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How progressively lost?

Usually, there is a distinction drawn between age-related "progressive" hearing loss, and that caused by environmental exposure. I am curious: How fine a scientific line has been drawn in that distinction?

Could progressive hearing loss in a given individual be composed of a large number of small environmentally driven events? What sort of measurements are needed to rule this out? Something with fine time resolution? Are statistics based on populations and subjective evaluations obscuring fine-time-resolution effects?

On the other hand, what is the genetic component to the argument? How strongly can it be argued that the loss of function is caused by a biochemically driven progressive cell loss/change? This, as opposed to an increased sensitivity to the environment that has a genetic basis?

The answer may be both. I am just really curious about the distinction.