Hear, Hear!

March 3, is observed as World Hearing Day. The theme for 2021 is ‘Hearing Care for All’. Hearing may seem like a normal and obvious sensory activity, but around 466 million (46.6 crores) people worldwide have disabling hearing loss, and 34 million of these are children. It is estimated that by 2050 over 900 million (90 crores) people – or one in every ten people – will have disabling hearing loss. Hearing loss may result from a number of reasons. Genetics, complications at birth, certain infectious diseases, chronic ear infections, the use of particular drugs, exposure to excessive noise, and ageing are some of the most prevalent causes.

A billion people – aged between 12-35 years – are at the risk of hearing impairment due to exposure to noise while consuming media. The majority of people with disabling hearing loss live in low- and middle-income countries. Almost one third of people over 65 years of age are affected by disabling hearing loss. The incidence in this age group is greatest in South Asia, Asia Pacific and sub-Saharan Africa.

Hearing Loss and Deafness

A person who is not able to hear as well as someone with normal hearing – hearing thresholds of 25 decibel (dB) or better in both ears – is said to have hearing loss. Hearing loss may be mild, moderate, severe, or profound. It can affect one ear or both ears, and leads to difficulty in hearing conversational speech or loud sounds. ‘Hard of hearing’ refers to people with hearing loss ranging from mild to severe. People who are hard of hearing usually communicate through spoken language and can benefit from hearing aids, cochlear implants, and other assistive devices as well as captioning.

People with more significant hearing losses may benefit from cochlear implants. ‘Deaf’ people mostly have profound hearing loss, which implies very little or no hearing. They often use sign language for communication.

Functional Impact of Hearing Loss

One of the main impacts of hearing loss is on the individual’s ability to communicate with others. Spoken language development is often delayed in children with unaddressed hearing loss.

Social and Emotional Impact of Hearing Loss

Exclusion from communication can have a significant impact on everyday life, causing feelings of loneliness, isolation, and frustration, particularly among older people with hearing loss.

Economic Impact of Hearing Loss

World Health Organization (WHO) estimates that unaddressed hearing loss poses an annual global cost of US$ 750 billion. This includes health sector costs (excluding the cost of hearing devices), costs of educational support, loss of productivity, and societal costs. In developing countries, children with hearing loss and deafness rarely receive any schooling. Adults with hearing loss also have a much higher unemployment rate. Among those who are employed, a higher percentage of people with hearing loss are in the lower grades of employment compared with the general workforce.

Prevention

Overall, it is suggested that half of all cases of hearing loss can be prevented through public health measures. In children under 15 years of age, 60% of hearing loss is attributable to preventable causes. This figure is higher in low- and middle-income countries (75%) as compared to high-income countries (49%). Preventable causes of childhood hearing loss include, but are not limited to following healthy ear care practices and reducing exposure (both occupational and recreational) to loud sounds by raising awareness about the risks.

Identification and Management

Early detection and intervention are crucial to minimizing the impact of hearing loss on a child’s development and educational achievements. People who develop hearing loss can learn to communicate through development of lip-reading skills, use of written or printed text, and sign language. Officially recognizing national sign languages and increasing the availability of sign language interpreters are important actions to improve access to sign language services.