Hearing loss

Can hearing aids delay development of dementia?

by Daniel Fink, MD, Chair, The Quiet Coalition

Can hearing aids delay the development of dementia in older people? This question has been discussed since research showed an association between hearing loss and dementia, with greater hearing loss being associated with a greater chance of dementia. This study indicates that the answer may be “yes.” 

The study is based on insurance claims data, not clinical data, so clinical studies are needed to confirm the results. But in analyzing data on 79 million adults insured by a private health insurance company, hearing aid use among adults diagnosed with hearing loss was associated with a decreased risk of Alzheimer’s disease or dementia.

Hearing loss leads to lack of brain stimulation, social isolation, and depression, all of which have been linked to development of dementia. So the results of the study make sense. It’s possible that treating hearing loss with hearing aids may help delay or prevent dementia.

Of course, preventing hearing loss in the first place is far better and far cheaper than providing hearing aids to those with hearing loss, and certainly cheaper than treating dementia. And preventing most hearing loss is easy: avoid loud noise exposure or wear hearing protection if one can’t.

Because if something 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.

Will personal music players be the next public health disaster for young people?

Photo credit: Elena Buzmakova(borisova) from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalitio

This article in The New York Times details ten years of regulatory dithering while millions of young people became addicted to nicotine through vaping. The health dangers of vaping were clear to many, but political considerations, lawsuits, and perhaps an early lack of clear evidence of harm led to inaction. And now young people, and a few older ones, are being sickened with several dying.

I see a similar situation developing with the widespread use of personal music players by young people.

The Sony Walkman was marketed in 1979, the iPod in 2001, and the now ubiquitous iPhones in 2007 and Androids in 2008. A large number of Americans use personal music players, and surveys find that users listen for several hours a day.  This report citing Nielsen figures says that Americans listen to music 32 hours a week!  That’s 4.5 hours every day. The World Health Organization recommends listening to no more than one hour daily, to prevent hearing loss. Other studies show that some users typically listen to music at high volumes, loud enough to drown out ambient noise.

There has been some media coverage about prolonged exposure to personal music players, but most people don’t seem to be aware of the problem.

I have communicated with the Federal Trade Commission’s Division of Advertising Practices, the Consumer Product Safety Commission, the National Institute on Deafness and Other Communication Disorders, and the Centers for Disease Control and Prevention about what I see as a future epidemic of noise-induced hearing loss when today’s young people reach mid-life, after 30-40 years of excessive noise exposure. The CDC has begun a research program into noise and the public and undertaken educational efforts about the dangers of noise on hearing, but as with vaping devices, it’s clear to me that regulatory action is needed and that’s not something CDC does. Education can help change health behaviors, but regulation is much more effective.

Will there be media reports in 2030 or 2040 about the lost opportunity to prevent the epidemic of noise-induced hearing loss? I wouldn’t be surprised if there were.

Unfortunately, then it will be too late to prevent the epidemic of noise-induced hearing loss. The time for action is now.

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.

Genetic susceptibility to hearing loss from noise exposure

by Daniel Fink, MD, Chair, The Quiet Coalition

This article in The Hearing Journal reviews research on genetic susceptibilities to hearing loss from noise exposure. The author notes that 34 genetic variants have been reported to show an association with increased susceptibility to hearing loss from noise exposure. She concludes that “[f]urther work on the genetic and cellular bases of NIHL could enable the characterization of individual susceptibilities and help prevent this widespread disease.

Actually, additional work isn’t needed to help prevent noise-induced hearing loss (NIHL).  Additional research is always good, but the molecular bases of NIHL are very well understood.

Even better understood is how to prevent it: Avoid exposure to loud noise, leave the noisy environment, or wear hearing protection of one can’t do either. The CDC states that NIHL is 100% preventable.

Because noise exposure causes hearing loss, and if something 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.

Starting January, help comes to the hard of hearing at your local drug store

Photo credit: Kateweb licensed under CC BY 2.0

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

This New York Times article is a wake-up call to all Americans with hearing loss: Starting January 2020, and for 1/10th the price of conventional–and ugly–hearing aids, you can buy “hearing assistive devices” at your local drug store or directly online. The innovation economy has finally come to the hidebound hearing aid industry!

And we can thank a genuinely bi-partisan team in Congress for making this happen. Charles Grassley, Republican from Iowa, and Elizabeth Warren, Democrat from Massachusetts, teamed up in late 2016 to write the “Over the Counter Hearing Aid Act,” pushed it through both houses of Congress, and in 2017 convinced President Trump to sign it.

