Health and Noise

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.

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.

Grant given to airport to lessen aircraft noise on nearby homes

Photo credit: Cliff licensed under CC BY 2.0

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

I was especially pleased to learn that the Piedmont Triad Airport Authority received a $1.9 million grant from the Department of Transportation to continue its program to lessen the impact of aircraft noise on the homes near the airport. The program to reduce noise impacts at residences was initiated eleven years ago when the FedEx cargo hub joined the airport.

In 2001, I was asked by the law firm representing residents concerned about the negative impacts from the development of the FedEx cargo hub to comment on the Federal Aviation Administration’s Environmental Impact Statement for the proposed runway associated with this hub. My comments explained that the EIS was seriously deficient in that it had minimal analyses of noise impacts on adults and children. Essentially, noise was defined as “an annoyance and a nuisance,” but there already was a growing body of literature that concluded that noise was a hazardous pollutant. The report also merely stated that noise “can disrupt classroom activities in schools,” even though studies had been published showing that noise can impede children’s learning. Finally, sleep was noted as being disrupted by noise when it was already known that loss of sleep may have serious consequences on the individual’s health and well-being.

I had concluded in my analysis of the environmental impact statement that the growing body of literature on the adverse effects of noise on mental and physical health was largely ignored and the authors of the statement relied on outdated studies and research in preparing the report.

I submitted my report and the hub opened years later in 2009. I now learned that noise mitigation accompanied the opening of the hub and the airport continued to work towards limiting impacts of aircraft noise on individuals living near the airport. I hope my statement in 2001 played a role in the Airport Authority’s recognition that airport-related noise does indeed have deleterious effects on mental and physical health.

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.

Swiss grocery chain tests quiet hours

Photo credit: Roland zh licensed under CC BY-SA 3.0

by Daniel Fink, MD, Chair, The Quiet Coalition

The Swiss Coop grocery chain is testing quiet hours in several stores in Switzerland, where the Spar chain already has quiet hours. Lights will be dimmed from 1:00 p.m. to 3:00 p.m. on Tuesdays and Thursdays, and there will be no announcements. This is being done to make shopping easier for those with autism. About 1% of the Swiss population is thought to be affected by autism spectrum disorders.

We think quiet hours are a good idea for lots of people, not just those with autism. These include people with hyperacusis, veterans and others with PTSD, parents with babies and toddlers, and really just anyone who is bothered by noise.

There is no reason for background music in grocery stores (or any retail stores) to be turned up to rock concert volumes. Announcments don’t need to be made at deafening volumes, either.

As many have observed, environmental modifications meant to help the disabled actually make life better and easier for us all.

The example I often cite is the ADA door handle, a lever style handle mandated by regulations implementing the Americans with Disabilities Act. These handles are easier for everyone to use than the old round door handles–not just people with arthritis or a weak grip from a stroke or neuromuscular disease, but children, older people, and those with both hands full who can use a wrist or elbow to turn the handle.

Similarly, ramps or curb cuts meant to help those with mobility disorders help parents pushing a stroller, delivery workers with carts full of packages, or repair technicians with tools and equipment on carts, as well as people like me with creaky knees.

And like ADA door handles and curb cuts, quieter retail stores will benefit everyone.

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.

How noise affects our brains

Image credit: Pete Linforth from Pixabay

by Daniel Fink, MD, Chair, The Quiet Coalition

Everyone acquires information by different means. Some people talk to friends, some people do an internet search, some read newspapers or magazines, and these days many listen to podcasts.

I am too impatient to listen to podcasts–I can read much faster than anyone can talk–and I have hyperacusis, so I don’t listen to podcasts on my smartphone while walking around. I prefer to obtain information by reading.

But from time to time I make an exception, and this wonderful podcast is one of those exceptions.

On his “This Is Your Brain” podcast, Dr. Phil Steig interviews our friend Mathias Basner, MD, PhD, MSc, Professor of Psychiatry at the University of Pennsylvania and Director of the Behavioral Regulation and Health Section. Dr. Basner is one of the world’s experts on the effects of noise on sleep and human health, and in this podcast he shares his knowledge about the effects of noise on hearing and the brain.

I listened on my computer. It’s only 19 minutes long, and well worth your time.

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.

Dementia isn’t inevitable, and neither is hearing loss

Photo credit: Andrea Piacquadio from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

This new study from the Alzheimer’s Cohorts Consortium, published on an open access basis in the medical journal Neurology, reports that dementia rates appear to be on the decline in Europe and North America. Analyzing results from seven different research studies, the Consortium found that the incidence of dementia declined 13% per decade in the last 40 years, with a confidence interval of 7-19% per decade. The decline was more pronounced in men than in women.

