A Cochrane review found that training of earplug insertion can reduce noise exposure at short term follow-up compared to workers wearing earplugs without training. Higher consistency of performance has been found with custom-molded earplugs. Because of their ease of use without education, and ease of application or removal, earmuffs have more consistency with both compliance and noise attenuation. Active ear protection (electronic pass-through hearing protection devices or EPHPs) electronically filter out noises of specific frequencies or decibels while allowing the remaining noise to pass through. A personal attenuation rating can be objectively and subjectively measured by using a hearing protection fit testing system. Education
Education is key to prevention. Before hearing protective actions will take place, a person must understand they are at risk for NIHL and know their options for prevention. Hearing protection programs have been hindered by people not wearing the protection for various reasons, including the desire to converse, uncomfortable devices, lack of concern about the need for protection, and social pressure against wearing protection. Although youth are at risk for hearing loss, one study found that 96.3% of parents did not believe their adolescents were at risk, and only 69% had talked to their children about hearing protection; those aware of NIHL risks were more likely to talk to their teens.A systematic review of the effectiveness of interventions to promote the use of hearing protection devices such as earplugs and earmuffs among workers found that tailored interventions improve the average use of such devices when compared with no intervention.
This up regulation of GR thus prevents GR down regulation induced by acoustic trauma
The protective effect of noise-conditioning is blocked by adrenalectomy or pharmacological treatment with RU486 + metyrapone (a glucocorticoid receptor antagonist). Treatment
Treatment options that offer "cures" for NIHL are under research and development. Currently there are no commonly used cures, but rather assistive devices and therapies to try and manage the symptoms of NIHL. Acute acoustic trauma
Several clinical trials have been conducted to treat temporary NIHL occurring after a traumatic noise event, such as a gunshot or firework. In 2007, individuals with acute acoustic trauma after firecracker exposure were injected intratympanically with a cell permeable ligand, AM-111. The trial found AM-111 to have a therapeutic effect on at least two cases of those with acute trauma. Treatment with a combination of prednisolone and piracetam appeared to rescue patients with acute trauma after exposure to gunshots. However, those who received the treatment within an hour of exposure had higher rates of recovery and significantly lower threshold shifts compared to those who received treatment after one hour.Additionally, clinical trials using antioxidants after a traumatic noise event to reduce reactive oxygen species have displayed promising results. Injections with allopurinol, lazaroids, α-D-tocopherol, and mannitol were found to reduce the threshold shift after noise exposure. Another antioxidant, Ebselen, has been shown to have promising results for both TTS and PTS. Ebselen mimics gluthathione peroxide, an enzyme that has many functions, including scavenging hydrogen peroxide and reactive oxygen species. After noise exposure, gluthathione peroxide decreases in the ear.