Exposure to loud noise continues to be the largest cause of hearing loss in the adult population. The problem of NIHL impacts a number of disciplines. US standards for permissible noise exposure were originally published in 1968 and remain largely unchanged today. Indeed, permissible noise exposure for US personnel is significantly greater than that allowed in numerous other countries, including for example, Canada, China, Brazil, Mexico, and the European Union. However, there have been a number of discoveries and advances that have increased our understanding of the mechanisms of NIHL. These advances have the potential to impact how NIHL can be prevented and how our noise standards can be made more appropriate.

The Institute of Medicine carried out a study mandated by Congress and sponsored by the Department of Veterans Affairs to provide an assessment of several issues related to noise-induced hearing loss and tinnitus associated with service in the Armed Forces since World War II. The resulting book, Noise and Military Service: Implications for Hearing Loss and Tinnitus, presents findings on the presence of hazardous noise in military settings, levels of noise exposure necessary to cause hearing loss or tinnitus, risk factors for noise-induced hearing loss and tinnitus, the timing of the effects of noise exposure on hearing, and the adequacy of military hearing conservation programs and audiometric testing. The book stresses the importance of conducting hearing tests (audiograms) at the beginning and end of military service for all military personnel and recommends several steps aimed at improving the military services' prevention of and surveillance for hearing loss and tinnitus. The book also identifies research needs, emphasizing topics specifically related to military service.

In September 1985, NATO sponsored an Advanced Study WOl'kshop entitled, "Noise-Induced Hearing Loss: Basic and Applied Aspects." Tne meeting was held in a mountain retreat near Lucca, Italy and was attended by scientists, clinicians, and public officials from 12 countries. This was the third in a series of such conferences organized by the authors. The first two were supported by the United States National Institute of Occupational Safety and Health; their proceedings were published as "The Effects of Noise on Hearing" in 1976 and "New Perspectives on Noise-Induced Hearing Loss" in 1982. The Organizing Committee approached NATO because it was felt that the problem of noise was common to all industrialized countries and was an especially serious problem for the military. Thus, the NATO sponsorship and the Italian site of the meeting were part of the Organizing Committee's plan to obtain an international and thorough repr'esentation on the problem of noise-induced hearing loss. The NATO meeting and proceedings followed the format of the previous two symposia with an initial focus on the anatomical and physiological disturbances resulting from noise-induced hearing loss. This was followed by sections devoted to studies of a more applied nature involving general auditory performance in noise, issues associated with the establishment of noise-exposure criteria, nonauditory effects of noise, and the interaction of noise with other agents.

Translational Research is the interface between basic science and human clinical application, including the entire process from animal studies to human clinical trials (phases I, II, and III). Translational Research moves promising basic science results from the laboratory to bedside application. Yet, this transition is often the least-defined, least-understood part of the research process. Most scientific training programs provide little or no systematic introduction to the issues, challenges, and obstacles that prevent effective research translation, even though these are the key steps that enable high-impact basic science to ultimately result in significant clinical advances that improve patient outcome. This volume will provide an overview of key issues in translation of research from “bedside to bench to bedside”, not only from the perspective of the key funding agencies, but also from the scientists and clinicians who are currently involved in the translational research process. It will attempt to offer insight into real-world experience with intellectual property and technology transfer activities that can help move auditory technologies ahead, as scientists and clinicians typically have little or no formal training in these areas. Translational Research in Audiology and the Hearing Sciences will be aimed at graduate students and postdoctoral investigators, as well as professionals and academics. It is intended to function as a high-profile and up-to-date reference work on Translational Research in the auditory sciences, emphasizing research programs in the traditional areas including drugs and devices, as well as less traditional, still emerging, areas such as sensorineural hearing loss, auditory processing disorder, cochlear implants and hearing aids, and tinnitus therapies.

The loss of hearing - be it gradual or acute, mild or severe, present since birth or acquired in older age - can have significant effects on one's communication abilities, quality of life, social participation, and health. Despite this, many people with hearing loss do not seek or receive hearing health care. The reasons are numerous, complex, and often interconnected. For some, hearing health care is not affordable. For others, the appropriate services are difficult to access, or individuals do not know how or where to access them. Others may not want to deal with the stigma that they and society may associate with needing hearing health care and obtaining that care. Still others do not recognize they need hearing health care, as hearing loss is an invisible health condition that often worsens gradually over time. In the United States, an estimated 30 million individuals (12.7 percent of Americans ages 12 years or older) have hearing loss. Globally, hearing loss has been identified as the fifth leading cause of years lived with disability. Successful hearing health care enables individuals with hearing loss to have the freedom to communicate in their environments in ways that are culturally appropriate and that preserve their dignity and function. Hearing Health Care for Adults focuses on improving the accessibility and affordability of hearing health care for adults of all ages. This study examines the hearing health care system, with a focus on non-surgical technologies and services, and offers recommendations for improving access to, the affordability of, and the quality of hearing health care for adults of all ages.