- Published on 20 June 2013
It is well worth the effort to activate European citizens to maintain or rehabilitate their hearing capabilities. This message was put across convincingly during a breakfast meeting at the European Parliament in Brussels, exclusively covered by Audiology Infos. It was organized by Member of the European Parliament Ádám Kósa who is severely hard-of-hearing together with the European Federation for the Hard of Hearing people (EFHOH) and the European Hearing Instrument Manufacturers Association (EHIMA). Representatives of the Irish Presidency, the European Commission, MEPs, experts and NGOs met to discuss how the 'silent killer' of productivity and social inclusion could be countered. They pleaded for a comprehensive, practical and affordable European policy based on the principle of personal connectivity.
It is most fascinating to get a glimps on the lobby machine at work around the European Parliament in Brussels. Several groups are gathering at the entrance of the Altiero Spinelli building on April 10th - for instance to speak about medical devices and other issues. A number of meeting rooms is converted into a breakfast area. One of these is the scene for the breakfast meeting 'Hearing loss, how to activate Europeans with an invisible disability'.
The initiative in this particular case originated from the European Parliament itself, namely from the Hungarian MEP dr. Ádám Kósa. Kósa, EFHOH and EHIMA jointly wished to raise awareness among members of the European Parliament and the European Commission for the most widespread disability in Europe: hearing loss. They especially wanted to point out that rehabilitation of hearing loss has one of the most cost-effective treatments. Raising awareness and treatment pays out in terms of economy (labour participation, prevention of healthcare costs) as well as well being (social participation, prevention of further physical and mental decline).
The breakfast meeting was part of the Hearing Week with several venues. In the European Parliament building there was a booth where visitors could have their hearing checked. Some two hundred people grasped the opportunity and underwent tone audiogramme hearing tests. In the booth also information about hearing and hearing loss was distributed. From the conversations it became clear that there is a general lack of awareness on hearing loss and rehabilitation among European Parliament staff. The tests showed, by the way, that the hearing abilities are above European average. This is a comforting outcome in a work environment where language and communication are paramount. Especially interpreters, whose jobs depend so much on the quality of their hearing, proved to have excellent hearing.
Differences within Europe
In his introduction to the breakfast meeting Kósa summarized: “According to the World Health Organisation (WHO), hearing impairment is the biggest invisible disability in the world. Approximately ten per cent of the world population, including fifty million Europeans, are affected. Most of them are unaware or don't treat their disability.” Søren Hougaard, Secretary-General of EHIMA further stated: “The costs of untreated hearing loss within the EU are huge and investment in better hearing will ensure great savings and social benefits.”
It was then time for Lidia Smolarek-Best of EFHOH to take the stage. She spoke, among other things, about the differences within the EU in terms of provisions for hearing aids and the quality of life that people with hearing loss enjoy. “A report that we published in 2011 learned, that there is a huge difference between European countries when it comes to subtitling of TV-programmes. The EFHOH vision is 100% subtitling of public TV all over Europe bij 2020. The UK is almost there and also the Netherlands score well, followed bij France and the Czech Republic. But there are also still countries with no or hardly any subtitling at all, mainly in Eastern Europe. From Holland we know that out of a population of seventeen million, there are 1.6 million hard of hearing people. But 5.4 million people follow the TV with help of the subtitling. 67% of these people even change the channel when the next programme has no subtitling.” It's hardly a cost matter. “In the movie industry, only 1% of the marketing budget alone would suffice to subtitle all films.”
This is just one small barrier hard of hearing people face in their daily life. Other, random issues are for instance the reliance of society on telephone, barriers in public transport and the difficulty to follow life long education. A major issue is the reimbursement of hearing aids. “In the UK we have now full reimbursement. But there are other countries, like Poland where I originally come from, where people first have to prepay the full cost of the hearing aid(s) before they get reimbursement. For many people this hurdle cannot be overcome. I would like to see concsistency throughout Europe, with free hearing aids to the point of need. Rehabilitation is 90% of the success of anything with hearing loss. This is for instance shown in a 2006 EHIMA survey among people with hearing loss. It is especially difficult for people with low self esteem. When people loose their hearing, they begin to feel socially isolated.”
This is a point Curtis Alcock from Audira also makes: “In every area of life we know how important it is to keep our connections strong and constant. We rely on running water, electricity, phone and road connections. One connection we take for granted: hearing. Over 99% of Europeans use hearing as one of their primary means to stay connected. We rely on it to remain strong and constant. It's easy to forget about those not hearing well, and it's easy to forget that will happen to amost all of us at some point.”
