Hearing Help for Those Who Need It

"I hear things just fine. My wife says I don't hear her, but she just mumbles a lot."

Paul Dragul, M.D., is not a marriage therapist, but he often hears this complaint in his line of work. Instead of marital counseling, he recommends a hearing test and the use of ear plugs while at work.

As an ear, nose, and throat (ENT) specialist, Dragul recognizes that the inability to understand the higher-pitched voices of women and children may be a sign of high-frequency hearing loss. Unfortunately, he said the majority of his patients fail to recognize these and other signs of hearing deficiencies. "It's amazing how few know that they have a hearing loss," he said. "Some people have lost as much as 20 percent of their hearing, and they don't even know it."

Many individuals suspect they are experiencing decreased hearing but choose to ignore the problem, just accepting it as an unavoidable part of aging. After years of performing hearing tests in a mobile van unit at industrial sites and interacting with patients in his own clinic, Dragul had heard this reasoning one too many times. "It became clear that the public wasn't getting the right message," he said.

To get the "right" message across, Dragul developed healthyconnections.com, a Web site that, in addition to covering vision and ENT topics, features a collection of information on hearing, common hearing disorders, lifestyle risk factors, treatments for hearing loss, and hearing loss prevention. "I realized that everyone thinks that as you age you must live with the devastation of hearing loss, but this is not necessarily the case," he said. "Just like so many other things, if you catch it early, there may be many treatment and prevention options available."

And while some hearing difficulties may be the result of (or result in) marital nagging and may be unpreventable, occupational noise exposure is a common cause of hearing damage and loss and is definitely worth treating and preventing. After all, your life may depend on hearing your co-workers' warnings, not that you need to take out the trash.

Test Myself? Did I Hear You Right?
According to Dragul, nearly two-thirds of those who use the Internet today are seeking health information. When it comes to hearing, healthyconnections.com is a good place to start.

The hearing section of the site begins with a Hearing Information link. This section features general information on hearing, how it works, the types of hearing loss, and common hearing problems. Visitors also can learn about the warning signs of hearing loss, how to protect their hearing, and the types of hearing specialists. All of these topics are presented in simple, easy-to-understand language with little of the medical jargon often heard during a visit to the doctor. Additional links include Hearing Aids and Instruments, Lifestyle Risks, FAQs, and News & Resources. The site also will provide the contact information for a certified hearing specialist in your area. While other medical-related Web sites may provide similar information, healthyconnections.com is unique in making the issue real. It allows a user to test his/her own hearing with an online hearing test. Based upon the results, the individual can decide whether or not he/she should see a specialist, Dragul said.

The online test is a simplified version of the House Ear Institute's hearing in noise test (HINT) and is currently available in English and Spanish. A French Canadian version is in the works. Other hearing tests are based upon hearing pure tones in a quiet environment, but Dragul said he thinks the HINT test is more realistic: "You should give a test in a noisy situation. These are the situations people commonly find themselves in."

The test can be performed using regular computer speakers or headphones. The user listens to a series of simple sentences spoken amid a noisy background, then is asked after each one if he/she heard the entire sentence correctly. He/she can click "yes" or "no" or choose a button that displays the sentence. The program gives a pass or fail result upon completion of all of the sentences.

Honesty Required
When asked to elaborate on the "devastation" of hearing loss, Dragul said his patients expressed feelings of anger, isolation, and a loss of dignity. As reflected in these sentiments, society often views hearing loss as a problem of the elderly that is correctable only with a hearing aid. "Younger people have a particularly hard time admitting they have a hearing loss," he said. "They think they'll need a hearing aid, and they don't want to go there cosmetically."

It would follow that this type of person might not want to fail a hearing test, and might try to cheat. Dragul's HINT test would be easy to "cheat" on because a user can simply click that "yes" he/she did hear every sentence correctly and receive a passing score. The results might be more accurate if users had to type the sentence or choose the correct sentence from multiple choices. However, Dragul feels the online test version may be one of the best options to reach this type of person.

"In the confines of their home, I feel that people will be pretty honest with themselves," he said. "There's not a doctor hovering over you, and it's less intimidating." Dragul said the online test can't take the place of a medical visit, but if it raises awareness of the possibility of a problem, then it's done its job. "If we alert someone who works in a factory to at least be cognizant of a problem, then there's more of a chance that he'll do something about it."

And that should make even his spouse happy.

This article originally appeared in the August 2003 issue of Occupational Health & Safety.

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