May 2021 MedCity News

airpodsIn September 2020, Apple increased the functionality of its popular wireless earbuds for people who need hearing assistance. The iOS 14 release empowers consumers to program their AirPods Pro with their unique audiogram. As a result, the AirPods Pro now may provide customized amplification when worn in Transparency mode.  Apple’s expansion of AirPods Pro into personal sound amplification devices (PSAPs) garnered attention throughout the hearing health world.  An overlooked yet central aspect of Apple’s solution is that the AirPods Pro now integrates customised amplification with hearing protection against noise in a single device. 

The company’s first-generation hearing health offering won’t immediately replace traditional hearing aids. Yet over the medium term, the AirPods Pro’s ability to function as PSAPs, combined with Apple’s 113 million U.S. iPhone user base and iconic brand power means only one thing: the California company has the power to disrupt the $7B U.S hearing aid market. 

In the U.S., 40M people aged 50 and over have a hearing loss, ranging from mild to profound.  A review of the clinical literature shows the significant responsibility noise has in causing hearing loss.  Loud noise can damage cells and membranes in the cochlea, with the presence of an existing hearing loss potentially indicating heightened susceptibility to noise damage.

A study conducted by Apple found that 25% of its iPhone users experience every day an average environmental sound exposure that exceeds the limit recommended by the World Health Organization. Yet traditional hearing healthcare has not provided a viable solution to protect hearing aid wearers against excessive noise.

Enter Apple’s hearing health solution. Leveraging the basic technology of hearing aids, the AirPods Pro’s customised amplification increases audibility of the specific set of frequencies that impact speech understanding, according to an individual’s unique hearing loss. Just as importantly, AirPods Pro includes automatic noise cancellation (ANC). The feature detects and cancels unwanted environmental noise before consumers hear it. Depending on the situation, consumers can switch between Transparency mode and ANC, using one device that helps them hear better and protects their hearing.

Take, for example, a business executive with a mild hearing loss. For a day of video calls in a quiet office environment, the executive requires continuous amplification. Stepping out for lunch into a busy cityscape, however, the executive would be prudent to switch into ANC for hearing protection.

Traditional hearing aids, in contrast, use noise-reduction algorithms to throw speech signals into relief, but do not provide a noise cancellation mode.  In other words, hearing aids contain safeguards against amplifying sounds to unsafe levels, but they do not protect against unsafe noise levels already present in the environment.    

Apple’s solution has real limitations—most pressingly that the AirPods Pro when programmed with an audiogram may not sufficiently amplify high-pitched sounds.  The AirPods Pro battery life of 4.5 hours is insufficient for people who wear hearing aids all day. Finally, AirPods Pro are personal sound amplification devices, not FDA-approved hearing aids.

Yet the combination of customised amplification with noise protection via ANC provides real value to consumers with hearing loss. Other earbud companies in the hearing space, such as Nuheara, have paired these capabilities for years, but these companies lack Apple’s vast market penetration. 

The clinical literature clearly supports the conclusion that for people with hearing loss, while customised amplification is essential for everyday functioning, protection from noise damage is critical, even though protection may at first seem paradoxical. For people with a genetic susceptibility or an inner ear that has aged beyond its biological years, the stakes of protecting remaining hearing escalate.  

Apple’s presence in the market—and its Hearing Study—will have the effect of better informing consumers about the dual needs for customised amplification and protection. As a result, consumers may begin to view on-demand protection to be as important as amplification.

Both Apple and the global hearing aid companies have important work ahead of them to better address the needs of people with hearing loss. Apple would be wise to promote more explicitly the AirPods Pro’s integrated benefits of customised amplification and protection. The global hearing aid companies would benefit from developing a line of hearing aids with meaningful noise protection. The outcome of consumers’ hearing health depends upon equal attention to helping people to hear better while protecting the hearing that they’ve got

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