What Is Noise Induced Hearing Loss


Noise poses a significant health risk in the workplace and surrounding environments, contributing to hearing loss, irritation, disrupted sleep, weariness, and hypertension.1

We are constantly exposed to sound in our surroundings, including those from radios, televisions, home appliances, and traffic. Usually, these sounds are not harmful to our hearing because they are within safe levels; however, sounds that are both loud and prolonged or excessively loud even for a brief period of time can be hazardous. Noise-induced hearing loss (NIHL) can occur due to the damage these sounds can inflict on the sensitive components of the inner ear2   and is also known as occupational hearing loss, professional deafness, or hearing loss through loud exposure at work.

Noise-induced hearing loss has long been acknowledged as the major and most important health consequence of excessive noise exposure. According to the World Health Organisation, workplace noise exposure accounts for an estimated 16% of debilitating hearing loss in adults.1
An estimated 5% of people worldwide experience NIHL, which presents not only a significant global financial burden but also negatively impacts the quality of life of those who are affected.3

Causes of noise induced hearing loss

Noise-induced hearing loss can be brought on by a number of reasons, such as:

  1. Loud noises: Prolonged exposure to loud noises, such as those made by machinery, construction equipment, musical performances, or pyrotechnics, can harm the inner ear's delicate hearing structures
  2. Volume level: The loudness or intensity of the noise is a key element. The likelihood of hearing loss increases with volume. Your hearing can be harmed by prolonged exposure to noises that are louder than 85 decibels (dB)
  3. Time period of exposure: Hearing loss is influenced by how long you are exposed to loud noises. The risk continually increases the longer the exposure to loud noises without adequate breaks
  4. Exposure on a regular basis: Loud noises, even if they are not excessively loud, can harm your hearing if you are repeatedly exposed.. Over time, cumulative exposure is likely to gradually damage hearing
  5. Personal susceptibility: Genetic predispositions or pre-existing medical disorders may make certain people more vulnerable to NIHL. Ears may be more susceptible to harm from loud noises as a result of these circumstances
  6. Lack of hearing protection: In noisy environments, the risk of hearing loss increases if adequate hearing protection equipment, such as earplugs or earmuffs, are not worn. Wearing protective equipment can lessen the intensity of sounds when it reach your ears

Signs and symptoms of noise induced hearing loss

Noise-induced hearing loss has an epidemiologically significant prevalence in urban areas.. This type of hearing loss is initially most predominant at 3, 4, and 6 kHz and progresses to affect 8, 2, 1, 0.5, and 0.25 kHz subsequently.4

You might have hearing loss caused by noise if you have any of the following symptoms or signs:

  1. Usual and common sounds, including speech, seem diminished.
  2.  Difficulty hearing high-pitched sounds, such as birds, doorbells, telephones, and alarm clocks.
  3. Trouble hearing conversations in busy environments or public spaces. 
  4. Trouble comprehending phone conversations.
  5. Having difficulties distinguishing speech consonants, such as between the sounds of s and f, p, and t, or sh and th.
  6. Requesting that others speak louder and slower.
  7. Often requesting an individual to repeat what they said during a conversation.8. Increasing the radio or television volume higher than usual.
  8. An earache, ear pain, or ringing in the ears (tinnitus).
  9. Hypersensitivity to some noises (certain sounds may trigger discomfort or pain).5

Although hearing loss is not a life-threatening medical condition, it has a significant negative impact on a person's quality of life, primarily due to the social handicap caused by communication problems and feelings of isolation, which could potentially lead to other consequences, such as depression, embarrassment, loss of self-esteem, conflict in relationships, and stigma.1

Management and treatment for noise induced hearing loss

To aid in the management and treatment of NIHL, several strategies can be used to reduce additional harm to hearing and improve communication.

