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The Truth About Noise

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U.S. Preventive Services Task Force recommendation, Part II

Photo Credit: Pennsylvania National Guard licensed under CC BY-NC-ND 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

As we reported, the U.S. Preventive Services Task Force recently posted a draft recommendation against recommending screening for hearing loss in adults.

Our colleagues at the Centers for Disease Control and Prevention sent us this email yesterday:

All,

The U.S. Preventive Services Task Force has provided the attached communication toolkit to help inform partners and stakeholders about the public comment period of their draft recommendation and evidence review on Screening for Hearing Loss in Older Adults. The materials are available to use online and in newsletters and may be edited as needed.

Take Care and Be Well,

NCEH Noise Induced Hearing Loss Team

That draft recommendation can be accessed here, and public comments on the draft recommendation can be accessed here.

I will definitely be sending in comments. One of my main comments will be about the statements of USPSTF member Chien-Wien Tseng, MD, MPH, MSEE, in the USPSTF press release, who said, “Increasing age is the most important factor for hearing loss.” In so stating, Dr. Tseng perpetuates an inaccurate belief, not supported by scientific research.

Yes, the terms presbycusis or age-related hearing loss are in common usage, both implying that hearing loss is part of normal aging, but this is not the case.

There is age-related hearing loss, but it is caused by a lifetime of noise exposure. Noise exposure is the most important factor for hearing loss, not age. I spoke about this in Zurich in 2017 at the 12th Congress of the International Commission on the Biological Effects of Noise. My conclusion, based on a literature review going back to the 1960s when Dr. Samuel Rosen showed preserved hearing in older Mabaan people in the southern Sudan region, is now supported by the research of Wu et al. from Dr. Liberman’s laboratory at the Massachusetts Eye and Ear Infirmary. Age-related hearing loss in humans stems from hair cell death, not from normal aging or vascular damage. Hair cell death is caused by noise exposure.

In 2017 the CDC reported that about 25% of American adults age 20-69 had noise-induced hearing loss, with about 20% of those with hearing loss having had no significant occupational noise exposure. In addition, about 25% of those with hearing loss had no idea that they had any auditory problems.

The USPSTF press release also stated, “[i]f someone is concerned about their hearing [sic], they should talk to their clinician to get the care they need.” But the CDC publication also found that only 46% of those who knew they had hearing problems had seen any health care practitioner about this.

That’s something I will also comment on. I think the scientific evidence is pretty clear that treating hearing loss benefits those who can’t hear, and may encourage them to protect their hearing from further damage.

Because if something sounds loud, it is too loud, and hearing loss will likely eventually occur.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He is the founding chair of The Quiet Coalition, an organization of science, health, and legal professionals concerned about the impacts of noise on health, environment, learning, productivity, and quality of life in America. Dr Fink also is the interim chair of Quiet Communities’ Health Advisory Council, and he served on the board of the American Tinnitus Association from 2015-2018.

Noisy and dangerous helicopters assault NYC skies

This photo is in the public domain

by Arline L. Bronzaft, Ph.D., Board of Directors, GrowNYC, and Co-founder, The Quiet Coalition

Transportation noise has been recognized as a hazard to health and well-being. This includes noise from aircraft, including helicopters, as well as from nearby roads and rail. We, indeed, have the research that underscores the adverse impact of helicopter noise, as discussed in Julia Vitullo-Martin’s article in the Gotham Gazette, on residents who have to deal with “[t]he incessant low-flying air traffic tormenting parks and neighborhoods.”

While tourists view helicopter flights over New York City as fun and providing the opportunity to take some wonderful photographs, the people who live in areas over which the helicopters fly judge one of the frequent sightseeing companies, FlyNYON, as not only loud but dangerous. Vitullo-Martine writes that the company is known for “evading federal safety regulations by classifying its doors-off tours as photographic in purpose rather than for tourists.” With modern technology now allowing individuals to track helicopter flights, whether commuter or sightseeing, Vitullo-Martin reports that citizens have the data to establish that rules of flying are not always observed.

New Jersey residents, Vitullo-Martin notes, also complain about the intrusive helicopters, but the two states have not yet worked toward coming up with a solution to the noise problem.

One answer to resolve the issue of dangerous, noisy helicopters is through appropriate legislation at the city, state, and federal levels. Several New York City congresspeople have co-sponsored the Improving Helicopter Safety Act of 2019, which would “prohibit non-essential helicopters from flying in covered airspace of any city” with a very large population and a huge population density. This would definitely include New York City. But nothing is happening in Congress regarding this bill.

