Design

It’s time to change our definition of “old”

Annual National Veterans Golden Age Games | Defense Department photo/Army Sgt. 1st Class Michael J. Carden

by Daniel Fink, MD, Chair, The Quiet Coalition

According to Joseph Coughlin, director of the AgeLab at MIT and author of “The Longevity Economy,” a new book about marketing to aging baby boomers, it’s time to change our definition of “old.”

Coughlin claims that old age is a made-up social construct invented 150 years ago.

I’m not sure I agree with him completely, but he’s right about something. Much of what we think of as normal aging–obesity, hypertension, diabetes, weakness, disability, and early demise–isn’t normal aging but pathological aging.

I’d add hearing loss to that list.

Pathological aging stems from four factors:

  1. Abnormal exposures, e.g., sun, cigarette smoke, or noise;
  2. Poor quality nutrition, i.e. too much of the wrong nutrients (including calories) and not enough of the right nutrients;
  3. Disuse atrophy, especially for the musculoskeletal system; and
  4. Medical care based on inadequate knowledge about the best treatments for common conditions.

The treatment of hypertension is one example of the fourth factor. In the 1970s, it was thought that a normal systolic blood pressure was 100 plus the patient’s age, and that treating hypertension in the elderly was dangerous. Then a randomized trial–the Systolic Hypertension in the Elderly Program–showed that treatment of high blood pressure in older people prevented stroke. Two more recent examples are studies showing that treatment of cardiac risk factors prevents what was once thought to be inevitable heart disease as people age and then was found to reduce dementia risk, too.

Hearing loss in old age is very common. It’s called presbycusis, or age-related hearing loss. But the world’s literature–which I reviewed for a presentation I gave at the 12th Congress of the International Commission on the Biological Effects of Noise in Zürich, on June 20, 2017–shows that it isn’t normal. Without exposure to loud noise, good hearing is preserved well into old age.

In his book Coughlin discusses “transcendent design”–not just accessible design, or universal design, but:

[A]nother, even higher level of accessibility that I believe has been mistakenly lumped in with universal design: transcendent design. It’s essentially universal design that has been dialed up to 11 on a 10-point scale, with accessibility attributes so useful that they turn out to be highly desirable—even aspirational—for people with and without disabilities. If the defining, narrative-shaping forces in our older future will be those that make it easy for older adults to achieve their jobs as consumers, transcendent products and design features will be at the vanguard of this process.

Coughlin highlights, as an example of transcendent design, the OXO line of kitchen utensils, initially designed by entrepreneur Sam Farber because his wife couldn’t grip standard utensils due to arthritis. People buy OXO utensils not necessarily because they have arthritis or other grip issues, but because OXO utensils they are so good-looking and easy to use. The iPhone and Apple watch are other examples.

People with mobility, musculoskeletal, or auditory disorders don’t need special designs. They and everybody need well-designed utensils, tools, garments, furniture, and spaces that meet needs as people age and suffer inevitable temporary or sometimes permanent impairments.

Perhaps one day architects and interior designers can come up with transcendent designs for quiet restaurants, to make it possible to carry on normal conversations without straining to speak or to be heard, while enjoying the food and the company of our dining companions.

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.

Want better sleep? Bose® has you covered

Bose® noise-masking sleepbuds™

by David M Sykes, Vice Chair, The Quiet Coalition

This CNET review is a intriguing article about Bose’s quest to tap into the auditory health and better sleep market.

PSAPs, or personal sound amplification products, is a term brought to public attention in 2015 by the White House President’s Council of Advisors on Science and Technology followed by a report from the National Academy of Medicine last October. PSAPs are an emerging class of products that are also called hearables (think wireless earbuds with extra features) that we’ve been following for the past couple of years.

PSAPs are interesting because they represent a host of tech innovations and innovative young tech companies that promises to disrupt the traditional hearing-aid industry that has been dominated for decades by a hegemonic group of risk-averse manufacturers known as the “Big Six,” a market that is carefully regulated by the FDA. The result of decades of regulation and dominance by a handful of companies is that traditional hearing aids are both absurdly expensive, and also not particularly innovative. No surprise there.

But a couple of months ago, the emerging market for PSAPs blew wide open thanks to bi-partisan legislation (the Over-The-Counter Hearing Aid Act, co-sponsored by Senators Warren and Grassley) which exempts PSAPs from regulation. And that means three things:
1. Now you can buy PSAPs directly from the manufacturers or at CVS/Walgreens etc. (“over the counter”) without a prescription and you don’t have to pay an audiologist to fit them;
2. PSAPs cost a fraction of what a pair of traditional hearing aids costs (PSAPs may cost you $150 to $400, but compare that to $4,000 to $10,000 for conventional hearing aids); and
3. Two dozen hungry, young start-ups funded through crowd-sourcing or by venture capital professionals are charging into this market.

