Hearing protection

What I did during the COVID-19 lockdown (and before and after)

Photo credit: Bidvine from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

When I was in elementary school, a common assignment during the first days or weeks of school was to write an essay on the topic, “What I did during summer vacation.” I don’t know if schoolchildren today will be asked to write essays about “What I did during the COVID-19 lockdown” when they return to school in person, but this is my report, with a nod to October’s being National Protect Your Hearing Month.

What did I do during my abundant free time during lockdown? When I wasn’t working on noise activities I worked home-improvement or repair projects at our home, with a major project at my in-laws’ home as well. I won’t bore you with the entire list, but it includes:

  • Removing shelving and flooring from two large closets, patching the walls, repainting them, and installing new shelves and flooring.
  • Removing carpet from one room, patching the walls, repainting the walls, and installing new flooring.
  • Removing a warmer drawer in the kitchen, modifying the cabinet to fit the new warmer drawer, refinishing that side of the kitchen island, and installing the new warmer drawer.
  • Removing a trash compactor, finishing the inside of the cabinet, and installing the new trash compactor.
  • Cutting out wood rot in an exterior door frame, installing a new piece of wood, patching and filling the repair, sanding it smooth, and repainting the door frame.
  • Repainting the interior and exterior of the front door and the windows surrounding it.
  • Removing six exterior lights in front of the house and installing new exterior light fixtures.
  • Removing old water feeds for all toilets and sinks and replacing them with new shutoff valves and braided stainless steel water feeds.
  • Repaired the washing machine and replacing a leaking hose.
  • Reconstructing a large trellis at my in-laws’ house.

What’s the connection to National Protect Your Hearing Month? Every project was noisy. Demolition work is noisy. Power tools are noisy. And many hand tools, perhaps with the exception of a pliers or screwdriver, are noisy when used. Among the power tools used were a circular saw, a sliding compound miter saw, hand saws, drills, a nut driver, a hammer drill, a multitool, two different reciprocating saws, and a quarter-sheet sander. Hand tools included hammers, pry bars, crowbars, screwdrivers, chisels, scrapers, paint brushes and rollers, etc. Painting is quiet and plumbing is quiet, but all the other tasks were noisy. The only time I didn’t have my earplugs in was when I was painting or using pliers, a wrench, or a screwdriver.

And that’s my advice to you: If like many other Americans you’re doing repair and home improvement projects during the COVID-19 lockdownHome improvement projects are underway during COVID-19 please protect your hearing!

There is no such thing as temporary auditory damage, and the cumulative effect of loud noise will eventually cause hearing loss.

So even if you’re hammering in only one nail or cutting one board with your circular saw, wear hearing protection.

That’s my advice before, during, and after October, National Protect Your Hearing Month.

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.

London deploys noise cameras to combat “antisocial supercar drivers”

Photo credit: Adrian Dorobantu from Pexels

by Arline L. Bronzaft, Ph.D., Board of Directors, GrowNYC, and Co-founder, The Quiet Coalition

The BBC reports that “[m]ore than a hundred people have been threatened with fines after London’s first noise cameras were set up to combat antisocial supercar drivers.”  Drivers who have been using Knightsbridge streets as racetracks will first receive warnings but second offenses will carry fines. The cameras identify cars exceeding a threshold of 74 decibels, and fines are imposed ranging from $130 to $3,230 (U.S. equivalent of pounds noted in article)–persistent offenders may have their vehicles taken. It should be noted that the Council member of Transport recognized that most drivers are considerate.

In an earlier post, I wrote about a group in Washington Heights and Inwood who has set up a task force to address the increase in noise levels in the community, including noise from drag racing. I have also spoken with other groups in New York City and Westchester that have noted an uptick in noisy vehicles racing down their streets. These groups, as well as many other New Yorkers, would welcome legislation calling for noise cameras on their streets to combat noise that is increasing and detrimental to their health and well-being.

