Hearing loss across the life course

This blog describes how people are affected by hearing loss across the life course and sets out actions for prevention and treatment | Public Health England

There are around 11 million people across the UK with hearing loss – the partial or total inability to hear in one or both ears, of whom 50,000 are children.

The Health Profile for England: 2018 highlighted that hearing loss, together with vision loss, skin diseases and oral problems account for nearly 20% of morbidity (Years Lived with Disability), with age-related hearing loss a growing burden. By 2031, it is estimated that 14.5 million people, approximately 20% of the UK population, will have hearing loss.

Why is this an important public health issue? Firstly, hearing loss affects around 1 in 6 of us, from birth or acquired during the course of our lives and has a huge impact on our health and wellbeing; secondly, it is largely preventable or treatable with cost effective interventions; and thirdly, the costs of unaddressed hearing loss to individuals, their families and wider society are immense.

Read the full article at Public Health England

[NICE Consultation] Hearing loss (adult onset) In development [GID-QS10074]

NICE | February 2019| Hearing loss (adult onset) In development [GID-QS10074]

NICE are holding a consultation on Hearing loss (adult onset) In development [GID-QS10074], the consultation is open until Tuesday 12 March 2019 at 5pm

Draft quality standard (PDF version) 

Equality impact assessment 2

Full details about the consultation and how to comment are available from NICE 

New WHO-ITU standard aims to prevent hearing loss among 1.1 billion young people

World Health Organization | February 2019 |New WHO-ITU standard aims to prevent hearing loss among 1.1 billion young people

1.1 billion young people, equivalent to half of people aged betwen 12-35 years – are at risk of hearing loss due to prolonged and excessive exposure to loud sounds, including music they listen to through personal audio devices. In advance of World Hearing Day (3 March 2019) WHO and the International Telecommunication Union (ITU) have issued a new international standard for the manufacture and use of these devices, which include smartphones and audio players, to make them safer for listening.



Dr Tedros Adhanom Ghebreyesus, WHO Director-General said:

“Given that we have the technological know-how to prevent hearing loss, it should not be the case that so many young people continue to damage their hearing while listening to music. They must understand that once they lose their hearing, it won’t come back. This new WHO-ITU standard will do much to better safeguard these young consumers as they go about doing something they enjoy.”

Overall, it is suggested that half of all cases of hearing loss can be prevented through public health measures.

The Safe listening devices and systems: a WHO-ITU standard recommends that personal audio devices include:

  • “Sound allowance” function: software that tracks the level and duration of the user’s exposure to sound as a percentage used of a reference exposure.
  • Personalized profile: an individualized listening profile, based on the user’s listening practices, which informs the user of how safely (or not) he or she has been listening and gives cues for action based on this information.
  • Volume limiting options: options to limit the volume, including automatic volume reduction and parental volume control.
  • General information: information and guidance to users on safe listening practices, both through personal audio devices and for other leisure activities.

The standard was developed under WHO’s “Make Listening Safe” initiative which seeks to improve listening practices especially among young people, both when they are exposed to music and other sounds at noisy entertainment venues and as they listen to music through their personal audio devices. The WHO-ITU standard for safe listening devices was developed by experts from WHO and ITU over a two-year process drawing on the latest evidence and consultations with a range of stakeholders, including experts from government, industry, consumers and civil society.

New WHO-ITU standard aims to prevent hearing loss among 1.1 billion young people

Read the full news item at WHO


Type 2 diabetes and the risk of incident hearing loss

Gupta, S., Eavey, R. D., Wang, M., Curhan, S. G., & Curhan, G. C. |2019|Type 2 diabetes and the risk of incident hearing loss| Diabetologia|62|2|P. 281-285.

New research published in the journal Diabetologica examined whether type 2 diabetes (including diabetes duration) is associated with incident hearing loss in two prospective cohorts. 



Type 2 diabetes mellitus has been implicated as a risk factor for hearing loss, with possible mechanisms including microvascular disease, acoustic neuropathy or oxidative stress. A few small studies have examined the longitudinal association between type 2 diabetes and hearing loss, but larger studies are needed. Our objective was to examine whether type 2 diabetes (including diabetes duration) is associated with incident hearing loss in two prospective cohorts: Nurses’ Health Studies (NHS) I and II.


We conducted a longitudinal study of 139,909 women to examine the relationship between type 2 diabetes and the risk of self-reported incident hearing loss. A physician-diagnosis of diabetes was ascertained from biennial questionnaires. The primary outcome was hearing loss reported as moderate or worse in severity (categorised as a ‘moderate or severe’ hearing problem, or ‘moderate hearing trouble or deaf’) on questionnaires administered in 2012 in NHS I and 2009 or 2013 in NHS II. Cox proportional hazards regression was used to adjust for potential confounders.