So If you, like me, like to watch a tech-race unfold, then get out your binoculars and join the crowd at this track because its an exciting race in a market that has been moribund and over-regulated for decades.

Watching this restless bunch of young PSAP startups and their colorful jockeys (I mean their CEOs), and eyeing them very carefully, are a small but high-powered group of suits you’ll recognize from consumer electronics: Apple, Sony, Phillips, Bose, et al. Why? Because these are the big guys who are already in the ear business–they sell earbuds and headphones, among other things and wireless hearables is a potentially important new market. The ear is their turf. So if they can grab a piece of the de-regulating market for wireless hearing-assistive devices that’s a great business opportunity, right? After all, 48 million Americans are hearing-impaired so this is potentially a big niche market, and who knows how many Americans are sleep-deprived?

But what about Bose?

Bose—an intensely private, even secretive consumer electronics company headquartered on top of a small mountain near Boston—is the first of these big consumer electronics players to make a move in the PSAP race. Bose’s founder, Amar Bose, died a couple of years ago, but he was a singular, legendary force in consumer electronics and seemed to be the fountain from whom all of the company’s products poured. With his death, ownership of the company was turned over to Amar Bose’s alma mater, MIT (yes, MIT controls the majority stake but has no say in management). But can the company still innovate now that it founder and chief idea-guy is gone?

One approach to innovation is through acquisition. So last year, Bose acquired the San Diego-based startup Hush and recently announced the release of a new Bose-branded product based on the work done by three engineer-entrepreneurs who founded Hush not too long ago. If you’ve been watching this emerging market, you probably noticed that only last week, the self-declared front-runner in PSAPs/hearables a product called “Here One” from the company Doppler Labs, ran out of juice and went out of business. Why? They burned through $50 million trying to win this horse race, but then ran out of money and couldn’t get Apple or Sony or any of the rest of the big guys to pony up and buy them out. Sometimes that happens to front-runners and it’s too bad, but it clears the way for others to emerge. And Bose wants to be one of the next group as these horses round the first corner.

Now Bose, in addition to being intensely secretive, has also always done things differently. And they’re certainly going after this emerging PSAP/hearables market from some intriguing angles. For instance, they recently have launched a crowdfuning campaign for their new Bose® noise-masking sleepbuds™. Another example is their newly announced Hearphones for people who need help understanding speech in noisy environments. Both of these products indicate that Bose is probing the now-deregulated “hearing health market”—a big departure from their traditional focus on consumer electronics. Perhaps they think 48 million Americans is a viable niche market where they can beat Apple, Sony, Phillips and the Big Six hearing aid companies by getting out of the gate faster. Who knows? Bose has succeeded by focusing on niches ignored by others and they’ve got their own retail stores, so keep your eyes on them.

It’s a race. And some of us are watching closely to see what happens. If you placed a bet on Here One and lost, then just swallow hard and keep your eyes on the race. It’s only just begun.

In addition to serving as vice chair of the The Quiet Coalition, David Sykes chairs several professional organizations in acoustical science: The Acoustics Research Council, American National Standards Institute Committee S12, Workgroup 44, The Rothschild Foundation Task Force on Acoustics, and the FGI Acoustics Working Group—a partner of the American Hospital Association. He is the lead author of “Sound & Vibration 2.0 (2012, Springer-Verlag), a contributor to the National Academy of Engineering report “Technology for a Quieter America,” and to the US-GSA guidance “Sound Matters”, and co-founded the Laboratory for Advanced Research in Acoustics (LARA) at Rensselaer Polytechnic Institute. He recently retired from the board of directors of the American Tinnitus Association. 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.

Can a machine learn to solve our speech in noise problem?

by Daniel Fink, MD, Chair, The Quiet Coalition

This piece in The Hearing Journal asks, “Can a Machine Learn to Solve our Speech in Noise Problem?”

Maybe yes, maybe no.

The “speech in noise” problem is the difficulty many people with hearing loss–and even people with normal hearing as tested by pure tone audiometry–have  following a conversation if the room (often a restaurant or party) is noisy.

I have that problem, as many adults do, and I also have three problems with this article.

First, talking about a technological solution to the speech in noise problem without discussing how we can interfere with the development of this condition by simply making the world quieter to prevent hearing loss is irresponsible. Imagine public health officials in the 1950s focusing on making better wheelchairs, braces, and crutches for those affected by polio without also working to prevent polio by developing a vaccine. You can’t, because that would have be absurd. To prevent noise-induced hearing loss, we don’t need more research. We don’t need a vaccine. All we need is to make a quieter world, something that has been known for decades.

