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Like yourself, i have a touch of tinnitus and i also don't hear well in my left ear. Sirens are particularly painful, as are jackhammers, leaf blowers, and diesel trucks.
Having put that out, i don't think that there's an alternative to loud sirens and other emergency vehicle warning sounds (and bright lights.) The problem being many drivers simply do not hear them. The reason can be traced to many, if not most, modern cars are truly cocoons: they're basically soundproof especially when the windows are closed. Also,too many drivers often have the car's sound systems cranked, or they're on the 'phone, or in deep conversation with passengers, or just plain zoned out. And again, many people- not just drivers- have become so inured to the urban soundscape that they just don't even notice the noise.
Mike hits the nail on the head with this response.
The thing is that I'm sure that the passenger of the ambulance is appreciative of the ability of those in their cocoons to hear the approach and get out of the way. Better for them to arrive at their destination too soon than too late.
I think the emergency vehicles here in Chicago overdue it when it comes to using the siren. There is no reason to have it blasting continuously as they progress down the street. In Washington DC they only use it at intersections and give it a short "toot, toot" if necessary to clear the way. If it works there, why can't it work the same way here?
I can't speak to D.C., but even with sirens blasting at the volume they use in Chicago, I've witnessed more close calls when an ambulance is going through an intersection and a car doesn't yield (or instances where cars simply won't pull over while driving down a street) than I care to think about.
Sure, the volume level likely has nothing to do with it, and the cars are likely simply trying to beat the ambulance, but 9 out of 10 times a driver will probably claim they didn't here the siren if an accident happens. Unfortunately, drivers here seem to respect emergency vehicles a lot less than some other cities, and that in turn seems to lead to emergency departments constantly running sirens to try and clear the way.
To me, it's not the volume that is the problem, so much as the pitch or tone. First, something about the sound of a siren makes it difficult to locate in space. (Ever noticed that?) Some sounds are very directional; for some reason, sirens are not among them. So, a siren sound that is easy to locate would be great.
A lower pitch might also help make it more audible. Most people (but not me!) have hearing loss in the upper registers when they start to lose their hearing, so having such high-pitched sirens means that they are actually less audible to some people than lower sounds. (And for those of us who have retained our high-end hearing but lost more in the middle, sirens are excessively painful.)
Finally, a new siren sound, one that is totally unfamiliar, would likely get drivers' attention, at least for a week or two!
One tip, wear ear plugs while riding. You will adjust to the lower decibel sounds before you even get on the bicycle.
I've never thought about earplugs, but maybe I'll consider that the next time I'm biking through River North and Streeterville. Since areas with a lot of high rises all around(including also the Loop), seem to be the only times I ever find emergency vehicle sirens to be obnoxiously loud. Most of the time, it doesn't bother me too much. In a way with how loud emergency vehicle sirens can get and echo all over, I can see why Ald. Hopkins chose to move(per a report I read in some newspaper, don't remember which one reported it) from Streeterville to a different part of his ward!
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