Health and Noise

Chronic noise exposure linked to heart disease, stroke

Photo credit: G.M. Briggs

by Daniel Fink, MD, Chair, The Quiet Coalition

In 2017, research done at Massachusetts General Hospital reported that stress caused activation of the amygdala, a part of the brain involved with emotions, and this in turn was correlated with vascular inflammation and increased rates of cardiovascular disease and death. But to my knowledge, no one had yet linked stress caused by transportation noise directly to increased cardiovascular risk.

At the recent American Heart Association meeting, however, researchers also from Massachusetts General Hospital presented information to make this direct connection.

The adverse effects of transportation noise on health have been reviewed before, but the new report shows yet another mechanism for these adverse effects.

As Mathias Basner, MD MSc, president of the International Commission on the Biological Effects of Noise, wrote in 2016, “[t]he overwhelming majority of noise effect researchers today accept that there is a causal relationship between environmental noise exposure and increased cardiovascular risk.”

This new report is another piece of evidence to support Basner’s statement.

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.

Hearing loss associated with depression

by Daniel Fink, MD, Chair, The Quiet Coalition

I’m not sure this new report on the association between hearing loss and depression in older Hispanic people in JAMA Otolaryngology adds much to our knowledge of how hearing loss affects people. It has been known for some years that hearing loss is associated with depression in older people. The report extends the research to Hispanic people in several large cities, but as best as I can tell, that’s the only new information. The authors claim that this study’s importance is that it measured hearing loss rather than relying on reports of hearing difficulties, but some earlier studies did that, too.

In older people it’s hard to tell if the hearing loss was caused by noise or not, because over time changes indicating hearing loss from noise lose specificity as hearing loss becomes worse. But my analysis of the literature suggests that what is commonly called age-related hearing loss, as in the JAMA Otolaryngology article, is really noise-induced hearing loss, which is entirely preventable.

Now that the connection between hearing loss and depression is clear, doesn’t it make sense for government and the medical community to commit resources to educate the public about the dangers of noise-induced hearing loss? A host of health concerns will diminish or disappear if we focus on stopping 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.

Why hospitals should let you sleep

Photo credit: Ivan Obolensky from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

This piece by Austin Frakt in the New York Times discusses the need for hospital patients to get more sleep, and the many things that disrupt a patient’s sleep when they are in the hospital. The list of culprits is obvious: alarm noise, carts in the hall, blood draws, vital signs measurements, and so on.

Uninterrupted sleep is important for everyone, not just hospital patients. Anything that interrupts sleep–horns, sirens, road traffic noise, train horns, aircraft noise, horn-based alerts, patrons exiting a nightclub or bar at closing time–is a health hazard.

I have no doubt that if enough people complain to enough elected officials about health problems caused by noise, governments at the local, state, and national levels will take action to make our cities and towns quieter.

It worked for smoke-free restaurants, workplaces, airplanes, and in some states even smoke-free beaches and parks.

Let’s all resolve to work together for a quieter world in the New Year.

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.

My 4th Noise Activist Anniversary

by Daniel Fink, MD, Chair, The Quiet Coalition

Anniversaries are special. We celebrate wedding anniversaries. Alcoholics Anonymous celebrates the anniversaries of those who are in recovery. Wounded military veterans celebrate their Alive Day, the day on which they were wounded. And yesterday was my anniversary, the fourth anniversary of my becoming a noise activist.

I developed tinnitus and hyperacusis after a one-time exposure to loud noise in a restaurant on New Year’s Eve, 2007. As midnight approached, they kept turning up the music louder and louder. My wife could tell that the noise was bothering me and suggested that we leave, but I didn’t want to offend our friends who had arranged the dinner. As soon as it was polite to leave, maybe 12:30 a.m., we did. My ears were ringing when we left, and the ringing never stopped.

I also found that noise that didn’t bother others hurt my ears: Movie soundtracks, the grind of a food processor, loud exhausts and sirens, and especially noise in restaurants. I’m a doctor and have always done what I could to stay healthy. But I had no idea that a one-time exposure to loud noise could cause tinnitus and hyperacusis for the rest of my life. When my wife would suggest an evening out, I would ask, “Can’t we eat at home?”