New York bill S.B. 9009, introduced by State Senator Andrew Gounardes, would increase fines for loud car and motorcycle exhaust systems and mufflers. This law would require police vehicles to be equipped with decibel meters to measure the sounds of passing vehicles and would issue violations in excess of decibel limits set by the law. The current law sets a fine of a maximum of $150 for after-market violations but this bill would increase the maximum fine to $1,000. Also, under the current law police officers are to determine whether noise is excessive, but under the proposed bill police officers would be equipped with decibel meters to measure the actual sound levels.

State Senator Gournades’ legislation clearly indicates an awareness of the hazards to health brought about by loud vehicle equipment as well as a desire to remedy this problem. But enforcement of legislation is key and enforcement of noise regulations often falls seriously short as underscored by New York State Comptroller DiNapoli’s 2018 report regarding the New York City’s Noise Code. I would suggest that New York State legislators look into the UK program and consider a pilot project to identify loud vehicles by cameras which might make enforcement easier, and, more importantly, curb a dreadful noise pollutant.

Dr. Arline Bronzaft is a researcher, writer, and consultant on the adverse effects of noise on mental and physical health. She is co-author of “Why Noise Matters,” author of “Listen to the Raindrops” (children’s book illustrated by Steven Parton), and has written extensively about noise in books, encyclopedias, academic journals, and the popular press.  In addition, she is a Professor Emerita of the City University of New York and Board member of GrowNYC.

Could wearing a mask protect your hearing?

Photo credit: Anna Shvets from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

COVID-19 (technically SARS-CoV-2) is a novel coronavirus first detected less than a year ago. Because it is new, no one has immunity to it, leading to a worldwide pandemic. And also because it is new, physicians, public health experts, virologists, and many others have much to learn about it.

Two recent articles add to this knowledge.

One, in JAMA Otolaryngology-Head and Neck Surgery, reports that COVID-19 was isolated from mastoid bone and middle ear tissue. The other, in BMJ Case Reports, described a case of sudden irreversible hearing loss ascribed to COVID-19 infection.

It is well known that respiratory viruses can affect the middle and inner ear. Now we know this is also true for COVID-19.

Could wearing a mask to protect yourself and others from COVID-19 also protect your hearing?

Based on these two articles, I think the answer is, “Yes.”

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.

An international perspective on National Protect Your Hearing Month

by Daniel Fink, MD, Chair, The Quiet Coalition

As I recently wrote, October is National Protect Your Hearing Month. In that blog post, I noted that hearing loss with age is not part of normal physiological aging but in the U.S. largely represents noise-induced hearing loss. That is also likely true in other major industrialized countries, e.g., those of the European Union and the UK.

An international perspective on the importance of hearing protection is provided by the Global Burden of Disease report recently published in the British medical journal, The Lancet.

As NPR reported, “the key to health … is wealth. (And education … and women’s rights),” with the latter two factors assuming much greater importance in developing nations. Additionally, as infectious diseases and starvation become smaller relative problems as national incomes improve, non-communicable diseases such as obesity, hypertension, diabetes, and cancer become more important. Ironically, in many cases these “diseases of civilization” are specifically caused by improvements in daily living and dietary intake.

The analysis was coordinated by the Institute for Health Metrics and Evaluation in Seattle, which recently has received notice because of its coronavirus predictions for the U.S. One of the measures examined was the “healthy life expectancy,” abbreviated HALE. Another was Disability-Adjusted Life Years, or DALYs.

Sadly, when it comes to hearing, the IMHE and The Lancet’s editors still use the term “age-related hearing loss,” which wrongly implies that hearing loss is part of normal aging. As people live longer, hearing loss becomes a greater problem in all societies, including developing ones.

As shown in the Table in The Lancet article, DALYs from hearing loss increased for all populations, and especially for adult populations, since 1990.

