Hearing protection

Hidden hearing loss

Photo credit: Daria Shevtsova from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

Hidden hearing loss is the term used to describe nerve damage in the inner ear (cochlear synatptopathy) which causes hearing loss detected only by special research techniques, not by standard hearing testing (pure tone audiometry). That’s why it’s called “hidden.” The clinical manifestation of hidden hearing loss is thought to be difficulty understanding speech in a noisy environment, but auditory training might help improve understanding of speech in noisy places.

This article describes a survey of adults who were asked if they would be willing to participate in auditory training. What’s of interest to me is that 22% of adults surveyed report having difficulty understanding speech in a noisy environment. That fits with other reports I’ve seen, but I think it’s an underestimate.

Many people with hearing loss think their hearing is excellent, and I think the same is true for people asked about difficulty understanding speech in a noisy environment. Due to the stigma of hearing loss, no one wants to admit that he or she has a problem.

More importantly, if people have difficulty understanding speech in noisy environments, it would seem to be much easier to make those environments quieter, rather than offering auditory training to those with the problem.

Quieter environments would make it easier for everyone to converse, and would prevent auditory damage in those without it.

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.

My 4th Noise Activist Anniversary

by Daniel Fink, MD, Chair, The Quiet Coalition

Anniversaries are special. We celebrate wedding anniversaries. Alcoholics Anonymous celebrates the anniversaries of those who are in recovery. Wounded military veterans celebrate their Alive Day, the day on which they were wounded. And yesterday was my anniversary, the fourth anniversary of my becoming a noise activist.

I developed tinnitus and hyperacusis after a one-time exposure to loud noise in a restaurant on New Year’s Eve, 2007. As midnight approached, they kept turning up the music louder and louder. My wife could tell that the noise was bothering me and suggested that we leave, but I didn’t want to offend our friends who had arranged the dinner. As soon as it was polite to leave, maybe 12:30 a.m., we did. My ears were ringing when we left, and the ringing never stopped.

I also found that noise that didn’t bother others hurt my ears: Movie soundtracks, the grind of a food processor, loud exhausts and sirens, and especially noise in restaurants. I’m a doctor and have always done what I could to stay healthy. But I had no idea that a one-time exposure to loud noise could cause tinnitus and hyperacusis for the rest of my life. When my wife would suggest an evening out, I would ask, “Can’t we eat at home?”

On December 2, 2014, I read an article about hyperacusis in the New York Times science section, written by journalist Joyce Cohen, who has since become a friend. I circled it in red and gave it to my wife, saying, “Honey, this is why I don’t want to go to restaurants any more. They are all too noisy. The noise hurts my ears. Just like it says in this article.” My wife finally understood that while I might have been getting grumpier with age, my dislike of noisy restaurants was caused by an auditory disorder.

So I decided to do something to make the world a quieter place. I reached out via email to the four experts cited in Joyce’s article. One thing led to another, and I ended up serving on the board of the American Tinnitus Association and helping create The Quiet Coalition, where I am the board chair.

I learned that I wasn’t the only person in the world with auditory disorders. Hearing loss, tinnitus, and hyperacusis are all too common. But auditory disorders are invisible, and largely occur in older people, who themselves are largely invisible in our society. Except for congenital deafness, auditory disorders tend to be ignored.

It’s been quite an odyssey. I found that via the internet, I could communicate with experts in various areas of noise, across the country and even around the world. At the urging of one of them, I submitted abstracts to scientific meetings about noise. Those were accepted for presentation, and I spoke at national and international scientific meetings. I have had publications based on my talks appear in peer-reviewed medical and scientific journals, and I have been quoted in articles and have advised national and international health authorities about noise. And I have learned, through the nonprofit Hyperacusis Research, how truly life-limiting noise-induced hearing problems can be. All because I read an article and decided to do something to make the world quieter.

The world is still too noisy, and I still can’t find a quiet restaurant, but apps like iHEARu and SoundPrint are now available.

And as more evidence becomes available about noise as a health and public health hazard, I am confident that an informed public will push legislators and public health officials to eliminate unnecessary 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.

Girl scout receives national honor for work on hearing health

Photo credit: Elizabeth Goodspeed licensed under CC BY-SA 4.0

by Daniel Fink, MD, Chair, The Quiet Coalition

Christina Mayo, The Miami Herald, reports about Girl Scout Kelly Culhane, who was honored for being an exceptional leader for her work with the Ear Peace Foundation. It’s a heartwarming story.

Mayo reports that Culhane was named a National Gold Award Girl Scout, the highest honor awarded by the Girl Scouts–and she’s the first Girl Scout from Miami to win this award. She won this distinction for her “Gold Award-winning project in which she partnered with the Ear Peace: Save Your Hearing Foundation.”  Says Mayo:

Kelly wrote the script, filmed and edited an educational video called “Band Together to Protect Your Hearing,” which is used in the foundation’s teacher training workshops for 392 schools in Miami-Dade County.

You can see Culhane’s video and learn more here.

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.

85 decibel headphones aren’t safe for children

Photo credit: Leonid Mamchenkov licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

Many headphones are advertised as safe for children’s hearing, using the occupationally derived 85 decibel (dB) standard as the volume limit without giving an exposure time.

When I contacted them in December 2015, the U.S. Federal Trade Commission’s Division of Advertising Practices declined to take action about this false advertising. Earlier this year, I learned about the UK Advertising Standards Authority, a quasi-governmental agency serving approximately the same role in England and Wales. I filed the same complaint with ASA, on behalf on The Quiet Coalition to protect children’s auditory health. On October 31, 2018, the ASA issued a ruling that Amazon’s advertising of these headphones as safe for children was indeed false advertising.

