Monthly Archive: September 2018

Should we focus on clinical services or on preventing hearing loss?

Photo credit: Florida Fish and Wildlife licensed under CC BY-ND 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

This viewpoint article in the latest issue of The Journal of the American Medical Association by Frank Lin, MD, PhD, and colleagues at Johns Hopkins University School of Medicine and the Bloomberg School of Public Health, makes the case for expanding Medicare coverage of audiology services to help older Americans with hearing loss.

Dr. Lin and his colleagues are the leading researchers in the epidemiology of hearing loss. They have published a series of reports documenting the prevalence of hearing loss in older Americans and showing that hearing loss is strongly correlated with social isolation, depression, falls, accidents, and other conditions, all of which are associated with increased mortality in older people.

What’s missing from the article? Two things.

First, the report doesn’t explain that devices, whether they are hearing aids or over-the-counter personal sound amplification products, just don’t work as well as preserved normal hearing. The “elephant in the room” for hearing health care is the 30-40% non-usage rate among those who have obtained hearing aids, because in real-life situations, e.g., noisy stores or restaurants, these just don’t work as well as normal ears. The analogy I use is dentures. It really doesn’t matter if one has to have dentures made by a dentist and prosthodontist, or if one could walk into a drugstore or warehouse store and buy them. One’s natural teeth work better.

Second, the report doesn’t discuss the prevention of hearing loss. Continuing the dental analogy, it takes a lifetime of care, with daily brushing and flossing, regular cleanings, and dental work to keep one’s natural teeth one’s entire life. In contrast, avoiding noise-induced hearing loss is easy and costs nothing or very little–simply avoid exposure to loud noise. And if you can’t, wear hearing protection.

Remember: if it sounds too loud, it IS too loud.

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.

Silence, please! Is it really possible to mute the world?

Photo credit: Kat Jayne from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

In a word, no. But this fascinating essay mentions a 1957 science fiction story by Arthur C. Clarke predicting a machine that does that, and now scientists are working on actualizing that idea.

We’ll see how successful they are, and of course how much the new technology costs. But it seems to me that it’s much simpler to use existing technologies, or even just to enforce existing noise ordinances, than to try to develop a whole new technology. Acoustic technology is highly developed. Reduce noise at the source by design and material choices, and if that can’t be done, insulate, isolate, reflect, or contain the sound. And laws to reduce harmful and unwanted noise have long existed, including building codes, zoning codes, federal laws about vehicle mufflers, local laws about horn use, etc.

As noise pioneer Arline Bronzaft PhD wrote many years ago, it’s a matter of will, not of way, to make the world a quieter and more enjoyable place for all.

I sent these remarks to Dr. Bronzaft as a courtesy, to make sure she wanted to be quoted and to make sure I got it right. She replied with a wonderful insight: people don’t want silence, they want quiet so they can hear others talk, hear the raindrops fall, hear birds singing.

Of course, she’s right!

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.

What should we do about intentional noise?

Photo credit: Daniel from Pexels

Two recent op-eds have focused on intentional noise, specifically noise made by people who profess to love the stuff. Marcus Gee, The Globe and Mail, in his piece titled Let’s crack down on unnecessary noise pollution, focuses on enforcement–and shaming–as a means of reducing noise pollution.

Bill Reader, The Athens News, cuts to the chase when he says that “those who enjoy noisy recreation also, often quite boastfully, enjoy ruining everybody else’s peace.”

Writes Reader:

There is a reason why the word “peace” is often followed by the phrase “and quiet,” while “loud” leads almost automatically to “and obnoxious.” Whether it’s a screeching herd of ATVs hurtling down a woodland trail or a single juiced-up river boat carving its way up an otherwise placid lake, the result is the same: those who go to those public spaces for “and quiet” will instead have their day ruined by “and obnoxious.” And more often than not, “Obnoxious” could care less.

Airplane noise is an increasing problem in San Francisco

Photo credit: Jim Trodel licensed under CC BY-SA 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

This article discusses the problem of airplane noise from San Francisco International Airport (airport code SFO). One of the people affected was Rep. Jackie Speier (D-CA), who lives near the airport. She was at home, rather than in Washington, because she was recovering from surgery.

As others have found, when they are at home all day rather than in the office, environmental noise pollution really is a problem. Often it’s gas-powered leaf blowers, but this time it’s airplane noise.

Airplane noise isn’t just an annoyance. Aircraft noise causes heart disease, strokes, and death.

Maybe the fact that an elected official is herself affected by airplane noise will lead to some federal action to help solve this problem.

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 CDC is trying to prevent heart attacks. When will it try to prevent hearing loss?

by Daniel Fink, MD, Chair, The Quiet Coalition

The Centers for Disease Control has embarked on a public education campaign to reduce preventable cardiovascular mortality. They are calling it Million Hearts. Among the things people can do to prevent heart disease and fatal heart attacks are what CDC is calling “the ABCs”: a daily baby aspirin (unless there are medical reasons not to take it), blood pressure control, cholesterol control, and not smoking. Other actions include exercising, maintaining an ideal body weight, and eating a healthy diet.

Thanks to the Framingham Study, we know that heart disease and stroke are not part of normal aging but are largely preventable. Similarly, hearing loss is not part of normal aging but largely represents noise-induced hearing loss.

So when will CDC embark on a similar campaign to educate the public about preventing hearing loss? I suggest calling it the Million Ears campaign. Maybe Ten Million Ears.

