A high-volume world takes a toll on ever younger ears

By Linda Kulman

Like any good Georgia native, Marilynn Mobley grew up with the classic film Gone with the Wind. She just had her own interpretation of it. "Until I actually read the book," Mobley says, "I thought Rhett's last words were 'Frankly, I'm here and I wanna dig a dam.' " Mobley, 42, started to lose her hearing at age 15 from repeated exposure to gunfire. Because her father was a gunsmith, she and her four siblings spent their summers practice shooting at bales of hay on their 80-acre farm. But like many people, Mobley didn't always take the proper precautions. "My father told us to wear ear protection," she says. "But you know teenagers don't listen."

Everyday life is growing noisier and as it does, more Americans are losing their hearing sooner. Long accustomed to treating senior citizens, a growing number of hearing specialists now report that patients in their 40s and 50s–and sometimes even in their teens–are turning up in their waiting rooms complaining that things don't sound as clear as they should. "I see middle-aged patients," says Dr. Thomas Balkany, a professor of otolaryngology at the University of Miami, "who have the kind of hearing we'd expect to see in their parents."

Turn it up. Statistics are starting to bolster the experts' observations. The National Health Interview Survey shows that from 1971 to 1990, hearing problems among people ages 45 to 64 shot up 26 percent, and among those ages 18 to 44, they grew by 17 percent. A study conducted in Alameda County, Calif., over three decades shows that hearing loss for men between the ages of 50 and 59 leapt by more than 150 percent. Perhaps more troubling, a study published last year in the Journal of the American Medical Association showed that nearly 15 percent of young people 6 to 19 years old showed signs of hearing loss. "You expect your kids to be better off than you are," says John Wheeler, president of the Deafness Research Foundation. "But I had to turn the radio up louder when I reached 50, and my son will probably have to do it at 40."

For nearly one third of the 28 million Americans with hearing loss, "toxic noise" is the main culprit. Loud workplaces remain the most common source. Over the years, legions of Americans lost their hearing working unprotected in steel mills and mines. Other people lost it in the military. But today, a growing source of hearing impairment is the tools and toys of recreation. Americans are pounding their ears with gas-powered leaf blowers and high-amplified stereos, with nascar races and 1,875-watt hair dryers, even, remarkably, with children's playthings.

No warning. Yet the public remains largely unaware of the damage that modern living may be doing to the delicate organs attached to the sides of their heads. Warning labels on noisy appliances are virtually nonexistent. And while Americans are bombarded with admonitions to wear helmets while bike riding and condoms while having non-monogamous sex, they rarely think to wear earplugs while mowing the lawn. "You don't bleed when you suffer hearing loss," says Les Blomberg, executive director of the Noise Pollution Clearinghouse in Montpelier, Vt., "so people do not recognize the damage they're doing."

Individual sensitivity to noise, scientists believe, depends on such variables as genetics, previous injury to the inner ear, chemical exposure, and even the use of medications like aspirin. The louder the din, measured in decibels on a logarithmic scale, the less time you can be safely exposed. The problem, though, is that there is no test to predict how tough or tender your ears might be. Sadly, by the time you realize it's your ears failing and not the people around you mumbling, irreversible harm usually has already been done. Dale Scott, 54, a San Francisco firefighter who for years drove a hook and ladder complete with air horn and siren, didn't realize he had lost considerable hearing until he went fishing and could not hear the chirping of the crickets he had bought to use as bait. Hearing loss "is like watching children grow," he says. "If they're yours, you don't notice it."

At the other extreme, there is Peter Jeffery, 45, a Princeton University music professor, who is suing the Smashing Pumpkins rock group and its warm-up bands for allegedly damaging his hearing at a concert he attended two years ago. He claims that even wearing earplugs at the event, he got a sharp pain in his skull behind his left ear. He says that when he woke up the next day, both ears were hissing steam-pipe-like with tinnitus, a sensation that can accompany hearing loss. Jeffery says the internal noise hasn't stopped since. Meanwhile, the sounds outside his head, like conversations and music, are muffled. "I have the feeling of being inside a jar," he says. "There's silence where there ought to be sound, and sound where there ought to be silence."

