About 20 percent of all American adults report some degree of hearing loss. That means there are approximately 48 million people who can no longer enjoy everyday sounds, including music, conversations with a friend, or the sound of a child’s voice. Sometimes the hearing loss is predictable, including cases where the individual had a severe illness or accident that involved hearing. The causes of some hearing loss, however, are quite surprising.

Here are some surprising ways you might be damaging your ability to hear well.

Growing older

One out of three people have some degree of hearing loss the age of 65. Much of this hearing loss is cumulative damage from years of loud sounds and other factors. While this may not be surprising to some, the simple unavoidable act of growing older can cause hearing loss for many people.

Overdoing the Decibels

Decibels (dB) are a scientific way to measure and describe the volume of a sound with numbers. Complete silence produces zero decibels while a jet engine produces 140 dB. Not surprisingly, standing next to a jet engine could damage hearing because loud sounds damage the microscopic hair cells found inside the cochlea, the part of the ear responsible for hearing.

Different groups of hair cells work to “hear” different sound vibrations, known as frequencies. The healthy human ear can hear a wide range of frequencies, from 20Hz to 20,000 Hz, with 20Hz creating very low tones and 20,000 Hz is a very high pitch. When groups of the hair cells die, you will lose your ability to hear certain frequencies.

A sudden, extremely loud noise – like an explosion – can damage or break these hairs but repeated and prolonged exposure to loud noise can damage or break these tiny hairs too. Damage enough of these hairs and you start to lose your hearing.

Blow-drying your hair

Your hair dryer may be doing more than styling your locks – it may be blowing out your hearing too. A blow dryer produces 80 to 90 decibels.

Mowing the lawn

Now you have one more reason to dislike mowing the lawn – it can harm your hearing! The sound a power lawnmower produces measures about 100 decibels, which is about eight times as loud as the typical vacuum cleaner. At that volume, serious hearing damage is possible during prolonged exposure lasting eight hours or more.

Using earbuds

Earbuds are those tiny speakers that connect to your iPod or MP3 player and plug into your ears. While they are fine at low volume, listening to loud music can damage your ears.

Sticking your finger or other foreign objects into your ear

While sticking foreign objects in your ear does not generally cause hearing loss, forcefully inserting something into your ear certain can. As a rule, put nothing smaller than your elbow into your ear canal. This includes cotton swabs – you can use the swab on every part of your ear except for the little hole that leads to your ear canal. You can stick a pencil in your ear only if it is larger than your elbow.

Medications

More than 200 medications can cause hearing loss, a condition doctors call “ototoxicity.” These ototoxic medications include drugs to treat infections, cancer, and heart disease. Hearing often returns after you quit taking the drug, but the damage may be permanent in a few cases. Always ask the doctor prescribing you medication if it could possibly cause hearing loss. If so, request an alternate medication when possible.

Smoking

Studies show that smokers are more likely to suffer hearing loss than are non-smokers. People exposed to second-hand smoke are also at greater risk for hearing problems. Scientists have not yet determined how smoking damages hearing, but it is possible that the heart disease associated with smoking may play a role in hearing loss as heart disease would decrease the flow of oxygen-rich blood to the hair cells of the ear.