Preserving hearing in a high-decibel profession

Long-term hearing loss may be covered by your state’s industrial insurance plan, but it can be difficult to document

Assuming that readers of this column correspond to typical U.S. law enforcement, you pay more attention to your health and fitness than do non-cops in your demographic group. You’re aware of hazards encountered in the workplace such as trauma from criminal acts and other violence, auto accidents, bloodborne pathogens, and stress.

You’re probably less concerned about something you’ve always taken for granted — your hearing.

Hearing losses are so uncommon in young people (in this case, people under 50 or so) that testing is seldom included in a routine physical exam. If the physician is able to carry on a conversation with the patient, he usually assumes that hearing is within normal limits. He’s usually right.

Ringing in Your Ears
Hearing loss tends to be insidious. It’s not like one day you wake up and can’t hear anything (although, rarely, that happens, too). More likely, you slowly become aware of a high-pitched tone in one or both ears that never goes away. In fact, “become aware” is a misleading way of describing it, because it comes on so slowly and so gradually that most people aren’t aware of it unless they think about it.

Hearing this constant, high-pitched tone, sometimes characterized as “ringing,” is called tinnitus (tin-NY-tuss). The most common cause is cumulative damage to the hair cells of the inner ear. These hair cells, located in the cochlea, are named for the tiny cilia (hair-like protuberances) that vibrate in response to sound. The vibrations create chemical-electrical impulses that are transmitted to the brain and interpreted as sound.

A one-time exposure to very loud sounds, such as a firearm discharge, can cause permanent damage to the hair cells and hearing loss, but most people recover at least some of their hearing after such an event. More commonly, chronic exposure to high noise levels causes deterioration of the hair cells and a more gradual hearing loss that is not immediately apparent.

One Sign of Normal Aging
Some hearing loss is genetic, and is usually aggravated with age. This gradual hearing loss often comes on at about the same time as the afflicted person is having difficulty with near vision (called presbyopia). That comes on when the crystalline lens, a clear membrane located behind the iris of the eye, becomes less flexible and the ciliary muscles that control it weaken.

Relaxed focus of the eyes is at infinity; close focus requires these muscles to contract and force the lens into a round shape. The more the muscles weaken and the more inflexible the lens becomes, the further the closest point of sharp focus extends away.

In my cop days, I watched officers who were maybe ten years older than me struggle with this. They had perfect vision their entire lives, and viewed wearing glasses as a sign of weakness and aging. Even so, they found they could no longer read normal-size type at a comfortable distance, and had to get the paper (or the computer display) farther and farther away to focus. 

Much of the time, presbyopia is made tolerable by wearing cheap reading glasses when needed.

Catching the Onset of Hearing Loss
Hearing loss is not so easily fixed or even diagnosed. Signs that you may notice in the police workplace include:

•    Difficulty understanding what people are saying unless they face you when speaking. You may not realize it, but you’re doing as much lip-reading as hearing.
•    An inability to separate out and comprehend simultaneous conversations. One day, you could drive a patrol car with the AM-FM radio turned to a talk station, keep track of everything that was happening over the police radio, and carry on a conversation with someone in the other seat, and never miss a word. Now, all you can hear is a cacophony of noise.
•    A preference to watch TV or movies with closed captions turned on, so you don’t miss the dialogue.
•    Inappropriate responses to questions asked in high-noise environments, like coffee shops:
     o    “Would you like regular or decaf coffee?”
     o    “Yes, please.”

Long-term hearing loss may be declared a workplace injury and covered by your state’s industrial insurance plan, but it can be difficult to document. One method is to get your hearing tested every year, especially toward the start of your career. If you can show that you have lost hearing acuity over time, you may be able to make a claim for the costs of treatment, including hearing aids when they’re needed. Given that a cheap pair of hearing aids goes for about $2,000, need to be replaced every few years, and are typically not covered by health insurance, this is not an insignificant benefit.

Next month in this space, I’ll talk about some technology available to preserve the hearing you have, and compensate for what you may have lost.

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