Toxic noise can deal a blow to the snail-shaped inner ear called the cochlea in two ways. Acoustic trauma can result from a single strike typical of a firecracker exploding at close range or the high-powered discharge of a rifle, stretching the tissue until it splits. Far more common is noise-induced hearing loss, a cumulative process that occurs as excessive sound blasts away the ears' 20,000 to 30,000 sensory receptors known as hair cells. The way hearing works is that tufts of microscopic cilia on the hair cells' surface pick up mechanical vibrations relayed by the bones in the middle ear, instantaneously converting them to electrical signals for delivery by the nerve fibers to the brain. Initially, sound waves typically cause only temporary distortion of the hair cells, and the hearing deficit doesn't last: You come out of a basketball game feeling like you've got cotton in your ears, and the next day you feel fine. Over time, however, hair cells lose their resilience, and the damage can become permanent. "Hair cells are like the fibers of a new shag carpet," explains Nancy Nadler, director of the Noise Center for the League for the Hard of Hearing in New York. Walking back and forth will flatten the fibers, but they will stand up again after being vacuumed. Put a piece of heavy furniture on the carpet for a year, though, and no amount of attention will help it rebound.

Dick Melia, 55, can attest to that. Growing up outside Boston, Melia worked his way through college and graduate school cutting grass and doing construction. After he moved to Virginia, he continued to do yardwork and use power tools around the house. Although he noticed subtle differences in his hearing starting at age 40–difficulty picking out conversation in noisy restaurants or interpreting messages on his answering machine–he didn't really think he had a hearing problem until a fire alarm went off at his U.S. Department of Education office and he was oblivious to it. "There are a lot of people like me," Melia says, "who can't put their finger on it [hearing loss] and say this is how it happened."

War and peace. American GIs didn't know any better, either. During World War II, thousands of soldiers sustained hearing loss in target practice, even before they got to the battlefield. And in the Korean War, "There used to be stories that if you got caught putting your fingers in your ears, they gave you push-ups to do," says Doug Ohlin, a hearing-conservation-program manager for the U.S. Army. The value of hearing protection wasn't fully recognized until the early 1970s, and even then it wasn't always top of mind. "You'd be out there at 7 in the morning at 50 below zero and your headset wasn't the first thing you thought about," says Paul St. Cin, 50, a businessman from St. Louis, who joined the Air Force in 1971 and was a pilot trainee on a plane affectionately known as the "6,000-pound dog whistle." From 1977 to 1998, hearing impairment cost the Veterans' Administration in excess of $4 billion, much of it from noise.

It's not war, however, but peace that audiologists believe is sending younger patients and more women to their offices. When Melody James, now 52, was just out of college and living in San Francisco, she watched folk rocker Bob Dylan put aside his acoustic guitar and plug in his electric one. And she marched in political protests, where she would chant for hours at a stretch. "It was wonderful and important and I think it made a difference," says James. But it also made a difference in her hearing. "Sound," sighs James, who has been fitted for hearing aids, "is no longer as automatic."

Thirty years since James's heyday, louder is better than ever, and technological advances like digital sound keep driving the volume up. In contests called "decibel drag racing," for instance, car stereo enthusiasts have clocked their audio equipment at 155 decibels or more. Rock concerts, long a threat to fragile ears, can reach up to 120 decibels. And the recent box office hits Armageddon and Saving Private Ryan reached 118 decibels. At those levels, says Ray Hull, professor of communicative disorders and sciences at Wichita State University, you can listen to the sound for about five minutes before you risk permanent damage to your ears.

Hearing danger can come from the unlikeliest places, including, ironically, from activities that are explicitly meant to keep you healthy. A study from the mid-1990s found that 80 percent of the health clubs and fitness spas surveyed cranked up the music in group exercise classes from 105 to 110 decibels, and a few exceeded 120 decibels. IDEA, the association of fitness professionals, recommended that its 23,000 members lower the volume, but a follow-up study last year revealed that nothing has changed. "It tends to be loud," admits Susie Cossaboon of Gold's Gym & Aerobic Center in Washington, D.C. "Once you have all the pieces of cardio equipment going, you've got to be able to hear over them."

Some people are actually addicted to listening to loud music, a new study shows. But toxic noise is not always voluntary. The shelves in Nadler's office at the League for the Hard of Hearing are lined with toys, some testing as loud as 135 decibels with a sound meter. Among them is a Playskool clock that registers 79 decibels at adult arm's length but 125 decibels at close range each time it tells infants, "Let's have fun." Even if the toys don't sound as loud to adults, Nadler argues that kids tend to hold them up to their ears when they play. "And they are not going to say, 'Mommy, I have tinnitus.'"