In New York City, legislation was introduced in July “to amend New York City’s administrative code to reduce noise by chartered helicopters.” I checked with one of the sponsors of the proposed bill and was told it was put on hold, largely due to all the attention being paid to the COVID-19 pandemic at this time.

Until any level of government is willing to act, New Yorkers will have to continue to live with the noisy and dangerous helicopters flying above their heads.

Dr. Arline Bronzaft is a researcher, writer, and consultant on the adverse effects of noise on mental and physical health. She is co-author of “Why Noise Matters,” author of “Listen to the Raindrops” (children’s book illustrated by Steven Parton), and has written extensively about noise in books, encyclopedias, academic journals, and the popular press.  In addition, she is a Professor Emerita of the City University of New York and Board member of GrowNYC.

Quieter, cleaner future is Airbus’ newly-announced goal

Image courtesy of Airbus

by David M. Sykes, Vice Chair, The Quiet Coalition

One hundred and twenty years ago, two Ohio bicycle makers, the Wright Brothers, founded the aircraft industry by developing the world’s first motorized airplane. Now the technology leadership of that industry is lifting off for the EU, where the multi-national EADS (Airbus) is headquartered. On September 21st, Airbus announced a major, strategic initiative called “InNOVAtion” that lassos all of the technology advances in physics, materials science, and electrically powered flight and ties them to the global demand for aircraft that can be significantly cleaner, environmentally sustainable, and quieter.

This is a very big deal as anyone in the aircraft industry will attest–2020 marks an early stage of what is already understood to be a significant and necessary transformation of this huge, and very rich, industry which has been America’s leading, federally-supported export since WWII.

But this is not the first time the Wright brothers’ invention has been taken over by outsiders. When America’s power brokers turned up their noses at the two under-educated Ohio bicycle-builders fledgling innovation, Germany enthusiastically encouraged the Wrights, and by WWII Germany was far ahead in both internal combustion-fueled and rocket-fueled flight. Germany’s dominance in the early stages of WWII provoked the U.S.’s competitive drive to re-capture the industry, something that was only accomplished with the help of thousands of German scientists who emigrated here after WWII.

Why aren’t Boeing and it’s engine partner GE—those once unbeatable, rich and globally domineering hegemons—taking the lead in the current re-invention of this extraordinarily successful, American industry? That’s a long story but it includes their cozy, undemanding relationship with the FAA and their short-term, Wall Street-driven focus on shareholder return instead of innovation.

Here at Quiet Communities, Inc. and The Quiet Coalition, we’ve focused for nearly a decade on a method we call “Push-Pull.” Push-Pull achieves change by focusing on both pushing government and communities to envision quieter, cleaner futures, and pulling companies and communities to accelerate development of technologies and methods that deliver the products and solutions we all need for healthier lives and an environmentally sustainable world.

So we’re thrilled to see Airbus embracing it’s leadership role and leading the way. Maybe their initiative will wake up and push the FAA, Boeing, GE, the Department of Defense, and Congress so that they understand that cozy, undemanding relationships backed by gigantic government subsidies are a recipe for losing a vital industry, not for growing it.

Our colleague Arline Bronzaft sent me this wonderful quote: “It’s time for all to come together and to come to grips with the problem of aviation noise, and to build, at long last, an air transportation system that is safe, healthy and quieter.” Arline was being ironic–the statement was delivered at a conference 44 years ago, on April 5, 1976, by EPA leader Russell Train.

Maybe the new competition from Airbus will change some entrenched minds in Washington and Seattle so that Russell Train’s statement will take on a second life.

David Sykes chairs several professional organizations in acoustical science: QCI Healthcare Acoustics Project, ANSI Committee S12-WG44, the Rothschild Foundation Task Force on Acoustics, and the FGI Acoustics Committee. He is lead author of “Sound & Vibration 2.0” (Springer, 2012), a contributor to the NAE’s “Technology for a Quieter America” and the GSA’s “Sound Matters,” and co-founded the Laboratory for Advanced Research in Acoustics at Rensselaer Polytech. A graduate of UC-Berkeley with advanced degrees from Cornell, he is a frequent organizer of professional conferences in the U.S., Europe, Asia and the Middle East.

