Health and Noise

Inventors receive patent for new online hearing test

Photo of the National Technical Institute for the Deaf | Photo credit: DanielPenfield licensed under CC BY-SA 3.0

by Daniel Fink, MD, Chair, The Quiet Coalition

Faculty inventors at the National Technical Institute for the Deaf, located at the Rochester Institute of Technology, received a patent for a new online hearing test.

One of the difficulties in performing at-home testing of hearing using a home computer is standardization of the equipment. The new online hearing test, using speech comprehension as a measure, may overcome this problem.

We’ll have to wait to see how this works in real life when and if the test is introduced for public use.

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.

An international perspective on National Protect Your Hearing Month

by Daniel Fink, MD, Chair, The Quiet Coalition

As I recently wrote, October is National Protect Your Hearing Month. In that blog post, I noted that hearing loss with age is not part of normal physiological aging but in the U.S. largely represents noise-induced hearing loss. That is also likely true in other major industrialized countries, e.g., those of the European Union and the UK.

An international perspective on the importance of hearing protection is provided by the Global Burden of Disease report recently published in the British medical journal, The Lancet.

As NPR reported, “the key to health … is wealth. (And education … and women’s rights),” with the latter two factors assuming much greater importance in developing nations. Additionally, as infectious diseases and starvation become smaller relative problems as national incomes improve, non-communicable diseases such as obesity, hypertension, diabetes, and cancer become more important. Ironically, in many cases these “diseases of civilization” are specifically caused by improvements in daily living and dietary intake.

The analysis was coordinated by the Institute for Health Metrics and Evaluation in Seattle, which recently has received notice because of its coronavirus predictions for the U.S. One of the measures examined was the “healthy life expectancy,” abbreviated HALE. Another was Disability-Adjusted Life Years, or DALYs.

Sadly, when it comes to hearing, the IMHE and The Lancet’s editors still use the term “age-related hearing loss,” which wrongly implies that hearing loss is part of normal aging. As people live longer, hearing loss becomes a greater problem in all societies, including developing ones.

As shown in the Table in The Lancet article, DALYs from hearing loss increased for all populations, and especially for adult populations, since 1990.

This is a shame. Noise-induced hearing loss is entirely preventable, and no country, not even wealthy countries such as the U.S. or Switzerland, can afford to provide hearing aids to everyone who could benefit from them. Moreover, preventing noise-induced hearing loss is simple: avoid loud noise or use hearing protection if one can’t.

Because if it sounds loud, it is too loud and one’s auditory health is at risk.

This is true in the U.S. and in every country in the world during October, National Protect Your Hearing Month.

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.

October is National Protect Your Hearing Month

by Daniel Fink, MD, Chair, The Quiet Coalition

October is National Protect Your Hearing Month!

As I have noted before, I’m not a big believer in special months or days to celebrate or honor or remind us of people or things that should be celebrated or honored or observed every day, but the special days and months may serve as a useful reminder of the people or things. Hearing protection is one of those things that should be observed every day.

Hearing loss represents the cumulative impact of a lifetime of noise exposure, just as skin discoloration, deep wrinkles, and skin cancers represent the cumulative impact of a lifetime of sun exposure.

The basics of hearing protection are very easy:

  1. Avoid noise exposure, or wear hearing protection (ear plugs or ear muffs) if you can’t.
  2. The only evidence-based noise exposure level to prevent hearing loss is a daily average of 75 decibels.
  3. If a noise sounds loud, it is too loud and your hearing is at risk.

I would add a caveat and some scientific information to support my three points.

The caveat: The commonly cited 85 decibel noise level is not a safe noise exposure level for the public, but an occupational noise exposure level that doesn’t protect all exposed workers from hearing loss. Don’t believe the National Institute on Deafness and Other Communication Disorders or misinformed audiologists when they promulgate dangerous misinformation with statements like, “[l]ong or repeated exposure to sounds at or above 85 dBA can cause hearing loss (dBA means A-weighted decibels. A-weighting adjusts sound measurements for the frequencies heard in human speech.) Auditory damage probably begins at sound exposure levels far below 85 decibels, and after only one hour of exposure to 85 decibel sound it’s impossible to achieve the safe daily average of 70 decibels for 24 hours.

The science: A literature review, now confirmed by research published this year, demonstrates that there is no such thing as age-related hearing loss. Hearing loss is not part of normal aging but largely represents noise-induced hearing loss.

