Hearing protection

What’s better than a cheap hearing aid?

Photo credit: ReSound licensed under CC BY 3.0

by Daniel Fink, MD, Chair, The Quiet Coalition

The New York Times asked recently why hearing aids are so expensive. They should have stepped back and asked a more important question: What’s better than a cheap hearing aid?

A: Preserved natural hearing.

As a paper I presented at the 12th Congress of the International Commission on the Biological Effects of Noise discussed, the scientific evidence suggests that significant hearing loss (25-40 decibel hearing loss) is probably not part of normal aging, but is actually noise-induced hearing loss in the vast majority of cases. Research supporting this conclusion includes studies of hearing done in populations not exposed to noise, different rates of hearing loss in males vs. females, decades of occupational studies correlating increased noise exposure with greater hearing loss, and recent laboratory experiments showing the molecular, genetic, and sub-cellular structural mechanisms by which noise damages the auditory system.

If you protect your hearing now–by avoiding noise exposure or using hearing protection (ear plugs and ear muffs) if you can’t–you shouldn’t need a hearing aid in the future.

Preserved natural hearing…it’s better than a cheap hearing aid!

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He serves on the board of the American Tinnitus Association, is the interim chair of Quiet Communities’s Health Advisory Council, and 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.

Hearing loss a big problem for farmers and ranchers

by Daniel Fink, MD, Chair, The Quiet Coalition

This report discusses the problem of occupational hearing loss in farmers and ranchers. You may be confused, thinking farmers and ranchers must surely work in some of the most peaceful workplaces that exist. And that may be true part of the time, but they also use heavy equipment (tractors, harvesters, etc.) for long periods of time. Says Dr. Richard Kopke, M.D., FACS, chief executive officer of the Hough Ear Institute in Oklahoma City, “[e]xposure to tractors, forage harvesters, chain saws, combines, grain dryers, even squealing pigs and guns, can lead to significant hearing loss.”

Dr. Kopke offers advice to farmers and ranchers on how to avoid hearing loss, including the same point I always make: if you have to raise your voice to be heard, the ambient noise is above 75 A-weighted decibels and hearing loss is occurring.

But it’s not just farmers and ranchers at risk of noise-induced hearing loss. It’s everyone.

Hearing is precious. Speech is the main way humans communicate and relate to one another. As Helen Keller said (paraphrasing), “blindness separates people from things, but deafness separates people from people.”

It’s National Protect Your Hearing Month. Once hearing is lost, the only treatment is a hearing aid (or a cochlear implant for the severely impaired). If it sounds too loud, it IS too loud! Turn down the volume, leave or move away, or insert ear plugs or use ear muff hearing protection.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He serves on the board of the American Tinnitus Association, is the interim chair of Quiet Communities’s Health Advisory Council, and 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.

How to reduce the risk of noise-induced hearing loss

Photo credit: Rex Roof licensed under CC by 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

Reducing the risk of noise-induced hearing loss (NIHL) isn’t rocket science. It’s actually quite simple: avoid loud noise exposure and if you can’t do that, wear hearing protection.

This piece from Hear It Now, which claims to be the world’s #1 website on hearing and hearing loss, has a nice summary of practical tips. Click the link to see the full list of tips. Your ears will thank you!

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He serves on the board of the American Tinnitus Association, is the interim chair of Quiet Communities’s Health Advisory Council, and 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.

Football stadium noise still here for another season

by Daniel Fink, MD, Chair, The Quiet Coalition

It’s been years since I’ve been to a college football game. The last games I attended were at the Los Angeles Coliseum, one of the quieter big-school stadiums, during the Pete Carroll era at USC. But I have read about and written a number of stories on stadium noise. Here is the latest story about the stadium noise at the University of Oregon’s Autzen Stadium.

This article, like every other article about stadium noise, says the same things: the noise is distracting so the coaching staff makes the team practice with loud music being blasted at them. Why is it understood that the coach should “condition” his team rather than demand that the noise level be controlled? Simply put, crowd noise shouldn’t be a factor in a football game. What Coach Riley (and everyone else attending the game) doesn’t know is that if it’s loud enough to impact play on the field, it’s loud enough to cause auditory damage.

The Quiet Coalition is still waiting for the National Collegiate Athletic Association (NCAA) and its member colleges and universities–many of which have medical schools, schools of public health, audiology programs, or all three–to do something to protect the hearing of their student athletes and those attending the games. At least this University of Tennessee audiology professor understands the problem, which is why she recommends that students use earplugs when they attend UT football games. Kudos Dr. Patti Johnstone! But rather than having students block the noise, why not demand that the university control the noise in the first instance?