Second, an even better solution to the speech in noise problem would be to require quieter indoor spaces.

Third, requiring quieter public spaces is exactly what the Americans with Disabilities Act (ADA) requires. People with hearing loss clearly meet the ADA definition of having a disability, and they require “reasonable accommodations” to allow them to fully enjoy (yes, this is the legal standard in ADA) places open to the public. I will be speaking about “Disability Rights of Ambient Noise for People with Auditory Disabilities Under the Americans with Disabilities Act” at the December meeting of the Acoustical Society of America, in New Orleans. I recent learned that my talk will be broadcast live over the internet. Details of how to listen will be posted when they become available.

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.

Clever hacks for dealing with noise

in your home. Louise Smithers, D’Marge, writes about various tricks and design choices you can employ to keep noise to a minimum in your castle.  While some options are obvious–use rugs and say yes to drapes–others are a bit more novel, like using attractive fabric covered acoustic panels to add visual interest and noise reduction to your space. While no one suggestion will likely solve every situation, Smithers’ list is a good place to start.

Click the link above to read for the full list of options.

Another reason to avoid fast food and chain restaurants

Photo credit: Mike Mozart licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

My wife and I don’t eat in restaurants much anymore–the vast majority are just too noisy to enjoy both the meal and the conversation–and we don’t patronize fast food or chain restaurants. Burgers and fries and sodas are just not healthy food, and I try to stay healthy.

But for those who do, according to Culture Cheat Sheet noise is a major problem, joining a list of complaints that includes dirty spaces, bad service, and bad food. Culture Cheat Sheet cobbled together survey results from Consumer Reports, the American Customer Satisfaction Index, and Temkin Experience Ratings to come up with their report on the most hated restaurant and fast food chains.

Most fast food and chain restaurants use a formula of tasty but unhealthy food with too much fat, too much sugar, too much salt, and too many calories at a relatively low price to lure customers.

Research shows a clear correlation between the density of fast food restaurants in neighborhoods–largely poor neighborhoods populated by African-American and Hispanic people–and obesity. The epidemic of obesity in the U.S. is related to changes in eating patterns–fast food, sugary sodas, bigger portions–and decreased exercise.

But now it appears that these restaurants also serve up a side order of hearing loss with their food. Because noise is causing an epidemic of noise-induced hearing loss, too.

And that’s another reason to avoid these restaurants.

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.

NASA demonstrates another way to reduce aircraft noise

Photo credit: NASA

David M. Sykes, Vice Chair, The Quiet Coalition

I hope you’ve read the new post by our chairman, Dr. Daniel Fink, about the “denialist playbook.” It has been actively used for decades to sideline and undermine all efforts to address aircraft/airport noise. In fact aircraft/airport noise is a textbook case of well-organized and well-funded “denialism” in action.

What’s particularly astonishing is that answers already exist—they’re just not being implemented by aircraft manufacturers or by airlines. Nor are the FAA and the UN agency ICAO (the International Commercial Aviation Organization, based in Montreal) encouraging their adoption. For instance, the EU manufacturer Airbus already produces aircraft that are substantially quieter. The A380 and the A320neo, with it’s American-produced engines from Pratt & Whitney, are reportedly 75% quieter. How many of those planes are in the fleets of U.S. airlines? Why not a higher percentage?

We’ve also reported on work by NASA to quiet helicopters and launch electrically-powered aircraft. Now here’s another example of significant progress, in this case progress on reducing noise from the airframe itself. Wouldn’t a 30% reduction in airframe noise be a good idea?

In fact, there’s no lack of “good ideas”—the problem is that the air travel industry, including manufacturers, airlines, and local airport agencies, refuse to acknowledge that noise is actually a health hazard for people living near airports. In fact, the “denialist” argument is that aircraft noise is merely local “annoyance,” but there’s plenty of credible medical and public health evidence that health effects are real, serious, and wide-spread.

The Congressional Quiet Skies Caucus recently submitted a request to the Chair and Ranking Member of the House Appropriations Committee’s Subcommittee on Transportation, Housing and Urban Development requesting funds to evaluate the health effects of airport and helicopter noise—though many would argue that the existing evidence is already sufficient to prove the case.

We support the work of the Congressional Quiet Skies Caucus, but respectfully submit that there’s little need for more evidence to prove this point, so if this request fails, there’s no need to wait and write another one.

What’s needed is for more members of Congress (in addition the the 36 who are already members of the Congressional Quiet Skies Caucus) to wake up and realize that the Department of Transportation, of which the FAA is a part, has been playing the “denialism” game for far too long, that the agency is a victim of what economists call “regulatory capture.”

