Years of drag racing without hearing protection also hurts. I didn't start pistol shooting until about 6 years or so ago, have used ear plugs plus muffs nearly the entire time, but shoot several hundred rounds per week under a large three sided shed in .22/.45/9mm and have STILL added some damage to my hearing. Plus I'll be 70 next year and some of what I've seen my be deterioration not gun related.
But I found that I wasn't even getting my Howard Leight expanding plugs inserted correctly and had to become more careful with them--when they are right, they block nearly everthing. If you can see them from the front, they aren't inserted far enough.
My worst fear now is loosing my hearing aids while on a trip or at a conference.
I should have been a look more careful for the last 57 years, less open headers, more silencers, more care with the hearing protection.
Joe