APPENDIX176Avoid potential hearing lossProlonged exposure to loud sounds is the most common cause ofpreventable hearing loss. Some scientific research suggests that usingportable audio devices, and cellular telephones, at high volume settingsfor long durations may lead to permanent noise-induced hearing loss.This includes the use of headphones (including headsets, earbuds andBluetooth® or other wireless devices). Exposure to very loud sound hasalso been associated in some studies with tinnitus (a ringing in the ear),hypersensitivity to sound and distorted hearing. Individual susceptibility tonoise-induced hearing loss and other potential hearing problems varies.The amount of sound produced by a portable audio device variesdepending on the nature of the sound, the device, the devicesettings and the headphones. You should follow some commonsenserecommendations when using any portable audio device:x Set the volume in a quiet environment and select the lowest volumeat which you can hear adequately.x When using headphones, turn the volume down if you cannot hearthe people speaking near you or if the person sitting next to you canhear what you are listening to.x Do not turn the volume up to block out noisy surroundings. If youchoose to listen to your portable device in a noisy environment,use noise-cancelling headphones to block out backgroundenvironmental noise.x Limit the amount of time you listen. As the volume increases, lesstime is required before your hearing could be affected.x Avoid using headphones after exposure to extremely loud noises,such as concerts, that might cause temporary hearing loss. Temporaryhearing loss might cause unsafe volumes to sound normal.x Do not listen at any volume that causes you discomfort. If youexperience ringing in your ears, hear muffled speech or experienceany temporary hearing difficulty after listening to your portable audiodevice, discontinue use and consult your doctor.You can obtain additional information on this subjectfrom the following sources:American Academy of Audiology11730 Plaza America Drive, Suite 300Reston, VA 20190Voice: 800-AAA-2336Email: infoaud@audiology.orgInternet: http://www.audiology.orgNational Institute on Deafness and Other Communication DisordersNational Institutes of Health31 Center Drive, MSC 2320Bethesda, MD USA 20892-2320Voice: (301) 496-7243Email: nidcdinfo@nidcd.nih.govInternet: http://www.nidcd.nih.gov/health/hearingNational Institute for Occupational Safety and Health1600 Clifton RdAtlanta GA 30333 USAVoice: 1-800-CDC-INFO (1-800-232-4636)Internet: http://www.cdc.gov/niosh/topics/noise/default.html