  1. Avoiding loud noises: When possible, reduce your exposure to loud noises. It is also recommended to always use hearing protection equipment, such as earplugs or earmuffs, to lessen the intensity of the sound that reaches your ears
  2. Hearing conservation programmes: These are aimed at avoiding hearing loss through education, which can then also be implemented in the workplace by employers. These programmes can inform staff members of the risks posed by excessive noise, when to offer hearing protection equipment, and how to conduct workplace noise level assessments
  3. Rest intervals: Taking regular breaks from excessive noise exposure gives your hearing a chance to recover and lowers the risk of hearing damage from being exposed to loud noises for an extended period of time. It is important to schedule quiet times throughout the day
  4. Treatment of underlying illnesses: If ear conditions such as ear infections or impacted earwax are present, addressing these conditions may help to improve hearing and relieve discomfort. To get the right diagnosis and care, be sure to consult a medical expert
  5. Assistive listening devices: Use hearing aids to better communicate in noisy settings. These include assistive listening systems, which can be utilised in specific environments such as classrooms or auditoriums, in addition to hearing aids, which can aid in the enhancement of sounds
  6. Communication strategies: People who have hearing loss due to noise may benefit from modifying their communication methods. To allow the other person to lip-read and take in visual clues, speak clearly, and face them when conversing. using hand signals, written notes, or technology such as texting may also aid communication3
  7. Pharmacological testing: Only a limited selection of substances useful for the prevention of noise damage in animals have undergone human testing. The majority of these studies have explored medications that affect cell death and antioxidant defences, some of which have already demonstrated utility in other medical settings. While the scientific findings may vary, there is evidence for the potential mitigation of NIHL following the use of some pharmacological therapies6

Once hair cells are damaged, they do not regenerate, and therefore, sensorineural hearing loss brought on by noise exposure is an irreversible disorder that cannot currently be effectively treated. Despite this, NIHL may be mostly avoided.6 Detecting such hearing loss promptly through routine audiometric exams may aid in the prevention of additional loss, and acknowledging existing loss is crucial for medical and educational reasons. OSHA, the Occupational Safety and Health Administration, acknowledged the importance of a yearly audiometric test for a successful hearing conservation programme.1

Diagnosis of noise induced hearing loss

An extensive examination performed by a healthcare professional, such as an audiologist or an ear, nose and throat (ENT) doctor, is often required to diagnose NIHL.. 

Medical history: The doctor will begin by inquiring about your health history, including any exposure to loud noises, any symptoms you may be displaying, and any relevant medical disorder.

Physical examination: Ears will be physically examined to determine any obvious damage or other disorders that could be impairing your hearing.

Pure-tone audiometry: This hearing test is used to evaluate hearing capabilities. You will be required to listen to tones of various frequencies and levels and provide your response. This assesses the scope and frequency range of an individual's hearing loss. 

Speech testing: Speech testing assesses the capacity to comprehend speech under various listening circumstances. This enables you to assess your ability to understand spoken words and sentences.

Tympanometry:  This monitors the eardrum's movement in response to variations in air pressure. It aids in locating any middle ear problems, such as fluid buildup or eardrum damage.

Test for otoacoustic emissions (OAE): Measures the sounds that the inner ear produces in response to stimulation. It is used to evaluate the performance of the cochlea's microscopic hair cells, which are essential for hearing.

The results of these tests allow the medical practitioner to identify and assess the severity of NILH, demonstrating the cruciality of getting a thorough evaluation by a licensed medical professional in order to receive an accurate diagnosis and determine useful therapy options.7


Can noise induced hearing loss be prevented?

Yes, it is possible to prevent hearing loss brought on by noise. Avoiding extended exposure to loud noises, using earplugs or earmuffs in noisy areas, keeping the volume down when using headphones or earbuds, and taking part in hearing conservation programmes at work are some preventive methods. In addition, technological advances now allow close monitoring of volume use over time, which could also be utilised to monitor exposure from headphones or earphones. If you work in a high-noise environment, ensure all workplace procedures with regard to hearing health and safety are being adhered to.

How common is noise-induced hearing loss?

