Health and Noise

Looking for a quiet place?

by Daniel Fink, MD, Chair, The Quiet Coalition

This review of a science fiction horror movie, A Quiet Place, discusses the movie’s basic premise, namely: “Living an isolated existence, the onscreen duo are trying to protect their children from an unseen menace. As the trailer tells us, if they hear you, they’ll hunt you.“

That’s a very interesting premise for a movie, regardless of what the menace is. The hearing sense evolved from a primitive vibration sense, which developed in primitive one-celled organisms to help them either find food or avoid becoming another organism’s food. Humans and our invertebrate, vertebrate, and primate ancestors evolved in quiet, as shown by the National Park Service noise map. And there was no selective advantage to any protective mechanisms from loud noise; in fact, from the external ear to the auditory canal to middle ear and inner ear adaptations, everything possible was done for the human ear to amplify sound.

This is why noise is so bad for humans. And all parents would be wise to protect their children from the unseen menace of noise causing hearing loss.

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.

 

Nick Foles may have won Most Valuable Player at the Super Bowl last week

Photo credit: Matthew Straubmuller licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

But his daughter stole the Super Bowl limelight in this wonderful picture.

So what does Philadelphia Eagles quarterback Nick Foles know about protecting his daughter’s ears that most parents and most pediatricians don’t know?

He knows that noise is bad for children’s ears, causing auditory damage including hearing loss.

Football stadiums are among the noisiest places in the U.S., with the noise record exceeding allowable occupational exposure levels, so Nick Foles absolutely did the right thing.

We hope all parents will follow his example.

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.

NY Comptroller: Noise is a serious issue in New York City

And New York Comptroller Thomas P. DiNapoli’s report concludes that silencing excessive NYC noise a major challenge. DiNapoli notes that “[n]oise in New York City is a significant quality of life and public health concern.”

We agree.

So does Arline L. Bronzaft, Ph.D., professor emerita, City University of New York, chair of the Noise Committee of GrowNYC, and co-founder of The Quiet Coalition, who notes that “[r]esearch shows that noise is not only a nuisance, but more importantly, has adverse effects on our mental and physical health.”

You can read DiNapoli’s report here (pdf).

 

Don’t believe everything you read on the internet

by Daniel Fink, MD, Chair, The Quiet Coalition

Many health experts and health educators warn the public not to believe everything they read on the internet unless it comes from a reliable source, e.g., the Centers for Disease Control, the American Heart Association, etc. Even then, respected agencies make mistakes. The National Institute for Deafness and Other Communication Disorders, for examples, still states, “[l]ong or repeated exposure to sound at or above 85 decibels can cause hearing loss,” without time limit for exposure, but the 85 decibel limit is actually from the occupational standard and doesn’t protect all workers from hearing loss. It is not a safe noise level for the public. The only evidence-based safe noise limit to prevent hearing loss is a time-weighted average of 70 decibels for 24 hours.

That said, one must be especially careful about information from the alternative health literature. A lot of claims are made that are just not supported by science. This report from the Alternative Daily is one of them. The headline states that six nutrients are scientifically proven to boost hearing, which implies that taking these nutrients will improve hearing. But the studies cited merely are correlation or association studies, showing, for example, that people with hearing loss had lower folate levels. This does not demonstrate that insufficient folate intake causes hearing loss. This certainly doesn’t show that taking supplemental folate, or eating a healthier diet with foods containing folate, will improve hearing.

There are many different causes of hearing loss–ototoxic drugs, ear infections, trauma–and associations with chronic diseases such as hypertension and diabetes and bad health habits such as smoking or poor quality diet, but noise is the most common cause of hearing loss.

So what’s the sensible way to protect yourself and your family from hearing loss and other hearing injuries?  The answer is revealed by this one fact: noise-induced hearing loss is 100% preventable.  So throw away the pills and miracle cures and avoid loud noise to protect your hearing.

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 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 causing hearing loss in traffic police in India

Photo credit: GPS licensed under CC BY-SA 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

This report from the Indian city of Pune documents hearing loss in traffic police. Apparently car horns are the main culprit. So how bad could it be?  This bad:

A study of 46 traffic personnel “found that 39 of the 46 traffic personnel could not pick up high frequency tones, indicating alarmingly high (83%) presence of noise-induced hearing loss (NIHL) among the city’s traffic police.”

And the damage isn’t limited to hearing loss, as “the traffic personnel were also screened for hypertension,” and “13 of the 46 traffic personnel have been diagnosed with hypertension, a condition they were unaware about.

I have traveled in India, although not to Pune, and it is a noisy country. The big cities–Mumbai and Delhi–are noisier than New York City, so this report isn’t a surprise to me.

But there’s no reason to believe that ears in India are different from ears in the U.S. Traffic noise causes hearing loss and other health problems in the U.S., too.

Perhaps India–and the U.S.–should follow Kathmandu’s successful effort at eradicating traffic noise, because it can be done if the political will exists.

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.

How likely are you to get tinnitus from clubbing?

by Daniel Fink, MD, Chair, The Quiet Coalition

This article from the UK asks the question: How likely are you to get tinnitus from clubbing?

The article points out that there really isn’t any way to predict who will develop tinnitus, i.e., ringing in the ears, after noise exposure, and that’s the most important thing to know.

I didn’t know that a one-time exposure to loud noise could cause tinnitus the rest of one’s life. I developed tinnitus (and hyperacusis, a sensitivity to noise that doesn’t bother others, with noise causing pain in the ear) after a one-time exposure to loud music in a restaurant on New Year’s Eve ten years ago.

Fortunately, there is one simple rule to protect your ears: if it sounds too loud, it IS too loud.

