World Hearing Day, celebrated today!
Purpose behind the campaign
World Hearing Day is a campaign held each year by Office of Prevention of Blindness and Deafness of the World Health Organization (WHO). Activities take place across the globe and an event is hosted at the World Health Organization on March 3rd. The campaign's objectives are to share information and promote actions towards the prevention of hearing loss and improved hearing care. The first event was held in 2007.[1] Before 2016 it was known as International Ear Care Day.[2] Each year, the WHO selects a theme, develops educational materials, and makes these freely available in several languages. It also coordinates and reports on events around the globe.
2020 World Hearing Day theme
The theme of the campaign for 2020 is "Hearing for Life. Don't let hearing loss limit you".[3] The selection of the theme by the World Health Organization expresses the key message that timely and effective interventions can ensure that people with hearing loss are able to achieve their full potential. It recognizes that, at all life stages, communication and good hearing health connect us to each other, our communities, and the world. It highlights that appropriate and timely interventions can facilitate access to education, employment and communication. Regrettably, across the globe, ear and hearing care are insufficient, and the WHO argues that all public health systems should include ear and hearing care.
Deafness and Hearing Loss
Key facts
- Around 466 million people worldwide have disabling hearing loss (4), and 34 million of these are children.
- It is estimated that by 2050 over 900 million people will have disabling hearing loss.
- Hearing loss may result from genetic causes, complications at birth, certain infectious diseases, chronic ear infections, the use of particular drugs, exposure to excessive noise, and ageing.
- 60% of childhood hearing loss is due to preventable causes.
- 1.1 billion young people (aged between 12–35 years) are at risk of hearing loss due to exposure to noise in recreational settings.
- Unaddressed hearing loss poses an annual global cost of US$ 750 billion. Interventions to prevent, identify and address hearing loss are cost-effective and can bring great benefit to individuals.
- People with hearing loss benefit from early identification; use of hearing aids, cochlear implants and other assistive devices; captioning and sign language; and other forms of educational and social support.
Over 5% of the world’s population – or 466 million people – has disabling hearing loss (432 million adults and 34 million children). It is estimated that by 2050 over 900 million people – or one in every ten people – will have disabling hearing loss.
Disabling hearing loss refers to hearing loss greater than 40 decibels (dB) in the better hearing ear in adults and a hearing loss greater than 30 dB in the better hearing ear in children. The majority of people with disabling hearing loss live in low- and middle-income countries.
Approximately one third of people over 65 years of age are affected by disabling hearing loss. The prevalence in this age group is greatest in South Asia, Asia Pacific and sub-Saharan Africa.
Causes of Hearing loss and Deafness
The causes of hearing loss and deafness can be congenital or acquired.
Congenital causes
Congenital causes may lead to hearing loss being present at or acquired soon after birth. Hearing loss can be caused by hereditary and non-hereditary genetic factors or by certain complications during pregnancy and childbirth, including:
- maternal rubella, syphilis or certain other infections during pregnancy;
- low birth weight;
- birth asphyxia (a lack of oxygen at the time of birth);
- inappropriate use of particular drugs during pregnancy, such as aminoglycosides, cytotoxic drugs, antimalarial drugs, and diuretics;
- severe jaundice in the neonatal period, which can damage the hearing nerve in a newborn infant.
Acquired causes
Acquired causes may lead to hearing loss at any age, such as:
- infectious diseases including meningitis, measles and mumps;
- chronic ear infections;
- collection of fluid in the ear (otitis media);
- use of certain medicines, such as those used in the treatment of neonatal infections, malaria, drug-resistant tuberculosis, and cancers;
- injury to the head or ear;
- excessive noise, including occupational noise such as that from machinery and explosions;
- recreational exposure to loud sounds such as that from use of personal audio devices at high volumes and for prolonged periods of time and regular attendance at concerts, nightclubs, bars and sporting events;
- ageing, in particular due to degeneration of sensory cells; and
- wax or foreign bodies blocking the ear canal.
Among children, chronic otitis media is a common cause of hearing loss.
Prevention
Overall, it is suggested that half of all cases of hearing loss can be prevented through public health measures.
In children under 15 years of age, 60% of hearing loss is attributable to preventable causes. This figure is higher in low- and middle-income countries (75%) as compared to high-income countries (49%). Overall, preventable causes of childhood hearing loss include:
- Infections such as mumps, measles, rubella, meningitis, cytomegalovirus infections, and chronic otitis media (31%).
- Complications at the time of birth, such as birth asphyxia, low birth weight, prematurity, and jaundice (17%).
- Use of ototoxic medicines in expecting mothers and babies (4%).
- Others (8%)
Some simple strategies for prevention of hearing loss include:
- immunizing children against childhood diseases, including measles, meningitis, rubella and mumps;
- immunizing adolescent girls and women of reproductive age against rubella before pregnancy;
- preventing cytomegalovirus infections in expectant mothers through good hygiene; screening for and treating syphilis and other infections in pregnant women;
- strengthening maternal and child health programmes, including promotion of safe childbirth;
- 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.
- screening of children for otitis media, followed by appropriate medical or surgical interventions;
- avoiding the use of particular drugs which may be harmful to hearing, unless prescribed and monitored by a qualified physician;
- referring infants at high risk, such as those with a family history of deafness or those born with low birth weight, birth asphyxia, jaundice or meningitis, for early assessment of hearing, to ensure prompt diagnosis and appropriate management, as required;
- implementing the WHO-ITU global standard for personal audio systems and devices. This can be done by governments and manufacturers of smartphones and MP3 players. If adhered to, the standard could help prevent hearing loss due to listening practices that are harmful to hearing; and
- educating young people and population in general on hearing loss, its causes, prevention and identification.
Identification and Management
Early detection and intervention are crucial to minimizing the impact of hearing loss on a child’s development and educational achievements. In infants and young children with hearing loss, early identification and management through infant hearing screening programmes can improve the linguistic and educational outcomes for the child. Children with deafness should be given the opportunity to learn sign language along with their families.
Pre-school, school and occupational screening for ear diseases and hearing loss is an effective tool for early identification and management of 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.
People with hearing loss can benefit from the use of hearing devices, such as hearing aids, cochlear implants, and other assistive devices. They may also benefit from speech therapy, aural rehabilitation and other related services. However, global production of hearing aids meets less than 10% of 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.
Making properly-fitted, affordable hearing aids and cochlear implants and providing accessible follow-up services in all parts of the world will benefit many people with hearing loss.
People who develop hearing loss can learn to communicate through development of lip-reading skills, use of written or printed text, and sign language. Teaching in sign language will benefit children with hearing loss, while provision of captioning and sign language interpretation on television will facilitate access to information.
Officially recognizing national sign languages and increasing the availability of sign language interpreters are important actions to improve access to sign language services. Encouraging organizations of people with hearing loss, parents and family support groups; and strengthening human rights legislation can also help ensure better inclusion for people with hearing loss.
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