Let’s stop arguing with the denialists because the science is clear. Let’s instead start demanding that aircraft manufacturers and airlines simply adopt the technologies and solutions that are already available. Doesn’t that sound like progress we can all live with?

In addition to serving as vice chair of the The Quiet Coalition, David Sykes chairs several professional organizations in acoustical science: The Acoustics Research Council, American National Standards Institute Committee S12, Workgroup 44, The Rothschild Foundation Task Force on Acoustics, and the FGI Acoustics Working Group—a partner of the American Hospital Association. He is the lead author of “Sound & Vibration 2.0 (2012, Springer-Verlag), a contributor to the National Academy of Engineering report “Technology for a Quieter America,” and to the US-GSA guidance “Sound Matters”, and co-founded the Laboratory for Advanced Research in Acoustics (LARA) at Rensselaer Polytechnic Institute. He recently retired from the board of directors of the American Tinnitus Association. 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.

Quiet aircraft? NASA’s on the job, but when?

By David Sykes, Vice Chair, The Quiet Coalition

Hope is nice now and then—don’t expect results tomorrow, but maybe next year?

If you like an occasional look ahead—toward a world with quieter aircraft—read the August 14-September 3 issue of Aviation Week.* In an article entitled “Sound Barrier: Noise is emerging as the biggest challenge to high-density urban air-taxi operations,” the magazine’s managing editor for technology, Graham Warwick writes about what NASA (and yes, Uber) are doing to build a future of inter-urban transport. Are you ready to imagine “Air-Uber”?

The key is convincing municipal governments that these air-taxis will be quiet(er) than conventional aircraft. So note the term “eVTOL” (Electric Vertical Take Off and Landing craft, or distributed electric-propulsion vehicles). That’s right, they’re electric. This is the likely future of quieter, low-emission air transport—and as the video above proves, it’s no joke.

Do we really need eVTOL air-taxis? That depends on what “we” means. At any rate, it turns out the kink in this scenario is the noise problem: so switching to quiet eVTOLs is a prerequisite to getting this air-taxi fleet off the ground in urban areas. Hence, NASA has taken on the noise issue—at last! (NOT the FAA—which is a good thing overall since FAA has steadfastly resisted doing anything at all about noise for decades).

Meanwhile back in the real world, why can’t American airports and airlines simply encourage adoption of the new Pratt & Whitney quiet jet engine that is already in use in the UK and EU (the PW1100G geared turbofan). It’s supposed to be 75% quieter and 15% to 20% more fuel-efficient than conventional jet engines. Furthermore, Airbus has already installed the Pratt & Whitney engine on it’s new A320neo aircraft and 90 of them have already been delivered to 11 airlines (only two of which are American: Spirit and Frontier). Another issue of Aviation Week* reported favorably on the launch of this new, quieter aircraft and cited one source as saying “[t]he A320neo is now the quietest aircraft.”

There are plenty of Airbus planes in the fleets of US-based airlines, so let’s urge airlines to order a few more and retire their noisy fleets of aging aircraft! Airbus is set to deliver 200 more of them this year.

Sadly, the FAA is not going to get out in front of the noise issue anytime soon. They continue to insist that while noise may be “annoying” to some people, they won’t let that get in the way of the roll-out of their NextGen program—despite the fact that NextGen is precisely the program that has so enraged the three dozen members of Congress who formed the Congressional Quiet Skies Caucus and the 36 communities across the USA that have formed the National Quiet Skies Coalition.

Take a look at this recent presentation given by the FAA to the Congressional Quiet Skies Caucus: FAA Powerpoint PDF.

Doesn’t sound like they’re in any rush to quiet down America’s airports, does it? So I’m betting on NASA’s approach, i.e., electrically powered aircraft and “alternative solutions”—such as convincing airlines to stock their fleets with Airbus planes. Maybe the competition will finally wake up Boeing and GE and they’ll realize that some of us understand that noise is much more than “annoyance,” it’s a public health issue.

*Sorry, you’ll either have to subscribe to Aviation Week online or read it in the library.

In addition to serving as vice chair of the The Quiet Coalition, David Sykes chairs several professional organizations in acoustical science: The Acoustics Research Council, American National Standards Institute Committee S12, Workgroup 44, The Rothschild Foundation Task Force on Acoustics, and the FGI Acoustics Working Group—a partner of the American Hospital Association. He is the lead author of “Sound & Vibration 2.0 (2012, Springer-Verlag), a contributor to the National Academy of Engineering report “Technology for a Quieter America,” and to the US-GSA guidance “Sound Matters”, and co-founded the Laboratory for Advanced Research in Acoustics (LARA) at Rensselaer Polytechnic Institute. He recently retired from the board of directors of the American Tinnitus Association. 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.