top of page

Hi Doc; how can I protect my hearing from loud noises?

Dear friends,

Welcome back to Dr Euan's TGIF blogpost!

Today we are looking into a common question we are asked, especially these days where we are often surrounded by loud sounds, music, and noises, be it at home, or out in public:

How can I protect my ears from loud noises?

Q: What is Noise Induced Hearing Loss?

Nose Indued Hearing Loss (NIHL) is hearing loss as a result of exposure to loud sounds / noise.

It is a dose cumulative effect and gets worse with increased exposure.

Q: How do loud noises cause hearing damage?

Loud noises cause over-stimulation of the delicate inner ear cells and nerve endings, damaging them. This damage can be permanent and irreversible.

Q: What are some effects of Noise Induced Hearing Loss?

NIHL usually affects the ability to hear higher frequencies first, and can result in a constant high pitched ringing sound in your ears. This is known as tinnitus. You can read about tinnitus in Dr Euan's tinnitus blog post.

Other possible effects include:

1. Poor speech discrimination (making out words from hearing)

2. Poor speech in noise performance

3. Anxiety

4. Depression

5. Feelings of social isolation from not being able to understand what others are saying

Well, the Key TAKE HOME message is:

If You Need to Shout…then the Sound is Too Loud

Even without a device to measure sound, you can typically tell if the noise around you is too loud. If you or others need to shout in order to be heard, or cannot understand each other even at arm’s length away, the sound is too loud and may damage your hearing over time.

If you would like to know more about hearing loss, you can read Dr Euan's common symptoms of hearing loss blog post.

Q: How can I protect my hearing?

5 Ways to Protect Your Hearing:

  1. Turn the volume down.

  2. Walk away from the loud noise.

  3. Take breaks from the noise.

  4. Avoid loud, noisy activities and places.

  5. Use hearing protection.

At home, here are some ways to protect your hearing:

At Home:

  • Turn down the volume of the TV, radio, or music.

  • If listening to loud music, take listening breaks to reduce your exposure.

  • Use quieter products (power tools, toys, recreational vehicles) whenever they are available. (For more, visit CDC’s Buy Quiet webpage.)

  • Reduce equipment noise by replacing worn, loose, or unbalanced machine parts. Keep equipment well lubricated and maintained.

  • Use hearing protection devices (such as earplugs and earmuffs) when you cannot avoid loud sounds.

  • Make hearing protection convenient. Stash earplugs in your car or workshop for easy access.

  • Keep children away from loud music or equipment at home.

How about when you are outside your home?

At Public Events:

  • Move or stay far away from the loudest sound-producing source—such as loudspeakers or cannons at college stadiums—especially if attending with children.

  • Limit the length of time of exposure to loud sounds.

  • Pay attention to signs and information flyers warning of possible loud noise and the use of hearing protection.

  • Bring hearing protection devices with you. Keep them in your car, pockets, or other easy to access places.

Listening to sounds up close. such as through earphones, may also affect your hearing. If you are interested, you can read Dr Euan's blog post on if earphones can hurt your ears.

Using Hearing Protection

The best way to protect your hearing from noise is to avoid noisy activities. When you can’t avoid loud noise, use hearing protection. Hearing protection devices reduce the level of sound entering your ear. They do not block out sound completely. Hearing protection that does not fit properly will not protect your hearing.

You may want to consider wearing noise reducing headphones when playing loud music such as drumming to protect your hearing

Look for Noise Reduction Ratings

Hearing protection devices come with different noise reduction ratings. The noise reduction rating is usually labelled on the device container (it may say “NRR”) and it indicates the amount of potential protection the device provides.

More about Noise Reduction

Noise reduction ratings are measured in decibels (dB). Most hearing protection devices have ratings that range from 0 dB to 35 dB. A noise reduction rating is a “best case” rating measured in a laboratory; the actual sound reduction provided by the protector may be much less. It is best to choose a hearing protector that is comfortable and convenient, and that you are willing to wear consistently when exposed to noise. If you want to know exactly how much noise reduction you are getting, you can have the device “fit-tested” by a hearing professional.