On December 2, 2014, I read an article about hyperacusis in the New York Times science section, written by journalist Joyce Cohen, who has since become a friend. I circled it in red and gave it to my wife, saying, “Honey, this is why I don’t want to go to restaurants any more. They are all too noisy. The noise hurts my ears. Just like it says in this article.” My wife finally understood that while I might have been getting grumpier with age, my dislike of noisy restaurants was caused by an auditory disorder.

So I decided to do something to make the world a quieter place. I reached out via email to the four experts cited in Joyce’s article. One thing led to another, and I ended up serving on the board of the American Tinnitus Association and helping create The Quiet Coalition, where I am the board chair.

I learned that I wasn’t the only person in the world with auditory disorders. Hearing loss, tinnitus, and hyperacusis are all too common. But auditory disorders are invisible, and largely occur in older people, who themselves are largely invisible in our society. Except for congenital deafness, auditory disorders tend to be ignored.

It’s been quite an odyssey. I found that via the internet, I could communicate with experts in various areas of noise, across the country and even around the world. At the urging of one of them, I submitted abstracts to scientific meetings about noise. Those were accepted for presentation, and I spoke at national and international scientific meetings. I have had publications based on my talks appear in peer-reviewed medical and scientific journals, and I have been quoted in articles and have advised national and international health authorities about noise. And I have learned, through the nonprofit Hyperacusis Research, how truly life-limiting noise-induced hearing problems can be. All because I read an article and decided to do something to make the world quieter.

The world is still too noisy, and I still can’t find a quiet restaurant, but apps like iHEARu and SoundPrint are now available.

And as more evidence becomes available about noise as a health and public health hazard, I am confident that an informed public will push legislators and public health officials to eliminate unnecessary noise.

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.

Is noise pollution making you fat?

This image is in the public domain in the U.S.

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

The discussion that stress may be linked to obesity has gone on for many years but an internet search of research linking stress to obesity will reveal that stress can indeed increase weight. One could now ask the question whether continuous noise intrusions from railways, roads, and overhead aircraft could be associated with obesity. The answer to this question appears to be “yes” with regard to road noise, “less so” with rail noise and “no” for aircraft noise in the research paper cited in this Environment International article.

While the authors of the paper cited above believe that additional research needs to be conducted, including effects of aircraft noise, to strengthen the data supporting the relationship between noise and obesity, they stress that with obesity being a major public issue worldwide, the existing data suggest that noise needs to be seriously considered as a contributing factor. They also point out that: “obesity could represent one pathway through which transportation noise impacts cardiovascular disease,” recognizing that studies have linked transportation noise to cardiovascular ailments.

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.

Girl scout receives national honor for work on hearing health

Photo credit: Elizabeth Goodspeed licensed under CC BY-SA 4.0

by Daniel Fink, MD, Chair, The Quiet Coalition

Christina Mayo, The Miami Herald, reports about Girl Scout Kelly Culhane, who was honored for being an exceptional leader for her work with the Ear Peace Foundation. It’s a heartwarming story.

Mayo reports that Culhane was named a National Gold Award Girl Scout, the highest honor awarded by the Girl Scouts–and she’s the first Girl Scout from Miami to win this award. She won this distinction for her “Gold Award-winning project in which she partnered with the Ear Peace: Save Your Hearing Foundation.”  Says Mayo:

Kelly wrote the script, filmed and edited an educational video called “Band Together to Protect Your Hearing,” which is used in the foundation’s teacher training workshops for 392 schools in Miami-Dade County.

You can see Culhane’s video and learn more here.

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.

More evidence that headphone use causes hearing loss

Photo credit: Patrick Pielarski licensed under CC by 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

This isn’t a scientific study, but a news report from Ireland. An audiologist recommends that parents limit children’s headphone use to one hour daily. She notes that, “ten years ago, around 5pc of people aged under 45 were fitted with hearing aids. Now, 23pc of our hearing aids are for people under 45.”