And as this article shows, stadium noise is a factor in professional games, too. In fact, stadium noise probably contributed to the Los Angeles Chargers recent loss in Denver.

Should football games be decided on the field, or by the home crowd purposefully making too much noise for the visiting team to hear the play being called? Whatever happened to good sportsmanship?

Sadly, it appears the NCAA, professional football teams, and stadium owners won’t address noise until and unless someone sues them because they developed sudden hearing loss or tinnitus after attending a game. Let’s hope that happens before many players and fans suffer significant hearing loss or develop tinnitus.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He serves on the board of the American Tinnitus Association, is the interim chair of Quiet Communities’s Health Advisory Council, and 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.

How to motivate millennials to protect their hearing at work

by Daniel Fink, MD, Chair, The Quiet Coalition

The Quiet Coalition doesn’t spend much time worrying about occupational noise because our focus is on protecting the general public from noise. Workers’ ears are protected by regulations drafted and enforced by the Occupational Safety and Health Administration and similar state agencies. Moreover, workers generally have health care for occupational injuries, and are compensated for work-related permanent damage (including hearing loss) by state-administered workers compensation systems. If occupational hearing loss is established, hearing aids may be provided for those with occupational hearing loss.

From time to time we will agree with the many observers who think that the occupational noise exposure limit–90 A-weighted decibels for 40 hours a week, 240 days a year, for 40 years, causing excess hearing loss in 25% of exposed workers–is set too high, but at least workers have that meager protection. There are no such protections for the public, and no compensation for hearing loss, either.

That said, we’re making an exception to share with you this well-written article in Occupational Health & Safety Magazine. It’s focused on preventing hearing loss in younger workers, but it provides good information for everyone who is concerned about their hearing.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He serves on the board of the American Tinnitus Association, is the interim chair of Quiet Communities’s Health Advisory Council, and 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.

There is nothing inevitable or natural about chronic disease

Photo credit: Robbie Sproule licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

This thoughtful piece talks about chronic disease, pointing out that it is not inevitable or natural. The author, Dr. Clayton Dalton, writes that:

[T]raditional cultures across the globe, from hunter-gatherers to pastoralists to horticulturists, have shown little evidence of chronic disease. It’s not because they don’t live long enough – recent analysis has found a common lifespan of up to 78 years among hunter-gatherers, once the bottlenecks of high mortality in infancy and young adulthood are bypassed. We can’t blame genes, since many of these groups appear to be more genetically susceptible to chronic disease than those of European descent.

So what is the reason for the absence of chronic illness among these cultures? “Evidence suggests it is how they live,” Dr. Dalton replies. And what factors do these different cultures share?  Dr. Dalton writes that the “common denominator [is] defined by the absence of modern banes: absence of processed foodstuffsabsence of sedentary lifestyle, and likely absence of chronic stressors.”

Dr. Dalton doesn’t specifically mention noise-induced hearing loss, but that’s another chronic disease that he could have included in his essay.

I spoke about this at the 12th Congress of the International Commission on the Biological Effects of Noise in Zürich in June. Similar to Dr. Dalton’s comments about hypertension and diabetes, I presented information showing that significant hearing loss is probably not part of normal aging, but represents noise-induced hearing loss.

A useful analogy for noise and hearing is sun and the skin. It turns out that skin and subcutaneous tissues sag as we age–that’s normal–but deep wrinkles, age spots, and skin cancers are the result of ultraviolet exposure. Similarly, I’m sure there are changes that occur in our hearing as we age, but profound hearing loss (25-40 decibel decrement in hearing) is most often the result of noise exposure.

In the end, how we live our lives matters. If we want to hear well into old age, we have to work to preserve our hearing all during our lives. How? It’s easy: avoid loud noise or wear ear protection if you can’t.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He serves on the board of the American Tinnitus Association, is the interim chair of Quiet Communities’s Health Advisory Council, and 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.

Hearing loss is an occupational health hazard for musicians

by Daniel Fink, MD, Chair, The Quiet Coalition

It’s not surprising that hearing loss is an occupational health hazard for musicians, as highlighted in this recent report. After all, noise causes hearing loss. It doesn’t matter if the noise is from machinery in a factory, from a jet engine on the tarmac, or from loudspeakers at a rock concert. Whatever the source, the effect is the same.

And the type of music doesn’t matter, either, as noise-induced hearing loss is a problem for classical musicians, too.

The bottom line is this: hearing is precious. If hearing music is important to you–or hearing children or grandchildren speak, birds sing, whatever it is–protect your hearing.

