Most men think that noise is just part of life. We generally like it, it makes us feel connected to activities, it is a stimulant at times, and most importantly it is associated with many of the things we like to do. The roar of a hot rod, the feel of music from a car stereo, the concerts, the motorcycles, the guns, the sound of a jet, electric guitar playing, banging on the drums, the gigs at the local club, working in the garage, and many more great experiences are enhanced by noise.

Men, unlike women, are typically exposed to a variety of noises over time and are more likely to have noise induced hearing loss (NIHL). As I look back at all the years I have been seeing patients with this type of loss, I find that almost all of them were men. Noise is so prevalent in our society that …”ten percent of Americans between ages 20 and 69—or 22 million Americans—already may have suffered permanent damage to their hearing from excessive noise exposure” (National Institute on Deafness and Other Communicative Disorders). What is even more remarkable is the fact that almost all hearing loss from noise is preventable with a little bit of knowledge and the correct ear protection.

National associations such as the National Hearing Conservation Association and the Hearing, Education, and Awareness for Rockers (H.E.A.R.) association are involved with musicians and their need for hearing protection on stage, during practice sessions, and at home; however, it not only musicians that need to careful, the audience is also at risk. The biggest issues for concert goers is the loudness of the sound amplification system, their position and distance to the speakers, and recognizing that hearing protection can prevent the ears from being damaged. The biggest issue with ear protection is the type and most critical, the fit of the ear plug deep into the canal. There are two different types that can work, one is over-the-counter and the other is a custom set of ear molds used by musicians.

Rock concerts can produce noise levels in excess of 120 dBA. Since the human ear can be damage by repeat exposures at this intensity in as little as 7.5 minutes, some type of hearing protection is needed. Your first clue to over exposure is ringing in the ears and muffled hearing during or after the concert. Although a single exposure may not appear to cause any hearing loss, some micro-damage to the tinny nerve cells of the inner ear almost always occurs and prolonged exposure can change the nerve cells in the hearing nerve and brainstem. Repeating the exposure eventually damages enough of these cells to cause a permanent and noticeable hearing loss.

At many Fortune 500 companies, the standard E.A.R. foam plugs by 3M that are yellow in color and look like a miniature 55 gallon drum have been a standard in industry.  It is flat on either side and for most exposures will do the job when rolled up correctly and inserted deep into the ear canal. For smaller ears, tapered soft foam ear plugs are also an option for comfort and protection.  The important issue with ear plugs is to achieve a deep ear canal fitting whenever possible.  In some ear canals, however, a good fit is impossible and hearing loss ensues unless custom hearing protection is made by an Audiologist.  These are found in most pharmacies and are good for industrial and home shop noise.  The ear plugs may have a noise reduction rating (NRR) of 26dB, but don’t be fooled, most ear protection of this type produces less than half of that in the real world.  Whenever possible, I insist on the use of ear muffs that cover the entire ear and provide a consistent degree of noise reduction approaching 20 dB because they do not have to be fitted into the ear canal.  For music lovers, listening to live rock music, these standard plugs filter down the high tones too much and the sound quality is muffled and a special musician’s ear plug is recommended.  An over-the-counter disposable plug that does not do this unnatural filtering can be found at and is called the ER-20. Just like its custom relatives, the ER-20 gives a smooth and even noise reduction response across all frequencies leaving sound natural from the low to high frequencies.  I also make custom sets for musicians and frequent flyer’s to reduce loudness while maintaining clarity of music and speech. These use interchangeable filters reducing sound 9 to 25 dB (ER-9, ER-15, or ER-25). Those that are repeat concert goers would get great protection without muffled sound from these special filter systems and they are comfortable.

The bottom line is to understand that noise causes hearing loss, some people are more susceptible than others to acquiring hearing loss from noise, and men are most venerable because we like it, “noise.”