Thank you Senators Grassley and Warren!

What this Act does is tell the FDA to keep its regulatory hands off of a new class of hearing-assistive devices called “personal sound amplification products,” or PSAPs. PSAPs are miniaturized, multi-featured wireless high-tech in-ear devices that do lots of things conventional hearing aids don’t do, and all for about 1/10th the price of conventional hearing aids.

Maybe deregulation works after all!  In this case, it’s good-old-fashioned bi-partisanship that got the deal done.

So if you or a loved one really need hearing aids but haven’t been able or willing to spend the $5,000 to $10,000 the hearing aid cartel has been charging, now’s your chance to tune into the world of sounds you or they have been missing. Check it out!

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.

A revised definition of noise for National Protect Your Hearing Month

Photo credit: Chris Fithall licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

October is National Protect Your Hearing Month, and I am using the occasion to propose a revised definition of noise: noise is unwanted and/or harmful sound.

For many decades, noise has been defined as “unwanted sound,” a phrase usually attributed to the late acoustics pioneer Leo Beranek. The problem with this definition is that it implies that the perception of noise is subjective. This means that those complaining about noise have no real basis for their complaints, other than a personal reaction to noise.

The new definition acknowledges that noise can be harmful to human health and can interfere with human activity. Even if a noise is merely unpleasant, that experience is stressful.  Recent research shows that stress causes vascular inflammation and cardiovascular disease.

The revised definition is supported by my article in the Fall 2019 issue of Acoustics Today, summarizing the evidence-based noise levels affecting human health and function. My article makes it clear that there can be no rational doubt that noise is harmful, and unwanted noise especially so. Sounds as quiet as 30-35 A-weighted decibels (dBA) can disrupt sleep. A good night’s sleep is important for health and function. Forty-five decibel (dB) sound can disrupt concentration and interfere with learning. At 55 dB, non-auditory health impacts of noise begin, including hypertension, cardiovascular disease, and increased mortality. These effects are best studied for transportation noise, but are seen with occupational noise exposure. At 60 dBA ambient noise, people with hearing loss have difficulty understanding speech. At 70 dBA, those with normal hearing also have difficulty understanding speech.

Seventy dB time-weighted average for 24 hours is the only evidence-based noise exposure level to prevent hearing loss, but the actual safe noise level is probably lower than that. And 85 dBA is the occupational recommended noise exposure level, not a safe noise level for the public. And as I notedin my article, the World Health Organization recommends only one hour exposure at 85 dBA daily to prevent hearing loss. Because the decibel scale is logarithmic, this is mathematically the same as 70 dB time-weighted average for a day.

Hearing loss is very common in older people, but I’ve learned that this isn’t part of normal physiological aging. Rather, presbycusis or age-related hearing loss is largely noise-induced hearing loss.

So what can you do to protect your hearing? There are two ways to protect hearing: avoid loud noise, and if you can’t, use hearing protection devices.

We only have two ears, and unlike knees they can’t be replaced. So if a noise sounds too loud, it IS too loud. And if a noise is so loud that one can’t converse without straining to speak or to be heard, the ambient noise is above 75 dBA and your hearing is at risk.

And always remember that noise is unwanted and/or harmful sound

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 pioneer in protecting musicians and fans from hearing loss

Photo credit: Wendy Wei from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

This article in the San Francisco Examiner profiles Kathy Peck, who started advocating for hearing protection at rock concerts before anyone realized that rock concerts were loud enough to cause hearing loss. Peck’s efforts led to her starting the nonprofit Hearing Education and Awareness for Rockers, or H.E.A.R., and eventually to the adoption of laws in San Francisco requiring concert venues with a dance floor and capacity for 500 or more to provide earplugs for patrons.

Kudos to Ms. Peck for protecting the hearing of musicians and San Franciscans. Similar laws protecting the public’s hearing should be passed in other cities, 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.

Unilateral hearing loss may affect brain processing of sound

Photo credit: Colin Behrens from Pixabay

by Daniel Fink, MD, Chair, The Quiet Coalition

This report from Harvard Medical School states that chronic conductive hearing loss, a condition that can result from repeated middle-ear infections, may interfere with speech recognition.

People with unilateral hearing loss are often reluctant to wear a hearing aid on one side because their good ear allows them adequate hearing. But researcher Stephane Maison and colleagues found that people with unilateral conductive hearing loss, such as that caused by chronic ear infections, appeared to develop changes consistent with neural damage found in hidden hearing loss.

