Mahmoud Khouja came to Sweden two years ago. He fled from Aleppo, one of the cities worst affected by the civil war in Syria.
"I learnt to open my mouth and hold my ears when the explosions came. It was to cope with the pressure waves," he tells Swedish Television's local channel in Värmland.
He is one of 150 people, all with varying experiences from the war in Syria, who received hearing and sight tests as part of an investigative survey by a cooperative organization in the area consisting of the Social Insurance Agency, the Värmland county council, the municipalities and the Public Employment Agency.
"We felt that there were problems with SFI (Swedish language classes for immigrants) that many stayed on too long. We wondered if there were problems with sight or hearing," says Torbjörn Johansson, head of the employment service in northern Värmland.
"We want to get any new arrivals into jobs as quickly a possible," he tells Swedish Television.
Forty percent of the newly arrived refugees surveyed have hearing loss. Some of them serious, says Madeleine Karlsson-Svensc, who is a nurse in occupational health in Torsby.
"Those who have hearing loss and are under 60 years of age have often been affected by loud noise and we know that these people come from the war and have been close to various acts of war," says Karlsson-Svensc.
On Wednesday, the association representing those with a hearing disability (HRF), called for the employment agency to carry out hearing tests on all refugees coming to Sweden.
"The figures are alarming. Being able to keep up with what is said on the SFI program is essential to learn Swedish, and ultimately a prerequisite for successful integration - to study, get a job and build a new life in Sweden," says Mattias Lundekvam, from HRF, the organisation representing people with hearing difficulties.