A common saying is “nobody dies from going deaf,”* but that isn’t true. Hearing loss is associated with social isolation, falls, depression, and dementia in older people, all of which in turn are correlated and most likely causally related to increased mortality. Hearing loss also has major impacts on enjoyment of life and social function.

And unlike preventing heart disease and stroke, preventing noise-induced hearing loss is much easier–just avoid loud noise and wear hearing protection if you can’t.

Remember: If it sounds too loud, it IS too loud.

* The phrase “nobody dies from going deaf” is what is commonly said. The word “deaf,” however, usually denotes congenital hearing loss or severe hearing loss. The term “hearing loss” is more appropriately used for mild to moderate noise-induced hearing loss.

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 BBC dabbles in slow radio

The BBC is getting into “slow radio.” What is slow radio? According to Rosie Spinks, Quartz, The BBC‘s Radio 3 programming “will invite listeners to relax to the sounds of Irish cows being herded up a mountain and leaves crunching on walks through the country.” Alan Davey, Radio 3 Controller, says the programming with provide the audience with “a chance for quiet mindfulness.” Spinks notes that the programming sounds a lot like autonomous sensory meridian response, or ASMR, which is “the subjective experience of ‘low-grade euphoria’ characterized by ‘a combination of positive feelings and a distinct static-like tingling sensation on the skin.'” Or sounds that make you feel good.

According to Spinks, the slow radio programs will feature a range of sounds “from the animal murmurings of a zoo at dusk to one of the UK’s largest collections of clocks,” and “[o]n Christmas Eve, listeners can look forward to hearing a three-hour walk through the Black Forest in southwest Germany.”

Radio 3 already has a few offerings for you to enjoy via iPlayer radio, but, sadly, it’s not yet available in the U.S.

How to prevent hearing loss when using headphones

by Daniel Fink, MD, Chair, The Quiet Coalition

Here is another article about the dangers of using headphones for hearing. I disagree with the author’s statement that “[t]here’s nothing inherently dangerous about using headphones.” That reminds me of statements in the 1950s and early 1960s that asserted there was nothing inherently dangerous about smoking cigarettes.

I think headphones and earbuds are inherently dangerous and shouldn’t be used except for noise-cancelling headphones used in noisy situations such as aircraft cabins.

Very few headphone users worry much about the sound volume when listening to music or a podcast or book, and the natural tendency is to turn up the volume enough to be able to hear what one is listening to. There is no meter on the personal audio device to let one know what the audio output is in decibels. And there is no audio dosimeter installed on most personal audio devices, be they MP3 players or smart phones, to let the user know the time-weighted average sound exposure that day or week from the device. Even if one has this type of dosimeter–several are reportedly in the development stage–they don’t measure all noise exposure, so they may give a false sense of security.

The other quibble with this article, from the UK, is that it uses the UK and EU occupational noise exposure standard of 80 decibels as a safe noise exposure level. The UK standard is technically 80 dBA, which is safer than the 85 dBA standard used in the U.S., but it is not a safe noise exposure level to prevent hearing loss. The only evidence-based safe noise exposure level to prevent hearing loss is a time-weighted average of 70 dB for 24 hours, and even that may be too high.

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.

Living with misophonia

Photo credit: rawpixel.com from Pexels

Natalie Reilly, NZ Herald, writes about living with misophonia, the “hatred of sound.” Eating sounds are particularly enraging for Reilly, and she confides that she hates hearing her husband eat. Which could be a real problem, except he suffers from misophonia as well and, well, he hates the sounds she makes when she eats. And so this couple have found a solution to maintain marital bliss: one eats in front of the tv, the other eats in the kitchen.

Reducing Loud Sounds and Noise: A Health Matter

Photo credit: Paul Sableman licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

The Quiet Coalition’s board member and co-founder Arline Bronzaft, PhD, has an important article in the latest issue of The Hearing Journal.

Noise bothers people but it’s more than a nuisance. It is a public health hazard causing auditory disorders, such as hearing loss, tinnitus, hyperacusis, and non-auditory health problems, like hypertension, diabetes, heart disease, stroke, and death.

The scientific data about these problems and the causal nature of the relationships between noise and human disease is overwhelming.

There is always a need for more research, but there can be no rational doubt about the data. And the engineering techniques to make things quieter have been known since the 1960s. Making the world quieter is a political problem, not a scientific problem.

Those of us old enough to remember when restaurants, offices, planes, trains, and buses were filled with unwanted cigarette smoke know that banning smoking in public spaces has made the air we breathe cleaner, with dramatic impacts on health and well-being.

As with smoke, it will be with noise. If enough people complain to enough elected officials, or run for public office on a platform of making the world a quieter place, it can be made quieter, too.

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.

Tourists complain French cicadas are ‘too loud’

We understand. Cicadas can be loud and a forest full of them can be overwhelming. But the tourists accusing the insects of destroying their vacations need to reel it in a bit. The mayor of Beausset said that five different groups came to speak to him because they were being annoyed by the sound of the cicadas from morning to night. Said the mayor, “[f]or them the song is an infernal noise — crac-crac-crac — and they cannot understand that it is like music to the ears of us southerners.”

The cicada haters are joined by other tourists to rural France who “were ridiculed for asking for the bells on the village church to be silenced because they kept waking them at seven in the morning.”

When in Rome….