University of Iowa Health Science Relations and
Ruth A. Bentler, MA, PhD
Professor of Speech Pathology & Audiology
First Published: November 2000
Last Revised: March 2004
Peer Review Status: Internally Peer Reviewed

It sounds hard to believe, but some people can damage their hearing and not even know it. "You can experience hearing loss and not be fully aware of it," says Dr. Ruth A. Bentler, University of Iowa professor of speech pathology and audiology. "Sometimes people are surprised when I tell them they have hearing loss, because they haven't had problems communicating. What they don't realize is that damage can occur at many different frequencies, resulting in normal hearing for some sounds and hearing loss for others."

Hearing loss affects approximately 10 percent of persons in the United States. The causes of hearing loss vary and often lead to a gradual change in hearing sensitivity over a prolonged period of time. "Presbycusis is the term given to hearing loss that occurs with age," Bentler says. "Although some presbycusis is expected with the aging process, it is probably due to a combination of factors, including noise in work and play environments, stress level, and diet." Bentler adds that people in the United States are particularly vulnerable, since high levels of stress, noise, and fat consumption are the cultural norm.

"What many people don't understand is that noise doesn't have to hurt, or even sound too loud, for it to damage hearing," Bentler says. "Some people have a greater sensitivity to loud sounds, so activities such as listening to music, riding a motorcycle, or motor boating could cause hearing damage."

Federal guidelines designed to regulate levels of noise exposure are no guarantee against hearing loss. "The Occupational Safety and Health Administration has developed guidelines for acceptable noise exposure in the work environment, " Bentler says. "For about 95 percent of the population these guidelines protect hearing, but one to five percent of the population are still susceptible to noise damage at these levels." She adds that it is extremely difficult to measure noise in environments where the intensity fluctuates.

Bentler cites several symptoms that can frequently accompany hearing loss. A ringing and fullness in the ears and difficulty understanding speech in a background of noise are usually indicative of such damage.

Bentler recommends that people who have a family history of hearing loss or are exposed to loud sounds get tested at least once a year. People who experience difficulty communicating should also have their hearing tested. "When someone needs statements repeated, it might not be due to a lack of attention. It could mean the person has a hearing problem," Bentler says.

Treatment for hearing loss doesn't always involve the use of a hearing aid. The UI Wendell Johnson Speech and Hearing Clinic offers communication strategy counseling as well. "Counseling often entails teaching people techniques to enhance their communication skills or helping them learn how to reduce environmental noise," Bentler says. "A hearing aid may not always be appropriate or necessary."