I observed a client in his 50s who had not been tested for around 20 years. His main complaint was that he has been having trouble hearing in conversation, especially in background noise. He mentioned that he notices that he relies a lot on lipreading. He notes that his right ear is worse and has ringing in it that comes and goes. The hearing loss and ringing have been going on for a while now. He has a history of otitis media. He has a definite history of noise exposure from 37 years in contruction and hunting. He did not wear hearing protection until the past two years.
Otoscopy revealed normal results with all visible landmarks noticed. Tympanometry revealed normal results which is significant due to his history of otitis media. Puretone testing revealed a mild to moderate severe sensorineural loss with a noise notch for the right ear. Results for the left ear were similiar, but the loss ranged from mild to moderate, not as bad. SRTs for both the left and right ears were 25dB. Discrimination was at 82% for the right ear and 96% for the left ear.
In the case history, the client informed the clinician that if his hearing was bad enough that he would consider hearing aids. One of the main issues was that the client did seem to think that his hearing was really bad. Therefore, with his degree of loss, the clinician informed the client that aids may benefit him, but that it was his choise depending on how bad he considered his loss. The client decided that he would like to consider it and then get back to them.
I find it hard to believe that people do not take the two seconds to use hearing protection. Of course, they all have their reasons, but I believe it is partially our fault. Why you ask? Hearing protection isn't stressed enough. Most people do not truly understand or think about how debilitating hearing loss can be. For this reason, I conclude that we as audiologists need to take a stand for hearing protection! According to a document from ASHA, their are seven roles for us to play in occupational hearing protection: 1-Assess noise exposure, 2-Assessing clients occupational environment (controlling for noise), 3-Suggestion of hearing protection and training for use, 4-Audiometric assessment and followup, 5-Informing staff about hearing loss due to noise exposure, 6-Keeping records for noise exposed clients, 7-Asssessing how effective the noise protection program is (American Speech Language Hearing Association, 2004).
Also, for the hunter, Cabelas offers a ton of options for hearing protection and such! You should definately check out this site! http://www.cabelas.com/cabelas/en/templates/index/index-display.jsp?id=cat20801&navAction=jump&navCount=1&cmCat=MainCatcat20712&parentType=category&parentId=cat20712
References:
American Speech-Language-Hearing Association. (2004). The Audiologist's Role in
Occupational Hearing Conservation and Hearing Loss Prevention Programs [Technical
Report]. Available from www.asha.org/policy.
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