Noise-induced hearing loss is determined by noise exposure and life-course events, all age groups can be affected. Exposure to diff erent types of noise from early childhood might have cumulative eff ects on hearing impairment in adulthood.
Evidence is increasing that early social and biological factors might aff ect hearing in middle age (eg, a study of patients assessed at age
45 years).
Prevalence of hearing loss is highly related to age. How noise and age interact is a major gap in the specialty’s knowledge.
Data suggest that pathological but sublethal changes from early noise exposure substantially increase risk of inner ear ageing and related hearing
loss.30,31 In addition to noise, factors such as alcohol and tobacco use and hyperglycaemia are associated with agerelated hearing loss.
Thus, public health initiatives need to address both general health and auditory health.