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Promoting Hearing Health in Schools

The following are some steps schools can take to prevent noise-induced hearing loss, by limiting exposure to excessive noise on school property, screening for existing noise-induced hearing loss, and teaching students how to protect their hearing.

Establish Policies That Promote the Hearing Health of Students and Staff

School districts can adopt policies and procedures to minimize excessive noise during the school day and protect the hearing of their students and staff. For example, schools can

Eliminate or reduce construction and maintenance activities during school hours
Set noise level standards for events such as school dances
Ensure that hearing protection devices are available to students, that students are instructed on their proper use, and that these devices are required in classes or activities where students are exposed to potentially unsafe noise levels (e.g., music classes, marching band, industrial arts, and technology education classes).
Implement policies consistent with National Institute for Occupational Safety and Health (NIOSH) recommendations to support hearing loss prevention programs for school employees¹

Establish and Maintain Routine Hearing Screening for All Students

Many schools provide hearing screening as part of required student health assessments. Hearing screening, especially at an early age, provides the opportunity to detect a student's hearing loss or previously unrecognized hearing loss and intervene to limit further loss and improve learning.^2,3 According to the American Academy of Pediatrics (AAP), hearing screening should be conducted

At school entry for all children
At least once at ages 6, 8, and 10
At least once during middle school
At least once during high school
For any student entering a new school system without evidence of a previous hearing screening

Hearing screening might be required more often for students with other known health or learning needs; speech, language, or developmental delays; or a family history of early hearing loss.^4-6

Hearing screening programs should be consistent with the AAP Criteria for Successful Screening Programs in Schools² to ensure that

Screening tests are accurate and reliable
The school hearing screening site is suitable and appropriate for screening
Persons who screen students' hearing are well-trained and qualified professionals
Community and healthcare provider referral mechanisms are in place so that those with identified hearing loss can receive additional evaluation and diagnosis, and appropriate treatment if needed.
Student screening results are communicated effectively by the school to students, parents, and healthcare providers
Effective treatment and early intervention benefit those with identified hearing loss or hearing difficulties
Appropriate educational interventions are implemented to reduce the negative effects of hearing loss on student learning
The benefits of hearing screening outweigh the cost of implementing the screening program

Screening programs might not capture all cases of noise-induced hearing loss. Any student or school personnel reporting hearing difficulties or tinnitus (especially after loud sound exposure) should be referred to an audiologist for further evaluation.

Implement Hearing Loss Prevention Education

Education about noise and its effects on hearing, health, and learning can begin in elementary school.⁷ Studies have shown that people who are educated about noise-induced hearing loss and hearing loss prevention are more likely to use hearing protection devices in future occupational and recreational settings.^8,9 Comprehensive hearing loss prevention programs include instruction for students on

Normal hearing (auditory) function
Types of hearing loss and their causes
Common sources of noise that can contribute to hearing loss
Noise and its effects on hearing and quality of life
Warning signs of noise-induced hearing loss
Recommendations for preventing hearing loss^10-12

Hearing loss prevention education can be part of a school’s health education curriculum or integrated across curricula and other school programs by health professionals and trained volunteers, teachers, and parents. For example,

School nurses, physicians, audiologists, speech-language pathologists, or well-trained volunteers can help provide accurate information and interactive activities
Teachers can be taught how to reduce loud sounds in the school environment and model good hearing protection behavior and attitudes
Education also can be provided for parents, encouraging them to practice hearing loss prevention at home and to teach it to their children¹³

References

CDC/NIOSH. Revised Criteria for a Recommended Standard: Occupational Noise Exposure (NIOSH Publication 98-126). Cincinnati: US Department of Health and Human Services; 1998.
American Academy of Pediatrics, Committee on School Health. School Health:Policy and Practice. 6th edition. Elk Grove, IL: American Academy of Pediatrics; 2004.
American School Health Association. Comprehensive Health Services for Young Children [pdf 160K].
American Academy of Pediatrics, Committee on Practice and Ambulatory Medicine, Bright Futures Steering Committee. Recommendations for preventive pediatric health care. Pediatrics 2007;120:1376–1378.
American Speech-Language-Hearing Association. Hearing Screening. Rockville, MD: American Speech-Language-Hearing Association.
American Academy of Audiology. Position statement: identification of hearing loss and middle-ear dysfunction in preschool and school age children. Audiology Today 1997;9(3):21–23.
National Association of School Nurses. Position Statement: Noise Induced Hearing Loss [pdf 210K]. Castle Rock, CO: National Association of School Nurses; 2003.
Knobloch MJ, Broste SK. A hearing conservation program for youth working in agriculture. Journal of School Health 1998;68(8):313–318.
Ewigman B, Kivlahan C, Hosokawa M, Horman D. Efficacy of an intervention to promote use of hearing protection devices by firefighters. Public Health Reports 1990;105(1):53–59.
Lass NJ, Woodford CM, Lundeen C, Lundeen DJ, Everly-Myers DS. The prevention of noise-induced hearing loss in the school-aged population: a school educational hearing conservation program. Journal of Auditory Research 1986;26:247–254.
Anderson KL. Hearing conservation in public schools revisited. Seminars in Hearing 1991;12(4):340–364.
Folmer RL, Griest SE, Martin WH. Hearing conservation education programs for children: a review. Journal of School Health 2002;72:51–57.
Folmer RL. The importance of hearing conservation instruction. Journal of School Nursing 2003;19(3):140–148.

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