It would seem to me that firing indoors increases the duration of the sound over what happens outside, when the wave propogates away from the sound source without being reflected back and reflected yet again until the energy dissipates.
Absolutely.
Every shot indoors is experienced at near peak intensity for a much longer duration than the same shot outdoors.
This makes hearing damage far more likely.
The sound waves will reflect back and forth from hard surfaces and continue to hammer the ears until they run out of steam. While outside they continue to travel away from the location of the shooter. The ground is the closest hard surface outdoors, but even then the intensity is diminished as the angle the waves impact the ground send most of them away from the shooter.
In a rural outdoor environment with soft soil, living tree bark, bushes, grasses or ground cover, and other soft objects the sound will be more absorbed so what does eventually reflect back has been severely diminished in intensity.
Even further reducing the overall loudness.
Indoors the walls and ceiling are often hard flat surfaces that will direct the sound right at the shooter. The floor may be carpeted, but the space is still enclosed (further increasing the effects of the pressure wave.)
The sound waves will ricochet endlessly in an enclosed space until they run out of steam.
The smaller the space the worse the effects. A bedroom would be bad. A kitchen or bathroom with all hard surfaces would probably be the worst as the sound would reflect from those surfaces with the strongest intensity.
This means a shot fired indoors without hearing protection from many calibers will be worse than several shots outdoors.
Hearing damage is cumulative though. So as a person becomes more deaf or loses hearing of various frequency ranges they are less sensitive to the pain and damage of a similar decibel loud noise.
Allowing them to further damage their hearing with less discomfort.
People partially deaf don't notice what they can't hear until it typically has progressed pretty far.
The subtle rustling of the leaves, distant chirping of birds, a small animal moving in the brush, a gentle lapping of water, the majority of such things will just be absent from their perception.
It is not until the much louder noises like a person talking in a normal tone become difficult to hear that they typically realize they have a problem.
By then they have lost a lot more than they had realized.