Health and Noise

Football stadium noise still here for another season

by Daniel Fink, MD, Chair, The Quiet Coalition

It’s been years since I’ve been to a college football game. The last games I attended were at the Los Angeles Coliseum, one of the quieter big-school stadiums, during the Pete Carroll era at USC. But I have read about and written a number of stories on stadium noise. Here is the latest story about the stadium noise at the University of Oregon’s Autzen Stadium.

This article, like every other article about stadium noise, says the same things: the noise is distracting so the coaching staff makes the team practice with loud music being blasted at them. Why is it understood that the coach should “condition” his team rather than demand that the noise level be controlled? Simply put, crowd noise shouldn’t be a factor in a football game. What Coach Riley (and everyone else attending the game) doesn’t know is that if it’s loud enough to impact play on the field, it’s loud enough to cause auditory damage.

The Quiet Coalition is still waiting for the National Collegiate Athletic Association (NCAA) and its member colleges and universities–many of which have medical schools, schools of public health, audiology programs, or all three–to do something to protect the hearing of their student athletes and those attending the games. At least this University of Tennessee audiology professor understands the problem, which is why she recommends that students use earplugs when they attend UT football games. Kudos Dr. Patti Johnstone! But rather than having students block the noise, why not demand that the university control the noise in the first instance?

And as this article shows, stadium noise is a factor in professional games, too. In fact, stadium noise probably contributed to the Los Angeles Chargers recent loss in Denver.

Should football games be decided on the field, or by the home crowd purposefully making too much noise for the visiting team to hear the play being called? Whatever happened to good sportsmanship?

Sadly, it appears the NCAA, professional football teams, and stadium owners won’t address noise until and unless someone sues them because they developed sudden hearing loss or tinnitus after attending a game. Let’s hope that happens before many players and fans suffer significant hearing loss or develop tinnitus.

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.

Here’s the best mass-media article on noise-induced hearing loss

Photo credit: rainy city licensed under CC BY-ND 2.0

By David M. Sykes, Vice Chair, The Quiet Coalition

Despite impacting 48 million Americans, noise-induced hearing loss (NIHL) has languished in the shadows for decades. But that’s changing! Check out the 17-page beautifully illustrated article in the September issue of Real Simple magazine*, a Time/Life publication with 8.5 million readers nationwide (that’s eight times larger than the New York Times readership of 1.1 million).

If you’ve been looking for a “quick overview” you can hand to friends and family who fail to understand America’s unrecognized problem with hearing loss—whether it’s your kids’ and their constant earbud (ab)use, friends who can’t understand conversations when you’re dining out, or an elderly relative who’s stopped paying attention and is increasingly depressed—this article should get the conversation started. And if they ask “what else can I read about this?” Tell them to look at this issue of Scientific American, new information from the Centers for Disease Control, and this one-page Fact Sheet on the health effects of noise that The Quiet Coalition (TQC) published in 2016.

It’s clear that NIHL is, as TQC’s chair, Daniel Fink, MD, says, “a growing problem in America nearing epidemic proportions.” But there’s a lot of work to do to get people (including the nation’s leaders) to understand that this is a legitimate public health problem. Frankly, the European Union and Asia are far ahead of us on this issue.

In the meantime, take heart: major media are beginning to notice! Congratulations to the editor of Real Simple for recognizing this growing health crisis. We are extremely grateful that her magazine cited three of TQC’s Steering Committee experts in this piece–Rick Neitzel, PhD, Arline Bronzaft, PhD, and Bradley Vite–and also
described two practical success stories. We hope Real Simple will continue to cover this issue and give it the attention it deserves.

We have only one complaint: the magazine erroneously states that 85 dB is the threshold of hearing damage. In fact, research has shown that permanent hearing damage starts at noise levels as low as 75 dB; furthermore, non-audiological health effects, such as cardiovascular effects, can be caused by noises as low as 55 dB.

*NOTE: the best place to find Real Simple magazine may be at the checkout counter at Whole Foods or a local book store. Or you can get it here.

Originally posted at The Quiet Coalition.

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.

Protecting your teenager from noise-induced hearing loss

by Daniel Fink, MD, Chair, The Quiet Coalition

This piece suggests that you may decrease noise-induced hearing loss in your teenager by limiting personal music player listening to 60% of maximum volume for 60 minutes. I suppose anything is better than nothing, but I’m not sure how one precisely measures 60% of a personal music player’s volume. And if the one-hour limit is repeated several times a day–or the teen doesn’t follow this silly parental rule–I can guarantee that this approach won’t work.

