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Ear Care - Sound Sense

The Body's Watchdog

Hearing is the "watchdog of the senses." It is the last sense to go as you fall asleep and the first to return when you wake up. It enhances your life by giving you pleasure from music, hobbies and sports, and it is important to the learning and communication process.

Hearing begins when your outer ear collects sound waves from the air and directs them down the ear canal to the middle ear. These sound waves beat against the eardrum and cause vibrations that are further amplified by three tiny bones. The amplified vibrations travel into the inner ear where tiny hair-like sensors convert them into electrical impulses. These impulses travel along the auditory nerve to your brain which interprets them as specific sounds.

Whispers to Gunshots
The normal human ear can hear about 400,000 different sounds. Sound is measured in frequencies and decibels. Frequency indicates the pitch of a sound; decibels (dB) measure the loudness. Ten dB is barely audible; normal conversation occurs between 40 to 60 dB; a jet engine roars at 130 dB from 100 feet away. Listed below are more common sounds and situations and their decibel count:


Types of Sounds



Softest sound you can hear


A whisper


Normal conversation


Heavy traffic


Loud shout


Rock concert






World record for screaming





Sounds that are 120 dB or more can damage your hearing and cause pain. A person is considered legally deaf in Hawaii if he cannot hear sounds below 92 dB in both ears.

What is TOO Loud?
Too much noise can be harmful. It makes conversation difficult, causes irritability and fatigue and is a distraction which can result in inefficiency on the job. Researchers have linked excessive noise to mental and physical stress, accidents and certain illnesses. The Occupational Safety and Health Administration recommends that workers should not be exposed to more than an average of 90 dB per hour over an eight-hour period without adequate hearing protection.

You may be exposed to too much occupational noise if:

   • you have trouble understanding conversation with someone two feet away.
   • you hear a persistent ringing in your ear, or other strange noise, after you leave work.
   • your hearing returns to normal within a few hours after you end work.

Noise that causes hearing loss changes your "hearing threshold," the degree of loudness at which sounds are first audible to you. The change can be temporary or permanent, depending on the severity of the noise exposure:

   • Temporary hearing threshold shift is a partial hearing loss that occurs within the first two hours of noise exposure and returns to normal within two hours after the noise stops. The hearing loss can become permanent if you are exposed to this level of noise over a long period of time.
   • Permanent hearing threshold shift is a partial hearing loss that occurs gradually as the result of being exposed to noise over a long period of time. Early symptoms can include ringing in the ear and muffled sounds. High frequency and soft sounds are difficult to hear. Continued exposure to noise can result in permanent hearing loss in high frequency ranges.

Traumatic hearing loss is total loss of hearing resulting from a sudden, one-time explosion. Often, partial hearing is regained but the rest is permanently lost. If you think you've been experiencing hearing loss, check with your doctor. It is important to diagnose and treat problems early to prevent further damage or permanent loss of hearing.

Hearing Problems
Hearing problems can also be caused by physical reasons. Sometimes you can't hear because sound waves cannot reach the inner ear because of some kind of interference in the ear canal or middle areas. This type of hearing loss can usually be corrected by medical or surgical treatments. Symptoms of these kinds of hearing loss include an earache or discharge from the ear and sounds that seem faint or muffled.

Common causes include:

   • middle ear infections brought on by colds. Ear infections mostly affect children and can cause temporary or permanent hearing loss. Symptoms usually include swelling and pain.
   • outer ear blockage caused by earwax buildup or a foreign object in the ear. Ear blockages should be removed by medical professionals to avoid injuring the eardrum.
   • a ruptured or perforated eardrum caused by an object inserted in the ear, a sudden change in air pressure, a severe ear infection or a sharp blow to the head. Symptoms include earache, slight discharge or bleeding from the ear and hearing loss.

Another reason that you may not hear as well as you used to is because there may be damage to your inner ear parts, auditory nerve or brain. This damage causes permanent hearing loss.

Examples are:

   • Constant ringing or buzzing sounds in your ear. Its cause is not yet known, and it occurs mostly to people in mid-life and the later years of life.
   • Physical changes in the inner ear as you grow older. These physical changes can reduce or distort sounds.
   • Damage to the inner ear cells caused by drugs such as aspirin, antibiotics and some hypertension pills. You should call your doctor immediately if your hearing changes while you are taking medication. This type of hearing loss is not always permanent if detected early.
   • Trauma to the brain caused by a severe blow to the head, stroke or brain hemorrhage.