More science: Noise exposure in daily life is loud enough to cause hearing loss. A 2017 CDC study showed that about 25% of American adults age 20-69 had noise-induced hearing loss, many without significant occupational exposure to noise.

Your ears are like your knees–you only have two of them. So protect them, because unlike your knees, your ears can’t be replaced.

Protect your ears and protect your hearing during National Protect Your Hearing Month, and during every month!

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.

New research developments in tinnitus, noise-induced hearing loss

Photo credit: hov1s@ licensed under CC BY-NC-SA 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

This quite technical article from a research group in Taiwan describes new research developments and remaining gaps in assessment, treatment, and prevention of noise-induced hearing loss and tinnitus.

To me, the most important information in the article is contained in two lines in the conclusion at the end of the paper:

All people are exposed to noise. However, while the pathogenesis of NIHL is complex, cochlear neuropathy is largely preventable.

I came to the same conclusion in a literature review that was presented at the 12th Congress of the International Commission on the Biological Effects of Noise in Zurich in 2017.

And researchers at the Massachusetts Eye and Ear Infirmary recently came to the same conclusion analyzing human cochlear tissue and comparing changes found with ante-mortem hearing tests and exposure histories.

The authors of the article above state that “[s]tudies must continue to investigate ways to reduce NIHL,” but I would disagree with that statement. We have known for decades how to reduce and even prevent noise-induced hearing loss: avoid exposure to loud noise or wear hearing protection if you can’t.

Only about 8% of American adults reported using hearing protection when attending loud sporting or entertainment events. So studies about how to convince people to protect their hearing may be of some value, although regulation of product noise and use of noisy devices, as has been implemented in Europe, would be far more effective.

Because if a noise sounds loud, it is too loud, and your auditory health is at risk.

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.

COVID-19 and the city soundscape

Photo credit: Craig Adderley from Pexels

by Daniel Fink, MD, Chair, and David M. Sykes, Vice Chair, The Quiet Coalition

The Quiet Coalition’s Arline Bronzaft, PhD, wrote a very nice essay about COVID-19 and the city soundscape, which was published in New York City’s Our Town, the local paper for the Upper East Side neighborhood of Manhattan.

Dr. Arline Bronzaft is known and published worldwide for her expertise and teaching on community noise. But noise is personal too, a cause. So she’s never lost sight of its impact on her own home town, New York City, where she has been an adviser to five mayors. Nor the effect it has on her own neighbors on the upper east side of Manhattan, even during the recent COVID lockdown that brought life to a standstill an an eery quiet punctuated only by the frightening sounds of ambulance and police sirens at any hour of the day or night.

In her essay, Dr. Bronzaft notes that sound and noise received a great deal of attention during the first months of the coronavirus pandemic. In the absence of the usual hustle and bustle of noisy New York City, she writes:

There was talk about hearing and seeing more birds; not being awakened by overhead jets in the early morning hours; not being subjected to loud construction noises; and no music from nearby bars. However, an increase in loud ambulance sirens disturbed our ears and upset our minds because this meant more people were likely suffering from COVID-19.

She goes on to discuss possible future outcomes as urban activities return to normal, and expresses the hope that everyone–including city officials–will remember, when normality returns, what this period of calm and quiet was like.

Dr. Bronzaft’s piece dovetails very nicely with an editorial by Dr. Antonella Radicchi in a special issue of Cities & Health about sound and the healthy city.

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.

David Sykes chairs several professional organizations in acoustical science: QCI Healthcare Acoustics Project, ANSI Committee S12-WG44, the Rothschild Foundation Task Force on Acoustics, and the FGI Acoustics Committee. He is lead author of “Sound & Vibration 2.0” (Springer, 2012), a contributor to the NAE’s “Technology for a Quieter America” and the GSA’s “Sound Matters,” and co-founded the Laboratory for Advanced Research in Acoustics at Rensselaer Polytech. A graduate of UC-Berkeley with advanced degrees from Cornell, he is a frequent organizer of professional conferences in the U.S., Europe, Asia and the Middle East.

