Hearing loss

It’s time to change our definition of “old”

Annual National Veterans Golden Age Games | Defense Department photo/Army Sgt. 1st Class Michael J. Carden

by Daniel Fink, MD, Chair, The Quiet Coalition

According to Joseph Coughlin, director of the AgeLab at MIT and author of “The Longevity Economy,” a new book about marketing to aging baby boomers, it’s time to change our definition of “old.”

Coughlin claims that old age is a made-up social construct invented 150 years ago.

I’m not sure I agree with him completely, but he’s right about something. Much of what we think of as normal aging–obesity, hypertension, diabetes, weakness, disability, and early demise–isn’t normal aging but pathological aging.

I’d add hearing loss to that list.

Pathological aging stems from four factors:

  1. Abnormal exposures, e.g., sun, cigarette smoke, or noise;
  2. Poor quality nutrition, i.e. too much of the wrong nutrients (including calories) and not enough of the right nutrients;
  3. Disuse atrophy, especially for the musculoskeletal system; and
  4. Medical care based on inadequate knowledge about the best treatments for common conditions.

The treatment of hypertension is one example of the fourth factor. In the 1970s, it was thought that a normal systolic blood pressure was 100 plus the patient’s age, and that treating hypertension in the elderly was dangerous. Then a randomized trial–the Systolic Hypertension in the Elderly Program–showed that treatment of high blood pressure in older people prevented stroke. Two more recent examples are studies showing that treatment of cardiac risk factors prevents what was once thought to be inevitable heart disease as people age and then was found to reduce dementia risk, too.

Hearing loss in old age is very common. It’s called presbycusis, or age-related hearing loss. But the world’s literature–which I reviewed for a presentation I gave at the 12th Congress of the International Commission on the Biological Effects of Noise in Zürich, on June 20, 2017–shows that it isn’t normal. Without exposure to loud noise, good hearing is preserved well into old age.

In his book Coughlin discusses “transcendent design”–not just accessible design, or universal design, but:

[A]nother, even higher level of accessibility that I believe has been mistakenly lumped in with universal design: transcendent design. It’s essentially universal design that has been dialed up to 11 on a 10-point scale, with accessibility attributes so useful that they turn out to be highly desirable—even aspirational—for people with and without disabilities. If the defining, narrative-shaping forces in our older future will be those that make it easy for older adults to achieve their jobs as consumers, transcendent products and design features will be at the vanguard of this process.

Coughlin highlights, as an example of transcendent design, the OXO line of kitchen utensils, initially designed by entrepreneur Sam Farber because his wife couldn’t grip standard utensils due to arthritis. People buy OXO utensils not necessarily because they have arthritis or other grip issues, but because OXO utensils they are so good-looking and easy to use. The iPhone and Apple watch are other examples.

People with mobility, musculoskeletal, or auditory disorders don’t need special designs. They and everybody need well-designed utensils, tools, garments, furniture, and spaces that meet needs as people age and suffer inevitable temporary or sometimes permanent impairments.

Perhaps one day architects and interior designers can come up with transcendent designs for quiet restaurants, to make it possible to carry on normal conversations without straining to speak or to be heard, while enjoying the food and the company of our dining companions.

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.

Anti-social miscreant charged criminally

for being an anti-social miscreant: Man charged for playing car stereo too loud. No doubt there may be some who assume the cops in Central Saanich on Vancouver Island, Canada, have too much time on their hands and too little work to do.

And they would be wrong.

Although Dustin Hamilton, the offender, claims he didn’t mean to annoy people, well, let’s just say certain facts belie his feigned innocence. Like the fact that his “car is equipped with a decibel reader and he says he plays it at 150.” Or that he boasted to Asymina Kantorowicz, writer/producer at CTV News, that his sound system can reach 155 decibels. To give you an idea about how loud that is, according to Dangerous Decibels, a jet plane at 100 feet away is around 135 decibels, and the permissible listening time for someone exposed to 115 decibels is under 30 seconds. It’s a wonder he can even hear.

