Hearing loss: what causes it and when to act quickly

When sound waves enter the outer ear, they travel through the ear canal and cause the eardrum and tiny bones (hammer, anvil and stirrup) in the middle ear to vibrate. Vibrations travel to fluid in the cochlea where microscopic hairs send nerve signals to the brain where sound is understood. If any of these parts are damaged, or pathways blocked, it can cause hearing loss. We look at common causes of hearing loss, many of them preventable.

Posted Tuesday September 27, 2022

Act quickly if ...

But first, let's talk about sudden hearing loss. It occurs suddenly and without explanation, and is a medical emergency; you should see a doctor immediately. It may be instant or progress over a few days, and may affect only one ear. Symptoms can also include a feeling of ear fullness, dizziness and ringing in your ears. If this happens don't put off seeing a doctor because you think it’s sinuses, or an allergy, or earwax, it may be a warning that something is seriously wrong with the inner ear. Delaying diagnosis can decrease the effectiveness of treatment and lessen the chance of recovering your hearing.

Noisy workplaces and leisure activities

A quarter of the workforce is employed in noisy industries: manufacturing, agriculture and mining. And 13–17% of hearing loss is caused by working in these environments.[1] Noisy weekend chores and leisure activities can also damage hearing over time; such things as leaf blowers and chain saws, mowers and motorcycles, power tools and guns. To protect your hearing wear earplugs or ear protectors that fit over your ear, and when at work, avoid or take regular breaks from noisy activities if you can.

Trauma and pressure changes

A blow to your head can dislocate middle-ear bones and cause nerve damage and hearing loss.[2] You can also rupture your eardrum by sticking cotton buds or other objects into your ear; it’s a bad idea, don’t do it. Loud, sudden noises, such as firecrackers, gunshots or other explosions, can rupture your eardrum or damage the inner ear. Sudden changes in air pressure from flying or scuba diving can damage the eardrum, middle ear, or inner ear. Eardrums usually heal in a few weeks, but if seriously damaged you may need surgery.


Hearing loss is a potential side effect of some medicines, including some antibiotics and cancer drugs. Regular use of aspirin, NSAIDs, and paracetamol can also increase the risk of hearing loss. In most cases, side effects go away when you stop taking the medication, and your medical team may monitor your hearing during treatment, but sometimes hearing loss may be permanent.[3]

Chronic disease

Some chronic diseases, such as heart disease, stroke, high blood pressure and diabetes, can harm the inner ear by interrupting blood flow, and autoimmune diseases such as rheumatoid arthritis have been linked to some forms of hearing loss.[4]

Tumours or growths

Non-cancerous growths can block the ear canal and cause hearing loss, sometimes removing them can restore hearing. Acoustic neuroma, an inner ear tumour that grows on the hearing and balance nerve in the inner ear, will cause balance problems, facial numbness and tinnitus. Treatment can sometimes help preserve some hearing.

Concerts and tinnitus

The ringing in your ears after a loud concert is tinnitus. Tinnitus can last for hours, days, weeks, or be permanent. Whereas normal conversation registers at 60 decibels, the average rock concert at 110 decibels is loud enough to cause permanent damage after 15 minutes. Your hearing can be damaged with extended exposure of any noise over 85 decibels. To prevent damage, use earplugs and limit your exposure.

Headphones and earbuds

If others can hear the music you’re listening to through earphones, turn down the volume. Headphones and earbuds can cause temporary or permanent hearing changes, and the louder the volume and the longer the listening time, the greater your risk. For safe listening, decrease the volume and limit your listening time.


Earwax protects the ear canal against dirt and bacteria, but it can build up and harden, which will affect hearing. It may give you an earache or make you feel that your ear is clogged. If you think you have an earwax blockage don't try removing the wax with a cotton bud or inserting anything else into your ear canal. Your ear nurse or doctor can do it quickly and safely.

Childhood illness

Diseases known to affect children’s hearing include chickenpox, encephalitis, influenza, measles, meningitis and mumps. Vaccines can protect your children from several of these diseases. Ear infections can fill the middle ear with fluid and cause temporary hearing loss that usually clears when the infection and fluid are gone. If you think your child has a middle ear infection go see a doctor as the symptoms are similar to many other infections that may lead to permanent hearing loss.

Hearing loss at birth

Some children are born with congenital hearing loss, which often runs in families, but can also occur if the mother is diabetic or had an infection while pregnant. Premature babies or babies that are oxygen-deprived during birth can also develop hearing loss. Neonatal jaundice may also be responsible for some cases of neonatal hearing loss.[5]


Even if you protect your ears throughout your life, hearing loss occurs as you get older. Age-related hearing loss is caused by the progressive loss of inner-ear hair cells. You can’t prevent this, but there are many ways we can help you hear better.

[1] Listen Hear! New Zealand: Social and economic costs of hearing loss in New Zealand. A report by Deloitte Access Economics Pty Ltd. February 2017.

[2] https://www.ncbi.nlm.nih.gov/pubmed/1078976

[3] https://www.arthritis.org/living-with-arthritis/treatments/medication/drug-types/analgesics/pain-drugs-hearing-loss-men.php

[4] https://www.arthritis.org/living-with-arthritis/comorbidities/hearing-loss/cause-of-hearing-loss.php

[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6064763/


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