My children are more than a decade past their teens now, so personal music players just weren’t an issue when they were younger. And I’m not sure how I would address the subject, either, but one approach might be to take them to a hearing aid store, or point out older people wearing hearing aids (in this case, one of them happens to be Grandpa) and then to tell them that a hearing aid is in their future if they don’t turn down the volume.

It’s hard for a parent to keep teenagers from doing unsafe or unhealthy things which may have lifelong consequences. The teen brain just isn’t wired that way. And saying to a teen that occasional exposure to loud noise damaging hearing is ok is just like telling him or her that occasional unprotected sex, heroin use, or driving without wearing a seatbelt is okay too, when, obviously, they are not.

The real responsibility for protecting our young falls to governments. We don’t allow people under 18 to smoke. We set an age at which a teenager can get a license to drive a car. They can’t drink alcohol until 21. And maybe they shouldn’t be listening to personal music players until age 15 or 18 as well. At a minimum, the Consumer Product Safety Commission should require warning labels to be placed on personal music players, headphones, and earbuds:

WARNING: USE OF THIS PRODUCT CAN CAUSE HEARING LOSS

Yes, smokers ignore warning labels, but the smoking rate among men has fallen from about 50% in the 1950s to near 20% today. And at least with smoking the government has tried to do something to protect Americans’ health. The federal government should target the causes of hearing damage now, or risk almost an entire generation marked by 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.

Children need quiet

Jennifer King Lindley, Real Simple, has written a fascinating article about the importance of quiet time for children entitled, “The One Thing Your Kid Needs—and Isn’t Getting.” Lindley begins her piece with an interview of Arline Bronzaft, PhD, noted noise activist and co-founder of The Quiet Coalition, whose landmark research “found that the reading scores of elementary students in classrooms located next to train tracks lagged a full year behind their peers in quieter classrooms on the other side of the building.” Dr. Bronzaft states that not only does noise interfere with learning, it causes a great deal of stress that leads to learned helplessness, “the feeling that you just have to sit there and take it,” which then causes still more stress.

But noise doesn’t just interfere with formal education, as Lindley tells us that “even moderate background noise can interfere with the ability of babies to learn new words.”

So what can you do to protect your children? Lindley offers specific advice for young children and teens, but both sets of advice basically distill down to two important elements: reducing background noise and distracting devices and learning to embrace quiet time.

Lindley’s article is an interesting read and well worth your time. Click the link above to read it in full.

 

 

New federal law deregulates and disrupts hearing aid market

Photo of Here One wireless smart earbuds courtesy of Doppler Labs

by David M. Sykes, Vice Chair, The Quiet Coalition

Who says this Congress can’t get anything done? Last week huge news appeared for 48 million Americans with hearing disorders, but the media barely noticed::

A new bipartisan law, the “Over-the-Counter Hearing Aid Act of 2017,” will deregulate the hearing aid market, dramatically lowering costs for consumers and releasing a surge of new technologies that will be sold over the counter, without a prescription. Yes, there will be losers as well as winners, but that’s the nature of change….

The new law responds to two federally sponsored reports issued last year (under the Obama Administration). The first report came from the President’s Council of Advisers on Science and Technology. The second was from the National Academy of Medicine. Passed the day before Congress adjourned, the new law creates opportunities for new technology innovators, eliminates the need to get a prescription, and dramatically cuts the cost by allowing substitutes, called “hearables” and “PSAPs” (Personal Sound Amplification Products), to be sold “over the counter.” The goal? a more efficient market that meets the needs of consumers.

As Noah Kraft, co-founder and CEO of Doppler Labs said, “[t]his industry is going to be completely disrupted. The question is by who?”

We have reported about this on several occasions over the past year, but the market disruption is getting underway much sooner that we anticipated thanks to quick action in the House of Representatives and the Senate, action that has emboldened nearly two dozen new entrants to enter the market ahead of schedule.

Who gains? 48 million Americans with incurable noise-induced hearing loss and millions more who are at risk from noise exposure. Who loses? The Big Six  who have dominated the hearing aid market for decades along with approximately 14,000 audiologists, the medical specialists whose services were previously required by the FDA to dispense and “fit” hearing aids to patients. The new Warren-Grassley OTC Act stipulates that the FDA must create a new category for “over-the-counter” hearing assistive devices and let them be sold freely, without intervention.

