Is Australia Listening? attitudes to hearing loss
Australian Hearing s Health Report Foreword 3 Snapshot of Results 4 What causes hearing loss? Our exposure to loud noise Experiences of tinnitus 13 Protecting our ears 14 Perceptions of our own hearing 1 Getting our hearing checked 1 Attitudes to hearing aids 1 Living with hearing loss 19 Who is affected by hearing loss? 1 Looking ahead About Australian Hearing 4 Foreword Hearing loss is predicted to affect one in four Australians by and currently costs the economy in excess of $11.bn per annum. 1 Because of this growing problem, we recognised a need to assess Australia s attitudes to noise and hearing loss. Noise is becoming an increasingly popular topic, as society starts to see the impact of noisy lifestyles on physical and mental health. So, what noise do we expose ourselves to? Are we aware of the damage we may be causing to our hearing? And if so, how (if at all) do we modify our behaviour? In addition to the general public s interest in damage to their future hearing caused by today s activities, the problem of hearing loss is already very real among our ageing population. Over per cent of people in their s suffer from hearing loss and many would benefit from hearing aids. While hearing aids are becoming more widely accepted, there are still misconceptions and negative stereotypes attached to these devices, despite the benefits they provide from ever evolving technology. As baby boomers move into their s, Australian Hearing is trying to educate people about hearing loss and demonstrate how today s technology can provide excellent outcomes for people who can t hear well. We also want young people to be aware of the damage that overexposure to loud noise can cause later in life. This report represents our first survey into Australian s perceptions and behaviours regarding healthy hearing. About the survey One thousand Australian adults were interviewed via an online survey where they were asked various questions relating to their perceptions of hearing loss, hearing aids and their exposure to potentially harmful noise levels. The study was conducted by Quantum Market Research on behalf of Australian Hearing, the country s largest hearing service provider. Participants were surveyed for minutes online. The sampled included males and females from all adult age groups, all states including both metropolitan and regional areas and all socioeconomic groups. 1 Access Economics: Listen Hear! The economic impact and cost of hearing loss in Australia, February As baby boomers move into their s, Australian Hearing is trying to educate people about hearing loss and demonstrate how today s technology can provide excellent outcomes for people who can t hear well. Is Australia Listening? australian hearing australian hearing Is Australia Listening? 3
Snapshot of Results Most Australians think that loud noise is the major cause of hearing loss. Listening to loud music through headphones is thought to be more detrimental to hearing than other sources of leisure noise. Despite this, more than two thirds of respondents said they listen to music through headphones regularly and per cent of these people often have the volume above safe levels. Nearly half of younger Australians (1 34 olds) said they go to noisy bars and pubs and listen to music through headphones at least once a week. One quarter of younger Australians (1 4 olds) don t realise that once your hearing is damaged, it cannot be restored. Just over half the population actively protect their hearing by avoiding noisy places, limiting length of exposure to loud noise or limiting the volume of music played through headphones. Forty-one per cent of people believed their hearing was very good or almost perfect while one quarter believed their hearing was below average. About three quarters of older Australians ( plus) have had their hearing checked, and more than one third of these people have done so in the past. Sixty per cent of Australians reported suffering from noticeable tinnitus, with prevalence higher among younger Australians (1 34 olds). Younger Australians (44 s old and younger) associated hearing loss and hearing aids with negative words, like old, ugly and deaf. Older Australians chose softer words and 3 per cent of those aged over were willing to consider wearing a hearing aid. Four in five Australians reportedly know someone with a hearing impairment. The group identified as most likely to have a hearing loss was the elderly, however the next most likely group identified was teenagers. 4 Is Australia Listening? australian hearing australian hearing Is Australia Listening?