When communication becomes difficult, we become frustrated, he knows. “And when it's our hearing that fails, do we immediately get it checked? No, we still blame the other. Society takes hearing so much for granted that it fails to provide these individuals with the means they need to connect - and the normal hearing people themselves take hearing so much for granted that they fail to see after it.” Dangeroulsy loud music is for instance socially accepted. “Hearing loss in teenagers has increased by 30% in just ten years, afflicting one in five. In seven and eight year olds, it has even tripled. 75% of adults with hearing loss in Europe remain untreated - equalling the entire population of France. It is a waste of human potential. When hearing fades, the brain's 24/7 connection to the outside world also fades.” The result: deterioration of memory, concentration, physical energy, safety, sharpness of mind and ultimately also quality of life. Mental health is generally lower in individuals whose hearing has been allowed to fade unchecked.”
We first get people to the top of their potential by educating them... and then then let them simply slide downhill, Alcock states. “Hearing care in Europe shouldn't be about picking up the pieces at the bottom of the hill. It's time to create a new social norm for hearing and deafness, one based on the principle of staying connected. That's the way to see what needs to change and how to achieve this. We shouldn't focus on highlighting weaknesses afther the fact, but on maintaining people's full potential: to have the hearing checked routinely throughout life.” It comes down to the old saying: prevention is better than cure.
Full speed ahead
Next in line was dr. Gary Norman, representing the Irish National Clinical Lead for Audiology. He spoke on behalf of the Irish Presidency via a presentation by phone. “Hearing services in Ireland were fragmented for many years, with a variable quality of clinical practice. No hearing screening for newborns existed. There were long delays in diagnosis and waiting lists for both children and adults. There were a lot of dissatisfied patients before it was decided to be time for a change in 2009.” Professor John Banfor from the Univerfity of Manchester was asked for advice and recommendations. He came up with a list of twenty recommendations and a range of priorities. Brian Murphy and his people at the Health Office in Ireland started carrying out a National Hearing Programme on this basis. A hearing screening for newborns was accepted in 2013 and a national database of the results was started. To tackle the issue of insufficient staffing, twenty students are educated to get their master's degree in audiology.
“What we are doing is trying to provice lean, cost-effective hearing service”, says Norman. “under sound leadership and with a good regional spread. The service is to be provided according to a standard audiology procedure, open to adoption of new working methods and sharing good practices. We also monitor whether we are on target with the execution of the plans. So, all in all, we've come from far in just a few years.” Ireland is not there yet - that would be impossible in so short a timespan - but with the plan 'A national lead for audiology' the country knows where it's heading.
On behalf of the European Commission, Scientific Program Researcher Dr. Grigorij Kogan presented the outcomes of the last European Framework Programme (FP7) on research in hearing loss. He emphasises the chronic, urgent, technically difficult and costly nature of hearing loss. It is also economically costly in terms of unnecessary unempleyment. It transpires that in Europe untreated hearing loss is estimated to directly cost some 213 billion euros a year, with even higher indirect costs as a result of it. The Commission has therefore been setting up different projects, amounting to more than 61 million euros for transnational research in hearing loss.
The breakfast programme was so packed with information, that there only remained little time for questions and comments. Member of the European Parlimanent Elisabeth Schroedter, vice president os the Social Affairs Commission, invites EFHOH to comment on the accessibility of public websites. Nicolai Bisgaard, board member of GN Resound, commented that the story from Ireland was interesting: “They invited experts from the UK for an assessment of their current state of affairs and to present recommendations for improvements. Is there a possibility to carry out programmes like that in other countries also? Would bodies in Brussels support such procedures?” Kósa: “A good question, but the responsibities for this remain on a national level. It would be worth considering a Europe-wide survey, though.” Franco Gandolfo, president of the European Association of Audioprothesists (AEA) asks the members of the European Parliament to promote the recognition of audioprothesists throughout Europe. “To date, our profession is recognised in only thirteen EU-countries.” Kósa asks Gandolfo to give his comment and the details on different countries in writing, so that he can use the information in the future.
“It is of utmost importance that people are informed about hearing impairment, related issues and facts”, Kósa concludes at the end of the event series. “and also, that they are able to protect their hearing. If hearing loss has already occurred, people should have access to high quality rehabilitation. It has been the aim of this Hearing Awareness Week top promote this standpoint. We hope we haven been able to make many people aware of this important topic and help them to get informed about hearing, hearing loss and rehabilitation possibilities.”Photos: © L.v.d.E.