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GREENSBORO, N.C. — So many of the people who come to Pahel’s Audiology in Greensboro are hard of hearing, but the age of these patients may surprise you.

“I see so many 20-somethings with permanent hearing loss. I see a lot of it. It’s very, very common because they’ve had that number of years under their belts of exposure and have permanent hearing loss,” said Carolyn Franks, an audiologist with Pahel’s Audiology. “That’s the concern. Most people think it’s a loud boom or a bang that causes sudden hearing loss and it can be, but also very often, it’s the constant exposure of noise from iPods, power tools, concerts and racetracks that do so much harm to your hearing.”

According to the World Health Organization, it’s estimated 1 billion young people are at risk of hearing loss due to the increased use of earphones and headphones.

Among the teens most at risk are musicians, like David Leland. He plays bass guitar and is very mindful to only play at moderate levels for short periods of time. “Who wants to go deaf at 30? If I overdo it most of the time that will definitely affect my hearing over time.”

Franks recommends kids use headphones that limit the volume to 85 decibals. “Even then, I check sometimes, just to make sure it’s on the correct setting.” For teens, she says it’s key to have noise-canceling earphones or headphones. They filter out background noise, allowing listeners to hear music well at lower levels.

Finally, Franks says to go by what she calls the 60/60 rule. That means if the volume goes to a 10, keep it at a 6, or 60 percent. And then, only listen to music for 60 minutes maximum.

Signs of hearing loss include pain, ringing or buzzing in the ears during or after a noisy activity. If you suspect you or your child already have hearing loss, take them to an audiologist for a hearing test. If discovered early enough, they can take steps to prevent further hearing loss.