- By the year 2050, estimates predict that nearly 2.5 billion people globally will suffer from some degree of hearing loss, with at least 700 million requiring rehabilitation services due to significant hearing impairment.
- Over 1.1 billion young individuals are at risk of developing hearing loss from exposure to dangerously high levels of music.
- An increase in health services accessible to individuals worldwide affected by hearing loss requires an additional yearly investment of less than $1.40 per person.
- Over a decade, each dollar invested can yield an almost 16-fold return.
- Hearing Impairment and Deafness
- Factors Leading to Hearing Loss and Deafness
- Prenatal Stage
- Perinatal Stage
- Childhood and Adolescence
- Adulthood and Old Age
- Throughout Life
- Consequences of Untreated Hearing Loss
- Prevention Strategies: A Lifelong Approach to Hearing Loss Mitigation
- Early Identification and Management
- The Role of WHO
Currently, over 5% of the world’s population, which is around 430 million people, need rehabilitation services for debilitating hearing loss (including 432 million adults and 34 million children). Forecasts indicate that by 2050, the number will increase to more than 700 million people, or one in every ten, experiencing significant hearing loss.
The term “debilitating” hearing loss refers to cases where the hearing loss in the better ear exceeds 35 decibels (dB). Approximately 80% of such individuals live in low to middle-income countries. Ageing populations are mostly affected by hearing loss, with over 25% of individuals aged 60 and above experiencing the condition.
Hearing Impairment and Deafness
An individual unable to hear as efficiently as someone with normal hearing – defined by a hearing threshold of 20 dB or lower in both ears – is deemed to have a hearing impairment. Hearing loss can be categorized as mild, moderate, severe, or profound, impacting one or both ears and complicating the auditory perception of spoken words or loud sounds.
The descriptor “hard of hearing” refers to those with hearing loss spanning from mild to severe. Typically, such individuals utilize spoken language for communication and may resort to hearing aids, cochlear implants, and other assistive devices, along with captions, to enhance audibility.
The term “deaf” is generally attributed to individuals suffering profound hearing loss, meaning their hearing ability is either extremely limited or nonexistent. Sign language is often their preferred mode of communication.
Factors Leading to Hearing Loss and Deafness
Different influences can affect individuals at varying stages in their life. These impacts are most potent during pivotal life stages.
Hearing loss can be attributed to genetic factors, including congenital and acquired causes. Also, intrauterine infections, like rubella and cytomegalovirus infection, can contribute.
Birth asphyxia (oxygen deficiency during childbirth), severe neonatal jaundice (hyperbilirubinemia), low birth weight, and other perinatal complications and their treatments can lead to hearing loss.
Childhood and Adolescence
Chronic inflammation of the middle ear (chronic suppurative otitis media), fluid accumulation in the ear (chronic non-suppurative otitis media), meningitis, and other infectious diseases can cause hearing loss.
Adulthood and Old Age
Chronic diseases, smoking, otosclerosis, age-related sensorineural degeneration, and sudden sensorineural hearing loss can lead to hearing impairment.
Factors like earwax blockage, ear or head injury, excessive noise/loud sounds, ototoxic medications, ototoxic chemicals related to work, poor nutrition, viral infections and other ear diseases, and progressive hereditary hearing loss with late onset can influence hearing abilities over a lifetime.
Consequences of Untreated Hearing Loss
If no action is taken, hearing loss can affect numerous facets of an individual’s life, including:
- Communication and speech.
- Cognitive functions.
- Education and employment: In developing countries, children suffering from hearing loss and deafness seldom receive any education. Among adults with hearing loss, there is a significantly higher unemployment rate. Compared to the general working population, a greater proportion of deaf workers are engaged in less skilled jobs.
- Social isolation, loneliness, and stigmatization.
- Socioeconomic consequences.
- Years Lived with Disability (YLD) and Disability-Adjusted Life Years (DALY).
According to WHO estimates, the unresolved issue of hearing loss costs the world $980 billion annually. This includes healthcare costs (excluding the cost of hearing aids), costs related to assistance in education, loss due to disability, and social costs. Low and middle-income countries bear 57% of these costs.