Companies urged to hire “Chief Sound Officers”

Photo credit: Andrea Piacquadio from Pexels

by David M. Sykes, Vice Chair, The Quiet Coalition

My first reaction to this article by Frank Fitzpatrick in Forbes advising companies to hire “Chief Sound Officers” was that the author’s tongue was firmly planted in his cheek. But no, he’s making some very valid points that corporate leaders could learn from: sound matters to business in lots of ways that deserve consideration.

As Fitzpatrick says, “You may not be in the sound business, but sound is in your business.” He notes that ambient noise level in retail spaces and workplaces has important effects on customer behavior and satisfaction, and on employee satisfaction and productivity.

I’m most taken by his discussion of hearables technologies coming to market now like the Apple iWatch with built-in sound meter. But there’s much more than that coming out of R&D labs to connect biometric data to wearable technologies on the assumption that informed consumers are more likely to be healthier too.

As Dr. Daniel Fink says: if it sounds loud, it is TOO loud. But if you’re used to ignoring noise, having a warning system on your wrist, a wearable device like an iWatch with a built-in sound meter, could be very helpful, and if enough people use it, that would be good for public health.

David Sykes chairs several professional organizations in acoustical science: QCI Healthcare Acoustics Project, ANSI Committee S12-WG44, the Rothschild Foundation Task Force on Acoustics, and the FGI Acoustics Committee. He is lead author of “Sound & Vibration 2.0” (Springer, 2012), a contributor to the NAE’s “Technology for a Quieter America” and the GSA’s “Sound Matters,” and co-founded the Laboratory for Advanced Research in Acoustics at Rensselaer Polytech. A graduate of UC-Berkeley with advanced degrees from Cornell, he is a frequent organizer of professional conferences in the U.S., Europe, Asia and the Middle East.

U.S. Preventive Services Task Force says no to hearing loss screenings

Photo credit: Bundesinnung Hörakustiker licensed under CC BY-SA 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

The U.S. Preventive Services Task Force is a federal committee that recommends what screening tests should be performed by doctors and others to keep Americans healthy and to detect asymptomatic disease. By definition, a screening test is not prompted by symptoms or patient complaints–that would be a diagnostic test–so the standard for performing a screening test is very high. The decision for USPSTF to recommend a screening test must be strongly supported by scientific evidence.

The USPSTF reviewed the literature and concluded that the evidence doesn’t yet exist for hearing loss screening. There is extensive research showing that hearing loss is strongly correlated with dementia, but the studies examining whether providing hearing aids to those with hearing loss prevents or delays dementia haven’t been completed.

I am disappointed. Many adults with hearing loss don’t know that they have hearing loss, and their lives can be improved with hearing aids. Let’s hope that when the research is completed the evidence will be clear: treating hearing loss benefits adults as well as children.

Until then, we can prevent our own hearing loss by avoiding loud noise or wearing earplugs if we can’t avoid noise exposure, and can help educate others about preventing hearing loss.

Because if something sounds loud, it’s too loud, and auditory damage will follow.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He is the founding chair of The Quiet Coalition, an organization of science, health, and legal professionals concerned about the impacts of noise on health, environment, learning, productivity, and quality of life in America. Dr Fink also is the interim chair of Quiet Communities’ Health Advisory Council, and he served on the board of the American Tinnitus Association from 2015-2018.

Preventing hearing loss from recreational noise exposure

Photo credit: D Coetzee has dedicated this photo to the public domain

by Daniel Fink, MD, Chair, The Quiet Coalition

As I have written often, in public health prevention of disease is almost always cheaper and better than treating it after it affects someone. This is certainly true for noise-induced hearing loss, where the only current treatment is amplification using hearing aids or newer personal sound amplification products.

BioMed Central, one of the world’s leading open-access publishers of medical and scientific journals, published a recent blog post about public health interventions to prevent NIHL. A literature review found only eight studies on the subject, with effectiveness of public health interventions at encouraging use of earplugs before noise exposure being statistically significant in terms of effectiveness, but in my opinion not great enough to really protect the public.

Michael Loughran, the author of the blog post, concluded:

Overall the results tell us there are very few hearing protection interventions addressing recreational noise exposure, a global hearing health concern, and those that have tackled the issue have had mixed success. Further intervention studies should be conducted that employ randomized controlled designs, with use of systematic approaches to intervention development (e.g. the behavior change wheel), as this will help target specific behavior change techniques in an effort to increase hearing protection behaviors and raise effect sizes.

