Monthly Archive: August 2017

PSAPs appear to work (but preventing hearing loss is better)

Photo credit: Hadley Paul Garland licensed under CC BY-SA 2.0

By Daniel Fink, MD, Chair, The Quiet Coalition

Personal sound amplification products (PSAPs) appear to work. What is a PSAP? It’s really a hearing aid but it’s called a PSAP to avoid federal and state regulations. PSAPs can be sold directly to consumers without a physician or audiologist evaluation, and they are much cheaper than conventional hearing aids–in the range of $350 a pair instead of $3000 apiece.

This Research Letter in a recent issue of JAMA compared five PSAPs with a conventional hearing aid. The Johns Hopkins research team reported that some of the PSAPs worked quite well. Four of the PSAPs are traditional “behind the ear” devices that look like cheaper, less well made versions of traditional hearing aids, but one, the Etymotic Bean, might be placed into the newer category of “hearables” that are marketed as “smart earbuds.”

Why is this report important? PSAPs were strongly recommended by two recent expert federal reports (a report from the President’s Council of Advisors on Science and Technology in October 2015​ and a report from the National Academy of Medicine) as a solution–perhaps the solution–to the nation’s epidemic of hearing loss in older Americans.

To some they are the holy grail for hearing loss, enabling all to hear well without spending thousands of dollars. To others, especially audiologists and hearing aid dispensers, they are an existential threat. If grandma and grandpa can buy much cheaper hearing aids on their own from Amazon or Costco, why see an audiologist or hearing aid dispenser? Just buy your PSAPs online or at your nearby big box store.

Unfortunately, neither federal report mentioned the prevention as a solution for hearing loss. As I said in my presentation at the 12th Congress of the International Commission on the Biological Effects of Noise in Zurich on June 20, 2017, significant hearing loss is probably not part of normal aging but is noise-induced hearing loss caused by a lifetime of excessive noise exposure.

The inconvenient truth about hearing aids is that they don’t work very well at helping users understand speech in normal, everyday situations. For obvious reasons, there is little peer-reviewed research on this topic in the audiology literature, but two studies report approximately 40% non-usage rates. There is no reason to expect–especially without any training and teaching by an audiologist–that PSAP users will have any greater success.

Needing hearing aids or PSAPs in old age to treat hearing loss is not normal, just as needing complete dentures in old age because of tooth loss from poor dental care is not normal. Both are the only remedies available when we have failed to protect what Mother Nature gave us. But it’s much better to protect your ears and preserve your hearing than to use even the best hearing aid or the less costly PSAP alternatives.

The time to start protecting your ears is now! If it sounds too loud, it IS too loud. Avoid loud noise, and if you can’t avoid it, wear hearing protection.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He serves on the board of the American Tinnitus Association, is the interim chair of Quiet Communities’s Health Advisory Council, and 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.

Noise is the excreta of technological civilization

Photo credit: G.M. Briggs

Jonathan Power, author and former foreign affairs columnist for The International Herald Tribune, writes about favorite sounds and the scourge that is noise. Power’s favorite sounds “are the quiet sounds of the English Lake District,” which he contrasts with the sound of noise: cars and trucks, airplanes and builders, canned music in cafes, a symphony playing an atonal concerto.  “Noise,” he concludes, “is the excreta of technological civilization,” adding that “[o]ne study predicts that exposure to loud music will cause 50 million Americans to suffer heavy hearing loss by 2050.”

Power looks at the health effects of noise–not just damage to hearing, but also “high blood pressure, disturbed sleep and even heart disease.” He writes about the fight against another runway at Heathrow and the political fight that was lost–or is it?–by the tens of thousands living near the airport, while noting that smaller battles can be won. And while noise “is never likely to compete with other political issues such as unemployment and nuclear weapons in North Korea,” Power notes that politicians are sensitive to political pressure. Moreover, he lists measures that have been tried and tested in various places which can be borrowed wherever we live, like Switzerland’s ban on the driving of heavy trucks at night and on Sundays, or the U.S.’s and UK’s modification of noise regulations in 1976 which required older aircraft to comply with noise limits set for new aircraft.

