An audiologist should be consulted if hearing feels muffled, ringing persists, or speech sounds unclear after noise exposure. Sudden hearing changes or persistent symptoms should be evaluated promptly.
Early assessment helps determine whether damage has occurred and allows for appropriate guidance to prevent further hearing loss.
Yes, children are more vulnerable to noise-induced hearing loss due to developing auditory systems and longer lifetime exposure ahead of them. Damage that occurs early can have lasting effects on communication and learning.
Because children may not recognize or report discomfort, monitoring volume levels and limiting exposure is especially important.
Hearing damage risk increases as both sound level and exposure time increase. Louder sounds cause damage more quickly, while prolonged exposure to moderately loud sounds can be just as harmful.
Managing total daily exposure by reducing volume, limiting listening time, and taking breaks is critical for hearing protection.
Occupational hearing safety guidelines generally identify 80 dB as a safe exposure level for up to 8 hours. As sound levels increase, allowable exposure time decreases.
These guidelines are based on extensive research and are designed to reduce the risk of noise-induced hearing loss over time.
Phone apps can provide a reasonable estimate of sound levels and are useful for general awareness. While they are not as precise as professional sound-level meters, they are accurate enough to help identify potentially harmful listening environments.
Using a sound level app is far more reliable than relying on volume percentages or perceived loudness.
Temporary hearing loss after loud noise exposure, sometimes described as muffled or dulled hearing, can occur when the inner ear is overstimulated. While hearing may return to normal, this does not mean the exposure was safe.
Repeated episodes of temporary hearing loss increase the risk of permanent damage over time and should be taken seriously.
Ringing in the ears, also known as tinnitus, often indicates that the inner ear has been stressed or damaged by loud sound exposure. This ringing may be temporary or permanent, depending on the severity and frequency of exposure.
Even if the ringing resolves, it is a sign that the sound level was potentially harmful and that future exposure should be reduced.
Yes, loud concerts and events can cause permanent hearing loss, even after a single exposure. Sound levels at concerts often exceed safe limits, particularly near speakers or amplified sound sources.
Repeated exposure to loud events without hearing protection significantly increases the risk of long-term damage. Wearing ear protection and limiting exposure time can reduce this risk.
If you need to raise your voice to speak to someone within three feet, the sound level is likely too loud. Difficulty hearing others during or after exposure is another warning sign.
After noise exposure, symptoms such as ringing in the ears, muffled hearing, or a feeling of fullness in the ears may indicate stress or injury to the inner ear. Repeated exposure to damaging sound levels increases the risk of permanent hearing loss.
Safe daily listening levels depend on both sound intensity and total exposure time. As a general guideline, sound levels at or below 80 decibels (dB) are considered safe for up to 8 hours per day.
As sound levels increase, safe exposure time decreases. For every 5 dB increase above 80 dB, the recommended exposure time is reduced by half. Managing both volume and duration is essential for protecting hearing over time.
Safe listening time depends on the loudness of the sound, not just the duration. Higher sound levels significantly reduce the amount of time the ears can tolerate exposure without damage.
At 80 dB, sound exposure is generally considered safe for up to 8 hours. At 85 dB, safe exposure drops to about 4 hours. At 90 dB, it decreases to roughly 2 hours, and at levels above 100 dB, safe exposure may be limited to only minutes.
Because perceived loudness can be misleading, measuring sound levels and adjusting exposure time accordingly is the most reliable way to protect hearing. Taking listening breaks and reducing volume when possible further lowers the risk of noise-induced hearing loss.
Prolonged exposure to sound levels above 80 dB can cause permanent hearing damage. The risk increases as sound levels rise and exposure time lengthens.
As a general guideline, 80 dB is considered safe for up to 8 hours. For every 5 dB increase above 80 dB, the recommended safe exposure time is reduced by half. For example, 85 dB is considered safe for approximately 4 hours, 90 dB for about 2 hours, and 100 dB for only a few minutes.
Very loud sounds, such as explosions or amplified music at close range, can cause immediate damage even with short exposure.
No, the 60-60 rule is not an official medical or regulatory standard. It is an informal guideline sometimes used to help communicate safer listening habits, but it is not based on a defined or enforceable measurement.