What causes Hearing Loss? Our Exposure to Loud Noise Most Australians believe industrial machinery and loud music are the major causes of hearing loss. Seventy-one per cent of Australians believe that listening to loud music through headphones will have the greatest negative impact on a person s hearing compared to listening to music in other ways. Causes of hearing loss What do you think are the major causes of hearing loss? Working with industrial machinery Exposure to loud music Exposure to everyday noise Poor ear hygiene Old age/degeneration Genetics/genes/born deaf Other Greatest impact on a person s hearing % of Respondents (n=1,) 4 3 Listening to loud music through headphones or in your ear Two in five Australians think that everyday noise causes hearing loss. In reality, exposure to low and moderate everyday noise does not cause hearing loss. However, damage due to noise exposure is cumulative. This means the higher the noise level and the longer the exposure, the greater the damage. 4 4 Listening to loud music in an enclosed space (eg car or small room) % of Respondents (n=1,) Which do you think has the greatest negative impact on a person s hearing? 1 1 Listening to loud music in a large space (eg hall, theatre or music venue) Listening to loud music in an open space (eg park or garden or open air concert) 4 1 3 4 Not sure Exposure to loud music The most significant single cause of hearing loss in Australia is exposure to loud sounds. There is evidence of damage due to noise in the measured hearing thresholds of 3 per cent of Australians 1 s and older. Although most Australians appreciate that loud sounds could damage their hearing, one in five still frequently attend loud venues or listen to music through headphones. Of those 1 per cent of Australians who do use headphones or headsets to listen to music, 9 per cent do so for less than three hours a day on average. Alarmingly, almost two in three ( per cent) of those who listen to music through headphones sometimes have the volume so loud that people usually have to shout to be heard, indicating that it s too loud and could be causing damage. If you need to raise your voice or shout to be heard in background noise, then the noise is too loud. In terms of frequency, one in five Australian adults claim that they are exposed to unbearably loud noise at least once a week. Most Australians ( in ) go to noisy venues like bars and listen to music through headphones, but not surprisingly, younger Australians are more likely to do so. Nearly half of 1 to 34 old Australians go to noisy bars and pubs and/or listen to music through headphones at least once a week. Encouragingly, nearly half of the population stated that they would only be exposed to unbearably loud noise once or twice a at most. However, the definition of unbearable is subjective to each respondent. Generally speaking, the majority of Australians appreciate that loud noise has the potential to lead to hearing damage. Nearly half of Australians (4 per cent) thought that there would be a major impact on hearing in the long term when exposed to loud noise. Is Australia Listening? australian hearing australian hearing Is Australia Listening?
Awareness of the consequences of noise While four in five Australian adults are aware that once damaged or impaired, hearing cannot be restored to its original state, per cent of young Australians (1 to 4 olds) don t know this. This awareness grows, with age; while per cent of 1 to 4 old Australians were aware of this, per cent of plus olds knew this fact. However, a significant proportion (1 per cent) of younger Australians (1 to 4 olds) claim they don t consider that loud noise may be damaging their hearing. With age comes the acknowledgement that loud noise may have a negative impact on hearing. Only one in four Australians aged below 4 thought there would be a major impact on their hearing from exposure to loud noise, compared to 4 per cent of those above the age of 4. When asked whether noise damages hearing in the short, medium or long term, Australians are more likely to associate loud noise with short term or long term damage. Fewer Australians felt that there was medium term damage through exposure to loud noise. Is Australia Listening? australian hearing australian hearing Is Australia Listening? 9
