Editor's note:  

Ma Fengjie, holding an M.D.(Doctor of Medicine) degree, is a deputy chief physician and chief examining physician at the Institute of Civil Aviation Aircrew Medical Assessment, Civil Aviation Medicine Center of Civil Aviation Administration of China. He is also a member of the Otorhinolaryngology Group of the Civil Aviation Aircrew Examination and Assessment Expert Committee. His expertise lies in the diagnosis and differential diagnosis of ear diseases and hearing-related disorders.

In a world where cities are expanding, transportation is intensifying, and personal audio devices are used daily, the soundscape around us is becoming significantly louder. Amid these changes, hearing – one of our most essential senses for communication, learning and emotional connection – often receives less attention than vision, heart health, or mental well-being. Yet according to the World Health Organization (WHO), over 1 billion young people are now at risk of noise-induced hearing loss (NIHL), largely due to unsafe listening habits and constant exposure to environmental noise. Unlike many health conditions, NIHL is entirely preventable, but once it develops, the damage is usually irreversible.

Hearing loss is not simply an ear problem; it is a whole-body health issue that affects cognitive function, mental health, independence and overall quality of life. As scientific evidence grows, protecting hearing has become an essential part of maintaining long-term wellness.

Why hearing health matters more than ever

Modern research highlights hearing as a critical factor influencing broader health outcomes. The inner ear contains thousands of tiny sensory hair cells that convert sound vibrations into signals for the brain. These fragile cells do not regenerate. Once damaged – from loud noise, aging, or disease – the result is permanent hearing loss.

Recent studies illustrate why hearing protection is increasingly urgent:

• Hearing loss impacts brain health

The landmark ACHIEVE Study (2023), involving nearly 1,000 older adults, found that untreated hearing loss is linked to faster cognitive decline. Participants who received hearing interventions showed significant improvements in cognitive trajectories, suggesting that protecting hearing may also help protect memory.

• It increases the risk of dementia

A major review published in JAMA Neurology found that hearing loss is one of the most important modifiable risk factors for dementia.

• It affects mental and emotional well-being

People with hearing loss face higher rates of depression, anxiety and social withdrawal, as well as fatigue from straining to listen.

• It reduces communication and social engagement

Subtle hearing changes can make group conversations difficult, leading many people – especially older adults – to avoid social activities. Over time, this isolation impacts overall health.

• It increases the risk of injuries

Hearing loss reduces awareness of environmental cues, increasing the risk of falls, road accidents, and difficulty recognizing alarms.

Hearing is therefore not only about sound – it is connected to brain function, psychological health and safety.

How loud is too loud? Understanding daily sound exposure

Sound intensity is measured in decibels (dB), and risk increases sharply above 85 dB. Many everyday environments already exceed safe levels:

Quiet office: 40-50 dB

Normal conversation: 60 dB

Heavy traffic: 80-90 dB

School gym / fitness studio: 90-100 dB

Motorcycle: 95 dB

Headphones at max volume: 100-110 dB

Concerts & nightclubs: 110-120+ dB

Fireworks: 140 dB

A useful rule of thumb

If you need to raise your voice to speak to someone at arm's length, the noise is likely harmful.

Even moderate but continuous noise – such as traffic, household appliances, or busy workplaces – can contribute to cumulative hearing fatigue.

Lifestyle-centered strategies to protect your hearing

Hearing protection does not require major lifestyle changes. Instead, small daily habits can significantly reduce long-term risks.

1. Practice safe listening with personal audio devices

Headphones are now a major contributor to preventable hearing loss. 

Science-based safe listening recommendations include:

• The 60/60 rule: Listen at no more than 60% of maximum volume for no more than 60 minutes at a time.

• Use noise-canceling headphones: These reduce background noise, preventing the need to increase the volume.

• Choose over-ear designs: They reduce direct pressure on the ear canal.

• Avoid max volume: If someone next to you can hear your music, it is too loud.

WHO guidelines state that listening above 100 dB (comparable to many headphone settings) for more than 15 minutes can be harmful.

2. Create a hearing-friendly home and workspace

Noise exposure does not only come from concerts or machinery; chronic low-grade noise also damages hearing over time.

Practical steps include:

• Choose quiet appliances with certified noise ratings.

• Use curtains, carpets, or wall panels to absorb sound.

• Keep windows closed during high-traffic hours.

• Use soft background sounds (white noise or nature sounds) instead of a loud television.

• Designate a daily "quiet hour" to allow auditory recovery.

These adjustments improve both hearing and overall relaxation. 

3. Use hearing protection in loud environments

Earplugs and earmuffs can reduce sound by 20-35 dB, dramatically lowering risk.

They are essential during:

- Concerts, bars, clubs

- Sports arenas

- Air travel

- Construction work

- Motorcycling

- Using power tools or lawn equipment

Modern high-fidelity earplugs preserve sound quality while reducing volume – ideal for musicians and concertgoers.

4. Give your ears regular rest

After noisy activities, the ears need several hours of quiet time to recover.

Symptoms such as ringing, muffled hearing, or sensitivity indicate a temporary threshold shift, which may become permanent with repeated exposure.

Even 10–15 minutes of quiet can begin restoring auditory function.

5. Schedule regular hearing checkups

Despite its importance, hearing is rarely tested until problems are obvious.

Experts recommend:

• A baseline test for adults

• Testing every 2-3 years

• Annual screening for older adults or high-risk occupations

• Early intervention – including hearing aids when needed – supports communication, mental health and cognitive function.

6. Support hearing through a healthy lifestyle

Hearing depends on blood flow, nerve health and metabolic balance.

Evidence-based habits that protect long-term hearing include:

• Regular cardiovascular exercise

• A diet rich in omega-3 fatty acids, leafy vegetables, folate and antioxidants

• Managing blood pressure, cholesterol and blood sugar

• Avoiding smoking, which reduces oxygen supply to the inner ear

Healthy living strengthens the auditory system and slows age-related decline.

Towards a quieter and healthier future

As global soundscapes grow louder, hearing protection has become a vital part of everyday health. The science is clear – simple lifestyle choices can significantly reduce risk, improving not only hearing but also overall brain, emotional and physical well-being.

By practicing safe listening, creating quieter environments and embracing a health-oriented lifestyle, individuals and communities can protect one of the most precious senses that connects us to one another– and to the world around us.

China's National Health Commission previously issued guidelines to advance ear and hearing health initiatives, aiming to achieve the following goals by 2030:

• Increase the number of licensed (assistant) physicians in otorhinolaryngology to 4.2 per 100,000 population, and establish ENT (Ear, Nose and Throat) departments in over 95% of county-level general hospitals.

• Achieve a newborn hearing impairment screening rate of over 90%, and ensure that over 85% of workplace noise-exposed positions meet monitoring compliance standards. 

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