Medical and occupational hearing safety standards rely on measurable sound levels expressed in decibels (dB) and clearly defined exposure times. The 60-60 rule, by contrast, uses percentages of volume and generalized time limits, which vary widely depending on the device, environment, and sound output. Because of this variability, it cannot reliably determine whether a listening level is safe.
Established hearing safety guidelines, such as those used in occupational health, define safe exposure as 80 dB for up to 8 hours, with allowable exposure time decreasing by half for every 5 dB increase above that level. These standards are based on measurable data and provide clear guidance for preventing noise-induced hearing loss.
For this reason, while the 60-60 rule may raise awareness, it should not be considered a medical standard. Measuring actual sound levels and following established decibel-based exposure guidelines provides a far more accurate and protective approach to hearing health.
The “60-60 rule” is not an official medical rule or standard. It is a general guideline sometimes used to help people think about safer listening habits. The concept is meant to discourage listening to sound at excessive volumes for long periods of time.
Sound is measured in decibels (dB), and prolonged exposure to sound levels above 80 dB can cause permanent hearing damage. Many personal audio devices are capable of producing sound levels well above 100 dB at maximum volume, which is comparable to the sound of a chainsaw or motorcycle.
The limitation of the 60-60 guideline is that it relies on percentages rather than measurable sound levels. The first “60” refers to listening at no more than 60 percent of maximum volume, but most people do not know what the true maximum output of a device is, nor where 60 percent actually falls. As a result, 60 percent volume could still be unsafe depending on the device and environment.
The second “60” refers to limiting listening time to 60 minutes at that volume. However, without knowing the actual loudness in decibels, it is impossible to determine whether 60 minutes is safe or excessive.
A more reliable approach is to measure sound levels directly using a sound level app on a smartphone. This allows the listener to know the actual decibel level regardless of volume settings. Measured sound levels can then be compared to established occupational health standards, which identify 80 dB for 8 hours as a generally safe exposure limit. For every 5 dB increase above 80 dB, the recommended safe exposure time is reduced by half. For example, 85 dB is considered safe for up to 4 hours, 90 dB for up to 2 hours, and so on.
Using measurable sound levels provides clearer guidance because it is based on established standards and allows individuals to make informed decisions about exposure time.
During loud events, if you need to raise your voice to speak to someone within three feet, the sound level is likely too loud.
After noise exposure, symptoms such as a feeling of fullness in the ears or a high-pitched ringing sound may indicate temporary or permanent inner ear damage.
There are a number of different hearing healthcare professionals available, but each has different education and training requirements. An audiologist and a hearing instrument specialist (HIS) are two of the most common professionals when seeking treatment for hearing loss. To better understand which professional is best for you, it’s important to distinguish the differences between the two.
Audiologist: An audiologist is trained to diagnose, treat and monitor disorders of the hearing and balance system. They are trained in anatomy and physiology, amplification devices, cochlear implants, electrophysiology, acoustics, psychophysics and auditory rehabilitation. Doctors of Audiology complete, at a minimum, an undergraduate and doctoral level degree in audiology, as well as a supervised externship prior to state licensure and national certification. This usually requires eight years of post-secondary education (four years of college and four years of graduate school). The graduate school years focus on the medical, diagnostic and rehabilitative aspects of hearing loss, hearing aids and the vestibular system. Upon completion of training, audiologists must also pass a national standardized examination in order to be eligible for state licensure. Continuing education requirements must be met in order for an audiologist to maintain state licensure. For individuals with hearing loss, auditory issues or balance problems, an audiologist is the most qualified professional to assist with diagnosis and treatment.
Hearing instrument specialist (HIS): A hearing instrument specialist is licensed to perform audiometric testing to sell and fit hearing aids. In order to obtain a license, a HIS generally has to take a certification program in hearing aids, complete in-the-field training hours and pass an exam. Hearing instrument specialists are able to fit and repair hearing aids, however, they cannot diagnose a hearing loss.