If you think you have a hearing problem, make an appointment with your doctor or hearing specialist. Delaying treatment can make the problem worse. Your doctor can help you improve your ability to hear with treatments such as hearing aids, medications or surgery.

Hearing loss is classified by the loudness of the sounds people can hear:
(information provided by the American Academy of Audiology)

Mild Hearing Loss

   • People with mild hearing loss have trouble hearing sounds at 21-40 decibels, such as some speech and a ticking clock, but would not be able to hear birds singing or the wind blowing.

Moderate Hearing Loss

   • Those with moderate hearing loss could have a hard time hearing sounds at 41-55 decibels, can hear a vacuum cleaner or a baby crying, but very little speech.

Severe Hearing Loss

   • People with severe hearing loss have trouble hearing sounds at 55-90 decibels but can still hear a piano or a phone ringing.

Profoundly Deaf

   • People who are profoundly deaf could have a hard time hearing sounds at 90 decibels and above; they may be able to hear a jackhammer, a gunshot or a loud motor.

Water in the Ear
In Hawaii, where water sports are accessible and popular, a common problem is "swimmer's ear." Swimmer's ear is caused by an infection in the outer ear canal and is most commonly caused by bacteria and sometimes fungus. Bacteria and fungus can get into your ear when water gets into your ear. When the water runs back out, the ears dry out and everything is fine. Problems occur when water remains trapped in the ear canal; the skin in the ear gets soggy, and bacteria and fungus grow in this wet environment, leading to an infection.

When you have swimmer's ear, you may experience the following symptoms:

   • the ear feels "blocked" and may itch
   • the ear canal becomes swollen and sometimes swells shut
   • a runny, milky liquid may come out of the ear
   • the ear is very painful and painful when touched

If you experience any of these symptoms, you need to see your doctor for treatment.

Preventing swimmer's ear is quite simple. If your ears feel "blocked" after swimming, surfing or even showering, using antiseptic ear drops will help prevent swimmer's ear. These ear drops can be bought without a prescription at drug stores. Ask your pharmacist for product recommendations.

Flying Problems
Most people arrive in Hawaii by plane. Ear problems are the most common medical complaint of people who travel by plane. They are usually simple, minor annoyances, but sometimes they cause temporary pain and hearing loss.

When flying, your ears may "pop." Or if they don't pop, you get an earache. The things that make your ears pop or cause you to get an earache happen in the middle ear. Have you ever noticed an occasional "click" or make a "popping" sound in your ear when you swallow? When this happens, a small bubble of air is entering your middle ear from the back of your nose. The air passes through the Eustachian tube, which connects the back of the nose to the middle ear.

The air in the middle ear is absorbed by its lining, but air is constantly re-supplied to the middle ear via the Eustachian tube during the swallowing process. This process equalizes the pressure on both sides of the eardrum. When air pressure is not equal, the ear feels blocked.

When flying to and from the Mainland or Neighbor Islands, the changing air pressure from flying (especially when ascending or descending) can sometimes cause your ears to feel blocked.

To avoid that blocked feeling, you'll need to keep your Eustachian tube open wide during these changes of air pressure. Here are some things that you can do:

   • Swallowing activates the muscle that opens the Eustachian tube. Chewing gum or sucking on mints or hard candy will make you swallow more often. Avoid sleeping during takeoffs and landings because you may not swallow enough during sleep to keep up with the pressure changes.
   • Yawn. Yawning is an even better activator of the muscle that opens the Eustachian tube.

Babies cannot pop their ears on their own. Letting them suck on a pacifier or bottle will help them swallow. Babies should not be allowed to sleep during landings.

Ear Protection

Keep your ears healthy by following these suggestions:

   • Practice good safety and health habits.
   • Never stick anything into your ear, even to clean it. Only trained personnel should insert any kind of instrument into your ear.
   • Wear protective equipment such as earplugs or earmuffs when you are exposed to excessive or loud noise or are involved in an activity that could result in an ear injury. People in construction or airlines industries and those active in water sports or hard-contact sports such as football or hockey are especially susceptible to hearing losses and ear injuries.
   • When using headphones, keep the sound volume at a low, comfortable level.
   • Have regular checkups and hearing examinations.
   • Be alert for signals of an ear problem: pain, discharge from the ear, the need for sounds to be louder in order to be heard, no response to nearby sounds, and ringing or buzzing noises in the ear.
   •Get medical attention IMMEDIATELY for an accident, injury or infection involving the ear.