A closer look... One in four Australians believe that loud noise will have a major impact on a person s hearing in the short term. However, 1 to 4 old Australians were least likely to identify the link between loud noise and short term hearing damage. Younger Australians consistently downplayed the impact of loud noise on hearing, whether it be in the short, medium or long term. Overall, the most glaring results in this research are the awareness, perceptions and behaviours of young Australians in relation to healthy hearing. The severity and permanency of the impact of loud music and venues to their hearing has not yet been accepted by this age group. Frequency of using headphones or headsets How often do you listen to music or other recordings through headphones or headsets directly in your ears? % of Respondents (n=1,) 3 1 4 13 9 Frequency of exposure to noise How often are you exposed to noise that becomes unbearable? More than once a week week weeks month Every 4- Once or twice a Less than once a Never % of Respondents (n=1,) 1 1 More than once a week week weeks month Frequency of attending noisy pubs and bars Every 4-4 Once or twice a 4 14 Less than once a How often do you frequent noisy places (bars or pubs, clubs, rock concerts) where you have to shout to be heard over the music being played? Never Time spent listening through headphones or headsets On a typical day, for how long would you listen through headphones or headsets? % of Respondents (n=411) 4 3 Less than an hour Between 1-3 hours More than 3 hours More than hours and up to hours Volume of headphones/headsets 3 When listening through headphones or headsets, would someone need to shout in order for you to hear them? % of Respondents (n=1,) 1 More than once a week week 9 weeks month Every 4- Once or twice a 1 Less than once a 9 Never % of Respondents (n=411) 4 3 1 Yes, all the time Yes, sometimes No, never 4 4 Is Australia Listening? australian hearing australian hearing Is Australia Listening? 11
Volume of headphones/headsets When you are exposed to loud noise, do you consider that you may be damaging your hearing? % of Respondents % of Respondents (n=1,) 4 4 3 4 1 3 1 9 4 39 1-4 (n=4) 13 Yes, definitely 4 4-34 (n=14) 39 4 4 4 Perceived impact of loud noise 44 3-44 43 4 3 4 1 4-4 Possibly No Not sure 3-4 (n=1) To a major extent To a moderate extent To a mild extent Not at all Not sure Short-term damage Medium-term damage Long-term damage 1 3 4 4 4 + To what extent do you think exposure to loud noise affects a person s hearing in the short, medium and long term? Perceived impact of loud noise Are you aware that once damaged or impaired your hearing cannot be restored to its original state? % of Respondents 4 1-4 (n=4) Yes 1-34 (n=14) No 3 3-44 Not sure 4-4 11-4 (n=1) + Experience of Tinnitus Tinnitus can be described as a symptom resulting from a range of causes, including exposure to excessive noise. This research asked if respondents had ever experienced tinnitus, often referred to as a ringing in the ears. Almost two in three ( per cent) Australians have suffered from noticeable tinnitus and, alarmingly, this was more prevalent in younger Australians (1 to 34 s old). Seventy per cent of 1 to 34 s olds have experienced tinnitus compared to per cent of those above. This may reflect a lifestyle aspect, with younger Australians more likely to attend bars, pubs and listen to music through headphones. Tinnitus actually occurs in per cent of people and is a natural phenomenon. The classic research studies on tinnitus asks young people with perfect hearing to enter a sound proof booth and write on a piece of paper what they hear. They describe what is commonly known of as tinnitus, that is a ringing or buzzing sound. These are people who said they did not have tinnitus. In our research, one in four of those who report that they experience tinnitus, say they have a ringing in their ears at least once a week, while nearly two in five Australians said they would experience tinnitus no more than twice a. One third of tinnitus sufferers aged plus experienced ringing in their ears more than once a week. Typically, tinnitus lasts for less than an hour for most sufferers (4 per cent), but for some it can last more than 4 hours ( per cent). Ringing ears after exposure to loud noise means that the noise level was loud enough to have caused damage. Although younger Australians were more likely to experience tinnitus, as we look at the data by age, older Australians were more likely to suffer from it more frequently. Sixty-seven per cent of those aged 31 above s report that they suffer from tinnitus more than once a week, compared to only 1 per cent of 1 to 34 olds. And of those who have suffered from tinnitus, about half (4 per cent) claim 4 that it lasts less 9 than an hour, whilst one in 4 report that their tinnitus usually lasts more than a day. % of Respondents Hearing loss is sometimes accompanied 1-4 -34 by tinnitus. It may (n=4) come and (n=14) go and can be aggravated by other loud continuous or impulsive noise. Yes It can be triggered No by loud noise and may be an indication of ear damage. Experience of tinnitus 4 3 4 1 3-44 4-4 Have you ever experienced ringing in the ears (called tinnitus )? % of Respondents % (n=1,) of Respondents 1 31 9 1-4 (n=4) Yes More than once a week -34 (n=14) week 3 4 3-44 No weeks Frequency of experiencing tinnitus 4 4-4 month How often would you experience ringing in the ears? % of Respondents (n=) 1 More than once a week week weeks month Every 4-4 -4 (n=1) Once or twice a 1 49 + Every 4-1 Less than once a 49-4 (n=1) Once or twice a (n= L 1 Is Australia Listening? australian hearing australian hearing Is Australia Listening? 13