It’s no secret that the current Congress and the White House crave deregulation. Is deregulation potentially dangerous? Sure, but this is one instance where consumers will clearly benefit. Until now, hearing aids could cost you between $2,500 and $5,000 per ear, so $5,000 to $10,000 total. No wonder so few people have hearing aids—they weren’t covered by insurance or Medicare/Medicaid, so who could afford them? But now prices will drop to 1/10th of that—about $300 to $350 a pair–so lack of insurance coverage is less of a barrier.

We say thanks to the laudable bi-partisan cooperation between Senator Elizabeth Warren (D-MA) and Iowa Senator Chuck Grassley (R-IA) for getting this done at a time when Washington seems mired in dysfunction.

What’s the downside of this deregulatory innovation? There are many unknowns, so caveat emptor (buyer beware) and stay tuned…. But for now, it’s “Hip Hip Hooray”—or should we say, “Hear Here”!

P.S.: Our chair, Daniel Fink, MD, cautions that the real solution to the epidemic of hearing disorders in America is NOT more affordable hearing aids, but rather, a badly needed and long-awaited public health effort to prevent hearing loss—and we wholeheartedly agree with him. Prevention can be encouraged by three means:

  1. Educating people about the dangers of prolonged exposure to noise above 70 dB (permanent hearing damage occurs at levels much lower than currently recognized);
  2. Resurrecting federal efforts to reduce noise (as is being done in Europe and Asia already, where noise is recognized as a public health hazard) from obvious sources like planes, trains, trucks, consumer appliances, construction and outdoor maintenance equipment, etc.; and
  3. Educating companies in industries like aircraft manufacturing, car and truck manufacturing, mining, construction, HVAC, and appliance manufacturing, etc. that noise is harmful to public health.

Prevention can be done: currently, the European Union regulates noise emissions from 50 classes of products. According to Dr. Fink, “a hearable or PSAP is a poor substitute for well-preserved normal hearing; it’s far better to avoid loud noise or to wear earplugs!”

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.

There is nothing inevitable or natural about chronic disease

Photo credit: Robbie Sproule licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

This thoughtful piece talks about chronic disease, pointing out that it is not inevitable or natural. The author, Dr. Clayton Dalton, writes that:

[T]raditional cultures across the globe, from hunter-gatherers to pastoralists to horticulturists, have shown little evidence of chronic disease. It’s not because they don’t live long enough – recent analysis has found a common lifespan of up to 78 years among hunter-gatherers, once the bottlenecks of high mortality in infancy and young adulthood are bypassed. We can’t blame genes, since many of these groups appear to be more genetically susceptible to chronic disease than those of European descent.

So what is the reason for the absence of chronic illness among these cultures? “Evidence suggests it is how they live,” Dr. Dalton replies. And what factors do these different cultures share?  Dr. Dalton writes that the “common denominator [is] defined by the absence of modern banes: absence of processed foodstuffsabsence of sedentary lifestyle, and likely absence of chronic stressors.”

Dr. Dalton doesn’t specifically mention noise-induced hearing loss, but that’s another chronic disease that he could have included in his essay.

I spoke about this at the 12th Congress of the International Commission on the Biological Effects of Noise in Zürich in June. Similar to Dr. Dalton’s comments about hypertension and diabetes, I presented information showing that significant hearing loss is probably not part of normal aging, but represents noise-induced hearing loss.

A useful analogy for noise and hearing is sun and the skin. It turns out that skin and subcutaneous tissues sag as we age–that’s normal–but deep wrinkles, age spots, and skin cancers are the result of ultraviolet exposure. Similarly, I’m sure there are changes that occur in our hearing as we age, but profound hearing loss (25-40 decibel decrement in hearing) is most often the result of noise exposure.

In the end, how we live our lives matters. If we want to hear well into old age, we have to work to preserve our hearing all during our lives. How? It’s easy: avoid loud noise or wear ear protection if you can’t.

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.

Attention commuters: put down your earbuds!

 

Photo credit: Pedro Figueiredo licensed under CC BY-SA 2.0

A recent article in The Hearing Journal should give pause to mass transit commuters who use personal listening devices (PLDs) to mask background noise. Michelle Brady, AuD, Suzanne Miller, PhD, and Yula C. Serpanos, PhD, write that “[m]ass transit commuters are regularly exposed to excessive noise levels,” and note that use of PLDs “adds further stress on the auditory system as commuters listen at high volume levels to mask the background noise encountered during their daily commute.” By cranking the volume in areas of high noise, they note, commuters are “creating further risk of noise-induced hearing loss” (NIHL).

