Hearing protection

CDC educates public about the dangers of noise

by Daniel Fink, MD, Chair, The Quiet Coalition

Our contacts at the Centers for Disease Control and Prevention have informed The Quiet Coalition that the CDC’s National Center for Environmental Health will be educating the public about the dangers of noise exposure at sports events, via advertisements in official printed programs for NHL, NBA, and NFL games, including this year’s Super Bowl LIII. An example of the advertisement appears at the top of this post. One of the ads suggests that these efforts will even extend to NASCAR races.

Research done by the CDC showed that about 25% of American adults age 20-69 had noise-induced hearing loss, and that 53% of these people with NIHL had no major occupational exposure to loud noise. The hearing damage was occurring outside the workplace.

We applaud the CDC’s educational effort, but suspect that, as with creating the largely smoke-free environment we now enjoy, much more must be done. Namely, real change won’t happen until government regulations are promulgated that set standards for noise levels in different settings and require the use, or at least the offer, of hearing protection devices to attendees. Nothing less will protect the nation’s auditory health.

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 review of ear muff hearing protection devices

Photo credit: Hunting Mark licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

The Quiet Coalition does not endorse products, but does try to let people know about effective hearing protection devices. This article at NoisyWorld reviewing and rating ear  muffs may be helpful for two reasons: 1) it explains the science behind the Noise Reduction Rating measurements, and 2) it educates the reader about ear muff style hearing protection, discussing the pros and cons of several different models.

Of course, there are many more options than just those discussed in this article. Full-size ear muffs are big and bulky but they may be more comfortable than earplugs for longer-term use, while folding ear muffs may be easier to carry to loud sporting events.

A photographer once said to me, “the best camera is the one you have with you when the great shot is before your eyes.”

And the best hearing protection is what you are wearing when the ambient noise is too loud.

For certain situations–a subway commute, a noisy office, or prolonged work in a noisy environment or with noisy power tools–ear muffs may be the best option.

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.

Stadium noise is still a problem

Phto credit: David Reber licensed under CC BY-SA 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

This article predicted that crowd noise in Arrowhead Stadium, the home of the NFL’s Kansas City Chiefs, would be a problem for the visiting New England Patriots. Arrowhead Stadium is where the Guinness world record stadium noise of 142.2 A-weighted decibels (dBA) was recorded. That exceeds the OSHA maximum permissible exposure level for occupational noise.

Well, it was noisy, but the Patriots won in overtime and will be in the Super Bowl. And in New Orleans, the visiting Los Angeles Rams quieted the noisy New Orleans Saints crowd, also by winning in overtime, setting a matchup with the Patriots.

I hope those attending the few remaining football games–the Pro Bowl and the Super Bowl are the only professional games until August–wear hearing protection. Because any temporary symptoms of ringing in the ears or muffling of sound indicate that permanent auditory damage has occurred, presaging noise-induced hearing loss.

There’s no cure for hearing loss, which makes government inaction in the face of intentionally loud noise particularly galling. Noise-induced hearing loss is 100% preventable, and to not get it, we simply have to avoid loud noise or wear hearing protection.

So if you are headed to the few remaining games, bring your earplugs–because 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.

Protecting children’s hearing

Photo credit: Tim Parkinson licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

I’m an internist and was board-certified in geriatric medicine so I’m not sure I’m qualified to write anything about children, but I think being a new grandpa grants me that authority. One thing I have learned is that children’s ears are delicate, and they need to last a lifetime, so it’s important to protect children from loud noise.

At last year’s Super Bowl victory, the world saw Philadelphia Eagles quarterback Nick Foles carrying his infant daughter wearing her cute pink ear muff hearing protection.  Smart move. The Quiet Coalition doesn’t endorse products, but there are now many ear muff hearing protection devices available for infants, toddlers, and young children.

I suggest that parents and grandparents look for products with a noise reduction rating of 22 decibels or greater. The NRR is measured according to standards developed by the EPA, but the actual reduction in noise reaching the ear drum is less than the rated noise reduction. Just remember that the higher the NRR, the greater the hearing protection.

And start using ear protection early. If children get used to ear muffs for noise when they are infants, they are likely to develop lifelong habits of protecting themselves from environmental noise exposures.