Power calls for us to put these and other examples on social media and, more importantly, to “demand MORE, and distribute your demands far and wide.”  In the end, if we want to enjoy our favorite sounds, we have to fight for the right to hear them.

NYC’s DEP launches sound and noise education program

Photo credit: Arline Bronzaft, PhD

By Arline Bronzaft, PhD, Board of Directors, GrowNYC, and Co-founder, The Quiet Coalition (introduction by G.M. Briggs, Editor)

The educational arm of New York City’s Department of Environmental Protection (DEP) has recently launched a sound and noise education module.The module consists of:

Interactive, multi-disciplinary, STEM lessons and activities [that] introduce students and teachers to the study of the New York City sound environment, New York City’s Noise Code, and the public health issues, both mental and physical, associated with noise.

One element of the elementary lesson plan is the book “Listen to the Raindrops,” by Dr. Arline Bronzaft, noted noise activist, GrowNYC board member, and a co-founder of The Quiet Coalition. Dr. Bronzaft writes about her involvement in the DEP’s groundbreaking noise education efforts:

For years I have conducted research and written on the adverse effects of noise on mental and physical health, including the impacts of noise on children’s learning. One day discussing noise with a children’s book writer, she suggested that I take a stab at writing a book to teach children about the dangers of noise. My first response was that I was not suited for the task, but she said, “if not you, who?” When I left her apartment, I took pencil to paper and during the hour trip back to my home I completed the book “Listen to the Raindrops.” The book, which was written in rhyme, aimed to teach children about the beauty of the good sounds around them and the dangers of noise, especially to their ears.

A children’s book requires illustrations, of course, and I was fortunate that Steve Parton, an illustrator, and the father of a daughter who had received one of the first cochlear implants, agreed to provide the illustrations. After reading the book to a number of classes and listening to the children’s comments, it was clear that Steve’s illustrations beguiled the children.

For years I have worked closely with DEP in our joint efforts to bring the decibel level down in this city. Much still needs to be done, but I was delighted when the DEP’s educational arm added a sound/noise component to its website and asked to include “Listen to the Raindrops” to its curriculum.

The DEP has recently launched its sound and noise curriculum–it is online and all are invited to go to the site to see it. Now we need you to spread the word about the curriculum. Noise is not just a New York City problem. Cities and towns worldwide can include noise education in their school curricula. The federal Environmental Protection Agency also has materials on its website that educate elementary school children about the harmful effects of noise ( e.g., Listen Up!), but at one time the agency made a greater effort than today to reach out to schools nationwide about teaching children about the dangers of noise.

Let us alert public officials, educators, and all citizens to the importance of teaching children early on that noise will harm their ears, their learning ability, and their overall health. Promoting these educational materials will also inform the general public about the deleterious impacts of noise, as the children will undoubtedly bring home the sound and noise information they learn at school and become spokespersons for quieting our surroundings. And the children shall lead!

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.

We can curse those who made us deaf

Photo credit: Thomas Leuthard licensed under CC BY 2.0

By Daniel Fink, MD, Chair, The Quiet Coalition

There is a high likelihood that a large percentage of Americans will suffer significant (25-40 decibel) noise-induced hearing loss as we age because we are exposed to too much noise.

Fortunately, as this lively video shows, we will still be able to curse those who made us deaf using American Sign Language.

WARNING: The language and gestures on this video are explicit. They are not appropriate for those under 18 years of age and may upset others. Definitely NSFW.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He serves on the board of the American Tinnitus Association, is the interim chair of Quiet Communities’s Health Advisory Council, and 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.

Noisy restaurants in the news again

Photo credit: Matt Biddulph licensed under CC BY-SA 2.0

By Daniel Fink, MD, Chair, The Quiet Coalition

Two reports this week, one from the United Kingdom and one from Baton Rouge, again highlight the problem of noisy restaurants.

Restaurateurs say that a quiet restaurant is a dead or dying one. They want their places to be lively. But there’s a difference between a lively restaurant with spirited conversations going on among the diners, and one that is deafeningly loud, making it impossible to converse with one’s dining companions.

