Irish farming is quietly incubating a public health crisis we rarely name – hearing loss. Years of unprotected exposure to machinery noise leave many farmers struggling to follow a mart bid, a GAA broadcast, or their own child’s voice.
After several six-figure High Court settlements for delayed hearing loss diagnosis earlier this year, the moment has come to end the delay and implement the Health Service Executive’s National Hearing Care Plan. The HSE should launch a 12-month remote audiology pilot that brings “Farmer Hearing Days” to livestock marts in places such as Donegal, Mayo, Kerry, Galway, Roscommon, Cavan, Monaghan, Tipperary, Clare, and Offaly to screen 10,000 farmers over the age of 50, provide on-site hearing protection fittings, deliver same-day referrals, and cut audiology wait times by 20 per cent.
The Irish Health and Safety Authority estimates that farmers experience hearing loss at more than three times the national rate by their 30s, and by age 50, half are living with permanent impairment. Worse still, 70 per cent of teenagers growing up on farms already show early damage from machinery noise, an irreversible trajectory without protection and early care.
Because around 70 per cent of audiology services are private, the HSE’s audiology wait-list exceeds 28,000 people, pushing families towards long delays or expensive private services. Highlighted by a case of a woman in the Midlands who waited 12 months for an HSE audiology appointment, she became increasingly frustrated and isolated due to her untreated hearing loss.
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A national survey by Chime, the National Charity for Deaf and Hard of Hearing People, showed that 79 per cent of Irish participants waited until their hearing was “quite bad” before seeking hearing aids. Bringing screening and fittings to livestock marts meets farmers where they already are, reducing stigma and delay, and avoiding the estimated cost of €8,200 per person per year in lost productivity and quality of life.
What hearing loss does to everyday life
Most farm-related hearing loss is attributed to noise. Years of loud machinery noise damage the tiny cells in the inner ear, which is an irreversible form of hearing loss. People with hearing loss don’t just require an increase in volume to be able to hear; there is a loss of clarity that prevents them from being able to understand conversations in loud environments, like a busy mart or pub. Sounds are heard, but the words blur into mumbles, making speech harder to follow.
Long-term, untreated hearing loss is associated with falls, social withdrawal, depression, higher risk of dementia, and safety risks on farms, such as missed alarms or cries. The good news is that early protection and earlier fitting of hearing devices improve communication and can prevent further deterioration.
How it works
Remote booths and calibrated headsets can deliver validated hearing tests that are shared with specialists to trigger same-day referrals for those who need it. The remote service provides on-the-spot hearing protection device fittings with brief counselling sessions to cut noise exposure and boost awareness.
Each mart day includes SMS follow-ups for appointments and a simple dashboard displayed at the marts that reports monthly numbers screened, abnormal test rates, referral uptake, and hearing protection adoption. Every screened farmer either leaves with protection, a plan, or both.
What this looks like at the sales ring
Between lots at the mart in Donegal, Pádraig, a 58-year-old suckler farmer, steps into a quiet booth. He gets a five-minute screen and leaves with fitted ear protection, a printed audiogram, and a texted appointment date. No referral chase, no months of waiting, just a plan before his hearing loss becomes permanent.
Concerns about worsening the existing audiologist wait times by allocating trained professionals to these remote services are genuine. Even if the remote service did not prolong wait times, a surge in screening and referral may outpace specialist capacity to treat hearing loss. And without financial incentives for audiologists to participate in these farmer outreach programmes, it might be difficult to materialise. Health advocates have suggested that the Department of Health collaborate with the private sector to help meet the ongoing audiology demand.
How a public-private collaboration would work
On the private side, equipment suppliers can lease calibrated mobile booths to the HSE for scheduled mart days, with annual certification and insurance in place. The HSE funds locum audiologist sessions to staff the service, and it encourages supervised audiology students to participate in field days to help expand capacity but also gain clinical experience. Alternatively, the Department of Health can contract private audiology clinics on a bundled, bulk-rate basis to deliver the same service, with clear agreements on the services provided, quality-control testing of the equipment, GDPR data handling, and monthly performance targets.
After years of delayed hearing care plans on paper, marts are the place to start. Meet farmers where they gather, test early and refer fast to stop hearing loss before it becomes the sound that won’t come back.
- Mohammad AlSaad is a doctor (UCD, 2023) and a Master of Public Health candidate at Harvard University, focusing on hearing loss policy and rural access, with surgical experience in Kuwait
