Preventing Hearing Injuries in Children:

Tips to help children take care of their ears

by Daniel Sean Kaye

Many of today’s toys make noise. Beyond the sirens and whistles, there are beeps, automated voices, and the normal rumblings of battery-powered motors. While many of the sounds are nothing more than annoying to adults—and not even noticed by children—there is a great deal of concern regarding the long-ranging health impact of loud toys. The National Institute on Deafness and Other Communications Disorders says 10 million Americans have suffered irreversible noise induced hearing loss, and 30 million more are exposed to dangerous noise levels each day.

The issue on children’s hearing—and the detrimental impact of toys—is one of the focal points of “Trouble in Toyland: The U.S. PIRG Education Fund’s 22nd Annual Survey of Toy Safety.” According to the report, nearly 15 percent of children ages 6 to 17 show signs of hearing loss, and noise-induced hearing loss can be caused by a one-time exposure as well as repeated exposure over time.

Further, the report states, children are especially vulnerable to noise-induced hearing loss, which often happens gradually from overexposure to loud noises. It says that the Occupational Safety and Health Administration (OSHA) reports that prolonged exposure to sounds at 85 decibels (dB) or higher can result in hearing damage, and that the American Academy of Pediatrics (AAP) and the National Campaign for Hearing Health use 85 decibels as a benchmark for when noise damage begins.

Overexposure to loud noise can result in sounds becoming distorted or muffled as well as a difficulty understanding speech. Even minor hearing loss in children can impact speech and language comprehension.

In November 2003, the American Society for Testing and Materials (ASTM) offered new specifications to prevent hearing damage. While these newer standards are better than the ones they replaced, the PIRG report says that they may not be sufficient. This is due to the fact that “exposure to sounds at 85 to 90 decibels over two hours and sounds at 120 decibels over just 30 seconds can cause hearing loss.” Also, the standards are voluntary, not mandatory for toy manufacturers, and are based on “peak sound pressure levels” measured at a distance too far away from a child’s ear (children often play with toys at a much closer distance, including holding a toy right next to their ears).

In the report, PIRG measured the loudness of several toys, taking the readings from various distances to determine the exposure to range of noise levels that children experience. They found that some toys exceed 100 decibels when measured at close range and that many other toys exceeded ASTM standards for appropriately loud toys. The full detailed findings are included in the report.

“A Guide To Your Child’s Hearing,” by Dr. Judith Gravel, Children’s Hospital of Philadelphia, Philadelphia, Pa., also delves into this subject matter. Gravel says that parents should be alert to signals of hearing loss, such as situations where the child doesn’t respond to sound appropriately. And while it may be difficult to detect mild forms of hearing loss (such as hearing loss in just one ear), even mild hearing loss can “negatively impact a child’s ability to learn,” explains Gravel. They may have difficulty in school, or have attention, behavioral, or social problems.

Excessive exposure to loud sounds is the most common (and preventable) causes of permanent hearing according to Gravel’s report. High noise levels first cause temporary and then permanent damage to the sensory hair cells within the cochlea, she writes. And while noises produced by subways, trains, airplanes, snowmobiles, and the like, as well as home appliances (stereo music equipment, power tools, lawn maintenance equipment, hair dryers, etc.) can cause damage, some toys produce “intense sound” also.

Children inserting small objects in their ears (beads, food, and small pieces of toys) is another concern when it comes to hearing issues, writes Gravel. Sound can be impeded or an eardrum ruptured, and the ear canal may become inflamed if the surface lining is damaged by the object.

Here are some common hearing loss warning signs, courtesy of Gravel’s report:

• The child may not be responding to someone talking out-of-view.
• The child may display a surprised look when his name is called at a normal or even fairly loud level.
• There may be excessive use of “what?” or “huh?”
• The child may be intently watching the faces of those who are talking.
• The child may have difficulty understanding speech in background noise.
• The child may sit close to the TV when the volume is adequate for others, or increase the TV or stereo/tape/CD player volume to unreasonably loud levels.
• He/she may not respond to voices over the telephone or may switch ears continually when the phone is utilized.
• He/she may not be startled by intense sounds and may not be able to locate the source of a sound accurately.

To protect children from loud toys, PIRG suggests:
• If a toy seems too loud for you, then it is probably too loud for your child.
• Put tape over the speakers of any toys you already own that are too loud or remove the batteries.
• Report a loud toy to the CPSC.

Gravel says for parents to monitor noise levels. “If speech must be raised (shouted) to communicate, it is very likely that the noise is excessive and possibly damaging,” she writes. “Ringing in the ears (tinnitus) after noise exposure also indicates excessive sound levels. Children should be told about the dangers of noise exposure and the use of ear protection (earplugs, ear muffs, etc.),” when appropriate.

According to Gravel, parents must set a good example for their child. She recommends using hearing protection when mowing the lawn or using noisy tools or appliances, and have the child playing nearby do the same. “If hearing and the use of hearing protection are important to you, it will be important to your child as well,” writes Gravel.