Prevention Strategies: A Lifelong Approach to Hearing Loss Mitigation
- Across an individual’s lifespan, the adoption of public health strategies and clinical interventions can deter numerous factors that contribute to hearing loss. These preventive measures are crucial from the prenatal and perinatal stages through to old age.
- In children, nearly 60% of hearing loss incidents are attributable to preventable causes, highlighting the need for public health initiatives. Similarly, adult-onset hearing loss, often resulting from exposure to loud noises or ototoxic medications, can be effectively avoided.
- A suite of impactful measures, tailored to various life stages, can contribute to reducing instances of hearing loss:
- Immunization: Regular vaccinations play a significant role in maintaining overall health and in turn, preventing conditions that can lead to hearing loss.
- Maternal and Child Health Protection: Ensuring the health of both mother and child, especially during pregnancy, can minimize the risk of congenital hearing issues.
- Genetic Counseling: This can provide prospective parents with knowledge about potential inherited conditions, including hearing impairment, thereby enabling early intervention or preventive measures.
- Detection and Management of Common Ear Diseases: Early identification and effective management of prevalent ear diseases can prevent potential progression to hearing loss.
- Industrial Hearing Protection Programs: Implementing protective measures against noise and chemical exposure at workplaces can preserve workers’ hearing health.
- Safe Listening Campaigns: These campaigns aim to lessen exposure to loud sounds during entertainment activities, thereby safeguarding auditory health.
- Proper Use of Medications: Guided medication use can help avert hearing loss caused by ototoxic drugs, balancing therapeutic benefits against potential auditory harm.
- By implementing these strategies, we can foster a more hearing-conscious society and actively mitigate the risk of hearing loss across all age groups.
Early Identification and Management
The significance of detecting hearing loss and ear diseases promptly is crucial for effective patient management. For this purpose, a routine screening program is essential to identify ear ailments and accompanying hearing loss among populations most at risk, including:
- Infants and toddlers
- Pre-school and school-aged children
- Individuals exposed to noise or chemical substances in their workplace
- Individuals undergoing ototoxic medication treatment
- The elderly
Hearing evaluations and ear examinations can be conducted both in hospital settings and outpatient facilities. With tools like WHO’s ‘HearWHO’ app and other technological solutions, ear disease and hearing loss screenings can be carried out even without specialized training and resources.
On the detection of hearing loss, it’s important to act quickly and take appropriate measures to mitigate any adverse effects.
A range of rehabilitation strategies for those suffering from hearing loss includes:
Using auditory technologies such as hearing aids, cochlear implants, and middle ear implants.
Employing sign language and other sensory replacement methods like lip-reading, the Tadoma method (used by the deaf-blind where fingers are placed on the speaker’s lips and cheeks), and gestural communication.
Therapeutic rehabilitation aimed at enhancing perception skills and developing communicative and linguistic abilities.
Utilizing assistive auditory technologies and services such as frequency modulation systems, feedback systems, alerting devices, telecommunication devices, closed captioning, and sign language interpretation can provide individuals suffering from hearing loss with even more opportunities for communication and learning.
The Role of WHO
The World Health Organization (WHO) works to establish comprehensive, socially oriented ear and hearing health care systems (IPC-EHHC).
In this area, the WHO operates following the recommendations of the WHO Global Report on Hearing (2021) and the resolution on the prevention of deafness and hearing loss from the World Health Assembly.
The WHO’s activities include:
- Providing member states with guidelines and extending support to raise awareness about ear and hearing health issues.
- Facilitating the collection and dissemination of data and information in the field of ear and hearing health.
- Offering technical resources and advice to aid planning and capacity building of health systems aimed at preserving ear and hearing health.
- Assisting in the training of medical personnel in the field of ear and hearing health.
- Promoting safe listening practices to reduce the risk of hearing loss due to noise exposure during recreational activities, as part of the “Make Listening Safe” initiative.
- Recognizing World Hearing Day on an annual basis as a public awareness campaign.
- Building and strengthening partnerships for the development of effective ear and hearing health programs, including initiatives to ensure the availability of hearing aids, cochlear implants, and related services.
- Advocating for the importance of ear and hearing health through the World Hearing Forum.