Hearing loss

How to “rock out” with headphones without damaging your hearing? You can’t!

Photo credit: bruce mars from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

In this article from the Cleveland Clinic, Sandra Sandridge, PhD, Director of Clinical Services in Audiology, offers advice on protecting hearing when using ear buds or headphones to listen to music.

She first notes that hearing loss is 100% preventable, and this might be the only statement that is accurate. Unfortunately, the advice she gives to prevent noise-induced hearing damage is not.

This piece is like an article fifty years ago advising smokers on how to smoke safely. One can’t! There is no such thing as a safe cigarette, and there is no such thing as safe headphone or ear bud use.

Dr. Sandridge notes that many headphones and ear buds can be too loud–most personal music players put out 100-110 decibel sound and some player-headphone combinations can reach 120 to 130 dB–but she implies that 85 decibels is the sound level at which auditory damage begins.

That’s not the cutoff between safe and unsafe sound levels. It’s derived from the NIOSH recommended exposure level for occupational noise, an exposure level that doesn’t prevent hearing loss.

Even in children age 9-11, who haven’t been using headphones very long, auditory damage is already present.

The only way to prevent auditory damage is not to use ear buds or headphones. Or to use Dr. Sandridge’s language:

The only way to rock out with ear buds or headphones without damaging your hearing is not to rock out with them!

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He is the founding chair of The Quiet Coalition, an organization of science, health, and legal professionals concerned about the impacts of noise on health, environment, learning, productivity, and quality of life in America. Dr Fink also is the interim chair of Quiet Communities’ Health Advisory Council, and he served on the board of the American Tinnitus Association from 2015-2018.

Hearing loss associated with depression

by Daniel Fink, MD, Chair, The Quiet Coalition

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

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

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

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He is the founding chair of The Quiet Coalition, an organization of science, health, and legal professionals concerned about the impacts of noise on health, environment, learning, productivity, and quality of life in America. Dr Fink also is the interim chair of Quiet Communities’ Health Advisory Council, and he served on the board of the American Tinnitus Association from 2015-2018.

Hidden hearing loss

Photo credit: Daria Shevtsova from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

Hidden hearing loss is the term used to describe nerve damage in the inner ear (cochlear synatptopathy) which causes hearing loss detected only by special research techniques, not by standard hearing testing (pure tone audiometry). That’s why it’s called “hidden.” The clinical manifestation of hidden hearing loss is thought to be difficulty understanding speech in a noisy environment, but auditory training might help improve understanding of speech in noisy places.

This article describes a survey of adults who were asked if they would be willing to participate in auditory training. What’s of interest to me is that 22% of adults surveyed report having difficulty understanding speech in a noisy environment. That fits with other reports I’ve seen, but I think it’s an underestimate.

Many people with hearing loss think their hearing is excellent, and I think the same is true for people asked about difficulty understanding speech in a noisy environment. Due to the stigma of hearing loss, no one wants to admit that he or she has a problem.

More importantly, if people have difficulty understanding speech in noisy environments, it would seem to be much easier to make those environments quieter, rather than offering auditory training to those with the problem.

Quieter environments would make it easier for everyone to converse, and would prevent auditory damage in those without it.

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.

Girl scout receives national honor for work on hearing health

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

by Daniel Fink, MD, Chair, The Quiet Coalition

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

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

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

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

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He is the founding chair of The Quiet Coalition, an organization of science, health, and legal professionals concerned about the impacts of noise on health, environment, learning, productivity, and quality of life in America. Dr Fink also is the interim chair of Quiet Communities’ Health Advisory Council, and he served on the board of the American Tinnitus Association from 2015-2018.

More evidence that headphone use causes hearing loss

Photo credit: Patrick Pielarski licensed under CC by 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

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

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

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

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

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

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He is the founding chair of The Quiet Coalition, an organization of science, health, and legal professionals concerned about the impacts of noise on health, environment, learning, productivity, and quality of life in America. Dr Fink also is the interim chair of Quiet Communities’ Health Advisory Council, and he served on the board of the American Tinnitus Association from 2015-2018.