Protecting our Ears Perceptions of our own hearing Ear protection and limited exposure to loud noise are the best methods of hearing protection. It is encouraging to see these preventative behaviours being employed by many Australians. However, many of these preventative behaviours are likely to be social preferences based on age rather than conscious decisions to protect one s hearing. The most common methods Australians use to protect their hearing are avoiding places with loud noise ( per cent), limiting the time of exposure to loud noise ( per cent) or limiting the volume of music played through headphones (3 per cent). On a general level, about 3 per cent of Australians wore ear protection such as ear muffs or plugs to protect their hearing. Analysis by age shows that younger Australians are less likely to avoid noisy places for the sake of their hearing, but are more inclined to control the volume of their headphones. Australians aged between 1 and 4 were also less likely to wear hearing protection (3 per cent) than older Australians. Despite this relatively high awareness of the potential damage of loud noise to hearing, there has yet to be a significant change in behaviour. Very few people believe they have very poor hearing, with self assessments of hearing becoming more negative with age. Approximately two in five Australians (41 per cent) felt that their hearing was either very good or almost perfect. One in four ( per cent) Australians believe their hearing is below average, however each person s concept of average is subjective. In reality, one in six Australians suffers from hearing loss. Over half the population aged between and has a hearing loss and this increases to per cent of those over the age of. The research revealed some trends, with those having hearing checks in the last three s more likely to believe they had poor hearing, whilst more affluent respondents (those who earned above $K per ) were more inclined to feel their hearing was almost perfect compared with less affluent respondents. Perceptions of own hearing by age How would you rate your own hearing? % of Respondents (n=1,) 4 39 Total (n=) Those who believe that loud noise is not damaging their hearing also felt that they had better hearing than average. This would imply either a sense of denial or lack of knowledge regarding behaviour and consequences or unawareness of one s own hearing loss. Mitchell P et al: The Prevalence, Risk Factors and Impacts of Hearing Impairment in an Older Australian Community: the Blue Mountains Hearing Study, 9 3 1 14 1 14 Almost perfect, I can hear better than most people I know Very good Good Average A little below average Well below average Behaviour directed at protecting hearing by age Which, if any, of the following do you normally do to protect your hearing? Perceptions of own hearing by age How would you rate your own hearing? % of Respondents 4 3 3 41 9 Avoid places where loud noise is present 9 Limit the time of exposure to loud noise 4 43 Limit the volume of music played through headphones 3 33 34 34 Wear hearing protection (eg ear plug, ear muffs) 1-4 (n=4) -34 (n=14) 3-44 4-4 -4 (n=1) + 13 14 9 Other things % of Respondents (n=1,) 4 1 1 4 1 3 3 4 3 1 19 1 1 1 11 3 1 3 14 13 1 9 1 1 1-4 (n=4) -34 (n=14) 3-44 Almost perfect, I can hear better than most people I know 4-4 -4 (n=1) + Very good Good Average A little below average Well below average Very poor, I can hardly hear at all 14 Is Australia Listening? australian hearing australian hearing Is Australia Listening? 1
Getting our hearing checked Attitudes to Hearing Aids % of Respondents Nearly two in three (4 per cent) Australians report they have had their hearing checked, with older Australians more likely to have had a recent check. Forty per cent of young Australians (1 to 4 olds) say they have had their hearing checked, however this figure increases with age with at least seven in Australians above the age of stating they have had their hearing checked. Most Australians have had a basic ear check at primary school, although many may have forgotten. Older Australians are also more likely to recall having had their hearing checked recently. More than one third (3 per cent) of those aged and older who have had their hearing checked have done so in the past and an additional third (31 per cent) in the past three s. Getting our hearing checked Have you ever had your hearing checked? 4 4 1-4 (n=4) Yes 43-34 (n=14) 4 No 3-44 Australians aged between 1 and 4 are most likely to have had a check within the last s, while those aged between 3 and 44 are most likely to have had their last hearing check more than s ago. Interestingly, men were more likely than women to have had their hearing checked. This is an encouraging sign, given that hearing loss is more prevalent in men mainly due to noise exposure in the workplace and during military service. Also of note is that people residing in Sydney, Perth and Tasmania were significantly less likely to have had a hearing check than in other areas. 