Deafness and hearing loss toolkit
Guidance for GPs on the care of patients dealing with deafness and hearing loss.
Hearing Loss, a Global Problem
Around 466 million people worldwide (over 5% of the world’s population) have disabling hearing loss and 34 million of these are children. Disabling hearing loss refers to hearing loss greater than 40dB in the better hearing ear in adults and a hearing loss greater than 30dB in the better hearing ear in children.1
Disabling hearing loss is unequally distributed across the world with the low- and middle-income countries affected the most. The greatest burden of disabling hearing loss is in the Asia-Pacific area, southern Asia, and sub-Saharan Africa.2
It is estimated that by 2050 over 900 million people will have disabling hearing loss across the globe. Unaddressed hearing loss poses an annual global cost of US $750 billion. This includes health sector costs (excluding the cost of hearing devices), costs of educational support, loss of productivity, and societal costs.1
Hearing loss has been ranked as the fifth leading cause of years lived with disability in the Global Burden of Disease Study 2013, higher than many other chronic diseases such as diabetes, dementia, and chronic obstructive pulmonary disease. However, hearing loss receives limited research funding, public awareness and is presented as a silent epidemic. Global multidisciplinary and collaborative efforts are urgently needed to address the health needs of the child and adult with hearing loss.2
Interventions to prevent, identify and address hearing loss are cost-effective and can bring great benefit to individuals. Despite the fact that hearing loss can be prevented and treated, many people with hearing loss in both resource-poor and high-income settings do not seek or receive hearing health care, and the current production of hearing aids meets less than 10% of the global need and less than 3% of developing countries’ needs. The lack of availability of services for fitting and maintaining these devices, and the lack of batteries are also barriers in many low-income settings.2
In developing countries, children with hearing loss and deafness rarely receive any schooling. Improving access to education and vocational rehabilitation services and raising awareness especially among employers about the needs of people with hearing loss, will decrease unemployment rates for people with hearing loss.
Screening can be done using the hearWHO app. This app can be downloaded and used by adults to check and track their hearing regularly. It can also be used by health workers to screen people in the community with a view to referring them for hearing testing, when indicated.
The World Health Organisation (WHO) suggests that half of all cases of hearing loss can be prevented through public health measures. Some simple strategies for prevention of hearing loss include immunisation, avoiding the use of ototoxic drugs, early identification and intervention for both acute and chronic ear conditions, following healthy ear care practices, reducing exposure (both occupational and recreational) to loud sounds by raising awareness about the risks, developing and enforcing relevant legislation and encouraging individuals to use personal protective devices such as earplugs and noise-cancelling earphones and headphones.1
Educating young people and population in general on hearing loss, its causes, prevention and identification is essential. WHO suggests governments and manufacturers of smartphones and MP3 players to implement the WHO-ITU global standard for personal audio systems and devices.
If adhered to, the standard could help prevent hearing loss due to listening practices that are harmful to hearing. In 2017, the 70th World Health Assembly adopted a resolution on the prevention of deafness and hearing loss. This resolution calls upon Member States to integrate strategies for ear and hearing care within the framework of their primary health care systems, under the umbrella of universal health coverage. It also requests WHO to undertake a number of actions for promotion of ear and hearing care at global level.
A few actions WHO have already undertaken include:
- promoting safe listening to reduce the risk of recreational noise-induced hearing loss through the WHO Make Listening Safe initiative
- launching and hosting the World Hearing Forum, which is a global advocacy alliance of all stakeholders in the field of hearing.
- launching and promoting the WHO-ITU global standard for personal audio systems and devices;
- promoting World Hearing Day as an annual advocacy event;
- providing technical support to Member States in development and implementation of national plans for hearing care