bullerskador

Bullerskador is the Swedish term for injuries to the auditory system caused by exposure to loud acoustic energy. It covers noise-induced hearing loss (NIHL) as well as tinnitus and related symptoms. The condition is largely preventable and is a major concern in occupational health.

Causes and presentation: Most often, bullerskador result from repetitive exposure to loud environments (above about 85 dB(A)) over months or years. Sudden impulse noises can also cause immediate damage. Symptoms include difficulty hearing high-frequency sounds, muffled hearing, a sense of fullness in the ears, and tinnitus that may be persistent or episodic. The resulting damage is typically irreversible, especially to hair cells in the cochlea.

Diagnosis and assessment: Diagnostic workup typically includes pure-tone audiometry to document sensorineural loss with emphasis on high frequencies, along with a patient history of noise exposure. Additional tests such as otoacoustic emissions or speech-in-noise testing may be used in certain cases. Regular hearing checks are common in workplaces with high noise levels.

Prevention and regulation: Prevention relies on noise control, administrative measures to limit exposure, and hearing protection devices such as earplugs or earmuffs. Regular hearing checks are recommended for at-risk workers. International guidelines often set an exposure limit around 85 dB(A) over an eight-hour workday, with a 3 dB exchange rate, and emphasize education and PPE use.

Management and prognosis: There is no cure for NIHL. Management focuses on preventing further damage, using hearing aids or cochlear implants for substantial loss, and addressing tinnitus through counseling and sound therapy. Early intervention and sustained exposure reduction improve functional outcomes.