While there is no clear evidence that children's ears are more vulnerable to noise than adults', children have more to lose, notes Laurie Hanin of the League for the Hard of Hearing. "Children are going to suffer more than adults because they're still learning language," she says. Despite the risk, the only toys regulated for noise by the Consumer Product Safety Commission are cap guns, which cannot exceed 158 decibels–louder than a jet engine at takeoff. To limit the volume on other products, says a spokeswoman for the CPSC, the agency must have "documented damage." As for the toy industry, a spokeswoman for the Toy Manufacturers of America insists, "Using the toys appropriately, the child will not get hurt."

Bleeding earphones. Interestingly, personal stereo systems with headphones do not pose a substantial threat to hearing, most audiologists say, even though they can reach 112 decibels and seem permanently attached to some teenagers' heads. Models including Sony and Sanyo now come with a pamphlet warning about the dangers of playing the equipment too loudly. Still, users of personal stereos can harm their ears by abusing the appliances. A Walkman-type stereo is too loud, audiologists say, if you can hear the music "bleeding" out of the headphones of the person sitting next to you on the subway or if you speak to them and they can't hear you.

Simple rules of thumb, however, are not sufficient to protect the nation's hearing health. The Occupational Safety and Health Administration requires anyone in the workplace exposed to an average of 90 decibels for more than an eight-hour day to wear earplugs or earmuffs. Hearing experts have recommended even stricter standards, including lowering the decibel limit for hearing protection to 85 decibels and shortening the length of exposure.

But toughening the rules will solve only part of the problem: Many workplaces, especially smaller ones, don't even comply with the existing regulations or invest the few dollars needed to provide employees with earplugs. And OSHA does not protect individuals working in agriculture or construc-tion as stringently, despite the frequency with which these people show up in their doctors' offices with ringing ears.

The real barrier to combating noise-induced hearing loss is the absence of any OSHA-like rules or guidelines protecting Americans at play. Congress established the Environmental Protection Agency's Office of Noise Abatement and Control in 1972 to develop noise-emissions standards for everything from railroad equipment to lawn mowers. It lost its funding amid the antiregulatory fervor of the Reagan era. Once the federal government pulled out, cash-strapped municipal and state governments tended to sidestep it, too. Moreover, while the EPA office had started labeling earplugs and earmuffs with a noise-reduction rating, it closed before it could label the noisemakers themselves.

Private-sector efforts to make people aware of the potential dangers of noise have been tepid at best. When the E-A-R hearing protection company tried marketing earplugs and earmuffs to the general public in the 1980s, for instance, results did not meet expectations. "It's very different to play with earplugs," says would-be customer Willis Ann Ross, a flutist with the Omaha Symphony, who for years ignored the hearing dangers posed by the orchestra around her. "Just like a lot of motorcyclists don't like to wear helmets because it's not as much fun."

Some audiologists believe that all the new concern over noise-induced hearing loss is just so much alarmism. "There have been articles in our literature that say things are getting worse for 30 years," argues Robert Dobie, chairman of the Department of Otolaryngology at the University of Texas Health Science Center in San Antonio. "Very, very few people accumulate enough noise [to do damage] outside their occupation, besides people who shoot."

But other experts, including Wheeler of the Deafness Research Foundation, liken toxic noise to secondhand smoke: Twenty years ago, few took the problem seriously; today, virtually all states have smoking bans. What's needed, Wheeler believes, is a "cultural shift, where carrying earplugs becomes as much a habit as wearing your seat belt or brushing your teeth."

Congressional efforts to restore the EPA office have failed, but New Jersey Sen. Robert Torricelli plans to reintroduce legislation for a federal noise office this spring. And other noise-fighting initiatives are gathering force, among them a proposal in Massachusetts to require softer music in health clubs. Personal-injury lawsuits like Jeffery's may also lead to regulation. Movie theaters are turning down the volume of previews, which had been louder than the features.

Like Wheeler, many feel the time has come to draw even more attention to the issue of toxic noise. The League for the Hard of Hearing will sponsor International Noise Awareness Day on April 21. And this summer, the National Institute on Deafness and Other Communication Disorders will kick off a media-based campaign called Wise Ears! directed at every constituency whose ears could be affected by noise. The campaign will pay special attention to educating children.

Nate Schneider, age 14, has already gotten the message. An advocacy group known as Hearing Education and Awareness for Rockers has not fully succeeded in its decade-long efforts to make earplugs cool. But, Schneider says, it's not like, "Oh dude, take those out," either. A guitar player who has his own band, Schneider got scared when his ears started ringing about a year ago, and he had a pair of musician's earplugs custom made. It wasn't so much that Pete Townshend of the Who has gone deaf. What unnerved Schneider was the guy who runs the local guitar store. He can hear Schneider only with his good ear.

With Jennifer M. Couzin and Kenneth Terrell

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