How can you protect yourself? It’s easy. The auditory injury threshold is only 75-to-78 A-weighted decibels. That’s about the level at which ambient noise makes conversation difficult. If you are having a hard time having a conversation because of the ambient noise around you, it’s too loud. And if something sounds too loud, it IS too loud! Turn down the volume, leave the noisy place, always carry earplugs with you, and use them!

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He serves on the board of the American Tinnitus Association, is the interim chair of Quiet Communities’s Health Advisory Council, and 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.

Why is Cosmopolitan writing about hearing loss?

By Daniel Fink, MD, Chair, The Quiet Coalition

When The Quiet Coalition came together last year, there were few articles in the popular media about noise issues, and those that did appear often contained significant factual errors. But over the last few months, the number of articles has increased and errors within them have decreased. One example is a recent article in Cosmopolitan, an international women’s magazine covering fashion, beauty, and sex, which offers very sound advice about hearing protection, including the admonishment to abandon the use of earbuds.

Health education is one of the cornerstones of public health practice. It is believed that if people know what are healthy practices, they will do it. My observation is that this may be true for those at the higher end of the socioeconomic scale but doesn’t necessarily hold for the majority of people, who are either not interested, lack resources, or are too busy handling everyday life to worry about how what they do today might affect their health tomorrow. I think society has a responsibility to protect the health of all people whatever their socioeconomic status, and I believe that strict regulations are more effective in encouraging healthy behaviors than health education programs. If health education programs worked reliably, nobody would smoke, everyone would exercise, there would be no sexually transmitted diseases, and etc.

As with laws banning indoor smoking (and in some places, outdoor smoking at beaches and parks), comprehensive local, state, and federal indoor and outdoor quiet laws will be more effective than health education programs and articles in the popular media to protect the nation’s auditory health. But health education efforts about the danger of noise are a start, at least for those who read the information.

In the United States, the best example of disparate health habits correlated with educational status may be smoking, where only about 3.7% of adults with graduate degrees (and presumably higher income levels) smoke, compared to 25.6% of those without a high school diploma. This is a striking seven-fold variation. Another example is obesity, which is inversely correlated with educational status and annual income, but the relationship isn’t as strong. Nearly 33% of adults who did not graduate high school are obese, compared with 21.5% of those with a college or technical degree, and more than 33% of adults earning less than $15,000 are obese, compared with 24.6% of those earning at least $50,000 annually.

It’s clear that higher education and income levels are keys to better health. And this now likely applies to hearing health, including Cosmopolitan readers.

And that’s important. I’m an internist who believes in practicing what I preach. I don’t smoke. My body mass index (BMI) is 24.5. I walk an hour or more a day, eat at least 5 servings of fruits and vegetables daily, avoid red meat, eat lots of fish, wear a hat and long sleeves if I’m in the sun, and always use a seat belt. But I had no idea that a one-time exposure to loud noise could give me tinnitus and hyperacusis for the rest of my life. So if just one young woman who reads the Cosmopolitan article protects her hearing–and tells her friends and family to do so too–the staff at Cosmopolitan will have done a great public service.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He serves on the board of the American Tinnitus Association, is the interim chair of Quiet Communities’s Health Advisory Council, and 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.

Attention: DJs and clubgoers

Stoneyroads.com interviews DJ Dom Dolla about the importance of protecting your ears in nightlife. The article begins with the observation that “[m]any of your favourite musicians suffer from tinnitus, and the condition can worsen over time from exposure to loud noises.” Dolla, we are told, is one of them.  Dolla notes that the “average nightclub sits at around 110 dB (Decibels), often louder.” He mistakenly relies on then occupational noise exposure standard when he claims that “anything over 85db is dangerous for our ears,” but correctly adds that “at 110 dB you can accumulate permanent hearing damage in a very short number of minutes.” This is particularly concerning since “[w]e’re part of a generation that spends such a disproportionate amount of time around loud music.”

So what’s Dolla’s advice? “[G]rab yourself some 25+ dB reduction earplugs and wear those bad boys religiously.” And he tells DJs that they must “resist the temptation to pull them out when you’re performing,” adding that if they “keep them in, it’ll only be a matter of time before your brain cranks up your internal gain and you’re used to playing with them.”

Dolla gets it mostly right, but his statement that 85 dBA is the point at which hearing can be damaged is dangerously wrong. As we have reported here before, 85 dBA is an industrial-strength standard developed by NOISH and OSHA for workers, not the general public. To the extent that Dolla’s advice is directed towards club workers, quoting the occupational noise exposure standard isn’t technically incorrect, but that standard is never appropriate for the general public. Says Dr. Daniel Fink, Chair of The Quiet Coalition, “the only way to prevent tinnitus and other hearing disorders caused by exposure to loud noise is to avoid loud noise or wear ear protection if you can’t.”