The HHIA, for example, is a 25-item questionnaire that asks both social and emotional-specific questions such as: Does a hearing problem cause you to avoid groups of people?" (social) and "Does a hearing problem cause you to feel frustrated when talking to members of your family?" (emotional). Response options are yes, no and sometimes. A greater score indicates greater perceived handicap. Cause
The ear can be exposed to short periods of sound in excess of 120 dB without permanent harm — albeit with discomfort and possibly pain; but long term exposure to sound levels over 85 dB(A) can cause permanent hearing loss.There are two basic types of NIHL:

NIHL caused by acoustic trauma and
gradually developing NIHL. Acute acoustic trauma
NIHL caused by acute acoustic trauma refers to permanent cochlear damage from a one-time exposure to excessive sound pressure. This form of NIHL commonly results from exposure to high-intensity sounds such as explosions, gunfire, a large drum hit loudly, and firecrackers. According to one US study, excessive noise levels in cinemas are sufficiently brief that movie-goers do not experience hearing loss. Perceived harmfulness vs. actual harmfulness
The discomfort threshold is the loudness level from which a sound starts to be felt as too loud and thus painful by an individual. Industry workers tend to have a higher discomfort threshold (i.e. the sounds must be louder to feel painful than for non-industry workers), but the sound is just as harmful to their ears.
Along the same line of research, higher dietary or supplemental intakes of magnesium combined with antioxidant vitamins, specifically β-carotene and vitamin C, appear to be associated with a lower risk of hearing loss. Consuming excessive amounts of magnesium can be potentially harmful, so any treatments should be followed with caution.Tentative research in a mouse model suggests that blocking the GluA2-lacking, calcium-permeable forms of the AMPA receptor protects against hearing damage. Sound or stress training
Despite different people having different thresholds for what noises are painful, this pain threshold has no correlation with which noises cause hearing damage. The ear can not get more resistant to noise harmfulness by training it to noise. The cochlea is partially protected by the acoustic reflex, but being frequently exposed to noise does not lower the reflex threshold. It had been observed that noise conditioning (i.e. exposure to loud non-traumatizing noise) several hours prior to the exposure to traumatizing sound level, significantly reduced the damages inflicted to the hair-cells. The same "protective effect" was also observed with other stressors such as heat-shock conditioning and stress (by restraint) conditioning. This "protective effect" only happens if the traumatizing noise is presented within an optimum interval of time after the sound-conditioning session (-24 hours for a 15 min. sound-conditioning; no more protection after 48 hours). This "protective effect" had long been thought to involve the active mechanisms of the outer hair cells and the efferent system commanding them.