What makes NIHL insidious is that it “occurs in stages across several years,” and “[a]s such, its effects often go unnoticed.” Until they can’t be ignored, of course. The authors conducted a study on New York City commuters and found that “mass transit commuters in NYC do not completely understand the consequences of hearing loss and the proper use of PLDs.” They conclude that hearing health professionals need “to do a better job at educating the public about the risks of NIHL and safe listening habits.”

We agree that people need to be aware of the risks of NIHL, but also think there should be a role that government must play to protect citizens. And, of course, PLD manufacturers need to work with medical professionals and government to design safe PLDs that won’t deafen a generation.

 

Hearing loss is an occupational health hazard for musicians

by Daniel Fink, MD, Chair, The Quiet Coalition

It’s not surprising that hearing loss is an occupational health hazard for musicians, as highlighted in this recent report. After all, noise causes hearing loss. It doesn’t matter if the noise is from machinery in a factory, from a jet engine on the tarmac, or from loudspeakers at a rock concert. Whatever the source, the effect is the same.

And the type of music doesn’t matter, either, as noise-induced hearing loss is a problem for classical musicians, too.

The bottom line is this: hearing is precious. If hearing music is important to you–or hearing children or grandchildren speak, birds sing, whatever it is–protect your hearing.

How can you protect yourself? It’s easy. The auditory injury threshold is only 75-to-78 A-weighted decibels. That’s about the level at which ambient noise makes conversation difficult. If you are having a hard time having a conversation because of the ambient noise around you, it’s too loud. And if something sounds too loud, it IS too loud! Turn down the volume, leave the noisy place, always carry earplugs with you, and use 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.

Noise discriminates–heavier burden unfairly borne by the poor and non-white

Photo credit: Alicia Nijdam licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

Noise exposure has multiple effects on humans–it causes auditory disorders, interferes with learning, and disrupts sleep, causing increased cardiovascular disease and death, among other things. A new analysis of socioeconomic, racial, and spatial variation in noise exposure in the U.S. shows that the poor and nonwhite have greater exposure to noise than wealthier and nonminority populations.

Life may not be fair, but governments have a responsibility to try to make it more fair, and to protect all citizens from harm: rich and poor, white and non-white, native-born and immigrant. Those who often refer to the U.S. Constitution often seem to forget this, but the preamble includes a mandate to “promote the general Welfare.” A quieter environment for all Americans would appear to be part of this.

This also happens to be current federal law. The Noise Control Act of 1972 is still on the books, even if the Environmental Protection Agency’s (EPA) Office of Noise Abatement and Control (ONAC) was defunded in 1982. Reasonable people understand that the EPA and ONAC will not be properly funded during this current administration, but at some future time the funding must be made available. Noise damages more than hearing, and it is simply unacceptable that poor and nonwhite Americans suffer greater noise exposure while the federal government stands by and does nothing to protect 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.

“Health attacks” by inaudible sonic waves are real

Photo credit: Tess Watson licensed under CC BY 2.0

James Hamblin, The Atlantic, writes about the attacks on American and Canadian diplomats in Cuba in his article, “What Are Sound Weapons?” Hamblin starts his piece by describing the incidents which caused several Havana-based diplomats to suffer headaches, balance issues, and even severe hearing loss. Secretary of State Rex Tillerson, Hamblin notes, refered the to incidents as “health attacks.” And the AP reported that “U.S. officials concluded that the diplomats had been attacked with an advanced sonic weapon that operated outside the range of audible sound and had been deployed either inside or outside their residences.”

The weaponization of “energy waves with frequencies outside the range that the human ear can detect” is not new, writes Hamblin, and the health effects from exposure to inaudible sonic waves are real. Hamblin shares the story of residents of Kokomo, Indiana, who in 2001 experienced “annoyance, sleep disturbance, headaches, and nausea.” The U.S. National Institutes of Health investigated the matter but “couldn’t pin down the cause of the Indiana residents’ symptoms as infrasound.” The report, however, “did confirm that infrasound can cause fatigue, apathy, hearing loss, confusion, and disorientation.”

In the end, U.S. officials don’t know if Cuba is responsible or some third party, with the suggestion offered that the actor could have been “Russia, China, North Korea, Venezuela, or Iran.” But Hamblin adds that the attack is hardly sophisticated, as “[n]oise-induced hearing loss affects around one in four people,” although the source of noise is more mundane for most of us: loud concerts, shooting guns, and everyday failures to protect our hearing. Says Hamblin, “fascination with this sort of attack can be a reminder that it is worth arming ourselves in daily life against the more quotidian forms of sonic weaponry.”