People might laugh about tinnitus, but ‘the next time you go out could have major consequences for the rest of your life’, warns economics student Maurits. Maurits (his last name is known to the editors) suffers from tinnitus. It affects him 24/7. “I always hear a very high-pitched beep. It affects me particularly when it’s completely quiet at home, when I go to sleep, when I’ve been drinking and when I’m stressed.”
Quarter of young people
Tinnitus, which is often explained as a constant ringing in the ears, can be caused by prolonged exposure to excessively loud noise. Protecting your ears with party plugs when you go out may feel strange, until the worst happens and the ringing in your ears never goes away. Maurits feels that the risks are not yet getting through to the people around him.
3 March is World Hearing Day. The World Health Organization (WHO) organises this annual international day to raise awareness about hearing loss and deafness.
A total of two million people in the Netherlands are affected by tinnitus. A quarter of young Dutch people between the ages of 12 and 25 probably have hearing damage, concluded researchers at the Amsterdam Academic Medical Center in 2015 based on online self-tests. This number has increased in recent years due to our use of headphones and earphones, but also due to excessively loud music at nightlife venues. Experts fear a significant increase in the number of tinnitus patients in the coming years.
It might seem embarrassing to put in those earplugs or suggest that your group of friends might move a bit further away from the speakers. But Kimberley Boutkan (24, Health Economics, Policy & Law) isn’t embarrassed about it. She partly considers the subject important because her brother suffers from hearing damage. Kimberley: “I don’t care what other people think, this is my health we’re talking about. So when I go out, which doesn’t happen very often, I always wear earplugs to protect my hearing.”
Catering and entertainment venues play a major role in the increasing tinnitus problem. The WHO recommends a maximum volume of 100 dB, but this has not been incorporated into Dutch law. However, an RIVM guideline specifies that clubs are allowed to produce a noise level of 103 decibel. A 3 decibel might not seem to make a big difference. However, an increase of 3 decibel equals a doubling of the noise level.
Strict agreements between employers and employees do exist, for example to protect catering staff. According to the Working Conditions Act, employees must wear hearing protection from 85 decibel upwards.
An EUR student who works at a bar in the Oude Haven (his name and employer are known to the editors) says that this does not happen everywhere in practice. “My CLA and contract state that the company must provide their employees with earplugs. Unfortunately, this is not the case in practice. Earplugs have only recently been provided in the office for staff, but these are of poor quality which makes it very difficult to work while wearing them. As a result, most of my colleagues have now bought earplugs themselves. At one point the intention was to provide everyone with custom earplugs, but the owner doesn’t want to spend money on them.” When it comes to guests, the policy is that ‘it’s everyone’s own responsibility to provide hearing protection’.
Bass in the chest
You may be wondering why the music has to be so loud in the first place. This is often what partygoers themselves want. For example, history student Mikki van Spall (23) says: “The most annoying thing is really when you’re in a club and the volume of the music is too low.” People want to feel the bass in their chest, and in a club you don’t want to hear each other singing along out of tune.
Restaurant owner Jesse Pronk (37) has tinnitus himself. As the owner of the Colorado Charlie venue in Scheveningen, a beach club that is popular among Rotterdam students in summer, he is a ‘provider’ of loud music. He says: “I also have tinnitus myself, I’ve had it for ten years now.” The question is exactly where the responsibility lies: with the government, the entertainment venues or the music lovers themselves. Something that Pronk does notice: “The diehards head straight to the front. And yes, the volume is louder on the dance floor.”
What does Pronk do to prevent hearing damage among his audience? “We offer disposable earplugs for 1 euro and are working on a new sound system that will spread the volume more evenly across the room.”
Professor of Neurophysiology Gerard Borst is conducting research into tinnitus at the Erasmus MC. He is investigating whether people with tinnitus have more difficulty hearing as a result of their tinnitus. He explains that there are two types of tinnitus: “Objective tinnitus is rare; in this case, the sound can also be heard by others and is caused by noises produced by blood vessels or tiny vibrating bones in your ear, for example. Subjective tinnitus is produced in the brain. This variant is much more common.”
So what is subjective tinnitus exactly? “The nerve cells in your brain that are involved in processing sound exhibit abnormal firing behaviour, also in the absence of sound. Most people who have tinnitus for several months never get rid of it after that. Stress can worsen the burden of tinnitus symptoms.”
“There is a link between hearing impairment and tinnitus. You can get tinnitus from music that is too loud, but you can also get tinnitus without having hearing damage. The exact causes of tinnitus are not well known at this point.” For the time being, Borst advises people to stay away from loud music. Or else to protect their hearing and thus prevent hearing loss and reduce the likelihood of tinnitus developing in the first place.
Our hearing plays quite an important role in our well-being. Many people with tinnitus experience psychosocial problems. “When you consider that tinnitus can lead to suicidal thoughts, I’m managing pretty well”, says economics student Maurits. Although there is no cure for tinnitus, there are treatments that can alleviate the symptoms. Prevention and information are crucial.
Thankfully, Maurits believes the topic is being discussed more and more frequently these days, in the media but also among students. “I think many people are well aware that tinnitus can really affect your quality of life, but they’re too frivolous with the risk. That’s why it’s important for them to be well informed about this issue.” Tinnitus is easy to prevent, but you need to be aware of it in good time.