Depending on the severity and underlying condition causing the tinnitus, there are several treatments available to improve the perception of unwanted noise. The most common treatments for tinnitus include:
- Hearing aids with tinnitus-masking features
- Tinnitus retraining therapy
- Sound therapy
- Avoidance measures
- Avoidance of certain medications
- Behavioral therapy
The exact cause of tinnitus is not known in every case. However, there are several likely factors that may worsen tinnitus. These include:
- Noise-induced hearing loss
- Wax build-up in the ear canal
- Certain medications
- Ear or sinus infections
- Age-related hearing loss
- Ear diseases and disorders
- Jaw misalignment
- Cardiovascular disease
- Certain types of tumors
- Thyroid disorders
- Head and neck trauma
People with all types and degrees of hearing loss can benefit from an assistive listening device (ALD). Since the microphone of a typical hearing aid is worn on or behind your ear, its ability to enhance the talker-to-background-noise ratio can be limited. However, ALDs are designed to increase the loudness of a desired sound, such as a radio, television or a public speaker, without increasing the background noise. This is because the microphone of the assistive listening device is placed close to the talker or device being used, while the microphone of the hearing aid is always close to the listener.
ALDs include alarm clocks, TV listening systems, telephone amplifying devices and auditorium-type assistive listening systems. Many newer devices are small, wireless and compatible with a person’s digital hearing aids. Alarms and other home ALDs may be small devices that are placed discreetly on tables, next to the TV or on the wall.
There are many types of hearing aids today and the style or device depends on your lifestyle, budget and hearing loss needs. There are in-the-ear styles as well as behind-the-ear styles. In addition to selecting the right style of device, it’s also important to consider what features would be most beneficial to you. From directional microphones to waterproof options, there are numerous varieties to meet everyone’s personal needs. Today’s hearing aids are even equipped with Bluetooth connectivity to work with wireless technology like a cell phone or television.
Hearing aids are available in many different sizes and styles, thanks to advancements in digital technology and miniaturization of the internal components. Many of today’s hearing aids are considered sleek, compact and innovative – offering solutions to a wide range of hearing aid users. When selecting a style of hearing aid, the following should be considered:
- The type/degree of the hearing loss
- Power requirements
- Manual dexterity and visual abilities
- Budget
- Cosmetics and aesthetics
- Anatomical and medical considerations
- Lifestyle requirements
Hearing loss in children can occur at any time in life from acquired factors such as ear infections, head trauma, certain medications and genetic factors. You may suspect your child has a hearing loss if you observe any of the following:
- Failed newborn hearing screening
- Delays in speech and language acquisition, including baby babbling
- Frequent ear infections
- Not startled by loud sounds
- Not turning to the location of sounds after six months of age
- Difficulty following verbal directions
- Daydreaming in many situations
- Concerns by school teachers or failed school hearing screening
- Loud volume on the TV or radio
- Complaints from the child that they cannot hear
A pediatric audiologist is trained to test children of all ages. Any symptom of hearing loss in children should be addressed promptly so that speech, language and academic development are not delayed or negatively impacted.
There are three main types of hearing loss and each can be caused by different factors and require different hearing aid technology and features to have the best listening experience. The three types of hearing loss include:
- Sensorineural hearing loss: When the problem is in the inner ear or a problem with the auditory nerve, a sensorineural hearing loss is the result. This commonly occurs from damage to the small hair cells, or nerve fibers, in the auditory system. Sensorineural hearing loss is the most common type of hearing loss in adults and accounts for more than 90 percent of hearing loss in all hearing aid wearers. The most common causes of this hearing loss are age-related changes and noise exposure. Loss may also result from disturbance of inner ear circulation, increased inner ear fluid pressure or from disturbances of nerve transmission. There are many excellent options for the patient with sensorineural hearing loss.
- Conductive hearing loss: When there is a problem in the external or middle ear, a conductive hearing loss occurs. Conductive hearing loss develops when sound is not conducted efficiently through the ear canal, eardrum or tiny bones of the middle ear, resulting in a reduction of the loudness of sound that is heard. Conductive losses may result from earwax blocking the ear canal, fluid in the middle ear, middle ear infection, obstruction of the ear canal, perforation (hole) in the eardrum membrane or disease of any of the three middle ear bones. Individuals with conductive hearing loss can benefit from hearing aids, medical implants, medication or surgical options.
- Mixed hearing loss: When there are problems in the middle and inner ear, a mixed hearing impairment is the result. Because mixed hearing loss involves both sensorineural and conductive hearing loss, treatment options from hearing aids to surgery depends on the nature of the impairment and the symptoms experienced.
