Hearing loss

The CDC says “Protect your hearing”

by Daniel Fink, MD, Chair, The Quiet Coalition

The National Center for Environmental Health at the Centers for Disease Control and Prevention advises everyone to protect his or hearing during July, which is Fireworks Safety Month:

Of course, we agree.

We only have two ears, and unlike our knees, they can’t be replaced.

I’ll go one step further and recommend that fireworks on July 4th be left to professionals and not used at home. Every year, people lose fingers or eyes because they or someone who loves them sets off fireworks at home, with disastrous consequences.

Please stay safe this fireworks season and protect your ears, too.

Thanks to the CDC for helping educate Americans about how to protect our auditory health.

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.

Fireworks noise can damage your ears

Photo credit: ViTalko from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

This report from KCBD in Texas discusses the dangers of fireworks noise for auditory health. The audiologist interviewed, Leigh Ann Reel, Ph.D., is especially concerned about impulsive noise, as from an explosion. One exposure at close range can cause permanent hearing loss, tinnitus, or hyperacusis.

Fire departments and public health authorities generally recommend leaving fireworks displays to the professionals, but in many states and localities personal use of fireworks is legal and enforcement of fireworks bans is spotty.

I would prefer quiet fireworks, as have been mandated in many parts of Europe, both for people and for their pets.

Please stay safe.

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.

Protesting? Take a mask—AND hearing protection!

Photo credit: Z22 licensed under CC BY-SA 3.0

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

Been to a protest rally recently? You may have seen a cop car with a 2ft x 2ft box on the roof….What is it? Likely, it’s a long-range acoustical device, or LRAD, that emits an unbearable and ear-damaging signal intended to induce panic and temporary incapacity. First developed for the military, these devices are now in use by police in some cities to “control”/incapacitate protesters. Lynne Peskoe-Yang, in Popular Mechanics‘ weapons column, wrote an excellent summary of the subject that you should read and circulate to your friends and acquaintances.

Along with tear gas, tasers, flash-bang grenades and rubber bullets, LRADs are serious weapons—sonic weapons—that you need to prepare for because damage to your hearing will be permanent.

How damaging are LRADs? They can inflict serious pain, destroy your hearing, and leave you with permanent hearing damage. But police have been told they’re “harmless.” So expect indiscriminate use.

So be sure to wear or carry good earplugs AND earmuffs when you hit the street to join a protest march or rally. Once your hearing is gone, there’s no way to get it back. And the 16 million Americans who have tinnitus and/or hyperacusis can attest that hearing damage can be very, very painful and disabling.

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.

If it makes more noise than a rake, protect your hearing

by Daniel Fink, MD, Chair, The Quiet Coalition

The Centers for Disease Control and Prevention just published this fact sheet about protecting your hearing when doing yard care. All power tools, whether gasoline or electric, make enough noise to damage hearing. In general, electric tools are quieter than those powered by two-stroke gasoline engines, and they also don’t produce noxious and toxic gaseous emissions.

One of the big technological advances in yard care in the last year or two is the widespread availability of powerful battery-powered yard care equipment, including leaf blowers, hedge trimmers, even lawnmowers. These are now available online or in any of the big-box home improvement stores. There’s no need to worry about extension cords or shock hazards.

Other than my wife, children, and grandchildren, gardening is my first love. From 2005-2014 I served on the board of the Theodore Payne Foundation for Wild Flowers and Native Plants, Inc. When I was termed out from that service, I became a noise activist, focused on trying to make the world a quieter place. But I’d much rather be quietly working in my garden.

Raking leaves, trimming a plant, or pulling a weed, using hand tools as gardeners have done for centuries, is quiet and contemplative.

Only rarely will I use an electric pole trimmer to cut pesky branches that I can’t reach without getting on a ladder, but I’ll put in my earplugs first. Because if a yard care tool is louder than a rake or a pruning shears, it’s loud enough to cause hearing loss.

So when you are doing yard work, use earplugs or earmuff hearing protection now to avoid hearing aids later. And if you hire someone to maintain your landscape, insist that the workers are provided hearing protection. They are at special risk for hearing loss as well as other noise-related health problems.

Thanks to our friends at the CDC for helping educate the public about the dangers of noise.

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.

On hidden hearing loss

Photo credit: mentatdgt from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

This article by Alexia Hendrickson on About Manchester, a UK site, is a good primer on hidden hearing loss.

Hidden hearing loss got its name because people often complain of being unable to understand speech in noisy environments, but their hearing tests are normal. The auditory damage is “hidden,” because it is detected only by specialized research techniques.

Of note is the discussion about mild hearing loss in children being sufficient to interfere with learning. Hendrickson mentions some helpful tips, but to me the most important thing tip was missing. Namely, the best option is to prevent hearing loss of any kind–hidden or not–by avoiding exposure to loud sounds.

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.

The truth about children’s headphones

Photo credit: Andrea Piacquadio from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

In this piece for The New York Times parenting column, Joyce Cohen tells the truth about children’s headphones. The 85 decibel standard is not a safe listening volume for children, especially not without a specified exposure time.

In her article, Cohen cited The Quiet Coalition’s Rick Neitzel, PhD, associate chair of environmental health sciences at the University of Michigan, who said that “[t]reating 85 decibels as a safe level makes no sense at all,” adding that “[t]he 85-decibel number has achieved mythical status not because it is safe but because it is one of the few ways that occupational noise is regulated.”

I would add that a noise exposure standard that doesn’t even protect factory workers or heavy equipment operators from hearing loss is far too loud for a child’s delicate ears, which have to last her a whole lifetime. And an unknown factor is individual susceptibility. It’s impossible to predict whose ears are tough and whose ears are tender.