Based on this research, Maison and colleagues recommend that clinicians and patients should consider treating unilateral hearing loss to prevent neural deficits that can lead to difficulty understanding speech in noisy environments.

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.

London searching for ways to quiet the Underground

Photo credit: Skitterphoto from Pexels

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

That the London Underground has been recently cited as producing very loud noises that are disturbing to riders, employees, and nearby neighbors is nothing new to New Yorkers who have complained about New York City’s loud subways and elevated trains for many years.

Over forty years ago, I published a paper that found that nearby elevated train noise impacted adversely on the classroom learning of students in a school next to the elevated tracks.  The findings of this study resulted in the placement of resilient rubber pads on the nearby tracks to lessen the noise and the installation of acoustical ceilings in classes near the tracks.  A second study, after noise abatement, found that children in classrooms near the tracks were now reading at the same level as those on the quiet side of the building. The New York City Transit Authority then instituted a program to install these resilient rubber pads along the entire elevated track system.

After working with the Transit Authority on two occasions on its noise issues, I learned that transit noise is not only disturbing to all those subjected to these sounds but transit noise is often the result of poor maintenance and as a result can lead to potential breakdowns in the system. I wrote a paper linking transit noise to breakdowns in the system and explained that correcting transit noise is not a matter of knowing what to do but rather of not being willing to do it.  This is true for cities other than New York.

In reading that London is searching for technology to quiet its system, I noted that the same procedures that have existed for years to lessen the noise are being considered.

One would think that such procedures should have been examined at the first sign that the system was getting louder.  Actually, that they weren’t should not be surprising because my work on noise issues has taught me that for actions to be taken, those in charge have to be “hit on the head” before something is done to reduce noise.

A group of London campaigners concerned about transit noise has asked Transport for London to put up signs warning people about the noise. One would assume that hearing protection could then be used by transit riders. Transport for London’s response was that the transit system’s noise was ‘highly unlikely to cause long-term hearing damage.”

Really? What about the impacts on the hearing of employees who are exposed to these high sounds for many hours daily? What about the health of people living near the tracks who have been complaining? What about the discomfort to riders who use the system regularly? I would suggest that Transport for London learn more about the impacts of noise pollution which affects more than our ears—noise adversely impacts on our health and well-being. I would also urge that the noise issue be addressed with haste.

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.

 

Is Japan really the world’s noisiest country?

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

If you’ve been to Japan, you’re likely as astonished as I am to learn that the World Health Organization recently reported Japan to be the world’s noisiest country.

Chiara Terzuolo, Japan Today, writes:

[T]he WHO recommends avoiding being exposed to noise over 53 decibels. The legal average limit in Japan is about 70, a number based on data 50 years out of date, according to Prof Matsui of Hokkaido University who spoke about the problem in an NHK feature on noise pollution in Japan.

Personally, I found major cities in Japan, like Tokyo and Hiroshima, much quieter (and more polite) than American cities like New York or Chicago. And their bullet-train stations are eerily quiet—the trains make NO noise at all, the station PA system speaks in polite whispers, and there are white-gloved attendants around urging people to stand back from the tracks because you might not notice an arriving train. So if Japan is noisy, I don’t remember it that way at all.

In fact, Japan and other Asian nations, like Korea, are far ahead of the U.S. in adopting and enforcing ‘quiet’ ordinances. Visiting there, I’ve seen noise barriers around highways that are 65 feet tall and they’re better at blocking noise from radiating into nearby neighborhoods and more attractive than the crude prison-like fences installed along U.S. highways by the Department of Transportation at a cost of millions of dollars per mile.

Nevertheless, if the World Health Organization’s report is right, it’s interesting proof that noise pollution is a very difficult problem to solve, as difficult as smog and second-hand smoke.

If that’s the case, then it will be a long, long time before we see much improvement in America—because we’ve barely begun to think about this problem.

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.

Listening to the crickets

Photo credit: Beckie licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

This wonderful essay in the New York Times discusses listening to the sounds crickets make at night.

We have crickets where I live, and they can be noisy. I knew that their sounds were made by male crickets rubbing their wings together in hopes of finding a mate, but who knew that crickets have strategies to amplify their sounds?

The main reason to protect our ears is to be able to hear speech, but being able to hear nature’s wonderful sounds is another good reason.

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.