I’m a big believer in scientific research. There usually is no giant breakthrough from most research studies, but taken together they help provide useful information on which to base both public policy and personal behavior.

For prevention of NIHL, the science is clear and no further research is needed. Noise exposure causes hearing loss, which can be prevented by avoiding loud noise and prevented or reduced by wearing OSHA-rated hearing protection with a Noise Reduction Rating of 25 or greater.

More research on how best to encourage people to protect their hearing would be a good thing. But an even better thing would be for federal and state agencies to issue detailed guidelines for reducing noise exposure to prevent hearing loss, as it has been done for preventing skin cancer, and for federal, state, and local health agencies to issue regulations requiring quieter malls, stores, restaurants, concerts, sports events, vehicles, and aircraft.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He is the founding chair of The Quiet Coalition, an organization of science, health, and legal professionals concerned about the impacts of noise on health, environment, learning, productivity, and quality of life in America. Dr Fink also is the interim chair of Quiet Communities’ Health Advisory Council, and he served on the board of the American Tinnitus Association from 2015-2018.

The future of work is…quieter?

Photo credit: K2 Space licensed under CC BY 2.0

by David M. Sykes, Vice Chair, The Quiet Coalition

The 2020 pandemic has office designers dreaming up healthier, greener offices—don’t let them forget noise.

This article in NPR appeared in September as people were sending their kids to schools and dreaming of going back to work. While all of those office buildings have stood empty for many months, the people who design, build, and operate office buildings have been dreaming too about how to make offices healthier places to work: windows that open to let in fresh air, HVAC systems with good air filtration built into them, “green” plant-walls, touchless elevators and doors, doorless bathroom entries, and lots of hand-washing stations.

But nobody mentioned quiet and privacy–about wanting places where you can concentrate and work without disruption. This is not a new problem. And it certainly needs to be factored into anybody’s “office of the future” if the goal is to reduce unnecessary stress and increase the ability of “knowledge-workers” to do the thought-work they’re being paid for. I wrote about this with my health acoustics colleague Bill Cavanaugh for the U.S. General Services Administration a while back.

So if you’re dreaming of what kind of ideal working conditions you’d like to have when the world goes back to work in 2021, don’t forget that quiet and the sounds of nature are as important to your mental health and your motivation to work as windows and greenery and hand sanitizer stations!

David Sykes chairs several professional organizations in acoustical science: QCI Healthcare Acoustics Project, ANSI Committee S12-WG44, the Rothschild Foundation Task Force on Acoustics, and the FGI Acoustics Committee. He is lead author of “Sound & Vibration 2.0” (Springer, 2012), a contributor to the NAE’s “Technology for a Quieter America” and the GSA’s “Sound Matters,” and co-founded the Laboratory for Advanced Research in Acoustics at Rensselaer Polytech. A graduate of UC-Berkeley with advanced degrees from Cornell, he is a frequent organizer of professional conferences in the U.S., Europe, Asia and the Middle East.

Fake crowd noise poses real health threat

by Jan L. Mayes, MSc, Audiologist

With coronavirus pandemic restrictions on fan attendance, NFL football teams have lost the stadium crowd noise once called a home field secret weapon by the Seattle Seahawks.

As a solution, the NFL has developed club and stadium specific crowd-noise audio to use during TV broadcasts. While the TV crowd-noise audio will have dynamic volumes reactive to game situations, a separate field-level crowd-noise audio played during games has been described as “human torture” by 49ers coach Kyle Shanahan.

The steady volume continuous field-level noise is being played in the 70 to 75 decibel (dB) range which is much lower than typical levels in stadiums full of fans. This new NFL audio soundscape is a good example of the subjective nature of sound perception with teams preferring real or realistic crowd noise reactions over the lower volume drone of pre-recorded field-level audio.

Objectively, sound energy above 70 dB is a hearing health risk. Some teams use special earplugs to screen out harmful noise. Stadiums could also turn down the volume of the new ambient crowd-noise.

One day it will be safe again for fans to return to stadiums. But until then, the NFL’s new field-level crowd-noise won’t give a home field advantage to any team.

Jan L. Mayes is an international Eric Hoffer Award winning author in Non-Fiction Health. She is also a blogger and newly retired audiologist still specializing in noise, tinnitus-hyperacusis, and hearing health education. You can read more of Jan’s work at her site, www.janlmayes.com.