Hearing loss brought on by noise is an increasingly common condition. It affects various people, especially those who are exposed to loud noises frequently or for extended periods of time. It can occur in a variety of jobs and professions, in addition to those who engage in noisy hobbies, such as listening to loud music or using power tools without protective equipment.

Who is most at risk from noise induced hearing loss?

A higher risk of noise-induced hearing loss exists in those who are frequently exposed to loud noises, such as those who work in the manufacturing, music, or construction industries, as well as those who frequently go to loud concerts or wear headphones at high volumes.

When should I see a doctor?

If someone has signs of NIHL, such as trouble comprehending conversations, ringing in the ears (tinnitus), or a progressive decline in hearing ability, they should consult a doctor. To evaluate the severity of hearing loss, identify its source, and investigate suitable treatment options, prompt medical attention is required.


Noise-induced hearing Loss (NIHL) is a prevalent health concern resulting from prolonged exposure to loud noises, leading to issues such as hearing loss, irritation, and hypertension. Everyday sounds are typically harmless, but excessively loud or prolonged noises can damage the inner ear. The World Health Organisation indicates that 16% of debilitating hearing loss in adults stems from workplace noise, with 5% of the global population experiencing NIHL. This condition not only poses a financial burden but also significantly impacts the quality of life of those affected.

To manage and prevent NIHL, it's crucial to avoid loud environments, use hearing protection, and participate in hearing conservation programmes. Regular breaks from noise exposure and treating underlying ear conditions can also help. Early detection through annual audiometric tests is vital, and those experiencing symptoms like difficulty understanding conversations or ringing in the ears should seek medical attention. Individuals in industries like manufacturing, music, and construction are particularly at risk and should be vigilant about their hearing health.


  1. Hong O, Kerr MJ, Poling GL, Dhar S. Understanding and preventing noise-induced hearing loss. Disease-a-Month [Internet]. 2013 Apr 1 [cited 2023 Jun 2];59(4):110–8. Available from: https://www.sciencedirect.com/science/article/pii/S0011502913000217.
  2. Noise-induced hearing loss (Nihl) | nidcd [Internet]. 2022 [cited 2023 Jun 2]. Available from: https://www.nidcd.nih.gov/health/noise-induced-hearing-loss
  3. Oishi N, Schacht J. Emerging treatments for noise-induced hearing loss. Expert Opinion on Emerging Drugs [Internet]. 2011 Jun [cited 2023 Jun 2];16(2):235–45. Available from: http://www.tandfonline.com/doi/full/10.1517/14728214.2011.552427.
  4. Metidieri MM, Rodrigues HFS, Filho FJMB de O, Ferraz DP, Neto AF de A, Torres S. Noise-Induced Hearing Loss (Nihl): literature review with a focus on occupational medicine. Int Arch Otorhinolaryngol. 2013 Apr;17(2):208–12. 
  5. How do i know if i have hearing loss caused by loud noise? | nceh | cdc [Internet]. 2022 [cited 2023 Jun 5]. Available from: https://www.cdc.gov/nceh/hearing_loss/how_do_i_know_if_i_have_hearing_loss.html
  6. Sha SH, Schacht J. Emerging therapeutic interventions against noise-induced hearing loss. Expert Opin Investig Drugs [Internet]. 2017 Jan [cited 2023 Jun 5];26(1):85–96. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5527323/
  7. Coles RRA, Lutman ME, Buffin JT. Guidelines on the diagnosis of noise-induced hearing loss for medicolegal purposes. Clin Otolaryngol [Internet]. 2000 Aug [cited 2023 Jun 5];25(4):264–73. Available from:http://doi.wiley.com/10.1046/j.1365-2273.2000.00368.x
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Neha Minocha

Neha Minocha is a dentist from India and completed her Masters of Public Health from the University of York, United Kingdom, in 2022.

Her research interests include behavioral economics, health and social behavior, systematic reviews, qualitative research, mental health research, and epidemiology.

She is passionate about medical writing and advocating for mental health among young individuals. She is currently volunteering as a group facilitator for a mental health organisation and is an ambassador for Covidence.

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