Young people are increasingly experiencing permanent tinnitus -ringing in the ears- after festivals with heavy bass sounds, or a night out in a loud bar. This also happened to students Marlein Nijhuis and Sophie van Dijk. 'I will never again go out without earplugs.'

After her summer vacation in the mountains of South Africa in 2022, International Business Administration student Marlein Nijhuis (19) developed tinnitus. ‘In the mountains, your ears are constantly blocked due to the altitude. You can clear your nose to open your ears again. I think I did that too hard and too often, causing a perforation in my eardrum. Afterward, I also took two long flights home, and I ended up with a buzzing sound in my ear. Now I hear a high tone, a kind of beep, in the background.’

For Sophie van Dijk (19), a nursing student, a similar ringing started after a night out in Nijmegen. ‘Last October, I went out to café TweeKeerBellen. The speakers there are very low to the ground, and the music is quite loud. I was standing right next to the speakers and didn’t wear earplugs, which was not smart. The next morning, I woke up with a ringing in my ear. I thought, ‘it will probably go away.’ But unfortunately, that never happened.’

Damaged hair cells

‘Tinnitus is a personal perception of a ringing sound that usually cannot be objectively verified by others,’ explains Henri Marres, an Ear, Nose, and Throat (ENT) doctor at Radboudumc. ‘You may think you hear it, or it may even be experienced in your auditory cortex (the area in the brain that receives and processes information from the rest of the body, eds.).’

Usually, damaged hair cells are the cause of tinnitus. Sound is converted into electrical impulses by the hair cells in the cochlea, a part of the inner ear, which then travel to the brain. If the hair cells are damaged, sound is processed incorrectly. ‘This can lead to tinnitus,’ says Marres. According to the ENT doctor, there are two major factors that can cause tinnitus. The first is through medication, such as during chemotherapy, and the second is through noise trauma. ‘This can result in damage to the hair cells that cannot be repaired, leading to permanent hearing damage.’

‘Volume will be lowered and people are advised to use proper hearing protection. These are significant steps forward.’

A year and a half ago, audiologists raised concerns because the number of young people with tinnitus was increasing rapidly. They feared a surge in patients if the government did not intervene in time. ‘This has led to more attention being paid to the problem,’ says Marres.

On December 6, 2023, the Royal Dutch Hotel and Catering Association (Koninklijke Horeca Nederland) and sound technicians joined the covenant for preventing hearing damage. ‘This means that efforts will be made to minimize sound damage in all hospitality establishments,’ says the ENT doctor. ‘The volume will be lowered and people are advised to use proper hearing protection. These are indeed significant steps forward.’

Horror stories

The impact of tinnitus on the social lives of Nijhuis and Van Dijk is significant. ‘Because I am much more aware of it now, you realize that you can suffer hearing damage in many places,’ says Nijhuis. ‘For example, I also bring earplugs to the football stadium because there is a lot of noise there. If I didn’t do that, I could experience a lot of discomfort the next day.’

For Van Dijk, the first days after the onset of symptoms were the most challenging. ‘I was in panic because I had only heard horror stories. I couldn’t get out of bed and could only think about it. After a few days, I realized that that didn’t accomplish much; distraction was a lot more helpful. So, I started doing fun things with friends again.’

‘There is no treatment that cures tinnitus,’ says ENT doctor Marres. ‘Many of the treatments currently done are aimed at making life with tinnitus as bearable as possible. By suppressing the sounds as much as possible, you can ensure that it does not play a prominent role in your life.’

Therapy with a psychologist

To prevent tinnitus from playing too large a role in her life, Van Dijk underwent therapy with a psychologist. ‘They tried to help me shift my focus away from the ringing in moments of silence, so I wouldn’t concentrate on the beep but on other things around me.’ The therapy worked, the student says. ‘The symptoms have reduced, and the tone bothers me less because I have become accustomed to it.’

Nijhuis has not undergone treatment yet because, as she herself states, her symptoms are not as severe. However, the thought of tinnitus worsening makes her anxious. ‘When I think about the future, I am constantly afraid that it will get worse,’ she says. ‘That fear is really terrible. I will never go out without earplugs. If I don’t have them with me, I would rather cycle an extra hour to get them. Otherwise, I just won’t go out anymore.’

Finally, the two students have advice for other students – actually, for everyone. ‘Wear earplugs when going out.’

Translated by Siri Joustra