Should you allow your child to use headphones to listen to music? I think these are a bad idea. First, parents can’t monitor either content or sound volume. Second, even with volume limits, headphone use is likely to cause auditory damage. That was the finding of a Dutch study that showed auditory problems in children age 9-11 after headphone use. Third, and perhaps most importantly, it’s far better to interact with one’s child or grandchild than to use audio or audiovisual content as a babysitter. Read the kid a book!

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 the New York Philharmonic dangerously loud?

Photo credit: Shinya Suzuki licensed under CC BY-ND 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

One usually associates loud music with rock concerts and not classical music played by one of the world’s leading symphony orchestras, but that has changed. This report by Corinna da Fonseca-Wollheim, a New York Times music critic, says the New York Philharmonic is playing too loudly. Her concern is the effect loud playing has on the quality of the music, not preventing noise-induced hearing loss.

When I attend a concert, my concerns are about both.

I have hyperacusis, a condition where sound levels not bothersome to others cause discomfort and pain for me. And I know that noise causes hearing loss, tinnitus, and hyperacusis.

When Essa-Pekka Salonen was music director, the Philharmonic’s sound levels weren’t a problem. But under his successor, the wonderful Gustavo Dudamel, they are.

Don’t get me wrong. I love Dudamel’s conducting, and most of the time the orchestra’s sound is exquisite. But he plays some pieces about 10 decibels louder than Maestro Salonen did, e.g., Stravinsky’s Firebird Suite.

Now I make sure to bring a pair of earplugs with me when we go.

Because if something sounds too loud, it IS too loud.

And with louder symphony orchestras, hearing loss and other auditory problems aren’t just a worry for the musicians. They might be problems for the audience, 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.

85 dB is not a safe noise level to prevent hearing loss

This image is in the public domain.

by Daniel Fink, MD, Chair, The Quiet Coalition

The title of my article in the January 2019 issue of The Hearing Journal says it all. No, 85 decibels (dB) is not a safe noise exposure level to prevent hearing loss.

In the absence of a federal guideline, recommendation, or standard for non-occupational noise exposure, the 85 dB (actually dBA, A-weighted to reflect the frequencies heard in human speech) occupational noise exposure standard seems to have become the de facto safe noise exposure standard in the U.S. and around the world.

This misunderstanding might be why the world has gotten noisier over the last four decades.

I hope those charged with protecting the public’s health–including the Centers for DC, FTC, Consumer Product Safety Commission, and state and local agencies–will take steps to protect the nation’s auditory health in 2019.

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.

Swedish researchers discover 3 types of nerve fibers in the ear

This image from Gray’s Anatomy is in the public domain.

by Daniel Fink, MD, Chair, The Quiet Coalition

This report in Science Alert describes how researchers in Sweden figured out that there are three types of Type I nerve fibers in the ear. They did this using sophisticated DNA analysis techniques.

I often say that all research in a broad range of fields adds to our knowledge about noise and hearing and health, but quickly add that no new research, and no more research, is needed to know that noise causes hearing loss and non-auditory health effects including hypertension, heart disease, stroke, and death.

The scientific evidence is strong enough that there can be no rational doubt about this. And anyone who still has doubts about this can join the folks at the Heartland Institute who still don’t think the scientific evidence about cigarette smoking causing lung cancer is strong enough to be conclusive. Or the Flat Earth Society.

For the rest of us, guided by science, let’s aim to protect our ears and preserve our hearing.

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 hearing at holiday parties

Photo credit: Maurício Mascaro from Pexels

by G.M. Briggs

British charity Action on Hearing is advising Brits to protect their hearing this holiday by donning earplugs before going to holiday parties.  I agree.  At a recent holiday party, these came in handy:

Photo credit: Quiet City Maps

Ah, the joy of musician’s earplugs.  Not cheap at $250 (your price may vary), but they are fitted, long-lasting, and the cost may be covered by health insurance or flexible spending accounts. There are a variety of filters (the round white disc you see in the photo), but I opted for 25 decibels.  And while everyone was talking about how loud the music was, for once I was perfectly comfortable.

So have fun this season and enjoy the holiday parties, but don’t leave home without your earplugs!

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.