And then there’s the bit about the number of neighbors filing complaints. Said Hamilton, “[i]f somebody just came up to me nicely saying ‘hey I live here this is what’s happening’ you know we could do that but I never had that, I just had a guy follow me and try and assault me,” adding, “[i]t went from that to basically 17 people complaining and a mischief charge.” From one guy trying to assault him to 17 complaints, and he has no idea why.

Hamilton’s charge comes with certain conditions, like not contacting the complainants and not driving on certain roads. No surprise he is put out, as is his girlfriend, who likes her music as loud as he does, reminding us of the adage, “there’s a lid for every pot.”

In the end, Hamilton would claim that the reason for the crazy loud music isn’t some sociopathic need to torment his neighbors. No, for Hamilton it comes down to this: “I can play anything, rap, hip-hop, it all sounds good … I love sound man.”

Not for long, Hamilton.

Thanks to Jan L. Mayes for the link.

The health impact of environmental noise

by Jan L. Mayes, MSc, Aud(C), RAud, Audiologist

Environmental noise is damaging and inflicts unwanted sounds into everyday life. In 1984, Gordon Hempton, The Sound Tracker, found 20 natural locations in Washington State with noise-free intervals lasting over 15 minutes. No manmade noise at all. No planes, trains, or traffic. By 1995, only three locations were noise-free. When I employed current sound tracking in my suburban neighbourhood in the Pacific Northwest, I never had noise-free intervals last more than 4 minutes.  And I tried tracking at different times of the day, every day of the week for months.

Sociocusis is high distortion hearing loss caused by loud personal environmental noise (i.e., 75 dB average or higher). The louder the noise, the faster the damage. Noise-induced hidden hearing loss starts first. It begins with permanent rips in hearing nerves for which there are no symptoms, but damage is progressive for months after noise ends. More unprotected noise exposures causes yet more nerve damage leading to temporary or permanent inner ear hearing loss and what I call “hyper ears” (tinnitus and hyperacusis). Presbycusis, or age-related hearing loss, comes from gradual inner ear changes over time. Sociocusis, wrongly called early presbycusis, has a much greater impact on communication and music enjoyment than presbycusis alone.

There are also physical and mental health hazards from chronic environmental noise (i.e., 55 dB – 75 dB average). Health effects include stress, insomnia, learning problems in children, obesity, diabetes, high blood pressure, heart attacks, strokes, dementia, and shorter life. Blood pressure goes up with every 10 dB increase in environmental noise.

Ear protection prevents sociocusis from loud activities like nightclubs, concerts, and stadium events. Imagine if these venues were designated “Noise Hazard Zones”: no ear protection, no entry. Imagine Noise Free Zones like at Comic-Con 2017 in New York City. Imagine architects designing public spaces with quiet acoustics in the first place. Imagine if it was standard for manufacturers to make quiet products, dropping the noise hazard of everything from blenders, lawnmowers, planes, trains, and traffic.

The UK estimates noise pollution related healthcare costs at £1.09 billion annually. The EU is using urban planning and government polices to prevent environmental noise. Noise mitigation strategies include quiet asphalt, low-noise tires, traffic curfews, quieter airplanes, noise-optimized airport take-off and approach procedures, and better infrastructure planning.

But in the U.S., the FAA denies the crippling public health burden of noise pollution, and Congress hasn’t passed the Quiet Communities Act of 2016 or 2017.

Nobel Prize Winner Robert Koch predicted in 1910 that “[o]ne day man will have to fight noise as fiercely as cholera and pest.” I think the day is here.

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

What’s better than a cheap hearing aid?

Photo credit: ReSound licensed under CC BY 3.0

by Daniel Fink, MD, Chair, The Quiet Coalition

The New York Times asked recently why hearing aids are so expensive. They should have stepped back and asked a more important question: What’s better than a cheap hearing aid?

A: Preserved natural hearing.