That’s a shame. Hearing aids are costly, and even the best are a poor substitute for preserved natural hearing. It takes decades for noise-induced hearing loss to become bad enough that people are willing to use hearing aids.

A Dutch study earlier this year found auditory damage from headphone use in children age 9-11, and the damage only gets worse over time.

Parents–and indeed everyone–should limit headphone use, or better yet just put the headphones in the drawer.

One doesn’t need a continuous audio track to life! But if you do, for your own sake, for your ears, please turn down the volume.

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.

Should doctors screen middle-aged and older adults for hearing loss?

Photo credit: Flávia Costa licensed under CC BY 3.0

by Daniel Fink, MD, Chair, The Quiet Coalition

The Quiet Coalition received an email from contacts at the CDC’s National Center for Environmental Health. The U.S. Preventive Services Task Force is again looking at whether it should recommend screening for hearing loss. The last time it did this, USPSTF didn’t recommend screening for hearing loss in adults because no benefit had been shown from screening. The email reads:

Dear Hearing and Health Partners,

The U.S. Preventive Services Task Force has shared their Draft Research Plan for Hearing Loss in Older Adults: Screening on their website here. The draft plan also includes a graphic of a Proposed Analytic Framework and a Proposed Research Approach to identify the study characteristics and criteria that the Evidence-based Practice Center will use to search for publications for their evidence review.

According to the Task Force, The final Research Plan will be used to guide a systematic review of the evidence by researchers at an Evidence-based Practice Center. The resulting Evidence Review will form the basis of the Task Force Recommendation Statement on this topic. There is an opportunity for public comment on this draft until December 12, 2018. The draft research plan is available on the Task Force’s website here.

Cordially,

NCEH Noise-Induced Hearing Loss Program

There is important new research available that led to the USPSTF re-evaluating its recommendation. Several researchers have shown that most Americans get too much noise every day. The CDC reported that about 25% of American adults age 20-69 had noise-induced hearing loss, many without occupational noise exposure, and many thinking that their hearing was excellent.

Also, newer research shows that hearing loss is not a benign condition. It is correlated in stepwise fashion (i.e., more hearing loss, more problems) with social isolation, depression, falls, accidents, and dementia, all of which in turn are associated with increased mortality in older Americans.

And even more recent research shows that providing older people with hearing aids delays the onset of dementia, all of which compels the conclusion that doctors should absolutely screen their middle-aged and above patients for hearing loss.

If you have any thoughts about screening for hearing loss, send a comment to the USPSTF. I will!

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.

Better hearing and sight can help keep memory sharper

by Daniel Fink, MD, Chair, The Quiet Coalition

This report describes studies showing that giving hard of hearing older patients hearing aids reduced memory loss, as did cataract surgery in another study. It makes sense that more sensory input keeps the brain connections active. There are a number of studies with similar results.

As I get older, I’m intrigued by aging. People of the same chronological age can have dramatically different health profiles, activity levels, and intellectual capabilities. Why? Certainly genetics plays a role, as does diet, physical activity, smoking, alcohol intake, and many factors not yet understood. Yet despite our best efforts, we all eventually die. I think the goal should be compression of morbidity, that is, living full and active lives until one gets sick and dies relatively quickly.

That we have treatment of medical problems is great, but prevention is better. This applies to hearing and vision, too.

Avoiding loud noise prevents noise-induced hearing loss, the most common cause of hearing loss in the U.S. and probably in the developed world. There’s some evidence that what is called age-related hearing loss is really noise-induced hearing loss. And cataracts can largely be prevented by avoiding sun exposure and wearing sunglasses when outside.

But there’s no excitement in prevention, and little if any profit to be made for pharmaceutical companies, doctors, and hospitals. So the obviously better option–preventing damage to sight and hearing in the first place–is given short shrift.

Until prevention prevails, make sure your elderly relatives have their hearing and sight checked–hearing aids and cataract surgery might help prevent dementia.

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.