Philips 9030-I use my iPhone to turn the gain to -8 when brushing my teeth or driving and -7 when playing my nylon string classical guitar (unamplified). With the guitar, the total sound level is the same at -7 as at -0, but the sound suffers from terrible clipping distortion at -0. My conclusion is that the HA is not an AirPod and does not really have enough power to damage your ears, but different HA’s may be different.
Yes, (re Music). I don’t accept the report cited about hearing aids ‘causing damage’ vs. ‘wear correlating to ongoing decline in individuals who already have an established hearing loss’.
The report compares an aided and an unaided group, both of which comprise “patients with bilateral sensorineural hearing loss eligible for amplification”. The aided group did worse.
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I don’t think the hearing aids themselves cause damage. Loud dba levels cause damage whether come from a hearing aid or not.
Your ear doesn’t know where the loud sound is coming from. It just knows how loud it is, and for what length of time the loud volume is.
It can be your motorcycle, music, power tools, or anything else.
A guy of my parent’s generation was a truck driver. In the days before truck cabs were air-conditioned, truck drivers would lose their hearing in their left ear from hours of driving with the window open. The sound of the motor and air whooshing by was more than 88db.
For the sake of round numbers - If the sound is 85dba, and the gain of your aids is 10db at a certain frequency, you are getting 95dba at that frequency.
And every 3db of gain doubles the power. The db scale is not linear, it’s logarithmic.
If you value what’s left of your hearing, try to avoid loud anything. It might help to get a SPL meter.
I have one on my phone, but it’s not very accurate. I compared it to the reading from a SPL meter, and adjusted the threshold so it’s close. And I still have to be aware that my aids amplify high frequencies. So there is a lot of guesswork involved.
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@Um_bongo your comment about a steady level of sound without breaks posing a greater level of risk of hearing damage set me to thinking about a change in sound engineering approach in the music industry.
Back in the 90s-2000s a lot of popular music was re-mastered to go on CDs and into MP3s. The producers wanted the music to sound more “punchy” so when remastering the lows of the music would be compressed upwards to be nearer to the high levels, so the music sound levels have become “more steady”.
Based on your comment, this makes popular music more risky to listen to at high volumes as there are no breaks down to low levels.
Classical music was immune to this type of remastering as it would destroy the sound of the music being played.
That’s 100% correct, albums from the 70s and 80’s have way less ‘up-mix’ compression. Unless you’re listening to something full of continuous power chords or drumming, there’s going to be far fewer points of peak output.
Blame Run DMC (or don’t) 
, it’s certainly a mixing style that developed that wanted to increase the ‘punch’ of the sound. That coupled with the wider coolness in listening to your own music from your Sony Walkman-iPod-iPhone at levels audible to others has certainly had major consequences that haven’t existed since the Industrial Revolution (outside of a couple of professions), but now we’re literally doing it to ourselves.
If you want to see the difference in power you can usually get a VU read-out of both channels for most music; the ‘fatter’ the trace, the bigger the energy under the curve.
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For interest’s sake, compare to another study that used monaurally fitted patients as their own controls, comparing hearing loss in the aided and unaided ear and found no difference in progression of loss. The Effect of Monaurally Fitted Hearing Aid Use on the Evolution of Presbycusis - PubMed
As I said last time this came up, looking at the ages between ~8 and ~45, there is a huge population of individuals fit to pediatric targets whose hearing is stable across decades. Patients with congential hearing loss tend to be more consistent hearing aid users (10-16 hours a day) and because they are fitted to child targets are wearing hearing aids at a significantly louder volume (pediatric gain targets are higher than adult gain targets). I absolutely have these patients who I have been seeing for the entirety of my career who have moderate-severe hearing loss (so their hearing aid output is high to compensate) and their hearing hasn’t changed. So if your hearing aids aren’t exceeding pediatric gain targets, you should be fine.
We apply noise protection recommendations across the board because we don’t have precise knowledge about differential impact at different levels of hearing loss, etc., but realistically we know that noise induced hearing loss occurs most rapidly in the first 10-15 years of exposure and then slows down, which means loud noise doesn’t impact ears with loss in precisely the same way that it does normal ears.
Don’t worry about properly fitted hearing aids affecting your hearing.
Do protect your ears in loud noise, hearing aids are not hearing protection.
As for streaming, given the question marks that exist the conservative thing to do is to apply the same caution that anyone would. Consider exposure time versus volume, don’t crank it for 8 hours a day. Consider background noise–people are more likely to turn volume up over top of background noise than they are to listen to their music at damaging levels for long periods in quiet, so isolating yourself from background noise when listening to music will help. (You could also theoretically get your provider to run REM and check whether your prefered streaming volume is drastically exceeding your gain targets so that you can get an idea of where to set your volume control and when you are exceeding safe volumes, but I’ve recently lost a bit of my optimistic assumption that “any provider could easily do this for you”.)
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Wikipedia has an article about what @um_bongo comments under the heading: Loudness wars
I am retired now but at the last firm I worked at, the software developers listened to music on their headphones for the full 8 hours of the day - a recipe for future hearing loss IMO.
Thanks, @Neville. Any examples involving conductive or mixed hearing loss are a different story, right? Those patients’ inner ears aren’t exposed to the full output of their hearing aids.