The results of your hearing test are plotted on a chart called an audiogram. Loudness is plotted from top to bottom. The top of the graph is very quiet and the bottom of the graph is very loud. Frequency, or pitch, from low to high, is plotted from left to right. Hearing level (HL) is measured in decibels (dB) and is described in general categories. The general hearing loss categories used by most hearing professionals are as follows:
- Normal hearing (0-25 dB HL)
- Mild hearing loss (26-40 dB HL)
- Moderate hearing loss (41-70dB HL)
- Severe hearing loss (71-90 dB HL)
- Profound hearing loss (greater than 91 dB HL)
If you exhibit symptoms of hearing loss, you should see an audiologist to have a formal hearing evaluation. This hearing test, or audiologic evaluation, is diagnostic and allows the audiologist to determine the type and degree of your hearing loss. There will also be a hearing test that evaluates your sensitivity, acuity and accuracy to speech understanding. Your audiologist may also test for speech understanding at different volume levels and conditions – like noise – to help the professional recommend the best hearing aids for your particular needs.
The hearing evaluation will also include a thorough case history and a visual inspection of the ear canal and eardrum. Additional tests of middle ear function may also be performed depending on your symptoms. The results of the evaluation can be useful to a physician, if the audiologist believes your hearing loss may benefit from medical intervention.
Results of the hearing evaluation are plotted on a graph called an audiogram. The audiogram provides a visual view of your hearing test results across various pitches or frequencies, especially the ones necessary for understanding speech. The audiogram and results from your speech understanding tests are used to create a prescription by which hearing aids are programmed, if necessary.
Hearing loss can be due to several factors such as the aging process, exposure to loud noise, medications, infections, head or ear trauma, congenital (birth) or genetic factors, diseases, as well as a number of other causes. It is estimated that nearly 20 percent of adults in the United States (48 million) report some degree of hearing loss. Hearing loss often occurs gradually throughout a lifetime.
If you’re concerned you or a loved one may be experiencing hearing loss, you are not alone. Because hearing loss can come on gradually, it’s often the people around you who notice your hearing problems before you do. Typically, it takes people an average of seven years to seek treatment. If you exhibit the following symptoms, consider visiting an audiologist:
- You hear mumbling when people are speaking to you
- You have to ask people to repeat what they said
- You laugh at jokes even though you may not have heard the details
- You frequently complain that people mumble
- You need to ask others about the details of a meeting you just attended
- You play the TV or radio louder than your friends, spouse or relatives
- You cannot hear the doorbell or the telephone
- You find that looking at people when they speak to you makes it easier to understand
- You miss environmental sounds, such as birds chirping or leaves blowing
- You find yourself avoiding certain restaurants because they are too noisy
- You hear a ringing sound in your ears, especially when it is quiet.
Common services and treatments provided by an audiologist include:
- Diagnostic hearing tests
- Audiologic evaluations
- Hearing aid fittings and consultations
- Hearing aid repairs and maintenance
- Aural rehabilitation
- Pediatric hearing loss detection and treatment
- Hearing loss prevention and protection programs
- Earmold and earplug fitting and consultation
- Custom musicians earplugs and monitors
- Tinnitus treatment programs
- Dizziness and balance testing and treatment
- Hearing rehabilitation and auditory training
- Cochlear implant candidacy evaluations and implant programming
Audiologists are healthcare professionals who evaluate, diagnose and treat hearing loss and other auditory conditions like tinnitus and balance disorders. Audiologists also provide valuable insight and products to help you prevent hearing loss, like protective custom earplugs. Audiologists are trained to work with all ages, from newborns to the elderly, however some do specialize in certain age groups or conditions. An audiologist holds an advanced degree in audiology. Currently, audiologists are required to obtain a doctoral degree and must be licensed by the state in which they practice. Additionally, audiologists must be licensed in the state they practice and are regulated by the Division of Consumer Affairs.
In addition to their education and state licensure, an audiologist may be awarded the Certificate of Clinical Competence in Audiology by the American Speech-Language-Hearing Association (ASHA), otherwise known as the CCC-A. With additional training and expertise, the audiologist may receive the Honor of Fellow, which is awarded by the American Academy of Audiology (AAA).