Choosing the Right Hearing Protection

The choice of hearing protection device depends on your personal preferences of comfort and where you will wear it. How well the protection works depends on whether you wear it consistently and correctly. The most common types of hearing protection devices include earplugs, earmuffs, and specially made devices.

Insert-Type Earplugs

Ear plugs can help to reduce hearing damage when in loud noise environments

These devices provide an air-tight seal in the ear canal. They are generally cheap, effective, and easy to use. They can be any of the following types:

  • Pre-molded (pliable devices of fixed proportions)

  • Formable (usually made of expandable foam)

  • Custom-molded (to fit precisely the size and shape of an individual’s ear canal)

  • Canal caps (earplugs on a flexible plastic or metal band) (During quiet times, when not needed, you can leave the canal caps hanging around your neck so they will be easy to find when needed.)


Using earmuffs while operating loud or heavy machinery can be considered mandatory in some construction settings

Earmuffs come in many models designed to fit most people. They block out noise by completely covering the outer ear. Some earmuffs also include electronic parts to help users communicate or to block sound impulses or background noise. However, earmuffs might not work as well for people with heavy beards, sideburns, or glasses (which can create gaps between the earmuff cushion and your skull).

Note: Wearing both earmuffs and earplugs can reduce the sound further. However, the noise reduction ratings for the two do not add together.

Specially Made Devices

You can also get specially made hearing protection devices. They can be styled and sized specifically for a person’s individual ear. They can also have special features:

  • Custom earplugs moulded to fit your ear exactly.

  • Earmuffs with built-in radios or communication devices that allow you to listen at a safe level while still protecting you from the loud noise outside (such as at sporting events).

  • “Level-dependent” hearing protectors (such as earmuffs) that do not block sound when the environment is quiet, but block loud sounds. These can be very useful for hunters.

  • Lightweight active noise cancellation headphones for reducing low-frequency noise (for example, in aeroplane cabins). Noise cancelling devices work best for low-pitched droning sounds, such as from car and aeroplane engines and air conditioners. (These devices do not have a noise reduction rating.)

  • Uniform-attenuation earplugs for musicians and concert attendees. These devices act just like turning down the volume on a stereo (in other words, the sound intensity is decreased).

If you believe you may be suffering from hearing loss and are not sure what to do next, you can read our blog post on when you should consider getting a hearing aid written by Audiologist Shermin Lim.

If you would like to see an ENT specialist for possible Noise Induced Hearing Loss, please feel free to contact us at Euan's ENT Surgery & Clinic to book an appointment.

That's all for this week's blog post. See you all next time!

Thanks for reading

Dr Euan

If you are interested in finding out more, do look up these links:

  • For a list of available hearing protection devices by type and feature, visit NIOSH’s Hearing Protector Device Compendium.

  • For more information on fit testing, visit NIOSH’s Science Blog—HPD Well-Fit™: The Future is Fit-Testing.

  • To learn more about how to properly wear hearing protection devices, visit NIOSH’s website—Choose the Hearing Protection That’s Right for You.

  • For more about noise in the workplace, visit NIOSH’s website—Noise and Hearing Loss.

1. Chung I.S., Chu I.M., Cullen M.R. Hearing effects from intermittent and continuous noise exposure in a study of Korean factory workers and firefighters. BMC Public Health. 2012;12:1–7. doi: 10.1186/1471-2458-12-87. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

2. MacGregor A.J., Joseph A.R., Walker G.J., Dougherty A.L. Co-occurrence of hearing loss and posttraumatic stress disorder among injured military personnel: A retrospective study. BMC Public Health. 2020;20:1–7. doi: 10.1186/s12889-020-08999-6. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