Yesterday, while looking for another piece of information in the Environmental Protection Agency’s (EPA) classic 1974 “Noise Levels Report” Information on Levels of Environmental Noise Requisite to Protect Public Health and Welfare with an Adequate Margin of Safety (EPA, 1974). I came across Table D-10, which I had missed on an earlier reading.

EPA Recommended Acceptable Noise Levels for Restaurants  (Click to enlarge)

It turns out that the EPA recommends that restaurants be very quiet, only about 50-60 decibels. These days, that’s almost “library quiet”. In fact, some months ago I measured the sound level to be approximately 45 dBA in the main circulation room of my local library!

So concern about appropriate restaurant noise levels is not a new concern. It’s decades old.

Some have suggested that diners should walk out of noisy restaurants, or boycott them. But in many cities, if we did that, we would never eat in a restaurant. There just aren’t any quiet ones. And as long as the restaurants are full, there is no incentive for them to become quieter.

I don’t know about the UK, but in the U.S., lawsuits under disability rights laws may be the only way restaurants will become quieter.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He serves on the board of the American Tinnitus Association, is the interim chair of Quiet Communities’s Health Advisory Council, and 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.

Quiet aircraft coming to an airport near you?

Photo credit: Pedro Aragão licensed under CC BY-SA 3.0

By David Sykes, Vice Chair, The Quiet Coalition

People who live near airports have struggled with noise for over 50 years. The first attempts to address this problem began in 1967, literally 50 years ago! But frankly, there’s been more progress on this issue outside the U.S., where, for example, the World Health Organization has addressed the burden of disease from environmental noise and the European Union has established night noise guidelines for Europe.

Meanwhile, here on American soil, the struggle continues with groups like the Congressional Quiet Skies Caucus and regional Quiet Skies groups experimenting with different approaches. A variety of strategies have been tested with varying success: petitions, fines, law suits, noise curfews, legislation, even complete airport shutdowns. Every American community that has confronted this issue realizes it’s a tough, long, uphill battle against powerful regulatory agencies and corporations that are more committed to commerce than to public health and welfare.

So, why can’t Boeing or somebody just make a quiet aircraft?

Actually they can—that is, the EU conglomerate Airbus canand already does. And the world’s largest passenger airplane, also made by Airbus–the A380–is the quietest both inside and out. So this isn’t a technological problem. Rather, aircraft engineers, manufacturers (other than Airbus), and the airlines that buy their planes, don’t seem to care about the impact of their products on those on the ground.

Interestingly, the quiet jet engine on the Airbus A320neo is made by the American company Pratt & Whitney.

Hooray! So why don’t U.S. airlines buy the A320neo equipped with its quiet jet engines? Wouldn’t this help to address the aircraft noise problem?

Good question.

For U.S. residents there’s also this good news: a new NASA program to develop quiet electric aircraft was recently announced, but the quiet electric aircraft are small propeller craft, so this is the kind of innovation you’ll see at smaller local airports in a few years.

What about helicopters? Can they make quiet helicopters too? The answer is yes again. Quiet, electric helicopters are also in development.

Conclusion? Maybe “technology substitution”–which works in other sectors–is the uniquely American way out of this dilemma.

At any rate, government-funded research and development (R&D) efforts by NASA and Pratt & Whitney demonstrate that somebody is listening! And in typical American fashion, it appears we will invent our way out of the airport noise mess by convincing the government to accelerate funding of both public and private sector R&D—from which entrepreneurs and business titans will reap rewards later.

At The Quiet Coalition and our host, Quiet Communities, we believe that local and regional anti-noise groups might have greater success if, in addition to the other strategies they’re already trying, they also emphasize “technology substitution.” This approach has worked well in cities and towns on issues like:

– leaf blowers and lawn mowers (convince your parks and recreation department to buy electric!);
– motorcycles (get them off Harleys and onto quieter electric motorcycles);
– appliances (the best-selling dishwasher these days is made in Germany and has become very popular worldwide because it’s quiet);
– air conditioning equipment (the best-selling household air-conditioning equipment is the quiet kind from Korea called “mini-splits” that were engineered to be quiet); and
– outdoor concerts (where wireless headsets are replacing noisy outdoor concert venues).