As a paper I presented at the 12th Congress of the International Commission on the Biological Effects of Noise discussed, the scientific evidence suggests that significant hearing loss (25-40 decibel hearing loss) is probably not part of normal aging, but is actually noise-induced hearing loss in the vast majority of cases. Research supporting this conclusion includes studies of hearing done in populations not exposed to noise, different rates of hearing loss in males vs. females, decades of occupational studies correlating increased noise exposure with greater hearing loss, and recent laboratory experiments showing the molecular, genetic, and sub-cellular structural mechanisms by which noise damages the auditory system.

If you protect your hearing now–by avoiding noise exposure or using hearing protection (ear plugs and ear muffs) if you can’t–you shouldn’t need a hearing aid in the future.

Preserved natural hearing…it’s better than a cheap hearing aid!

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.

Coping with hearing loss and noisy restaurants is not a game

by Daniel Fink, MD, Chair, The Quiet Coalition

This report from CNN discusses a novel strategy to help people with hearing loss understand speech: a game to train the brain to process speech better.

This is a widely known but poorly understood problem–sometimes called the “Speech in Noise problem”–with people with hearing loss, but it can also affect people with normal or adequate hearing as tested by standard hearing tests (“pure tone audiometry”) who nonetheless can have problems understanding speech.

The problem is worse for those with hearing aids, which is probably why up to 40% of people with hearing aids don’t use them–they just don’t help understand speech in everyday situations. As hearing loss blogger Shari Eberts has written, hearing aids just are not like eyeglasses.

Some research supports a central cause for this, i.e., deficiencies in brain processing of auditory signals as people age. Other research puts the problem in the periphery, i.e., the ear. And the research on hidden hearing loss puts the problem in between, in the nerves connecting the ear to the brain. Most likely the explanation involves all three.

Even though the computer game reported in this story may eventually help people who struggle to understand speech, dealing with hearing loss and noisy restaurants isn’t a game.

The real answer isn’t brain training. It’s quieter restaurants, stores, and other public places.

Quieter indoor places will not only help those who already have hearing loss understand speech, they will prevent hearing loss in those still with good hearing.

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 can make you deaf

Photo credit: UrbanUrban_ru licensed under CC BY-SA 2.0

And the Hindustan Times, knowing this, advises its readers: This Diwali, turn a deaf ear to noise.

Diwali is happening now, so enjoy the sigts–and some of the sounds–and don’t forget to pack some disposable earplugs for yourself, your friends, and family.

Hearing loss a big problem for farmers and ranchers

by Daniel Fink, MD, Chair, The Quiet Coalition

This report discusses the problem of occupational hearing loss in farmers and ranchers. You may be confused, thinking farmers and ranchers must surely work in some of the most peaceful workplaces that exist. And that may be true part of the time, but they also use heavy equipment (tractors, harvesters, etc.) for long periods of time. Says Dr. Richard Kopke, M.D., FACS, chief executive officer of the Hough Ear Institute in Oklahoma City, “[e]xposure to tractors, forage harvesters, chain saws, combines, grain dryers, even squealing pigs and guns, can lead to significant hearing loss.”

Dr. Kopke offers advice to farmers and ranchers on how to avoid hearing loss, including the same point I always make: if you have to raise your voice to be heard, the ambient noise is above 75 A-weighted decibels and hearing loss is occurring.

But it’s not just farmers and ranchers at risk of noise-induced hearing loss. It’s everyone.

Hearing is precious. Speech is the main way humans communicate and relate to one another. As Helen Keller said (paraphrasing), “blindness separates people from things, but deafness separates people from people.”

It’s National Protect Your Hearing Month. Once hearing is lost, the only treatment is a hearing aid (or a cochlear implant for the severely impaired). If it sounds too loud, it IS too loud! Turn down the volume, leave or move away, or insert ear plugs or use ear muff hearing protection.

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.

Havana mystery: Weaponized sound or ‘spooky action at a distance’?

U.S. Embassy in Havana | Photo credit: Escla licensed under CC BY-SA 3.0

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

Albert Einstein never accepted quantum physics, proving that geniuses don’t know everything. One phenomenon he couldn’t explain—now known as “quantum entanglement”–he simply dismissed as “spooky action at a distance.” But it has lately (decades after Einstein’s death) been proven.