34 4-4 -4 (n=1) 3 + Although more than half of Australians were positive about wearing a hearing aid if their hearing deteriorated, young Australians have hesitations based on notions of hearing aids being ugly and associated with a disability. Overall, per cent of Australians stated they would wear a hearing aid if their hearing deteriorated, and 41 per cent said maybe. Willingness to wear a hearing aid increased with age. When asked what words are associated with hearing aids, the leading association is positive: it improves hearing. There was an observable difference between the associations with hearing loss of younger Australians and older Australians. Younger Australians (44 s old and younger) associated hearing loss with more negative and disease related words such as deafness, hearing aids, old age and impairment compared to older Australians (4 s old plus) who discussed more specific but softer aspects such as repeating questions, social isolation and being generally hard of hearing. Notably, 1 per cent of Australians mentioned that hearing aids are discrete and unobtrusive, matching the reality of today s highly sophisticated hearing aids. As expected, fewer young people (44 per cent) were willing to consider wearing a hearing aid, and per cent said no outright. Encouragingly, those in the middle age ranges positively associated the term, hearing aids with comments on improving hearing and how they are small and discrete. Image courtesy of Siemens 1 Is Australia Listening? australian hearing australian hearing Is Australia Listening? 1
Living with hearing loss Most Australians know someone with a hearing impairment, however younger Australians are less likely to have this personal contact, and are likely to be more ignorant to how hearing impairment may affect their lives. Four in five Australians reportedly know someone who suffers from hearing loss. There is a clear link between knowing someone with hearing loss and increasing age, which is not surprising given people generally associate with similar aged peers. Two in three Australians aged 1 to 4 knew someone with a hearing impairment, and this figure rises steadily with age. In the upper bracket, 93 per cent of Australians aged plus knew someone with a hearing impairment. The impact of interacting with someone with a hearing impairment was seen as minimal. Of those Australians who reported that they suspected someone of having a hearing impairment, nearly half indicated that it causes difficulties in terms of their interaction (4 per cent). Only about one in six people indicated that the burden of hearing loss on their relationship was quite difficult. Tips for talking to someone with a hearing loss There is a misperception that hearing loss affects a person s ability to hear volume. In reality, it commonly affects the ability to discriminate one sound from another. The first sign of hearing loss due to noise exposure is difficulty hearing in noisy situations, such as the dinner table or in a crowd. Here are some tips for being understood when talking to someone who suffers from hearing loss: Don t shout, speak normally. Face the person directly. Reduce background noise. If you are not being understood, find a different way of saying the same thing. A similar trend was found when people were asked if they suspected someone they know of having a hearing impairment. Sixty-nine per cent of Australians said yes, however this was more prominent the older the respondent was. 1 Is Australia Listening? australian hearing australian hearing Is Australia Listening? 19
Who is affected by Hearing loss? Words associated with hearing aids What three words or phrases do you associate with hearing aids? Improves hearing/helpful/assisting Deaf/deafness/hearing loss/disability Old/elderly Unsightly/ugly 4 3 1 Small/discrete/unobtrusive Bulky/cumbersome/large/obtrusive Uncomfortable Whistling/feedback/static/squealing 1 11 9 Expensive/money Essential/necessary/needed/useful Ear piece/ear implant/in ear/hearing aid Batteries/battery life Annoying/nuisance/inconvenient Other 9 4 The prevalence of hearing loss increases with age and this is well known among the general population, with the elderly being identified as the highest probability group. More than half ( per cent) of the Australians surveyed thought that to 3 per cent of the population suffer from hearing impairment at some level. This is a fairly accurate assessment, with one in six (1 per cent) Australians suffering from hearing loss. Over four in five (3 per cent) Australians feel that there are segments of the community which are at a higher risk of hearing impairment or loss than others. Older Australians (aged plus) are significantly more likely to hold this opinion and are most likely to think that elderly Australians were at the highest probability. Twenty-one per cent