If you can’t carry on a conversation without straining to speak or to hear, the ambient noise is above the auditory injury threshold of 75 A-weighted decibels, and your hearing is being damaged.

Research done over the last decade strongly suggests that there is no temporary auditory damage. In animal models, loud noise damages the synapses (nerve junctions) in the ear before it damages the hair cells. This damage isn’t detected by standard hearing tests (pure tone audiometry) but likely is the major reason why adults have difficulty following one conversation among many in a noisy environment.

Remember, your ears are like your eyes or your knees–God only gave you two of them! Take care of them, and they will last you your whole life.

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.

Gene therapy is great, but can anyone afford it?

by Daniel Fink, MD, Chair, The Quiet Coalition

Science holds great promise for treatments and cures. Among the areas of research in treating or curing hearing loss or even total deafness is gene therapy. Scientists at Columbia University and Stanford University and elsewhere are already working on this.

The main concern I have about gene therapy is its cost. A new treatment for a rare form of blindness costs $850,000. A recently approved gene therapy for a rare form of leukemia costs $500,000.

No one can predict how much a gene therapy treatment for hearing loss or deafness will cost, but the ballpark is several hundred thousand dollars. For a condition affecting 50 million Americans, that’s more than our country can afford. Insurance premiums would have to increase ten or one hundred times if health insurance or pharmacy benefits paid for the drug, or there would be prohibitive cost sharing. Out of pocket costs would be more than anyone except a few multimillionaires or billionaires could afford.

And the sad part is that the overwhelming majority of hearing loss in adults–I estimate up to 90% of all cases of adult hearing loss–is noise-induced hearing loss, which is 100% preventable.

My advice: avoid loud noise. If it sounds too loud, it IS too loud. Protect your ears. Like your eyes and knees, God only gave you two of them, and they have to last a whole lifetime!

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.

Pursuing an invisible threat

by Daniel Fink, MD, Chair, The Quiet Coalition

Prof. Richard Neitzel, of the University of Michigan and a co-founder of The Quiet Coalition, views noise as an invisible threat. In this university news release, he discusses some of his research and its implications for health.

Watch Dr. Neitzel talk about noise pollution and his career studying noise pollution exposure and health outcomes:

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.

Ringing ears is a sign of permanent damage to hearing

by Daniel Fink, MD, Chair, The Quiet Coalition

This article from the Cleveland Clinic makes the point that ringing in the ears–the technical term is tinnitus–after loud noise exposure indicates that permanent damage has occurred to the ears.

That’s good to know. I didn’t know that before a one-time exposure to loud noise ten years ago caused tinnitus for the rest of my life.

But I disagree strongly with two things Sharon A. Sandridge, PhD, Director of Clinical Services in Audiology at the Cleveland Clinic, says in the online article.

One is her statement, “[a]s you get older, it’s natural to experience some hearing loss.”

No, it’s not natural to experience hearing loss with age. Hearing loss with age is very common, but it is not part of normal healthy aging, representing largely noise-induced hearing loss. I spoke about this last year at the 12th Congress of the International Commission on the Biological Effects of Noise in Zurich.

Dr. Sandridge’s second erroneous statement, with much more serious implications, is “[a] majority of people are safe listening to 85 dB for eight hours.”

This is just wrong! The National Institute for Occupational Safety and Health (NIOSH) doesn’t think so and neither do I.

Eighty-five decibels–actually 85 A-weighted decibels (dBA) which usually measure 5-7 decibels lower than unweighted sound measurements–is the occupational noise exposure standard from NIOSH that even with strict time limits doesn’t protect all exposed workers from hearing loss.

The mathematics of the logarithmic decibel scale mean that after 2 hours of 85 dBA noise exposure, it is impossible to attain the only evidence-based safe noise level to prevent hearing loss, 70 decibels time-weighted average for 24 hours.

Most Americans are exposed to too much noise. Because of that, about 25% of American adults have noise-induced hearing loss, including many without any occupational exposure.

We’re running a great natural experiment–does noise exposure cause hearing loss?–and the answer is obviously “yes”.

And statements like those of “experts” like Dr. Sandridge, minimizing the health risks of noise exposure, are unfortunately part of the problem.

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.

New treatment for tinnitus gives hope

by Daniel Fink, MD, Chair, The Quiet Coalition

This report from the University of Michigan about Susan Shore PhD’s research gives hope to tinnitus sufferers that finally an effective treatment may be on the way.

Tinnitus, ringing in the ears, is most commonly caused by noise exposure, either chronic noise exposure or a one-time exposure to loud noise.

Given the causal relationship between noise exposure and both tinnitus and hyperacusis, a collapsed tolerance to usual environmental sound, many people have both. About half of those with tinnitus have significant hearing loss.

My own tinnitus developed after a one-time exposure to loud noise, so my hearing remains good. But I wish I had known that a one-time exposure to loud noise could cause symptoms the rest of my life. That’s part of the message I’m trying to get out to the world.

The other message is that both hearing loss and tinnitus are largely preventable. And certainly noise-induced hearing loss is 100% preventable.

Dr. Shore’s treatment is still in its experimental phase and no one can predict how much it will cost if and when it is approved by the FDA. Or, for that matter, if Medicare and private insurance programs will pay for it.

The most basic public health principle is that it’s far better, and far cheaper, to prevent illness or injury than to treat it. So while we wish Dr. Shore well, we hope those who do not yet have tinnitus, hyperacusis, or hearing loss take this sage–and free–advice:

Protect your ears! Avoid loud noise. Put in ear plugs if you can’t leave the noisy environment.

Remember, your ears are like your eyes or your knees: God only gave you two of them.

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.