Yeah, conductive losses are sort of walking around with their own earplugs all the time, although it varies to what degree. If it’s not a flat conductive loss, certain frequencies are still at risk. I actually have a minor low frequency conductive loss with the bad consequence that I want to crank my music up higher than I should to get the bass and am probably slowly causing a more high frequency loss. Further, depending on the degree of loss noise can still be damaging if you are attending, say, a rock concert.
But yeah, a flat maximal conductive loss like you might have if you have no middle ear function at all probably doesn’t need to worry about ear plugs in most situations.
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The way I understood it was they used compression to make their songs sound louder on the radio than the competition. The loudness wars.
Loud music just sounds better, so if your song can sound louder than the others, it creates more sales.
Me? I don’t like compression, because a lot of the expression in music comes from differences in volume of individual notes or phrases. (dynamics).
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I think the 85 db threshold is not for pain, but for damage to the delicate hair cells in your inner ear. So if the output of your HA is above 85, depending on how much more, and for how long, it can make your hearing worse. I don’t know about you, but I don’t need mine to get any worse.
Unless you have conductive loss, which blocks some of the energy before it gets to the inner ear.
That’s a good point.
I suspect for most of us it’s hair cell damage from either noise exposure, aging, and/or something else.
Is that accurate? First, is it not possible to damage the hairs below 85 dB? NIOSH recommended exposure limit is 85 dBA as a time-weighted average over 8 hours. 85 dB is loud. A safe sound limit is probably about 70 dB for over 12 hours. Even 80 dB all day with hearing aids might be too much. And now one has to accouy for streaming just as with headphones. Second, while the literature lacks information, some with auditory neuropathy who have used hearing aids were suspected of ending up with damage to the otherwise working hairs, even when compared to siblings who did not use hearing aids. Articles don’t detail the settings on the hearing aids.
Perhaps anyone with aids set above a threshold, and possibly all patients, should be warned for informed consent. Was anyone warned?
Can aids be set to clip or at least not amplify if the amplified sound would exceed a threshold? What would such a configuration sound like to the wearer? Would this be done by lowering UCL, setting MPO, or something else?
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I wasn’t.
I came to the conclusion by myself, after reading a lot about dba levels and exposure time.
So, I try to keep my levels as low as possible. Less than comfortable when possible.
I also try to keep a lot of quiet time during the day.
For me, it’s important to keep as much of the hearing that I have left as I possibly can.
It’s about average energy though. So, setting an aid to deliver speech at 85dB is very unlikely to cause an issue. As the average energy within speech is way less than the average energy of a fixed signal (machinery noise) at 85dB. Actually probably somewhere between 1/5 to 1/20 of the signal energy depending on whether it’s full choral signing or staccato speech.
Can you point to a noise exposure regulation that gives consideration to the energy level of the source sound? They do consider whether rhythmic sounds are continuous and also impact sounds.
Hearing aids are not amplifying only human speech but all noise including music, environmental sounds, vehicles, sirens, construction, etc. which make the hazard greater. OSHA General Industry exposure limits (https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.95) are 90 dBA for an 8-hour time weighted average duration, but only 15 minutes or less at 115 dBA. Does this mean that someone wearing aids set to a level 25 dB gain exposed to a hairdryer type noise (90dBA) for 15 minutes would exceed the OHSA daily TWA limit? And that would be before adding in the combined exposure levels from all the other noise exposure that day which would further bring the equivalent noise exposure factor above 1.0 for the day.
Rather than debate the risk, finding ways to mitigate against it for those who are concerned might help some. There’s no harm to mitigation and some might be able to hear adequately even with mitigation. Are there other approaches other than providing some amplification while finding a method to (a) limit the ability for the hearing aids to amplify softer noises above a threshold and (b) limited the ability of the aids to amplify input noises above a cutoff threshold?
Can one even rely upon OSHA limits or are these not aggressive enough to avoid all deterioration in hearing?
I might try some DIY around this, but I’m unsure how to best implement those settings? What are some approaches you would suggest taking in limiting aids in this way?
You’ve answered your own question there: but the hearing aids are firstly designed not to amplify steady state noise, secondly use output compression and thirdly have MPO limiters to reduce the signal amplitude. Yes though: you’d very soon be over the limit if they turned those sounds up.
This is why people who ride motorcycles and operate loud machinery are at risk: due to the continuous exposure to sound.
I can’t give you the actual figure in your case of the combined effect, but the noise dose can certainly be recorded by a ‘personal noise doseometer’ or even the function on an Apple Watch. With hearing aids, the best approximation might come from the data logging or even extrapolation of the REM result under certain stimulus. However seeing as nobody carries a portable REM kit on their person to give you an actual SPL at the eardrum, you’ve probably got to go with the estimates and exercise caution.
As for ‘speech’ you’d probably find some average intensity values, but again, due to the variation in your location relative to the sources, the person(s) speaking, the ambient Lombard function and background noise - even the laguage/dialect plus the Inverse Square rule for sound propagation: it’s likely to be a very arbitrary figure.
Me? I tend to think it’s best to err on the side of safety.
More damage cannot be reversed (yet).