3. Smalt C.J., Calamia P.T., Dumas A.P., Perricone J.P., Patel T., Bobrow J., Collins P.P., Markey M.L., Quatieri T.F. The Effect of Hearing-Protection Devices on Auditory Situational Awareness and Listening Effort. Ear Hear. 2020;41:82–94. doi: 10.1097/AUD.0000000000000733. [PubMed] [CrossRef] [Google Scholar]

4. Brown A.D., Beemer B.T., Greene N.T., Argo IV T., Meegan G.D., Tollin D.J. Effects of active and passive hearing protection devices on sound source localization, speech recognition, and tone detection. PLoS ONE. 2015;10:e0136568. doi: 10.1371/journal.pone.0136568. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

5. Abel S.M., Sass-Kortsak A., Kielar A. The effect on earmuff attenuation of other safety gear worn in combination. Noise Health. 2002;5:1–13. [PubMed] [Google Scholar]

6. Song H., Jeong S., Lee E., Alsabbagh N., Lee J., You S., Kwak C., Kim S., Han W. Types of hearing protection devices and application. Korean J. Otorhinolaryngol.-Head Neck Surg. 2019;62:1–14. doi: 10.3342/kjorl-hns.2018.00416. [CrossRef] [Google Scholar]

7. Tufts J.B., Jahn K.N., Byram J.P. Consistency of attenuation across multiple fittings of custom and non-custom earplugs. Ann. Occup. Hyg. 2013;57:571–580. [PubMed] [Google Scholar]

8. Abel S.M., Paik J.S. Sound source identification with ANR earmuffs. Noise Health. 2005;7:1–10. doi: 10.4103/1463-1741.31637. [PubMed] [CrossRef] [Google Scholar]

9. Carmichel E.L., Harris F.P., Story B.H. Effects of binaural electronic hearing protectors on localization and response time to sounds in the horizontal plane. Noise Health. 2007;9:83–95. [PubMed] [Google Scholar]

10. Talcott K.A., Casali J.G., Keady J.P., Killion M.C. Azimuthal auditory localization of gunshots in a realistic field environment: Effects of open-ear versus hearing protection-enhancement devices (HPEDs), military vehicle noise, and hearing impairment. Int. J. Audiol. 2012;51:S20–S30. doi: 10.3109/14992027.2011.631591. [PubMed] [CrossRef] [Google Scholar]

11. Byrne D.C., Palmer C.V. Comparison of speech intelligibility measures for an electronic amplifying earmuff and an identical passive attenuation device. Audiol. Res. 2012;2:17–24. doi: 10.4081/audiores.2012.e5. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

12. Dastpaak H., Alimohammadi I., jalal Sameni S., Abolghasemi J., Vosoughi S. Effects of earplug hearing protectors on the intelligibility of Persian words in noisy environments. Appl. Acoust. 2019;148:19–22. doi: 10.1016/j.apacoust.2018.11.017. [CrossRef] [Google Scholar]

13. Tufts J.B., Frank T. Speech production in noise with and without hearing protection. J. Acoust. Soc. Am. 2003;114:1069–1080. doi: 10.1121/1.1592165. [PubMed] [CrossRef] [Google Scholar]

14. Page M.J., McKenzie J.E., Bossuyt P.M., Boutron I., Hoffmann T.C., Mulrow C.D., Shamseer L., Tetzlaff J.M., Akl E.A., Brennan S.E., et al. The PRISMA 2020 statement: An updated guideline for reporting systematic revies. BMJ. 2021;372:1–9. [Google Scholar]

15. PROSPERO, Centre for Reviews and Dissemination. Title of subordinate document. International Prospective Register of Systematic Reviews. Centre for Reviews and Dissemination. 2014. [(accessed on 5 April 2021)]. Available online:

16. Macleod M.R., O’Collins T., Horky L.L., Howells D.W., Donnan G.A. Systematic review and metaanalysis of the efficacy of FK506 in experimental stroke. J. Cereb. Blood Flow Metab. 2005;25:713–721. doi: 10.1038/sj.jcbfm.9600064. [PubMed] [CrossRef] [Google Scholar]

