Hearing protection

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.

Should we focus on clinical services or on preventing hearing loss?

Photo credit: Florida Fish and Wildlife licensed under CC BY-ND 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

This viewpoint article in the latest issue of The Journal of the American Medical Association by Frank Lin, MD, PhD, and colleagues at Johns Hopkins University School of Medicine and the Bloomberg School of Public Health, makes the case for expanding Medicare coverage of audiology services to help older Americans with hearing loss.

Dr. Lin and his colleagues are the leading researchers in the epidemiology of hearing loss. They have published a series of reports documenting the prevalence of hearing loss in older Americans and showing that hearing loss is strongly correlated with social isolation, depression, falls, accidents, and other conditions, all of which are associated with increased mortality in older people.

What’s missing from the article? Two things.

First, the report doesn’t explain that devices, whether they are hearing aids or over-the-counter personal sound amplification products, just don’t work as well as preserved normal hearing. The “elephant in the room” for hearing health care is the 30-40% non-usage rate among those who have obtained hearing aids, because in real-life situations, e.g., noisy stores or restaurants, these just don’t work as well as normal ears. The analogy I use is dentures. It really doesn’t matter if one has to have dentures made by a dentist and prosthodontist, or if one could walk into a drugstore or warehouse store and buy them. One’s natural teeth work better.

Second, the report doesn’t discuss the prevention of hearing loss. Continuing the dental analogy, it takes a lifetime of care, with daily brushing and flossing, regular cleanings, and dental work to keep one’s natural teeth one’s entire life. In contrast, avoiding noise-induced hearing loss is easy and costs nothing or very little–simply avoid exposure to loud noise. And if you can’t, wear hearing protection.

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.

The CDC is trying to prevent heart attacks. When will it try to prevent hearing loss?

by Daniel Fink, MD, Chair, The Quiet Coalition

The Centers for Disease Control has embarked on a public education campaign to reduce preventable cardiovascular mortality. They are calling it Million Hearts. Among the things people can do to prevent heart disease and fatal heart attacks are what CDC is calling “the ABCs”: a daily baby aspirin (unless there are medical reasons not to take it), blood pressure control, cholesterol control, and not smoking. Other actions include exercising, maintaining an ideal body weight, and eating a healthy diet.

Thanks to the Framingham Study, we know that heart disease and stroke are not part of normal aging but are largely preventable. Similarly, hearing loss is not part of normal aging but largely represents noise-induced hearing loss.

So when will CDC embark on a similar campaign to educate the public about preventing hearing loss? I suggest calling it the Million Ears campaign. Maybe Ten Million Ears.

A common saying is “nobody dies from going deaf,”* but that isn’t true. Hearing loss is associated with social isolation, falls, depression, and dementia in older people, all of which in turn are correlated and most likely causally related to increased mortality. Hearing loss also has major impacts on enjoyment of life and social function.

And unlike preventing heart disease and stroke, preventing noise-induced hearing loss is much easier–just avoid loud noise and wear hearing protection if you can’t.

Remember: If it sounds too loud, it IS too loud.

* The phrase “nobody dies from going deaf” is what is commonly said. The word “deaf,” however, usually denotes congenital hearing loss or severe hearing loss. The term “hearing loss” is more appropriately used for mild to moderate noise-induced hearing loss.

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 hearing loss when using headphones

by Daniel Fink, MD, Chair, The Quiet Coalition

Here is another article about the dangers of using headphones for hearing. I disagree with the author’s statement that “[t]here’s nothing inherently dangerous about using headphones.” That reminds me of statements in the 1950s and early 1960s that asserted there was nothing inherently dangerous about smoking cigarettes.

I think headphones and earbuds are inherently dangerous and shouldn’t be used except for noise-cancelling headphones used in noisy situations such as aircraft cabins.

Very few headphone users worry much about the sound volume when listening to music or a podcast or book, and the natural tendency is to turn up the volume enough to be able to hear what one is listening to. There is no meter on the personal audio device to let one know what the audio output is in decibels. And there is no audio dosimeter installed on most personal audio devices, be they MP3 players or smart phones, to let the user know the time-weighted average sound exposure that day or week from the device. Even if one has this type of dosimeter–several are reportedly in the development stage–they don’t measure all noise exposure, so they may give a false sense of security.