Something else that’s not understood yet is the odd case of “weaponized sound” that appears to have sickened people at the U.S. embassy in Havana, Cuba. This piece in Wired Magazine, as well as this article in The New York Times, are by far the best so far on this mysterious and unexplained situation.

If you, like we, have been pondering this, wondering if an LRAD was involved or perhaps some secret source of weaponized infrasound or ultrasound, don’t expect a definitive answer just yet. Adam Rogers, the author of the Wired piece, and Carl Zimmer, of The New York Times, dug deeper than most and even talked to some scientists (in the U.S. and Russia) to see what, in anything, anybody knows. The answer is this: it’s still a mystery, but stay tuned because they’re gradually eliminating possibilities. The most probable scenario involves a combination of ototoxic chemical exposure with some form of weaponized sound. Yes, there are many ototoxic chemicals and drugs, that is, chemicals and drugs the exposure to which can destroy your hearing, including several chemotherapy drugs.

Is this kind of lethal combo possible? Probable? Likely?

Whatever it is, it apparently is NOT an LRAD. Yes, it’s true that LRAD’s are being distributed to and used by police forces since 2009, but whatever has been going on in Havana, that’s not the answer. Stay tuned.

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.

The wrong answer to the restaurant noise problem

Photo credit: Jeremy Keith licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

This report from the United Kingdom discusses expensive new headphones which can help someone understand conversations in a noisy restaurant.

This is the wrong answer to the restaurant noise problem.

Why should someone have to spend £400–about $530 at current exchange rates–just to be able to understand a conversation in a restaurant in London?

The right answer is making restaurants quieter, by reducing background music levels and adding sound-absorbing materials, so everyone can have a conversation without straining to speak or to be heard.

Noisy restaurants are a major disability rights issue for those with hearing loss, tinnitus, and hyperacusis. And it is an important issue for older Americans, many of whom have significant (25-40 decibel) hearing loss.

I will be speaking about the problem of restaurant noise at the December 2017 meeting of the Acoustical Society of America in New Orleans.

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.

Yet another reason to protect your hearing

by Daniel Fink, MD, Chair, The Quiet Coalition

October is National Protect Your Hearing Month, and Jane Brody’s column in the September 26, 2017, New York Times science section gives yet another reason to protect your hearing: hearing loss is tied to cognitive decline. In fact, studies are underway to determine if preventing hearing loss or treating hearing loss will prevent cognitive decline, because the correlation between hearing loss and cognitive decline is well established.

I try to lead a healthy life. I never smoked. I walk an hour or more every day. I eat 5-7 servings of fruits and vegetables daily. My BMI is 24.5. I wear a hat and long sleeves to protect me from the California sun. I always use my seat belt when driving or riding in a car. But I knew little about the importance of protecting my hearing.

Unfortunately, my ignorance hurt me. A one-time exposure to loud noise one New Year’s Eve left me with permanent tinnitus and hyperacusis. I started wearing ear plugs at movies and sports events, and dined out rarely because almost all restaurants are painfully noisy for me. Then three years ago, after reading a different piece in the New York Times science section on hyperacusis, I was motivated to become a noise activist and to learn more about preventing auditory damage.

Researchers are working on drugs and other treatments to reverse noise-induced hearing loss, tinnitus, and hyperacusis, but currently the only treatments for hearing loss are hearing aids or, for the most severely affected, cochlear implants. And hearing aids aren’t like eyeglasses or contact lenses for common visual problems. They just don’t work as well as people would like to help them understand speech.

When I learned how bad noise is for the ears, that the only safe noise exposure level to prevent hearing loss is 70 decibels daily average noise exposure, that most Americans are exposed to dangerously high noise levels in everyday life, that many American adults have noise-induced hearing loss because of the excess noise exposure, and that hearing aids don’t work particularly well in helping people with hearing loss understand speech, I realized I had to protect my hearing.

Now I use earplugs at the movies, at sports events, even if I have to go to a noisy restaurant. And if I use a power tool, or even bang in one nail with a hammer, I use ear plugs or ear muff hearing protection. You should, too!

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.