17. Group G.W. Grading quality of evidence and strength of recommendations. BMJ. 2004;328:1490–1494. [PMC free article] [PubMed] [Google Scholar]

18. Alali K.A., Casali J.G. The challenge of localizing vehicle backup alarms: Effects of passive and electronic hearing protectors, ambient noise level, and backup alarm spectral content. Noise Health. 2011;13:99–112. [PubMed] [Google Scholar]

19. Plyler P.N., Klumpp M.L. Communication in noise with acoustic and electronic hearing protection devices. J. Am. Acad. Audiol. 2003;14:260–268. doi: 10.1055/s-0040-1715736. [PubMed] [CrossRef] [Google Scholar]

20. Abel S.M., Lam Q. Sound attenuation of the indoor/outdoor range EAR plug. Mil. Med. 2004;169:551–555. doi: 10.7205/MILMED.169.7.551. [PubMed] [CrossRef] [Google Scholar]

21. Casali J.G., Robinson G.S., Dabney E.C., Gauger D. Effect of electronic ANR and conventional hearing protectors on vehicle backup alarm detection in noise. Hum. Factors. 2004;46:1–10. doi: 10.1518/hfes. [PubMed] [CrossRef] [Google Scholar]

22. de Faria C.A.R., Suzuki F.A. Pure tone audiometry with and without specific ear protectors. Braz. J. Otorhinolaryngol. 2008;74:417–422. doi: 10.1016/S1808-8694(15)30577-2. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

23. Bolia R.S., D’Angelo W.R., Mishler P.J., Morris L.J. Effects of hearing protectors on auditory localization in azimuth and elevation. Hum. Factors. 2001;43:122–128. doi: 10.1518/001872001775992499. [PubMed] [CrossRef] [Google Scholar]

24. Simpson B.D., Bolia R.S., McKinley R.L., Brungart D.S. The impact of hearing protection on sound localization and orienting behavior. Hum. Factors. 2005;47:188–198. doi: 10.1518/0018720053653866. [PubMed] [CrossRef] [Google Scholar]

25. Zimpfer V., Sarafian D. Impact of hearing protection devices on sound localization performance. Front. Neurosci. 2014;8:1–10. doi: 10.3389/fnins.2014.00135. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

26. Giguère C., Laroche C., Vaillancourt V. The interaction of hearing loss and level-dependent hearing protection on speech recognition in noise. Int. J. Audiol. 2015;54 doi: 10.3109/14992027.2014.973540. [PubMed] [CrossRef] [Google Scholar]

27. Manning C., Mermagen T., Scharine A. The effect of sensorineural hearing loss and tinnitus on speech recognition over air and bone conduction military communications headsets. Hear. Res. 2017;349:67–75. doi: 10.1016/j.heares.2016.10.019. [PubMed] [CrossRef] [Google Scholar]

28. Higgins J.P., Thompson S.G., Deeks J.J., Altman D.G. Measuring inconsistency in meta-analysis. BMJ. 2003;327:557–560. doi: 10.1136/bmj.327.7414.557. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

29. Simes R.J. Confronting publication bias: A cohort design for meta-analysis. Stat. Med. 1987;6:11–29. doi: 10.1002/sim.4780060104. [PubMed] [CrossRef] [Google Scholar]

30. The R Foundation R: A Language and Environment for Statistical Computing. The R Foundation. 2018. [(accessed on 7 April 2021)]. Available online:

31. Henshaw H., Ferguson M.A. Efficacy of individual computer-based auditory training for people with hearing loss: A systematic review of the evidence. PLoS ONE. 2013;8:e62836. doi: 10.1371/journal.pone.0062836. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

32. Rawool V.W. Conservation and management of hearing loss in musicians. In: Rawool V.W., editor. Hearing Conservation in Occupational, Recreational, Educational, and Home Settings. 1st ed. Thieme; New York, NY, USA: 2012. pp. 201–223. [Google Scholar]


Dr Euan Drawing.jpeg




bottom of page