The other quibble with this article, from the UK, is that it uses the UK and EU occupational noise exposure standard of 80 decibels as a safe noise exposure level. The UK standard is technically 80 dBA, which is safer than the 85 dBA standard used in the U.S., but it is not a safe noise exposure level to prevent hearing loss. The only evidence-based safe noise exposure level to prevent hearing loss is a time-weighted average of 70 dB for 24 hours, and even that may be too high.

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 best ear protection for babies and toddlers

Photo credit: Fimb licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

As a newly minted grandfather, I worry even more about the world and the future, and what it will hold for our grandson and for all children and grandchildren, especially about keeping him safe and healthy. The Centers for Disease Control and the American Academy of Pediatrics have lots of advice about avoiding sun exposure, but little to nothing about avoiding noise exposure.

This report reviews four earmuff-style hearing protective devices–that’s the correct term, not headphones–that are good for babies and toddlers.

A few quibbles. The article doesn’t state how these were evaluated. NIOSH and OSHA evaluate hearing protective devices and assign a Noise Reduction Rating-NRR, but this evaluation appears to be the opinion of one audiologist.

And while I’m glad that the industrial-strength 85 decibel sound exposure level wasn’t mentioned as the noise level at which hearing damage occurs, the 70 decibel standard cited may be too low. Sound above 70 decibels for short time periods probably won’t cause hearing loss. It’s a time-weighted average sound exposure of 70 decibels for the whole day that prevents noise-induced hearing loss. Noise dose calculators like this one can help one understand what constitutes safe noise exposures.

More information about noise and children’s hearing is provided by the American Academy of Otolaryngology-Head and Neck Surgery.

Parents and grandparents should remember that to protect children’s hearing, if it sounds too loud, it IS too loud.

Common recreational activities, including using certain toys, birthday and other parties with amplified music, sports events, air shows, car races, and children’s action movies, are often dangerously loud.

And headphones should probably not be used by children for personal music players or digital devices, with or without an 85 decibel 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.

Cochlear implants for children born without hearing

Photo credit: Matt Ralph licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

This op-ed by Irene Taylor Brodsky in the New York Times discusses the issue of cochlear implants for children born without hearing.

It raises all sorts of issues that most parents, and most people, don’t have to consider. Those of us born with normal hearing, and with children and grandchildren born with normal hearing, simply won’t have to deal with these issues.

But we should learn to value our hearing as much as those born without it, and we should protect it all our lives. A simple way to protect hearing is to avoid exposure to loud sound, and if loud sound can’t be avoided, to use hearing protection.

Remember: if it sounds too loud, it is too loud and your hearing is at risk of being damaged.

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.

Is your spin class destroying your hearing?

Photo credit: www.localfitness.com.au licensed under CC BY-SA 3.0

by Daniel Fink, MD, Chair, The Quiet Coalition

This could be my shortest blog post ever: In a word, “yes.”

Seriously, the only safe noise exposure level to prevent hearing loss is a time-weighted average of 70 decibels for the entire day. This is not new information. The 70 decibels safe noise level was calculated by the Environmental Protection Agency in 1974. The World Health Organization reached the same conclusion in 1999, as did the National Institutes of Health in 1990. (The NIH states that the safe noise exposure level to prevent hearing loss is 75 decibels average for 8 hours, which is the same mathematically as 70 decibels for the day.) And more recently, my analysis of the safe noise level passed editorial muster at two of the worlds leading medical journals, the American Journal of Public Health in 2017 and the New England Journal of Medicine in 2018.

There can be no rational doubt about this number.

Most people think that louder music improves athletic performance, but there is no scientific evidence for this. I have communicated with two of the world’s experts on the effects of music on athletic performance. who both informed me that music may help improve performance in rhythmic activities, e.g., running at a steady pace, but there is no research showing that louder is better.

Those who go to noisy gyms and noisy spin classes have a choice: wear earplugs now, or wear 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.

Going to a music festival this summer?

Make sure you go prepared with first-rate hearing protection. Cory Rosenberg, Mother Nature Network, writes about the growing popularity of music festivals and the potential harm they may cause.  Says Rosenberg, “live concerts have played a large part in the rise of noise-induced hearing loss over the past few decades for music fans and musicians alike.”

Rosenberg’s piece is pretty thorough, but he makes one glaring error when he says “[c]onsistent exposure to noise levels that reach 85 decibels A-weighted (dBA) is considered harmful.” As Dr. Daniel Fink has noted repeatedly, 85 dBA is an occupational noise exposure limit that was not intended, and is not appropriate, for the general public.

That proviso aside, if you are planing on going to a music festival this summer, you should give Rosenberg’s piece a read.