Evidence & References

The following sources inform our claims about community earwax removal, microsuction safety, hearing loss impacts, and care quality standards.

Guidance & Standards

• NICE Quality Standard: Earwax removal in primary/community care (QS185). Link
• ENT UK: Clinical guidance on microsuction (2024). Link
• British Society of Audiology: Aural Care (Ear Wax Removal) Practice Guidance (2021, minor update 2025). Link
• CQC Fundamental Standards for providers and managers. Link

Microsuction in NHS Services

• Guy’s & St Thomas’ NHS Foundation Trust: Microsuction overview. Link
• Royal Devon NHS: Microsuction patient information. Link

Hearing Loss, Isolation, Mood & Cognition

• NICE: Community delivery reduces delays and frustration associated with earwax build‑up. Link
• Age & Ageing (2022): Social isolation as a consequence of hearing loss. Link
• ELSA analysis (JAMA Otolaryngol, 2018): Association of untreated hearing loss, isolation and cognitive performance. Link
• Johns Hopkins (2024/25): Hearing loss as a modifiable risk factor in dementia. Link
• Falls reduction with hearing care (ACHIEVE secondary analyses; 2025 news summary). Link

External links provided for transparency and further reading; they do not imply endorsement.