Hearing loss

When hearing aids don’t work

Photo credit: ikesters licensed under CC BY-SA 2.0

by Jan L. Mayes, MSc, Audiologist

Many people with hearing difficulties delay getting help because they’re told hearing aids don’t work. But in my experience, properly fitted hearing aids can improve communication and quality of life for people with hearing difficulties.

Hearing aids are worn on each ear and come in different styles. Prescription hearing aids are selected so amplified sound and chosen features are best for all shapes and sizes of hearing difficulties in all ages. Retail hearing aids are meant for adults with mild to moderate high pitch hearing loss which is a common pattern across causes.

There are different reasons people think hearing aids don’t work. Some issues depend on the hearing aids, while others depend on the person wearing them. Unless there is a health reason that requires that they only wear one, it’s best to get a pair. Like ears, hearing aids should be in pairs for best sound audibility, localization, and communication.

Were the hearing aids fit by a hearing healthcare professional? If yes, then they were chosen to work based on individual testing results and the person’s reported difficult listening situations in daily life. Retail hearing aids won’t work if the wearer doesn’t have mild to moderate high pitch hearing loss.

Do the hearing aids have basic hearing and communication features? Basic or entry level prescription or retail hearing aids should include directional microphones for paired hearing benefits and a telecoil or hearing loop feature. Hearing aids without directional microphones won’t work well in daily life, and hearing aids without hearing loop compatibility won’t work in settings offering disability access.

Do the hearing aids offer modern digital technology? Current entry level features in behind the ear hearing aids, which start at around $1,000 per pair, include more than one listening program for quieter and noisier environments and wireless connectivity to other devices. Some hearing aids include sound therapy for people with tinnitus or decreased sound tolerance, i.e., hyperacusis. Many now have rechargeable batteries with an overnight recharging station which is a plus for convenience and the environment. Old technology hearing aids don’t work nearly as well as modern technology aids.

Were the hearing aids properly manufactured? Even brand new hearing aids can be lemons. While prescription hearing aid manufacturers typically meet international amplification acoustics standards, quality control is voluntary for manufacturers selling directly to the public with no Food and Drug Administration oversight in the U.S. Problems are common even among popular retail manufacturers, with defect rates of 100% for amplification under $150 and 66% defective when under $500 per hearing aid. New amplification sound quality problems include static and distortion, over-amplified or too loud, no high frequency amplification, broken volume control, malfunctioning directional microphones, and faulty telecoils. In my opinion, too many hearing aids sold directly to the public are poorly made and don’t work as advertised.

Does the wearer have hearing system distortion? Some people, especially with a history of noise exposure, have hearing loss with sound processing damage where sound becomes distorted or unclear while travelling up the hearing nerves to the brain. This happens after sound is amplified, meaning people feel their hearing aids don’t work because they still can’t hear or converse easily, especially in ambient environmental noise environments.

Are the hearing aids In-The-Drawer style? ITD style hearing aids worn only seldom or occasionally don’t help much. People with hearing loss need to practice hearing amplified sound again in their daily life. With regular use, people hear better with amplification than without, even in noisy or difficult listening situations.

The next time somebody says hearing aids don’t work, don’t forget there is often more to the story. Did the person get well manufactured hearing aids that meet their individual hearing and communication needs? Do they have realistic expectations of hearing aids? If not, a visit to a hearing healthcare professional could be helpful for problem-solving and guidance.

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.

 

How to make virtual meetings more accessible for the hearing impaired

Photo credit: Anna Shvets from Pexels

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

Virtual meetings have become the standard during the pandemic and participants have reported that at times it is difficult hearing others because their microphones are cutting in and out. But for the hearing impaired, virtual meetings are even more challenging because they often rely on reading lips to assist them in hearing what has been said and they find it more difficult to lip read during virtual meetings, according to this recent article.

Capital One has addressed the problem of hearing other participants in Zoom calls by employing a computer assisted real-time translation that enables all participants to read real time audio transcripts of what is being said at these meetings. One can readily find live transcription offers for Zoom on the internet. The post notes that many people working from home actually find it difficult to hear others during vitual meetings because of noises in their homes and, thus, the visual translation is proving beneficial for all people on these calls.

There are also other suggestions about how Zoom meetings can be made easier for people with hearing loss, e. g., sending out agendas for meetings ahead of time, sharing documents to be discussed before the meetings. Again, these suggestions will be appreciated by all the virtual meeting attendees.

I have found that generally making adjustments for people with disabilities, whether they be physical, auditory, or visual, usually benefits a larger body of individuals. For example, lowering the step on buses for individuals who cannot climb up the higher step, e. g. elderly individual, person with a cane, is also helpful to the mother who is entering the bus with her three-year old or the individual who is carrying heavy packages. And lowering the decibel level of music in restaurants not only benefits individuals with hearing deficits but is generally welcomed by all diners who find it easier to converse in quieter environments.

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.

How to help protect teens’ hearing while at school

Photo credit: Thomas Cizauskas licensed under CC BY-NC-ND 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

Our friends at the CDC’s National Center for Environmental Health recently released data on the use of personal hearing protection among young people at loud school events, such as sports events or band practice. There are probably fewer in-person events at schools these days due to the COVID-19 pandemic with most students learning remotely, but some school districts still have sports events and with the forthcoming availability of vaccine, school will return to normal eventually.

The CDC found that 46.5% of teenage students are regularly exposed to loud sound at school but almost none are given information about hearing protection or hearing protection devices.

Please help CDC spread the word. Forward this information to teachers, school administrators, boards of education, and others responsible for educating our students.

And if you have teenage children or grandchildren, forward this to them, too.

Noise-induced hearing loss is entirely preventable. Tell them, ‘Wear earplugs now, or need hearing aids later.”

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.

A COVID silver lining? Mask use in Korea reveals hearing loss

Photo credit: Jens-Olaf Walter licensed under CC BY-NC 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

This report from The Korea Biomedical Review notes that mask wearing during the COVID-19 pandemic is making many Koreans recognize that they have hearing loss. We all use facial expressions and gestures to help us understand what others are saying, and many people unconsciously lip read as well. But when we are wearing masks, awareness of facial expression is limited to the eyes and forehead and it’s impossible to lip read, so we are left dependent only on our hearing to understand what others are saying.

South Korea had an effective government response to the COVID-19 pandemic, involving universal mask wearing, social distancing, an early testing program, and effective contact tracing with isolation of infected individuals. Thanks to these efforts, according to WorldOMeter South Korea has had only 667 cases of COVID-19 per million population and only 10 deaths per million population.

In contrast, in the U.S., the lack of an effective national response has led to 41,444 cases per million and 823 deaths per million.

To use absolute numbers, which may be easier for some to understand, the population of South Korea is approximately 51 million and that of the United States 330 million. Using an adjustment factor of 7, which actually overstates the adjustment for the respective population sizes, South Korea has had 34,652 cases of COVID-19 and 526 deaths. If South Korea had as many people as the United States, it would have had 242,564 cases of COVID-19, and 3682 deaths. The U.S. has unfortunately had almost 14 million cases and almost 275,000 deaths. The difference in case and death numbers is due to almost universal mask wearing in South Korea.

But universal mask wearing in South Korea made it hard for those with hearing loss to understand what others were saying, because they were deprived of the visual cues associated with speech.

And according to Prof. Moon Il-jung in the Otorhinolaryngology Department at Samsung Medical Center, more patients are coming to the hospital to receive hearing tests, with hearing aids prescribed for those who have hearing loss.

And that may be a rare silver lining to the COVID-19 cloud.

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.

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.