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

Photo credit: Flávia Costa licensed under CC BY 3.0

by Daniel Fink, MD, Chair, The Quiet Coalition

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

Dear Hearing and Health Partners,

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

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

Cordially,

NCEH Noise-Induced Hearing Loss Program

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

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

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

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

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He is the founding chair of The Quiet Coalition, an organization of science, health, and legal professionals concerned about the impacts of noise on health, environment, learning, productivity, and quality of life in America. Dr Fink also is the interim chair of Quiet Communities’ Health Advisory Council, and he served on the board of the American Tinnitus Association from 2015-2018.

Better hearing and sight can help keep memory sharper

by Daniel Fink, MD, Chair, The Quiet Coalition

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

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

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

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

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

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

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He is the founding chair of The Quiet Coalition, an organization of science, health, and legal professionals concerned about the impacts of noise on health, environment, learning, productivity, and quality of life in America. Dr Fink also is the interim chair of Quiet Communities’ Health Advisory Council, and he served on the board of the American Tinnitus Association from 2015-2018.

85 decibel headphones aren’t safe for children

Photo credit: Leonid Mamchenkov licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

Many headphones are advertised as safe for children’s hearing, using the occupationally derived 85 decibel (dB) standard as the volume limit without giving an exposure time.

When I contacted them in December 2015, the U.S. Federal Trade Commission’s Division of Advertising Practices declined to take action about this false advertising. Earlier this year, I learned about the UK Advertising Standards Authority, a quasi-governmental agency serving approximately the same role in England and Wales. I filed the same complaint with ASA, on behalf on The Quiet Coalition to protect children’s auditory health. On October 31, 2018, the ASA issued a ruling that Amazon’s advertising of these headphones as safe for children was indeed false advertising.

A study in the Netherlands earlier this year showed that even in children age 9-11 years, headphone use was associated with an increased rate of auditory disorders.

Parents and grandparents would be well-advised not to allow their children or grandchildren to listen to music or videos using headphones, with or without the 85 dB volume limit.

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.

Newly identified gene plays critical role in noise-induced hearing loss

by Daniel Fink, MD, Chair, The Quiet Coalition

This report about research done at the University of California-San Francisco describes identification of a new gene and its effects on proteins in the cochlea. The cochlea is the part of the ear where sound waves are transformed into electrical impulses which are transmitted to the brain and perceived as sound. The article notes that insights about the newly identified gene and the proteins it codes for may eventually lead to drugs to prevent hearing loss after noise exposure.

I have a much more practical suggestion that those concerned about their hearing can use today. Until that drug is available on the market–which will be years to decades to perhaps never, and who knows at what price–avoid noise-induced hearing loss by avoiding loud noise exposure. It’s simple, easy, and inexpensive. And I speak from experience–it’s what I do. I avoid loud noise, e.g., rock concerts, and if I can’t avoid loud noise, when flying in an airplane or using a power tool, for example, I wear noise-canceling headphones or insert earplugs.

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 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 almost over. October is also National Protect Your Hearing Month.

I’m not big on special days or months. If something is worth doing or someone is worth honoring or worth being concerned about, we should do it or honor them or be concerned about it every day.

My late mother taught me that. Many decades ago, when at our father’s urging we asked her what she wanted for Mother’s Day, she would snap:

This is what I want for Mother’s Day. I want you boys to stop fighting. I want you to make your beds in the morning without me nagging. I want you to clean up your toys. And I want you to come to the table for dinner the first time I call you, not the fourth. Mother’s Day is every day. You can’t be mean to me 364 days of the year and expect being nice on one day to matter.

So that’s my approach to special days and months, including my own birthday and the month of October.

But the special days or months do provide the opportunity to remind ourselves and others of something important.

For National Protect Your Hearing Month, our friends at CDC informed us that on October 19, it released a Morbidity and Mortality Weekly Report (MMWR) entitled, “Use of Personal Hearing Protection Devices at Loud Athletic or Entertainment Events Among Adults — United States, 2018.” In this report, CDC researchers found that fewer than 20% of American adults used hearing protection when attending loud athletic or entertainment events.

Maybe this is part of the reason why CDC researchers reported last year that a large percentage of American adults age 20-69 had noise-induced hearing loss, many without any occupational exposure to loud noise.

Protect your hearing now to avoid needing hearing aids later.

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 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.