During >2.4 million person-years of follow-up, 664 cases of moderate or worse hearing loss were reported among those with type 2 diabetes and 10,022 cases among those without type 2 diabetes. Compared with women who did not have type 2 diabetes, those with type 2 diabetes were at higher risk for incident moderate or worse hearing loss (pooled multivariable-adjusted HR 1.16 [95% CI 1.07, 1.27]). Participants who had type 2 diabetes for ≥8 years had a higher risk of moderate or worse hearing loss compared with those without type 2 diabetes (pooled multivariable-adjusted HR 1.24 [95% CI 1.10, 1.40]).


In this large longitudinal study, type 2 diabetes was associated with a modestly higher risk of moderate or worse hearing loss. Furthermore, longer duration diabetes was associated with a higher risk of moderate or worse hearing loss.

Rotherham NHS staff can request this article from the Library

Is gout associated with a higher risk of hearing loss in adults?

A new cohort study examines whether gout is associated with a higher risk of hearing loss in older adults. 



Objectives To evaluate whether gout is associated with a higher risk of hearing loss in older adults.
Design Retrospective cohort study.
Setting USA.
Participants 5% random sample of US Medicare claims 2006–2012, representative of US adults aged 65 years or older.
Primary and secondary outcomes Incident (new) hearing loss identified by the presence of at least two claims at least 4 weeks apart with an International Classification of Diseases, Ninth Revision, 389.xx, with no respective claim in the baseline 1-year observation period.
Results Among the 1.71 million eligible people, 89 409 developed incident hearing impairment. The crude incidence rates of incident hearing impairment in people with versus without gout were 16.9 vs. 8.7 per 1000 person-years. Using Cox regression analyses adjusted for demographics, medical comorbidity and common cardiovascular and gout medications, we found that gout was associated with a significantly higher HR of incident hearing impairment, HR was 1.44. Findings were confirmed in sensitivity analyses that substituted continuous Charlson-Romano Index with categorical variable or all comorbidities and additionally cardiovascular risk factors, with minimal attenuation of HR.
Conclusions Gout is associated with a higher risk of development of hearing loss in older adults. Future studies need to assess the underlying mechanisms of this association.

The full article is available to read at BMJ Open  

Full reference: Singh, J.A.Cleveland, J.D. | 2018| Gout and hearing impairment in the elderly: a retrospective cohort study using the US Medicare claims data| 

The Influence of Hearing Aid Gain on Gap-Detection Thresholds for Children and Adults With Hearing Loss

A new article published in the journal Ear and Hearing considers how a hearing aid contributes to the ability to perceive a gap in noise for children and adults with hearing loss.


ObjectivesThe objective of this experiment was to examine the contributions of audibility to the ability to perceive a gap in noise for children and adults. Sensorineural hearing loss (SNHL) in adulthood is associated with a deficit in gap detection. It is well known that reduced audibility in adult listeners with SNHL contributes to this deficit; however, it is unclear the extent to which hearing aid amplification can restore gap-detection thresholds, and the effect of childhood SNHL on gap-detection thresholds have not been described. For adults, it was hypothesized that restoring the dynamic range of hearing for listeners with SNHL would lead to approximately normal gap-detection thresholds. Children with normal hearing (NH) exhibit poorer gap-detection thresholds than adults. Because of their hearing losschildren with SNHL have less auditory experience than their peers with NH. Yet, it is unknown the extent to which auditory experience impacts their ability to perceive gaps in noise. Even with the provision of amplification, it was hypothesized that children with SNHL would show a deficit in gap detection, relative to their peers with normal hearing, because of reduced auditory experience.

DesignThe ability to detect a silent interval in noise was tested by adapting the stimulus level required for detection of gap durations between 3 and 20 ms for adults and children with and without SNHL. Stimulus-level thresholds were measured for participants with SNHL without amplification and with two prescriptive procedures—the adult and child versions of the desired sensation level i/o program—using a hearing aid simulator. The child version better restored the normal dynamic range than the adult version. Adults and children with NH were tested without amplification.

ResultsWhen fitted using the procedure that best restored the dynamic range, adults with SNHL had stimulus-level thresholds similar to those of adults with normal hearing. Compared to the children with NH, the children with SNHL required a higher stimulus level to detect a 5-ms gap, despite having used the procedure that better restored the normal dynamic range of hearing. Otherwise, the two groups of children had similar stimulus-level thresholds.