felt that Indigenous people were a high-risk group in terms of hearing loss. This is a correct assumption although it s unclear whether respondents were aware that this is largely due to ear infections rather than noise exposure. The level of ear disease in the Aboriginal population is much higher than that of the general population. The prevalence of middle ear problems in Indigenous Australian babies aged 1-1 is somewhere between per cent and per cent. 3 Younger Australians (under 4 s old) were more inclined to think that fewer people suffered from hearing impairment, probably because they do not experience it first hand. However two in five young Australians (1 to 4 olds) felt that teenagers were likely to have a hearing impairment, though they did not think that many middle aged people have hearing loss. On a more personal level, four in five Australians know of someone with a confirmed hearing impairment and at least two in three people suspect someone as having a hearing impairment, though they did not think that many middle aged people have hearing loss. 3 Close GR, et al. Guidelines on the prevention and control of otitis media and its sequelae in Aboriginal children. Medical Journal of Australia 199; 14: supplement. Willingness to wear a hearing aid Would you consider wearing a hearing aid if your hearing deteriorates? % of Respondents 4 4 1-4 (n=4) 4 3 1 1 4 44 4-34 (n=14) 4 4 3-44 4-4 3-4 (n=1) 1 3 + Who is affected by hearing loss? Which, if any, of the following segments do you think are more likely to have hearing loss or impairment? Elderly people Teenagers 3 Young adults 34 Middle aged people 31 Youth Low income earners 3 Indigenous or aboriginal people 1 Average income earners 9 Children 9 Babies Yes Maybe No People from non-english speaking backgrounds High income earners People from English speaking backgrounds None of these 4 4 4 % of Respondents (n=1,) Is Australia Listening? australian hearing australian hearing Is Australia Listening? 1
Looking ahead Realistically, changing the long-term impact on young peoples hearing appears to involve several aspects. Education: Bring to light the permanency and reality of prolonged exposure to loud noise including music at indoor venues, concerts and through headphones. Increasing the awareness of the short and long term effects and providing realistic options to protecting their hearing may go a long way to improving healthy hearing behaviour. Top-of-mind: Bring the issue of hearing to top of mind for young Australians in the same way sun-smart and road driving behaviours have targeted youth attitudes and behaviours by presenting them as current and relevant issues. Tips for taking care of your hearing Listen to your MP3 player at a volume where you can hear someone who is at arm s length without him or her having to shout. Limit the amount of time you are exposed to very loud noise. Take time out periodically from noisy concerts or clubs. Wear ear plugs or muffs if you are exposed to loud machinery or industrial noise (such as mowing the lawn). Learn to fit ear plugs properly. Industry: Educate venue operators of the risks of high-volume noise in enclosed areas and attempt to change industry behaviours, as well as consumer behaviour for healthy hearing. Young people will always go out. Providing more realistic options with less excessive noise may provide positive change. While the ageing population is more acutely aware of hearing loss and its impact on life, there are opportunities to better educate the older community about hearing services and solutions to hearing problems. Our advice to people aged s and older is to get your hearing checked every two s. There are also long-term benefits to dealing with hearing loss early and wearing hearing aids at the outset. Is Australia Listening? australian hearing Image courtesy of Siemens australian hearing Is Australia Listening? 3
about Australian Hearing Australian Hearing is a federal government agency with 94 hearing centres and 4 visiting sites around the country. Our services include assessing hearing, fitting hearing devices and providing counselling and rehabilitation programs to help eligible clients manage their hearing impairment. Australian Hearing s clients are at both ends of the age spectrum, including young adults under the age of 1, aged pensioners, Veterans and Indigenous people aged over. Australian Hearing provides the best hearing care, the latest hearing aid technology and leads the world in hearing research. Check your hearing over the telephone You can check your hearing over the telephone in around five minutes. Based on extensive research, Telscreen has been developed by the National Acoustic Laboratories in conjunction with Australian Hearing and is the most advanced telephone hearing service in the world. Call 1 toll-free and follow the voice prompts. Contact us Call 131 9 to be connected to your nearest Australian Hearing centre. For media enquiries call 941. Supported by