’s hearing shows an echo. If it does not, the test will be repeated another day and possibly again two weeks later. (About 2 percent of babies tested show some hearing problem, she says.)

The majority of people who see audiologists are adults in their 60s or 70s who have been persuaded to come in by physicians or family members or else have noticed an appreciable hearing loss on their own.

Such was the case with Catherine Mitchell, a retired government worker who lives in the District’s Southeast. She had been having what she calls “popping sensations” in her left ear for several months and thought the cause might be an excess amount of ear wax or a reaction to medicines she takes for emphysema. Her physician found out that the problem wasn’t wax and sent her to Washington Hospital Center for an audiogram before taking further steps.

Mild loss seldom presents a problem except, possibly, when one is listening to someone talk in a crowded restaurant. Someone with “profound” loss has no hearing and may need a cochlear implant to function normally.

Apart from excess noise, the most frequent cause of diminished hearing is nerve loss from aging. According to Mrs. Wilson-Bridges, if the loss progresses with age, there is little a person can do besides investing in supplementary medical devices.

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