Why wearing headphones for long hours sans a break isn’t a sound idea

Avinash Gupta (name changed), a Delhi-based audio producer, perhaps never imagined that the ordinary shrill sounds of autorickshaw horns would one day become torture for him. But they did. And when his six-month-old daughter would cry, he found it jarring. It was not until he visited a neighbourhood clinic that he learned the headphones he wore for several hours a day as part of his professional work had left an adverse impact on his hearing health.As the days went by, Gupta's aversion to high-pitched sounds became severe. When he edited his podcasts, the 's' sounds made by higher-pitched women would hurt his ears. He'd try turning the volume down but that left him unable to equalise the tracks he was working on. And then there was the ringing. What started out as a shrill ringing in his ear for a few seconds every couple of months had now become 15-second-long episodes of tinnitus every two days.Desperate for a solution, Gupta walked into his neighbourhood ENT specialist's clinic in December 2023. After a quick visual examination, the doctor asked Gupta, “What do you do?” Following Gupta’s reply the doctor said, “This is a classic case of an occupational hazard.” Gupta was advised to stop using headphones, or at least reduce its usage and take frequent breaks. He was also prescribed a hearing test.Called pure-tone audiometry, it’s the first line of investigation into hearing loss issues, says Dr Ishwar Singh, former medical director of Indira Gandhi Hospital in Dwarka. “It’s done in a soundproof room. The sound level at which a patient hears is plotted on a paper, called an audiogram.” medium111346682“Chronic noise exposure leads to damage to sensitive neuronal endings in the inner ear,” says Dr Sachin Goel, an assistant professor, ENT department at Dr Ram Manohar Lohia Hospital in Delhi. This can lead to noise induced hearing loss, which is a type of sensorineural hearing loss, he adds.The diagnosisGupta’s audiometry test was in the type of a room that he’d been in many times before. It was a small soundproof studio with a glass partition in the middle. The technician made him listen to several beeping sounds from a machine – ranging from high shrills to low rumbles – and give a thumbs up for each of the frequencies he could hear. Although humans can hear sounds ranging from 20 Hz (Hertz) to 20,000 Hz, Gupta’s thumb didn’t go up for any of the sounds played at a frequency of 4,000 Hz. medium nocaption111346696 medium nocaptionhttp://youtu.be/PAsMlDptjx8?si=0ozj5_yzFkdhofZANot all cases of hearing loss are as easily diagnosed as that of Gupta’s. For Nitish Sharma, an anchor and emcee from Delhi, his symptoms started with an ear infection. He worked most of his days in loud events with speakers usually placed right behind him. Both his ears had swollen up, for which he was treated with antibiotics. The medicines worked but he gradually noticed diminished hearing in his right ear. At first, he thought it might just be a blockage. Eventually, his left ear too felt different. That’s when he went to a doctor. Actually, he went to five of them but none of them could diagnose what caused Sharma’s hearing loss. These doctors, however, had never asked Sharma what he did for a living.Dr Khushboo Goel, a consultant at Dr Hans Centre for ENT in Gurugram, says that prolonged exposure to loud noise affects the hearing nerves. “It is called noise trauma,” she adds. Sharma’s quality of life was greatly affected by his hearing loss. He had difficulty understanding his clients if they spoke too low during meetings, and when he was out and about, he’d find traffic noises unnerving. “Common symptoms of hearing loss include difficulty understanding speech, asking others to repeat themselves often, and experiencing ringing or buzzing in the ears,” says Dr Arup Senapati, a senior medical officer at the Goalpara Civil Hospital in Assam. Although Sharma didn’t complain of frequent ringings in his ear, he did say he had experienced it every now and then. “Tinnitus gives us a clue about the involvement of the inner ear,” adds Senapati.Three categoriesThere are three types of hearing loss: conductive, sensorineural and mixed. The first type occurs when sound is unable to reach the ear, says Dr Singh. “There is a blockage. The most common example of this is impacted wax.” In the sensorineural type, the hair cells present in the inner ear are affected by high-decibel sounds, he says, adding, “For example, [sounds from] firecrackers, gun fire, blasts, etc. These can damage the inner ear.”According to Dr Smita Nagaonkar, a consultant (ENT) at Sir HN Reliance Foundation Hospital in Mumbai, “Attending a concert for a long time in an open space can cause as much damage as a gunshot near the ear or an explosion [can]. Thus, the duration of the exposure matters just as much as the volume.”The mixed type of hearing loss is when both conductive and sensorineural hearing loss occurs together, explains Dr Singh. medium nocaption111346823Not all of these hearing losses are permanent. “Mostly, conductive causes of hearing loss are reversible and correctible,” says Dr Goel. They can be corrected depending on the cause, Dr Singh opines. For example, impacted wax needs to be removed. “Sensorineural hearing loss can be reversed only if the patient presents as soon as the symptoms develop without any delay,” says Dr Goel.Arti Mehta (name changed), a 35-year-old Mumbai doctor, suffered a sudden blockage in her right ear when her two-year-old son screamed at the top of his voice in her close proximity. She could hear a low humming noise (tinnitus) in the same ear. Realising this was an emergency, she contacted an ENT colleague, who advised her to undergo an audiometry test. The test results confirmed sudden sensorineural hearing loss in her right ear.Mehta was given steroids and other supportive medication. She also received two sessions of hyperbaric oxygen therapy (HBOT), which involves breathing pure oxygen in a pressurised environment. Besides, serial audiograms were done on a daily basis, which showed gradual improvement of hearing. And Mehta could hear properly within a week.The ENT specialist, Dr Neepa Vellimuttam of S L Raheja Hospital, Mahim, advised her to be careful in future and to avoid any loud noise. She was also told to avoid hearing music at high volumes on headphones.Be careful what you listen toExposure to any sound louder than 90dB (decibel) — that’s as loud as a hairdryer — for more than eight hours can cause sensorineural hearing loss, warns Dr Singh. medium nocaption111346852“Headphones lead to higher delivery of sound levels and pressures to our tympanic membrane [the eardrum],” according to Dr Goel. He often saw patients exposed to prolonged loud sounds complaining of decreased hearing. “It is also seen as an occupational hazard with industrial workers who are exposed to loud noises during their daily work routines,” Goel says. Prolonged exposure to loud noises can have several other consequences such as loss of sleep, diminished concentration, and irritability, says Dr Singh. For a 26-year-old Delhi-based singer, who goes by the name of Diamond, issues with hearing started just two years into his professional career. He would perform in loud live shows for hours, and for several times a week. One day, he felt a bit of discomfort in his left ear. There was no pain, so he wrote it off as fatigue. Over time, the discomfort turned into distorted hearing. Fearing that he might have damaged something in his ear, Diamond went to a doctor. He was examined, prescribed a hearing test, and was told nothing was wrong. That was five years ago, and now, Diamond has made peace with the distorted reality of his left ear.A billion casesIn 2022, a study published in the BMJ Global Health journal, said that more than a billion young people were at risk of developing hearing loss due to factors such as music festivals, headphones, and earphones.Dr Goel has noticed an increase in the number of young patients visiting his clinic. “Young people are presenting with decreased hearing, high frequency hearing loss and ringing sensation of the ears,” he says. Dr Khushboo says there was an uptick in such cases after work-from-home arrangements became popular during the Covid-19 pandemic. She also flags the increasing trend of children using earphones these days. medium nocaption111346855Headphones, however, can be used safely as long as the volume is not turned up too high. “A good quality headphone with noise cancellation can help prevent hearing loss,” she suggests. Dr Singh recommends using over-ear headphones instead of ear plugs or wired earphones. “Limit the usage time, keep the volume low and take breaks. Wherever it is required to use headphones for more than four or five hours, use the lowest volume possible and switch to speaker mode whenever possible,” advises Dr K K Handa, chairman, ENT and Head Neck Surgery, Medanta, Gurugram.“If your work demands that you need to use them, then you should take a break after every 45 minutes or one hour for 10-15 minutes. If that is also not possible, then do this for one ear and then for the next one,” says Dr Suven Kalra, consultant ENT at Max Super Speciality Hospital, Shalimar Bagh, Delhi.As for Gupta, he walked away with his diagnosis with some medicine and warnings of dire consequences if he didn’t change his headphone habits. His everyday life wasn’t affected much except when the occasional e-rickshaw would pass by, honking on its little rubber trumpet. “The honking noise is really unbearable,” says Gupta.With inputs from Lata Mishra