“The same noise dose has no apparent impact on some and a life-altering impact on others,” Bryan Pollard, president of the nonprofit Hyperacusis Research, told Cohen.

Consequences include not just hearing loss, but tinnitus, hyperacusis, and a sense of aural fullness. In her piece, Cohen interviewed pediatric audiologist Brian Fligor Ph.D. who summed things up: “We have done an atrocious job of teaching people to value their hearing.”

I hope Ms. Cohen’s writing will help parents know how dangerous headphones are for their children.

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.

Masks interfere with understanding speech for people with hearing loss

Photo credit: Cleyder Duque from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

Understanding speech can be difficult for people with hearing loss, and the requirement for wearing masks during the current COVID-19 pandemic exacerbates this problem. Mask wearing muffles speech, and it makes understanding difficult even for people without hearing loss, as many people with hearing loss consciously or unconsciously use lip reading and interpretation of expressions to help understand what is being said.

And sound decays according to the inverse square law, so the 6-foot social distancing requirement reduces sound volume compared to standing closer to the person one is conversing with.

As noted in this piece from CNN, there are things we can do to help communicate with people with hearing loss:

  • Face them and maintain eye contact when speaking.
  • Speak slowly and carefully.
  • Ask them to repeat back what they heard, so you can be sure they heard it correctly.

And If that doesn’t work, now there are masks being made with clear windows to allow the listener to see the speaker’s lips!

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.

May is Better Hearing and Speech Month

by Daniel Fink, MD, Chair, The Quiet Coalition

As I have written previously, I’m not a big believer in special days or months. As far as I’m concerned, every day is World Hearing Day, every month is Better Hearing and Speech Month, and, of course, this month every day is Mother’s Day!

But I have also acknowledged that it helps to have a special day or month to celebrate something or someone and to remind us of important events or topics.

Thanks to our friends at the Centers for Disease Control and Prevention for all the helpful information they have prepared on protecting our hearing, which they are sharing with the public every month.

Please stay safe, both from COVID and from noise.

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 noise be a risk factor for hypertension?

Photo credit: Kateryna Babaieva from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

Could noise be a risk factor for hypertension? This fascinating study from Chengdu, China, suggests that the answer is yes. The study design is innovative. The investigators measured bilateral high frequency hearing loss (BHFHL) and blood pressure in 21,000 workers, with an average age of 40. Hearing loss was a proxy measure for occupational noise exposure. Workers with greater hearing loss, as measured by audiometric tests, had a greater risk of also having high blood pressure.

The study is an exploratory one, and it is cross-sectional, i.e., the workers were not followed for decades and the study is based on one-time measurements of hearing and blood pressure. Other factors known to be associated with hypertension, such as weight and alcohol consumption, were not documented. And only a proxy measure of occupational noise exposure, bilateral high frequency hearing loss, was used, rather than actual noise measurements in the workplace. But the number of workers studied was large enough to provide high statistical significance, and the results were striking. As the researchers noted, “subjects having mild and high BHFHL had a higher hypertension risk of 34% and 281%, respectively (both P<0.001). Dose-response relationship between BHFHL and hypertension was found in both males and females.”

Studies done in the U.S. also show a correlation between occupational noise exposure and hypertension. The Chinese study may show a stronger relationship between occupational noise exposure and hypertension because workplace protections and their enforcement may be less stringent in China than in the U.S.

What are the implications of this study for public health? More than 100 million Americans have high blood pressure. At least two studies show that noise exposure in everyday life is great enough to cause hearing loss. Is it also great enough to contribute to the epidemic of hypertension in the U.S.?

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.

AARP on hidden hearing loss

Photo credit: Ken Lund licensed under CC BY-SA 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

This piece from the AARP discusses hidden hearing loss, although it really discusses the “speech-in-noise” problem. The speech-in-noise problem has been known for decades. Namely, people, usually in mid-life or older, complain that they can’t understand speech in a noisy environment, typically a restaurant, but their hearing tests are normal.

Recent research suggests that these people suffer from what is now called hidden hearing loss. Hidden hearing loss is an inability to process speech in noisy environments. It is called “hidden” because standard hearing tests (pure tone audiometry) are normal, but more sophisticated testing used only in research settings finds abnormal processing of complex sounds. The likely cause of hidden hearing loss is damage to the nerve endings in the inner ear, called cochlear synaptopathy. This scientific article discusses the problem in greater detail.

To me, there are two takeaway lessons from the AARP piece. The first is that the speech-in-noise problem is very common in older people.

The second is that this piece is a call to action. AARP advises us to seek out quieter settings, sit in a restaurant booth, or put the noise behind us and the speaker in front of us.

But the piece assumes that noisy restaurants are an inevitable part of life.

I would advise AARP members to ask the manager to turn down the amplified music. If they refuse, walk out or threaten to file a lawsuit under the Americans with Disabilities Act. And on your way out, tell management that the restaurant is too noisy and you refuse to eat there.  Make sure to note the restaurant’s indifference to your comfort and hearing health in a detailed review on social media, and let your city council representative know about the problem, too.

Restaurant patrons used to have to dine accompanied by unwanted secondhand cigarette smoke. When secondhand smoke was found to be a Class A carcinogen with no known safe level of exposure, we were able to get smoking banned. We have a right to dine without endangering our health.

Noise is also a health hazard, to our hearing and our cardiovascular health. Just as we are entitled to smoke-free restaurants, we have a right to quieter restaurants, too.

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.