Hearing loss

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.

What I did during the COVID-19 lockdown (and before and after)

Photo credit: Bidvine from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

When I was in elementary school, a common assignment during the first days or weeks of school was to write an essay on the topic, “What I did during summer vacation.” I don’t know if schoolchildren today will be asked to write essays about “What I did during the COVID-19 lockdown” when they return to school in person, but this is my report, with a nod to October’s being National Protect Your Hearing Month.

What did I do during my abundant free time during lockdown? When I wasn’t working on noise activities I worked home-improvement or repair projects at our home, with a major project at my in-laws’ home as well. I won’t bore you with the entire list, but it includes:

  • Removing shelving and flooring from two large closets, patching the walls, repainting them, and installing new shelves and flooring.
  • Removing carpet from one room, patching the walls, repainting the walls, and installing new flooring.
  • Removing a warmer drawer in the kitchen, modifying the cabinet to fit the new warmer drawer, refinishing that side of the kitchen island, and installing the new warmer drawer.
  • Removing a trash compactor, finishing the inside of the cabinet, and installing the new trash compactor.
  • Cutting out wood rot in an exterior door frame, installing a new piece of wood, patching and filling the repair, sanding it smooth, and repainting the door frame.
  • Repainting the interior and exterior of the front door and the windows surrounding it.
  • Removing six exterior lights in front of the house and installing new exterior light fixtures.
  • Removing old water feeds for all toilets and sinks and replacing them with new shutoff valves and braided stainless steel water feeds.
  • Repaired the washing machine and replacing a leaking hose.
  • Reconstructing a large trellis at my in-laws’ house.

What’s the connection to National Protect Your Hearing Month? Every project was noisy. Demolition work is noisy. Power tools are noisy. And many hand tools, perhaps with the exception of a pliers or screwdriver, are noisy when used. Among the power tools used were a circular saw, a sliding compound miter saw, hand saws, drills, a nut driver, a hammer drill, a multitool, two different reciprocating saws, and a quarter-sheet sander. Hand tools included hammers, pry bars, crowbars, screwdrivers, chisels, scrapers, paint brushes and rollers, etc. Painting is quiet and plumbing is quiet, but all the other tasks were noisy. The only time I didn’t have my earplugs in was when I was painting or using pliers, a wrench, or a screwdriver.

And that’s my advice to you: If like many other Americans you’re doing repair and home improvement projects during the COVID-19 lockdownHome improvement projects are underway during COVID-19 please protect your hearing!

There is no such thing as temporary auditory damage, and the cumulative effect of loud noise will eventually cause hearing loss.

So even if you’re hammering in only one nail or cutting one board with your circular saw, wear hearing protection.

That’s my advice before, during, and after 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.

Could wearing a mask protect your hearing?

Photo credit: Anna Shvets from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

COVID-19 (technically SARS-CoV-2) is a novel coronavirus first detected less than a year ago. Because it is new, no one has immunity to it, leading to a worldwide pandemic. And also because it is new, physicians, public health experts, virologists, and many others have much to learn about it.

Two recent articles add to this knowledge.

One, in JAMA Otolaryngology-Head and Neck Surgery, reports that COVID-19 was isolated from mastoid bone and middle ear tissue. The other, in BMJ Case Reports, described a case of sudden irreversible hearing loss ascribed to COVID-19 infection.

It is well known that respiratory viruses can affect the middle and inner ear. Now we know this is also true for COVID-19.

Could wearing a mask to protect yourself and others from COVID-19 also protect your hearing?

Based on these two articles, I think the answer is, “Yes.”

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.

Another study shows association of hearing loss with cognitive decline

Photo credit: Xiaofan Luo licensed under  CC BY-NC-SA 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

We have reported previously on associations between hearing loss and dementia in the U.S., and studies finding brain changes associated with decreases in auditory input due to hearing loss. Hearing loss is also associated with depression.

This study from China, published in JAMA Network Open, confirms these associations in a different population. The China Health and Retirement Longitudinal Study is following a nationally representative survey of adults age 45 and older, and their spouses. The current study looked at data from 18,038 participants with an average age of 59.9. Hearing impairment was associated with worse performance in episodic memory, mental intactness, and global cognition and a greater risk of depression.

Correlation is not causation, but this report from another country with a different language and culture confirms studies in the U.S. and Europe. It’s another piece of the puzzle in trying to understand why some people develop certain problems as they age. Research is ongoing to elucidate how hearing loss contributes to or causes cognitive decline, and whether providing hearing aids can prevent or slow cognitive decline.

In the meantime, we urge people to protect their hearing as assiduously as they protect their vision. We don’t stare at the sun. We wear sunglasses when outdoors. And we should view hearing loud noise just like staring at the sun. Loud noise is as dangerous for the ears as the sun is for the eyes.

Because if something sounds loud, it’s too loud, and auditory health is in danger.

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.

Low-cost hearing aid developed

Photo credit: Phil Gradwell licensed under CC BY-SA 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

According to the World Health Organization, hearing loss is a major problem in much of the world but few of the world’s total population can afford hearing care or hearing aids of any kind.

The World Bank estimates that 700 million people live on less than $2 a day. Daily life is a struggle. Providing food is a struggle. Preventing hearing loss is not even considered, and there are no resources to treat even profound hearing loss. Many African countries lack a single audiologist or ENT specialist.

My own observation during international travel, back in the old days when that was possible for someone holding an American passport, is that many developing countries–Myanmar and India come to mind–were much noisier than the U.S. or Europe. Unmuffled car motors are repurposed to power boats, and workers in noisy occupations like blacksmithing or metal work don’t use hearing protection.

Into the gap come the engineers from Georgia Tech, who have developed a low-cost hearing aid that can be assembled quickly. They call this LocHAid.

In the industrialized world, people don’t want a large hearing aid worn around the neck, but in developing countries, this would be a blessing.

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.

5 ways to protect against hearing loss

Photo credit: Nelson Sosa licensed under CC BY-NC-ND 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

As we have discussed, hearing loss is not an inevitable part of normal aging but largely represents noise-induced hearing loss.

This article from The Covington News discusses five ways to protect your hearing. The article is sensible, though I’m not sure a baseline audiogram is necessary, and cotton ear swabs aren’t recommended but aren’t a problem unless one pokes the eardrum.

The other three suggestions are spot on: turn down the volume, use hearing protection, and avoid loud noise.

Because if it sounds loud, it is too loud, and your hearing 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.

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.

Companies urged to hire “Chief Sound Officers”

Photo credit: Andrea Piacquadio from Pexels

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

My first reaction to this article by Frank Fitzpatrick in Forbes advising companies to hire “Chief Sound Officers” was that the author’s tongue was firmly planted in his cheek. But no, he’s making some very valid points that corporate leaders could learn from: sound matters to business in lots of ways that deserve consideration.

As Fitzpatrick says, “You may not be in the sound business, but sound is in your business.” He notes that ambient noise level in retail spaces and workplaces has important effects on customer behavior and satisfaction, and on employee satisfaction and productivity.

I’m most taken by his discussion of hearables technologies coming to market now like the Apple iWatch with built-in sound meter. But there’s much more than that coming out of R&D labs to connect biometric data to wearable technologies on the assumption that informed consumers are more likely to be healthier too.

As Dr. Daniel Fink says: if it sounds loud, it is TOO loud. But if you’re used to ignoring noise, having a warning system on your wrist, a wearable device like an iWatch with a built-in sound meter, could be very helpful, and if enough people use it, that would be good for public health.

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.