So our tech-driven American approach to “progress” may eventually get us to a quieter end-state—but the emphasis is on eventually.

In the meantime, until quieter times arrive, those of us who live near airports will have to either continue wearing earplugs or maybe experiment with the new “smart earbuds” that are now available.

And don’t forget the final option: move to a quieter neighborhood where your house isn’t underneath a flight path! Because you might have to wait a while before the above solutions arrive.

David Sykes chairs/co-chairs four national professional groups in acoustical science: The Acoustics Research Council, ANSI S12 WG44, The Rothschild Foundation Task Force on Acoustics, and the FGI Acoustics Working Group. He is also a former board member of the American Tinnitus Association, co-founded the Laboratory for Advanced Research in Acoustics (LARA) at Rensselaer Polytechnic Institute, served as lead-author of “Sound & Vibration 2.0 (2012, Springer-Verlag), and was a contributor to “Technology for a Quieter America” (2011, National Academy of Engineering). A graduate of the University of California/Berkeley with graduate degrees from Cornell University, he is a frequent organizer of and speaker at professional conferences in the U.S., Europe, Asia, and the Middle East.

How to deal with noisy neighbors

By Arline L. Bronzaft, PhD, Board of Directors, GrowNYC

Alexandra Levine’s recent article on noisy neighbors revealed how New York Today readers have dealt with noisy neighbors. While simply speaking to your “noisy” neighbor may result in a lessening of the din, there are many times when polite requests don’t work. Some residents, we learn from the article, turn to shaming their neighbors into quieting down. I have heard about others who “fight back” by inflicting similar intrusive sounds on the offensive neighbors. I do not suggest this latter response because I believe people inflicted by noise have a better case when they don’t engage in similar offensive behavior.

As a member of the board of directors of GrowNYC, where I oversee its noise activities, I am often asked to intervene on behalf of New York City residents whose requests to their neighbors–and even to the managing agents of their buildings–to “quiet it down” have gone unheeded. In writing to the managing agents on behalf of the people who have sought my assistance, I urge them to direct their attention to my research and writings on the adverse effects of noise on health. I explain that noise is not just an annoyance—it’s a health hazard–and that those in charge of managing buildings must familiarize themselves with the deleterious effects of noise so that they do not dismiss noise complaints, as many do.

When we talk about noise we are not necessarily talking about loud sounds, as bothersome sounds can disturb sleep, rest, or simply reading or watching television. Noise is defined as unwanted, unpredictable, and uncontrollable sound. Short of the harmful effects of noise on health that are discussed in the research, noise diminishes one’s quality of life.

I include GrowNYC’s Noise brochure which discusses health effects of noise and ways to lessen noise with my letters to managing agents. I also point out that under the the warranty of habitability clause in their leases residents in both rental buildings and cooperative dwellings are entitled to “reasonable quiet” in their homes. In follow-up phone calls to my initial letters, I explain the word “reasonable.” One could say that a reasonable person would be bothered by footsteps from the above apartment at six a.m. in the morning. Unreasonableness, on the other hand, would be a complaint of a toy dropped by a visiting grandchild once and only once.

I will then direct the telephone conversation to the specific noise problem and ways to abate it. I ask if the required carpeting is in place in the apartment and if the superintendent or managing agent has gone to the apartment to hear the noise. I, too, have dealt with a sex complaint that was handled by suggesting that the couple who was the source of the noise move their bed several inches from the wall so that it would no longer bang against it during sex. Often, I suggest that all residents receive flyers that speak to the harmful effects of noise and what can be done to lessen noises in their own apartments.  Finally, I stress that neighbors should be informed that living together in a building means respecting the rights of others, and this includes greater quiet in apartments.

New Yorkers face so much noise as they traverse the streets of our city. When they get to their apartments and close their doors, they hope for some quiet. Let’s join together and provide quiet for our neighbors and in return hope they will do the same for us.

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.