ConclusionThese findings suggest that apparent deficits in temporal resolution, as measured using stimulus-level thresholds for the detection of gaps, are dependent on age and audibility. These novel results indicate that childhood SNHL may impair temporal resolution as measured by stimulus-level thresholds for the detection of a gap in noise. This work has implications for understanding the effects of amplification on the ability to perceive temporal cues in speech.

Full reference: Brennan, M. A., McCreery, R. W., Buss, E., & Jesteadt, W. |2018| The Influence of Hearing Aid Gain on Gap-Detection Thresholds for Children and Adults With Hearing Loss|Ear and hearing| Vol. 39|(5)| P. 969-979.

This article can be requested by Rotherham NHS staff here 

Supporting older people with hearing loss in care settings

This guide has been produced to help staff working in longer-term care settings provide high-quality care and support to older people with hearing loss. It is written for care home managers | Action on Hearing Loss

hearing loss
Image source: actiononhearingloss.org.uk

The guide covers the following:

  • The need to support older people with hearing loss
  • Identifying and checking for hearing loss
  • Improving hearing aid use and management
  • Meeting residents’ communication needs
  • Providing assistive listening devices
  • Managing tinnitus
  • Managing ear wax
  • Appointing Hearing Loss Champions
  • Meeting the requirements of the CQC Inspection Framework

Full document: Guidance for supporting older people with hearing loss in care settings: A guide for managers and staff

Updates on Unilateral Hearing Loss

The Hearing Journal has published an update on unilateral hearing loss. It is based on the Unilateral Hearing Loss in Children Conference 2017, which featured current research presented by many of the foremost experts on Unilateral Hearing Loss (UHL). 

close-up-18753_1280Highlights include :

  • Can we Predict Outcomes of Children with UHL?
  • UHL in the Real World
  • Supporting the Whole Child

It can be read here 

Smith, J. & Wolfe, J. |The Hearing JournalFebruary 2018 | Vol. 71 |2 |  p. 18 -20|

doi: 10.1097/01.HJ.0000530648.17182.22

It can be downloaded here 

Owls May Shed Light on Age-Related Hearing Loss Prevention

Researchers have found that barn owls have what they call “ageless ears,” which could potentially help with identifying new treatment options for hearing-impaired humans.


In a study published in Proceedings of Biological  Science, researchers measured the auditory sensitivity of seven barn owls ranging from less than 2 years old to 23 years old by training them to fly to a perch to receive a food reward in response to an auditory cue. Young and old owls both responded to the varying levels of auditory cues, and the oldest owl at 23 years old heard just as well as the younger owls.

​According to Georg Klump, one of the study authors “birds can repair their ears like humans can repair a wound”.  “Humans cannot re-grow the sensory cells of the ears but birds can do this.” Work is underway to investigate the differences between birds and mammals, which commonly lose their hearing at old age. ​

Full reference: Krumm, B. et al. Barn owls have ageless ears Proc Biol Sci. 2017 Sep 27;284

Hearing aids for mild to moderate hearing loss in adults

Ferguson MA, et al. | Hearing aids for mild to moderate hearing loss in adults Cochrane Database of Systematic Reviews 2017, Issue 9. | Published online 25th September 2017

This study reviewed the evidence on the effects that hearing aids have on everyday life in adults with mild to moderate hearing loss. Authors were interested in (1) a person’s ability to take part in everyday situations, (2) general health-related quality of life, (3) ability to listen to other people, and (4) harm, such as pain or over-exposure to noise.


The main goal of hearing aids is to reduce the impact of hearing loss and to improve a person’s ability to take part in everyday life. Although hearing aids are the most common technology for adults with hearing loss and are in widespread use, it is not clear how beneficial they are.

Study characteristics

The evidence is up to date to 23 March 2017. Authors found five clinical studies involving 825 adults with mild to moderate hearing loss who were randomly given either hearing aids, no hearing aids or placebo hearing aids. Studies involved older adults with the average age within studies between 69 and 83 years. The duration of the studies was between six weeks and six months.

Key results

Evidence was found in three studies that hearing aids have a large beneficial effect in improving the ability of adults with mild to moderate hearing loss to take part in everyday situations. Hearing aids have a small beneficial effect in improving general health-related quality of life, such as physical, social, emotional and mental well-being, and have a large effect in improving the ability to listen to other people.

Only one study attempted to measure harms due to hearing aids. None were reported.


This review found that hearing aids improve the ability of adults with mild to moderate hearing loss to take part in everyday life, their general quality of life and their ability to listen to other people. If an adult with mild to moderate hearing loss seeks help for their hearing difficulties, hearing aids are an effective clinical option. It is important that future studies measure benefits consistently and report benefits separately for different age groups, genders, levels of hearing loss and types of hearing aids.

Hearing aids for mild to moderate hearing loss in adults: