Hearing loss and masks have been a hot topic since the start of the COVID-19 pandemic. And rightly so. Masks, while necessary for health and safety, make it much harder for people with hearing loss to communicate with others. Face masks not only physically block sound, but they also take away speechreading cues like lip movements and facial expression. A double whammy for people with hearing loss.

Clear masks are often cited as the solution because the transparent window allows for lipreading. But there is a trade-off. A recent study published in Audiology Today shows that clear masks block up to twice as much sound as an N95 mask and up to four times as much sound as typical surgical masks, depending on the type of clear mask tested. When face shields were added, the sound quality plunged further.




Audiology Today’s Study Showed Significant Sound Degradation with Many Clear Masks




The study was conducted in a double-walled sound booth using a white noise machine presented through a loudspeaker manikin head. The output was measured from 6 feet away. Researchers analyzed the decibel impact of a variety of masks when worn alone, and when combined with a face shield.

The table below shows the decibel degradation under each condition. Surgical masks showed the least impact on the sound, with a 5-decibel impact, while transparent cloth masks had the most, with a 21.2 decibel hit. Anytime a face shield was added, the result was significantly worse. Practically speaking, this may mean that the plexiglass dividers in the supermarket checkout line are doing more to negatively impact communication than the masks themselves.

Face Mask Decibel Levels
Audiology Today

Are Clear Masks The Best Option In All Situations?

This study raises critical questions about whether or not clear masks are the best solution for helping people with hearing loss communicate with others during these challenging times. As with any hearing loss question, the answer may vary situationally and from person to person. For good lipreaders, the benefits of the clear window may outweigh the additional sound degradation, while for others, the speechreading benefit may be less important. Results may also vary depending on the severity of your hearing loss.




Ryan Corey, a researcher at the University of Illinois found similar sound results in his mask study. He summarizes his findings as such: “Surgical masks and loosely woven cotton masks work best for sound, while denser fabrics and clear window masks muffle high frequencies.”




Dr. Corey recommends technology solutions like lapel microphones, especially for teachers and others who need to talk frequently while wearing a mask. He lays out more details in his captioned video, “Which mask is best for hearing?






Technology Fixes May Work Better than Clear Masks

More research is needed, but perhaps funds and attention should be redirected toward finding alternative solutions to clear masks via technology. Already, some hearing aid companies and creative audiologists have begun adding mask settings to hearing aids. These settings boost the higher-pitched sounds blocked by masks. Several programs may be needed, one for each type of mask you encounter.




In educational settings or public spaces, investments in captioning technology and/or looping solutions may be preferable in the short term, and have more lasting positive consequences for accessibility over the longer term. Maybe the best solution is a combination of both — clear masks to allow speechreading plus technology fixes to offset the sound degradation.




This article originally appeared on Living With Hearing Loss.

Shari Eberts is a guest editor and founder of Living With Hearing Loss, a blog and online community for people living with hearing loss. Living with adult-onset genetic hearing loss, Eberts has become an active hearing health advocate. She serves on the Board of Trustees of Hearing Loss Association of America and recently authored an E-book titled, “Person-Centered Care from the Patient’s Perspective.”