Beyond loud noise: Surprising causes of hearing loss that employers should know

Hearing loss is more common than you might think. It ranks as the third most common chronic physical health condition among adults, with only high blood pressure and arthritis coming in ahead of it.¹ It also tops the list of the most common work-related illnesses, often resulting from exposure to loud noise. While prolonged exposure to loud noise is a well-known cause of hearing loss, it's far from the only one.² Certain medications, chronic health conditions, stress, and other factors can also affect a person’s hearing health.

When prescription medications affect hearing

Prescription medications may not have been on your radar as a hearing loss risk, but some drugs can cause ototoxicity, a condition that can affect hearing and balance.³ Catherine Palmer, PhD, director of Audiology at UPMC and a professor in the departments of Otolaryngology and Communication Science and Disorders at the University of Pittsburgh,  explained that “[o]totoxicity means that a drug can damage a person’s hearing while at the same time working to improve their health. For instance, cisplatin, a chemotherapy drug used to treat cancer, is a lifesaving medication but at the same time can cause hearing loss.”

Because of this potential side effect of ototoxic medications like cisplatin and some strong antibiotics, prescribing and ongoing use should be approached with care, Dr. Palmer said.

“When a potentially ototoxic drug is prescribed, it is ideal for a person to see an audiologist for a baseline audiogram to establish their current hearing status and to have their hearing retested as needed so that the audiologist can determine if hearing has changed during the treatment. The managing physician can use this information to determine reconsidering the dosage.

“This may not be possible given the lifesaving nature of many of these treatments. If that is the case, it is helpful for the person to work with the audiologist to manage the hearing loss with communication strategies, hearing aids, or other treatment options. Many drugs that are ototoxic also can cause tinnitus, which is ringing in the ears. The audiologist can help patients manage this unwanted sound as well,” Dr. Palmer added.

Ototoxic hearing loss occurs in the inner ear and is typically permanent, but Dr. Palmer explained that proactive monitoring may help identify changes early and support appropriate treatment decisions. This makes access to preventive care, specialist services, and comprehensive health benefits critical. These benefits can help employees receive the support they need.

Dr. Palmer also noted that “[t]here is research that indicates that the auditory system could be more susceptible to noise damage while being exposed to ototoxic medication.”⁴ This finding may be especially relevant for employees who work in noisy environments, highlighting the importance of workplace hearing protection programs and access to hearing health resources.

The connection between chronic conditions and hearing loss

Hearing health is also closely connected to overall health. In fact, several chronic conditions can increase the risk of hearing loss, including diabetes. More than 40 million Americans have diabetes, and many of them are working-age adults.⁵

“Diabetes is a risk factor for hearing loss. This is related to the vascular issues associated with diabetes that also impact the vascular support to the auditory system,” Dr. Palmer said.

Diabetes-related complications can also affect hearing health. When kidney function fails, for example, toxins can build up and affect structures throughout the body, including the delicate inner ear.

Heart disease can also affect hearing. “Heart disease impacts blood flow, and the inner ear depends on healthy blood flow for oxygen and nutrients.  This lack of oxygen and nutrients can damage the inner ear,” Dr. Palmer explained.

The relationship between hearing health and overall well-being goes both ways. While certain health conditions can contribute to hearing loss, untreated hearing loss can also affect behavioral health. “Untreated hearing loss is associated with depression. The good news is that treating hearing loss can have a positive impact on depression,” said Dr. Palmer.

How stress can affect hearing health

Work-related stress is widespread among today’s workforce, with more than 80 percent of U.S. employees reporting that they experience it.⁶ Stress may not directly cause hearing loss, but it can contribute to symptoms such as tinnitus (ringing in the ear) and may negatively impact other aspects of health that support healthy hearing.

According to Dr. Palmer, “[i]ndividuals may experience new or more tinnitus when under stress. As stress can impact overall health—including an individual’s heart health and blood pressure—these impact hearing as well.”

Reducing hearing loss risks in the workplace

Whether it’s listening to music at high volume through earbuds or working in environments with continuous exposure to loud sounds, many employees are at risk of noise-induced hearing loss. Employers can play an important role in protecting hearing health by promoting safe listening habits both in the workplace and beyond. The EARS approach can help reduce noise exposure:

Earplugs
Avoid loud sounds
Reduce the level of sound
Shorten your exposure

How UPMC Health Plan can help

Occupational hazards, chronic conditions, medications, and lifestyle factors can all affect hearing health. Offering employees health insurance benefits that include hearing care can help support their overall health and well-being. That’s why UPMC Health Plan partners with Amplifon Hearing Health Care to offer comprehensive hearing benefits and other resources that can help your employees navigate hearing loss.