It is difficult to find the cause for the decline, but the researchers think it is due to a focus on treating cardiovascular risk factors, including reductions in smoking, better blood pressure control, and the use of antithrombotic medication. The article states, “[w]hile none of these has been specifically intended to halt cognitive decline, decades of cardiovascular risk management have likely had substantial effects on brain health, supported by reduction of small-vessel disease on brain imaging in more recent years.“

Why am I writing about a decline in dementia in a blog about noise issues?

Is it because research shows that hearing loss is a possible contributing factor to the development of dementia? No, although that statement is accurate.

The reason is that dementia used to be thought of as an inevitable part of aging, but that’s not true. Many cases of dementia have a vascular cause, and can be prevented by treating cardiovascular risk factors.

Similarly, hearing loss is thought to be part of normal aging, as shown by the use of the terms “age-related hearing loss” and “presbycusis”.

I presented a paper at the 12th Congress of the International Commission on the Biological Effects of Noise in Zurich in 2017, reviewing literature that showed that hearing loss was not an inevitable part of aging but largely represented noise-induced hearing loss. A recent research paper from the Massachusetts Eye and Ear Infirmary confirms that conclusion using ear tissue from post-mortem specimens.

I’ve said this before, but it bears repeating: If a noise sounds too loud, it is too loud.

If you protect your hearing–by avoiding loud noise and using hearing protection when you can’t–you should be able to hear well when you get old. And maybe you’ll reduce your chance of developing dementia, 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.

Does coronavirus affect the auditory system?

This image is in the public domain

by Daniel Fink, MD, Chair, The Quiet Coalition

Does coronavirus affect the auditory system and the vestibular system that regulates balance? Two recent articles suggest that it might. The research is very preliminary and based on small numbers of subjects, so the results must be interpreted with extreme caution.

The only problem may be that the treatments for coronavirus may also cause auditory damage, especially certain antibiotics with known auditory nerve toxicity, and also unproven therapies like hydroxychloroquine.

The best way to avoid having your auditory system affected by coronavirus is to avoid getting sick.

Follow the recommendations of public health experts, shown to be effective in European and Asian countries: wear a mask, maintain social distance, avoid large crowds and indoor spaces if possible, don’t touch your face, and wash your hands frequently.

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.

How loud noise affects your health

by Daniel Fink, MD, Chair, The Quiet Coalition

This article, online and in the print version of Prevention magazine, discusses noise pollution and how loud noise can affect health. Loud noise causes auditory problems–hearing loss, tinnitus, and hyperacusis–but also has less known non-auditory health effects as well. These include sleep disturbances, hypertension, obesity, diabetes, and cardiovascular disease, leading to increased mortality.

It’s relatively easy to protect one’s ears from auditory damage: avoid loud noise or use hearing protection if one can’t.

Protecting populations from the non-auditory health effects of noise will take concerted political effort to get legislation requiring quieter planes, vehicles, and trains passed and enforced.

But I believe if enough people complain to enough elected officials, a quieter world is possible.

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.

Harmful transit noise can be reduced

Photo credit: William Davies has dedicated this photo into the public domain

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

I recently learned about another group of people being subjected to the harsh and dangerous noises emitted from a railway. In this case it is the Squamish Nation community in Vancouver whose lives are being disrupted by engine noise, engines idling in the middle of the night and early in the morning, and 100 decibel whistle blows at night at a protected crossing. In response to these complaints, the Canadian National Railway has commented that “there will always be some noise associated with operations.” The Railway goes on to say that it has made efforts to minimize their operations.

First, let me note the research that has demonstrated that noise is harmful to health and well-being and this includes railroad noise. Second, having been a consultant to the New York City Transit Authority on rail noise and knowledgeable about the underlying causes of rail noise, I feel comfortable in wondering whether the Canadian Railway has done everything it could to lessen its system noise. This is underscored by the railway simply saying efforts have been made to lessen noise without citing examples. I would also venture to assume that the railway might believe that reducing noise could be costly. In fact, by reducing noise the New York City Transit Authority actually saved money. The building of less noisy traction motors for its trains resulted in a more efficient motor that would last longer and smoothing the rails didn’t just lessen noise, it placed less stress on the city’s aging structure where stress can lead to increased breakdowns.

It has been over forty years since my first transit noise study which found that children in classrooms exposed to passing elevated train noise had lower reading scores. Yes, we were able to remedy the noise of the passing trains and the children’s learning improved. Now all these years later, I still find that individuals are being exposed to harmful transit noise and the agency in charge appears to accept the idea that the people living near the noise have to learn to live with it.

Thanks to the Noise Curmudgeon for the story link.

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.

Protecting your ears at protests

Photo credit: Kelly Lacy from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

This article in Popular Mechanics reports on the recent use of military helicopters flying low over peaceful protests in our nation’s capital.

Helicopters at normal operating altitudes are too noisy, and at 40 feet over the ground are dangerously noisy. Flash-bang devices being used by police are also noisy.

If you are going to march in one of the demonstrators protesting police brutality and George Floyd’s death, put a pair of earplugs in your pocket.

Because if something 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.