Noise-induced hearing loss is a sensor neural hearing illness that begins at higher frequencies (3,000 to 6,000 Hz) and develops slowly as a result of constant exposure to excessive sound levels (Konopka 243). Although the loss is characteristically symmetric, noise that originates from firearms or sirens may generate an asymmetric loss. Shearing forces that result from different sounds have a major effect on the stereocilia of the hair cells found in the basilar layer of the cochlea; when extreme, these forces can result to death of vital cell (Wu and Yi-Ho Young 657). Acoustic trauma, a related condition of hearing loss, results from a prolonged experience with short-term impulsive noise. Acording to current studies, NIHL occurs at a younger age in the military compared to other groups of workers exposed to excessive noise (Talcott et al 23). Hearing problem caused by exposure to occupational and recreational noise results in distressing disability that is virtually 100% preventable (Flamme et al 231).
A comparison of noise produced by gun short to other sources of noise
Gunshot impulsive sound (peak level) 140 - 170dB
Jet takeoff sound 140dB
Rock and chain saw 110 - 120dB
Diesel Locomotive 100dB
Motorcycle, lawnmower 90dB
OSHA level hearing 85dB
Quite room 50dB
Whisper 30 – 40dB
The economic expenditure on work-related hearing loss has been thought to be several billions (Leigh 728). NIHL became rampant in the industrial revolution era. An early term that was used to refer to NIHL was “boilermakers' disease,” because majority of the workers who worked on steam boilers complained of hearing problems (Sliwinska-Kowalska and Adrian Davis 274). In today's increased noisy culture, it is more likely for anyone to develop hearing problems. However, individuals presented to loud sounds in their work spot are more likely to suffer from noise-induced hearing loss. A recent study found evidence of increased noise-induced hearing loss in the police and military personnel (Starck, Esko and Pyykko 63). The main cause of excessive loud and impulsive is the firearms that are used by these security and, law implementation personnel's. Maintaining a strategic distance from introduction to loud sounds stops further advancement of the ear harm.
Industrial impulse noise causes about 5-12 dB more severe hearing impairment than steady state noise. The exposure to impulsive noise is normally composed of very quick sound bursts that have short lifespan and low energy content (Pawlaczyk-Łuszczyńska 294). Hearing protection mechanism has proved to be less effective against impulsive sound from large calibre firearms because of the non-linearity of the lessening and the low recurrence segments (Murphy and Randy 688). Shooting with large calibre weaponries gives loud sounds greater than 140 dB. When working in an environment with loud impulses, a combination of earplugs and earmuffs are recommended.
The OSHA maintains that the employers should provide occupational hearing conservation programs for their workers in workplaces with excessive noise level (Wu and Yi-Ho 657). Hearing conservation program in an organizational set up should make use of engineering and managerial controls to reduce noise exposures, workers training in the use of hearing protection devices and annual audiometry test for all workers who are exposed to excessive noise.
How to address the problem
Workers who have been vulnerable to excessive noise should be screened (Lynch and Jonathan 1295). It is advisable to conduct screening on police officer after certain duration in order to ascertain their hearing condition. It is possible to know if a person has hearing problem through simple examinational questions. The physician can ask patients if they have difficulty perceiving speech in noisy environments, if they always need to increase the television volume or if they regularly have to ask people talking to them to repeat sentences.
Physicians providing work-related health services to the police service may supervise the hearing conservation program, make reviews on audiograms that appear abnormal and provide vital advice to the program administrators. A person whose audiogram shows a normal threshold shift deterioration of 10 dB on average at 2,000, 3,000 and 4,000 Hz when compared with the worker's baseline test) should be notified and be given extra training and evaluation (Konopka 243). When hearing problem is suspected, a thorough history, audiometry test, and hearing assessment should be performed (Lynch and Jonathan 1292). If these examinations reveal evidence of hearing loss, recommendation for full audiologic evaluation is necessary (Lynch and Jonathan 1292).
Based on the current knowledge, it is evident that there is the insufficiency of the equal energy principle in modeling the risk for hearing loss. Although there are no studies that have evaluated the effectiveness of educating patients about NIHL, family physicians can easily screen for extreme noise experience during health check-up visits. Employers (police service administration) should have an efficient system for responding and managing identified hazards. Although NIHL is not fully treatable, it is almost 100% preventable (Lynch and Jonathan 1292). Clinician should motivate patients to uphold their hearing health and thereby lessen the chance of hearing disability in the workplace.
It is important to avoid extreme noise whenever possible and make use of hearing protection devices when necessary. Hearing protection devices such as; earmuffs and custom-fitted earplugs can attenuate from 20 to 40 dB of unnecessary sound when utilized appropriately (Flamme 231). Also, counseling about hearing protection is effectual, although there is no sufficient evidence in favor of physician counseling.
A person whose screening reveals indications of hearing problem should be referred for an entire audiologic evaluation. Audiologists can examine a several frequencies and can help in determination of air or bone conduction in order to verify whether the issue is sensor neural, conductive or blended (McBride and Williams 47). They are also able to perform tests for speech discrimination and reception threshold. If a unilateral or asymmetric sensor neural loss is confirmed, either tinnitus or other considerable ear pathology is found; recommendation to a specialist such as otolaryngologist is warranted. Patients determined to have sudden sensor neural listening to misfortune ought to get quick referral, since treatment done inside of the initial 24 hours can essentially enhance results (McBride and Williams 48).
Currently, the treatment of NIHL is limited to hearing amplification and physician counseling (Tak et al 371). Initially, most patients may be unwilling to consider using hearing aids, as a result of stigma associated with hearing problems a young stage. However, the family physician or clinician can persuade a patient with considerable hearing loss to get treatment and can work with the sick person and his/her families to enable them cope with a hearing Impairment. Special hearing aids can enlarge the sounds but, despite major technologic advances, often cannot entirely correct problems of speech discrimination (Tak et al 359). Normally, hearing aids should be cautiously matched to the person's hearing problem and lifestyle by a trained audiologist. Vocational rehabilitation programs may be essential to ensure that patients can work safely and effectively even with their hearing impairment.
Noise exposure, whether occupational or recreational, is the main cause of hearing loss. Though it is a challenge to reduce impulsive noise from big firearms, there is need for technological advancement to produce improved machine with less impulsive sound. However, preventive measures such as using hearing protection aids should be employed whenever using firearms. Regular screening is necessary in order to prevent permanent ear damages. By preventing NIHL, patients can effectively reduce the effect of age-related changes on their hearing. Family physicians and clinicians should educate and motivate people of all ages to keep away from potentially harmful noise, use hearing protection devices when necessary and seek proper treatment for a prevailing hearing deficit.
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