 

World Hearing Day is March 3, 2021

by Daniel Fink, MD, Chair, The Quiet Coalition

Each year the World Health Organization sponsors World Hearing Day, selecting a theme for that year’s event. Next year’s World Hearing Day on March 3, 2021, will mark the launch of the World Report on Hearing, and will be an opportunity to raise awareness of this topic among policymakers and the public. The theme for next year will be “Hearing Care for ALL!”

The WHO notes that:

  • Good hearing and communication are important at all stages of life.
  • Hearing loss and related ear diseases can be avoided through preventative actions such as: protection against loud sounds, good ear care practices, and immunization.
  • Hearing loss and related ear diseases can be addressed when it is identified in a timely manner and appropriate care sought.
  • People at risk of hearing loss should check their hearing regularly.
  • People having hearing loss or related ear diseases should seek care from a health care provider.

Our focus has been on prevention of hearing loss, not on treatment. In public health, prevention is almost always cheaper and better than treatment.

Treatment of hearing loss is currently limited to hearing aids or newer personal sound amplification products. Unfortunately, according to the World Bank approximately 10% of the world’s population lives on less than $2 a day, and 20% on less than $3.20 a day. Even the least expensive hearing aid is unaffordable for people living in poverty, and even if they were given one, batteries and maintenance would be problems.

When one is struggling to earn enough money to have food to eat, prevention of hearing loss is low down on the priority list. And in under-resourced populations, infections may be a greater cause of hearing difficulties than noise exposure. The ultimate solution will be elimination of poverty, but that may be a long time coming.

In the meantime, for those of us with adequate resources, remember that if it sounds loud, it’s too loud.

Avoid loud noise, wear hearing protection if you can’t, or face hearing loss later in life.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He is the founding chair of The Quiet Coalition, an organization of science, health, and legal professionals concerned about the impacts of noise on health, environment, learning, productivity, and quality of life in America. Dr Fink also is the interim chair of Quiet Communities’ Health Advisory Council, and he served on the board of the American Tinnitus Association from 2015-2018.

Innovative design key to quieter aircraft

Photo credit: Courtesy of Otto Aviation

by David M. Sykes, Vice Chair, The Quiet Coalition

This article from CNN covers one of the odder looking innovations in aircraft design, the Celera by the California-based company Otto Aviation. It looks more like a gas-filled dirigible than a fixed-wing aircraft. But what it really demonstrates is how much room there is for improvements in aircraft design. Otto Aviation has focused on reducing power requirements–which also reduces noise levels–by optimizing “laminar flow.”

Their Celera 500L bullet plane results in a much lighter aircraft with much higher fuel efficiency and a much smaller engine. Marvelous! Doubtless, they’ve also taken great care to reduce the plane’s weight by using innovative materials.

The author of the CNN piece calls 2020 “the strangest year in aviation history” because of all the turmoil. Namely, Boeing’s grounded and deadly 737MAX, the COVID-19 pandemic, the emergence of commercially-available, electrically-powered aircraft, and the growing concern about the astonishing impact of air travel on the environment. And certainly some of the emerging aircraft we’re seeing are strange looking indeed. But as economist Paul Romer said, “a crisis is a terrible thing to waste.” So maybe we’ll look back on this period as one of remarkable innovation that is hopefully leading to a quieter and more environmentally-sustainable future.

But please note that these innovative designs are coming not from Boeing and it’s engine-partner GE. Both of those behemoths are looking a lot like dying dinosaurs right now. The innovations are coming from well-funded startups, Celera being one of a few in the U.S. Most of the innovators appear to be in the EU, where both environmental and noise issues are taken seriously and where industry leaders like Airbus and Siemens are solidly behind the next wave of innovation.

David Sykes chairs several professional organizations in acoustical science: QCI Healthcare Acoustics Project, ANSI Committee S12-WG44, the Rothschild Foundation Task Force on Acoustics, and the FGI Acoustics Committee. He is lead author of “Sound & Vibration 2.0” (Springer, 2012), a contributor to the NAE’s “Technology for a Quieter America” and the GSA’s “Sound Matters,” and co-founded the Laboratory for Advanced Research in Acoustics at Rensselaer Polytech. A graduate of UC-Berkeley with advanced degrees from Cornell, he is a frequent organizer of professional conferences in the U.S., Europe, Asia and the Middle East.