Hearing protection

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.”

Bicyclists at risk of hearing loss

By Daniel Fink, MD, Chair, The Quiet Coalition

A new study shows that bicycle riders may be at risk of hearing loss, and the culprit is wind noise. The study by Dr. Michael Seidman, an ear specialist who also is a bicycle rider, measured sound levels in a wind tunnel, finding that under many conditions noise level were high enough to cause auditory damage. The measurements need to be replicated on the road, which is a more challenging endeavor.

To me, the important thing to note is how Dr. Seidman conceived of the study: he was out riding with his brother and found that they had to shout at each other to be heard over the wind noise. He states that “OSHA, the Occupational Safety and Health Administration, says you can be exposed to 85dB of loudness for an eight-hour time period at work. But that does cause noise-induced hearing loss — we know that it does,” he said. “So anything over 85dB causes noise-induced hearing loss.”

I wrote about the 85 dB (actually A-weighted decibels, or dBA) occupational standard in the American Journal of Public Health, in which I noted that 85 dBA “is not a safe noise exposure level for the public.” Humans have difficulty understanding speech if the ambient noise is above 75 decibels. (Technically, those are A-weighted decibels, or dBA. That information is in Figure D-1 in the 1974 EPA “noise levels” monograph.) And Flamme et al. discussed the fact that the auditory injury threshold is only 75-78 dBA.

So, as Dr. Seidman realized, if it sounds too loud, it IS too loud. You don’t need a sound meter to know that. If you have to strain to speak or to hear conversation, the ambient noise is above 75 dBA and your hearing is being damaged.

What should bicyclists do to protect their hearing? Earplugs are an obvious choice, but Dr. Seidman says that they are illogical because “It’s not a good idea to wear earplugs when you ride — you can’t be aware of your surroundings.” He suggests that helmet design could address wind noise (but apparently isn’t offered at this time), but adds that accessories are available, such as AirStreamz Pro Cycling Wind Noise Reducer  by Cat-Ears, which are attached to eyeglasses or helmet straps and help to deflect noise.

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 block out city noise

This would work. Photo credit: Max Alexander / PromoMadrid licensed under CC BY-SA 2.0

In response to Winnie Hu’s article about New York City noise, The New York Times NY Regional reporter, Jonathan Wolfe, has written a piece on how to block out the city’s noise. To get some answers, Wolfe spoke with “Tim Heffernan, a writer and editor at The Wirecutter, the New York Times site that evaluates products, to ask for noise-reducing recommendations.” What follows is Hefferman’s recommendations for the best noise-canceling headphones and over-the-ear headphones, the best white noise machine, and, of course, the best disposable ear plugs.

In addition to the recommenations in Wolfe’s article, the New York City’s Department of Environmental Protection (DEP) suggests that apartment dwellers who live near busy streets with transient street noise consider the advice provided in the city’s “Residential Noise Control Guidance Sheet.” Says one DEP employee, “I use these principles in my own place.”

The DEP’s Residential Noise Control Guidance Sheet and Hefferman’s recommendations are sensible options for blocking noise that is intruding on your personal space. But we need to focus on the bigger issue, namely, keeping all noise in check. For example, along with recommending noise-blocking products, couldn’t The New York Times assign a health reporter to cover noise and its effect on health or report on why the federal government has abdicated its authority to regulate noise? (Here’s a hint: the Environmental Protection Agency’s Office of Noise Abatement and Control was kneecapped by industry after Ronald Reagan came into power.)

Blocking noise today may give us temporary relief, but it is a poor response to a long-term and significant public health hazard. We need government to regulate noise now to promote our wellbeing and protect our health.

Can fireworks hurt babies’ ears?

Cat Bowen, Romper, looks at whether fireworks can hurt babies’ ears. Bowen, who is deaf, has a daughter who is hard of hearing, so she is particularly concerned about the impact of noisy fireworks, writing “that what little hearing we have, we want to protect at all costs.”

Bowen points to a Boys Town National Research Hospital report which states that “fireworks register at over 140 decibels of sound” and recommends safe distances for adults and children. Bowen writes that adults “need to be about 65 feet away from the fireworks to be considered safe,” but it’s more than double that for a child.

But what about babies? Bowen says that “it’s different with babies,” because there is no hearing protection gear made for infants under six months. So “[c]an fireworks hurt your baby’s ears?” “Absolutely,” says Bowen, who recommends that you limit your baby’s exposure, try using protective headphones, and “keep you and your baby as far from the fireworks as you can while still enjoying the view.”