Hearing loss is something that does not receive as much attention as the other three types of injuries, but damage to the ears is something that is not rural specific. Anyone who subjects their self to loud noises (i.e. concerts, MP3 players, machinery) is at risk of hearing damage. Unlike wounds resulting from the other types of injuries, which will heal over time, hearing damage is irreversible and can only be improved with a hearing aid.

The case simulation used in the EOP materials for this type of injury depicts the decay of a farmer's hearing over many years of being around farm equipment without using any type of hearing protection. However, it is not just the farmer which suffers in the story. He also puts the people around him in danger because of his poor hearing.