Community to vote on noise control cost

Photo credit: Andy Nystrom licensed under CC BY-NC-ND 2.0

by Jan L. Mayes, MSc, Audiologist

What happens when citizens want highway noise control but the financial cost is high? The Canadian community of Beaconsfield, Quebec is facing skyrocketing noise control estimates for a long awaited concrete sound barrier. Since the need was identified in 2010, cost estimates have risen from $25.5 million to $46 million putting the entire project at risk.

Beaconsfield’s sound energy is above World Health Organization noise limits recommended to prevent health damage in pregnant women, newborns to teens, elders, and other groups-at-risk. This doesn’t mean the noise control budget should be unlimited. But a $46 million sound barrier may not be the only solution. Modern options include different sound barrier designs, lower speed limits, quiet asphalt, and greenscaping between residences and the highway. There are new technology sound barriers designed to cut noise and chemical air pollution that are as effective as other barrier styles, and might be less expensive.

While there is no doubt this highway noise is a public health risk, authorities have decided to let community members vote on whether to pay for noise control or not. This will pit resident against resident, leaving the outcome in the control of many people who don’t live near the highway.

If this was a contaminated water supply, there would be no vote on whether to pay what is needed to protect public health. Unfortunately, noise isn’t treated with the same seriousness even though exposure is linked to communication breakdowns, reading delays, and increased risk of impaired health like anxiety, depression, heart disease, Type 2 diabetes, obesity, hearing loss, and dementia.

One of the root causes of this Canadian noise control problem is lack of community planning. Highways and infrastructure were built and expanded too close to homes, schools, playgrounds, and parks. Now there is a $46 million price tag to fix the problem.

In the U.S., the Quiet Community Act of 2019 would include limiting vehicle source noise emissions and better infrastructure planning to prevent community noise. This Act needs senate funding at a cost of $21 million a year. Experts estimate for every $1 spent on noise control, there will be an estimated $1.29 in future savings by eliminating preventable diseases and other adverse social effects of noise.

When it comes time to vote, one hopes the community in Quebec will vote so everyone has equal health protection from harmful noise no matter where they live. When it comes time to vote in the U.S., one hopes citizens will vote for senators who support funding the Quiet Community Act. Prevention will improve public health equality and cost less than noise control after the fact.

Jan L. Mayes is an international Eric Hoffer Award winning author in Non-Fiction Health. She is also a blogger and newly retired audiologist still specializing in noise, tinnitus-hyperacusis, and hearing health education. You can read more of Jan’s work at her site, www.janlmayes.com.

 

Birds changed their tune during the Covid lockdown

Photo credit: Paul Knittel from Pexels

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

In several blogs I have written recently, I commented that the pandemic’s effect on the soundscape did not just impact humans but other species as well, e.g. birds, whales. A recent article on a study of birds in San Francisco found that birds started singing differently during the silence of the COVID-19 Lockdown, noting that male white-crowned sparrows in San Francisco have begun to sing more softly and with an improved vocal range. The article says this change in singing may make them “sexier to females.”

The article cites a paper that has studied how animals, including whales and birds, have changed their behaviors during the pandemic shutdown. Before the pandemic, cities characterized by loud noises, especially from traffic, forced birds to sing louder to be heard by other birds. The authors reached this finding by comparing birdsong data collected previous years at the same sites they collected data during April and May 2020. Their data allowed them to conclude that birds “can adapt to changing environments.”

Erik Stokstad, writing for Science, states that birdsong “recaptured its former glory,” referring to the white-crowned sparrows of San Francisco. He adds that when birds sing louder in noisy environments the stress created “can speed aging and disrupt their metabolisms.” With the noise also preventing birds from hearing their own chicks, there is the possibility that bird diversity is less in many cities. Furthermore, by demonstrating that some birds can adjust their songs to their environment, it might be that birds who could not adjust, and as a result left noisier cities, might return to places that are now quieter. But the quieter time of the pandemic has passed as cities have been returning to noisier times. Thus, the birds that have quieted down will very likely have to increase the volume of their songs. Also, may I add, that it is unlikely the birds who left will return.

Stokstad interviewed Elizabeth Danberry and her behavioral ecologists who have studied white-crowned sparrows in and around San Francisco for more than twenty years. Their research has clearly demonstrated the impact of noise pollution on the health and well-being of these sparrows. Similarly, long standing research has also clearly found that noise is hazardous to human hearing, health, and well-being. So I ask, how much more research do we need linking noise to adverse effects on humans and other species before we begin to lower decibel level in our environment?

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.

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.