Guns and other unilateral sources of noise cause more circumscribed lesions. Noise is often also a co-factor in medication type ototoxicity. Those who have hearing loss from an ototoxic antibiotic, for example, may be at much greater risk from noise. There is some evidence that heavy salt eaters are more susceptable to damage from noise. Little is known about protection.
Noise avoidance is likely important, but even here the story is complicated.
Moderate amounts of noise may protect from extreme amounts of noise. Anti-oxidants protect partially from noise or toxins in several animal models. In theory, protection from oxidative stress might be obtained by prevention of reactive oxygen species, neutralization of toxic products, and blockage of the apoptosis pathway . . Apoptosis can be blocked using capsase inhibitors. Rybak LP, Husain K, Morris C, Whitworth C, Somani S. Effect of protective agents against cisplatin otoxicity.