A study in the Netherlands earlier this year showed that even in children age 9-11 years, headphone use was associated with an increased rate of auditory disorders.

Parents and grandparents would be well-advised not to allow their children or grandchildren to listen to music or videos using headphones, with or without the 85 dB volume limit.

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.

Newly identified gene plays critical role in noise-induced hearing loss

by Daniel Fink, MD, Chair, The Quiet Coalition

This report about research done at the University of California-San Francisco describes identification of a new gene and its effects on proteins in the cochlea. The cochlea is the part of the ear where sound waves are transformed into electrical impulses which are transmitted to the brain and perceived as sound. The article notes that insights about the newly identified gene and the proteins it codes for may eventually lead to drugs to prevent hearing loss after noise exposure.

I have a much more practical suggestion that those concerned about their hearing can use today. Until that drug is available on the market–which will be years to decades to perhaps never, and who knows at what price–avoid noise-induced hearing loss by avoiding loud noise exposure. It’s simple, easy, and inexpensive. And I speak from experience–it’s what I do. I avoid loud noise, e.g., rock concerts, and if I can’t avoid loud noise, when flying in an airplane or using a power tool, for example, I wear noise-canceling headphones or insert earplugs.

Remember: if it 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.

October is National Protect Your Hearing Month

by Daniel Fink, MD, Chair, The Quiet Coalition

October is almost over. October is also National Protect Your Hearing Month.

I’m not big on special days or months. If something is worth doing or someone is worth honoring or worth being concerned about, we should do it or honor them or be concerned about it every day.

My late mother taught me that. Many decades ago, when at our father’s urging we asked her what she wanted for Mother’s Day, she would snap:

This is what I want for Mother’s Day. I want you boys to stop fighting. I want you to make your beds in the morning without me nagging. I want you to clean up your toys. And I want you to come to the table for dinner the first time I call you, not the fourth. Mother’s Day is every day. You can’t be mean to me 364 days of the year and expect being nice on one day to matter.

So that’s my approach to special days and months, including my own birthday and the month of October.

But the special days or months do provide the opportunity to remind ourselves and others of something important.

For National Protect Your Hearing Month, our friends at CDC informed us that on October 19, it released a Morbidity and Mortality Weekly Report (MMWR) entitled, “Use of Personal Hearing Protection Devices at Loud Athletic or Entertainment Events Among Adults — United States, 2018.” In this report, CDC researchers found that fewer than 20% of American adults used hearing protection when attending loud athletic or entertainment events.

Maybe this is part of the reason why CDC researchers reported last year that a large percentage of American adults age 20-69 had noise-induced hearing loss, many without any occupational exposure to loud noise.

Protect your hearing now to avoid needing hearing aids later.

Remember: If it 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.

Americans aren’t protecting their hearing

by Daniel Fink, MD, Chair, The Quiet Coalition

This newly published article from the CDC reports that 1) noise-induced hearing loss from non-occupational noise exposure is common in American adults, 2) recreational activities including sports and musical events are loud enough to damage hearing, and 3) very few American adults use earplugs or earmuffs–“hearing protective devices” in public or occupational health lingo–to protect their hearing.

This is a shame. Hearing loss is largely caused by noise exposure, and noise-induced hearing loss is entirely preventable.

Remember: If it sounds too loud, it IS too loud. Either turn down the volume, leave the noisy venue, wear earplugs or earmuff hearing protective devices, or wear hearing aids later.

The choice is yours.

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.

How to protect your child’s hearing

Photo credit: Fimb licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

This brief article from U.S. News offers a few basic tips to protect a child’s hearing.

The various health authorities–from the Centers for Disease Control and Prevention to the American Academy of Pediatrics and the American Academy of Family Physicians–offer little guidance for parents but not much. The CDC offers some resources, but I can’t find anything specifically about noise and hearing loss in children on the American Academy of Pediatrics or American Academy of Family Physicians online. This stands in dramatic contrast to the CDC’s sound advice offered about sun exposure, which is mirrored by offerings from the AAP and AAFP.

My advice to parents on protecting their child’s hearing is simple: if it sounds too loud, it IS too loud. Avoid the noise (e.g., don’t take a child to a rock concert or music festival), wear hearing protection (a less desirable choice in my opinion because it teaches the child that risky behaviors are acceptable), or leave if the noise is louder and expected. Parents (and grandparents) will be protecting their own precious hearing, 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.

How to prevent modern-day noise from damaging your hearing

by Daniel Fink, MD, Chair, The Quiet Coalition

There’s nothing new in this report from Care2, which appears to be a lifestyle website. But it offers some sound basic advice on how to protect your hearing.

I particularly like the idea of a noise vacation to give your ears a break. I would suggest a hike. You will find how quiet nature really is supposed to be.

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 Toronto Star says “Turn down the volume!”

by Daniel Fink, MD, Chair, The Quiet Coalition

This editorial in The Toronto Star discusses the adverse health impacts of noise and Toronto’s efforts to work towards quiet.

The Quiet Coalition’s Bradley Vite is quoted, saying “[i]t took decades to educate people on the dangers of second-hand smoke…[w]e may need decades to show the impact of second-hand noise.”

Mr. Vite may be correct. It took too long for those responsible for protecting public health to take action to clear the air in restaurants, stores, workplaces, and buses, planes, and trains. People can still smoke, but not where others are forced to smell or breathe their exhaled smoke involuntarily.

I am confident that if enough people complain to enough elected officials about noise, laws and regulations will be written and enforced to make the world a quieter place.

The scientific evidence is overwhelming. There can be no rational doubt that noise causes hearing loss and has major non-auditory health effects, including sleep disruption, hypertension, heart disease, stroke, and death.

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.