The NIH recognizes noisy restaurants are a problem

Photo credit: Alan Light licensed under CC BY 2.0

By Daniel Fink, MD, Chair, The Quiet Coalition

With this web content posted last year as part of its Dangerous Decibels program, the National Institute for Deafness and Other Communication Disorders (NIDCD), part of the National Institutes of Health, finally recognizes that restaurant noise is a problem. Unfortunately, NIDCD persists in stating that

Research shows that long or repeated exposure to sounds at or above 85 decibels can cause noise-induced hearing loss. Signs of having been exposed to too much noise include not hearing clearly or having ringing in your ears after leaving a noisy environment.

We disagree. By the time one can’t hear clearly or experiences tinnitus, it’s too late–permanent hearing damage has occurred. The damage occurs because 85 decibels is not a safe noise level for the public. As I wrote in the American Journal of Public Health, the only evidence-based safe noise exposure level to prevent hearing loss is 70 decibels time-weighted average for a 24-hour period. The 85 decibel standard NIDCD relies on is an occupational noise exposure level, and that standard fails to prevent hearing loss in all exposed workers. The National Institute for Occupational Safety and Health agrees, and the auditory injury threshold, discussed by Flamme, et al., is only 75-78 A-weighted decibels (dBA).

A simple rule to protect hearing is “if it sounds too loud, it IS too loud.” If you can’t carry on a normal conversation without straining to speak or to be heard, the ambient noise level is above 75 dBA (see figure D-1, “Information on Levels of Environmental Noise Requisite to Protect Public Health and Welfare with an Adequate Margin of Safety”) and auditory damage is occurring. And, unfortunately, many if not most restaurants are noisier than 75 dBA.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He serves on the board of the American Tinnitus Association, is the interim chair of Quiet Communities’s Health Advisory Council, and 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.

The unintended consequences of (failed) diplomacy

 

U.S. Embassy in Havana, Cuba (photo: U.S. State Department)

, McClatchy, reports on the mystery surrounding a sonic device used against U.S. and Canadian diplomats stationed in Cuba that caused hearing loss. Johnson writes that it is known that the “U.S. military deploys nonlethal noise and radiation weapons to incapacitate aggressors,” like a device that “can hit you with sound that will make you not be able to stand up” or that can “literally heat up water molecules under the skin’s surface.” And, of course, “[r]esearchers have also experimented with ultrasonic and infrasonic frequencies above and below the level at which humans can hear,” which, in some cases, “can cause physical discomfort at high intensity.” “They call them brown tones,” said Vahan Simidian, the CEO of HPV Technologies Inc., a firm that makes “long-range speakers that can send sound as far as two miles.” Why do they call them brown tones? Because they “can make you sick to your stomach.” And you can guess what happens next.

But the device used in Cuba was different. How? This device caused hearing loss in those it targeted. So why did Cuba purposefully deafen the diplomats? Vince Houghton, an intelligence historian employed by the International Spy Museum, speculates that it was a run-of-the-mill harassment campaign that got out of hand. Says Houghton:

The most likely scenario to me is this was used to harass, to annoy, to kind of goof off and be, like, ‘Ha ha! Let’s make them sick to their stomach. Let’s make them dizzy.’ And then, ‘Oh crap, it went too far…’

Houghton also believes that someone else was involved in developing this weapon, because the technology would be too “resource intensive” for “cash-strapped Cuba.”

The Cuban government responded by stating that it “has never permitted, nor will permit, that Cuban territory be used for any action against accredited diplomatic officials or their families, with no exception.” Meanwhile, The Washington Post reports that “investigators were looking into the possibilities that the incidents were carried out by a third country such as Russia, possibly operating without the knowledge of Cuba’s formal chain of command.”

The only good news from this twisted tale is that the unknown sonic device was probably intended only to harass, not disable. But when we read this piece our first thought was this: what if the resources marshalled to create this and the other appalling sound-based weapons were spent instead on educating the public on how to protect their hearing or distributing ear protection to vulnerable populations? That is, why do we accept that there is always money for weapons, but so little for public health?

Thanks to Bill Young, PhD, a noise reduction advocate from Stamford, Connecticut, for the link to The Washington Post article.