This is a shame. Noise-induced hearing loss is entirely preventable, and no country, not even wealthy countries such as the U.S. or Switzerland, can afford to provide hearing aids to everyone who could benefit from them. Moreover, preventing noise-induced hearing loss is simple: avoid loud noise or use hearing protection if one can’t.

Because if it sounds loud, it is too loud and one’s auditory health is at risk.

This is true in the U.S. and in every country in the world during October, National Protect Your Hearing Month.

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 National Protect Your Hearing Month!

As I have noted before, I’m not a big believer in special months or days to celebrate or honor or remind us of people or things that should be celebrated or honored or observed every day, but the special days and months may serve as a useful reminder of the people or things. Hearing protection is one of those things that should be observed every day.

Hearing loss represents the cumulative impact of a lifetime of noise exposure, just as skin discoloration, deep wrinkles, and skin cancers represent the cumulative impact of a lifetime of sun exposure.

The basics of hearing protection are very easy:

  1. Avoid noise exposure, or wear hearing protection (ear plugs or ear muffs) if you can’t.
  2. The only evidence-based noise exposure level to prevent hearing loss is a daily average of 75 decibels.
  3. If a noise sounds loud, it is too loud and your hearing is at risk.

I would add a caveat and some scientific information to support my three points.

The caveat: The commonly cited 85 decibel noise level is not a safe noise exposure level for the public, but an occupational noise exposure level that doesn’t protect all exposed workers from hearing loss. Don’t believe the National Institute on Deafness and Other Communication Disorders or misinformed audiologists when they promulgate dangerous misinformation with statements like, “[l]ong or repeated exposure to sounds at or above 85 dBA can cause hearing loss (dBA means A-weighted decibels. A-weighting adjusts sound measurements for the frequencies heard in human speech.) Auditory damage probably begins at sound exposure levels far below 85 decibels, and after only one hour of exposure to 85 decibel sound it’s impossible to achieve the safe daily average of 70 decibels for 24 hours.

The science: A literature review, now confirmed by research published this year, demonstrates that there is no such thing as age-related hearing loss. Hearing loss is not part of normal aging but largely represents noise-induced hearing loss.

More science: Noise exposure in daily life is loud enough to cause hearing loss. A 2017 CDC study showed that about 25% of American adults age 20-69 had noise-induced hearing loss, many without significant occupational exposure to noise.

Your ears are like your knees–you only have two of them. So protect them, because unlike your knees, your ears can’t be replaced.

Protect your ears and protect your hearing during National Protect Your Hearing Month, and during every month!

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.

Another study shows association of hearing loss with cognitive decline

Photo credit: Xiaofan Luo licensed under  CC BY-NC-SA 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

We have reported previously on associations between hearing loss and dementia in the U.S., and studies finding brain changes associated with decreases in auditory input due to hearing loss. Hearing loss is also associated with depression.

This study from China, published in JAMA Network Open, confirms these associations in a different population. The China Health and Retirement Longitudinal Study is following a nationally representative survey of adults age 45 and older, and their spouses. The current study looked at data from 18,038 participants with an average age of 59.9. Hearing impairment was associated with worse performance in episodic memory, mental intactness, and global cognition and a greater risk of depression.

Correlation is not causation, but this report from another country with a different language and culture confirms studies in the U.S. and Europe. It’s another piece of the puzzle in trying to understand why some people develop certain problems as they age. Research is ongoing to elucidate how hearing loss contributes to or causes cognitive decline, and whether providing hearing aids can prevent or slow cognitive decline.

In the meantime, we urge people to protect their hearing as assiduously as they protect their vision. We don’t stare at the sun. We wear sunglasses when outdoors. And we should view hearing loud noise just like staring at the sun. Loud noise is as dangerous for the ears as the sun is for the eyes.

Because if something sounds loud, it’s too loud, and auditory health is in danger.

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.

5 ways to protect against hearing loss

Photo credit: Nelson Sosa licensed under CC BY-NC-ND 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

As we have discussed, hearing loss is not an inevitable part of normal aging but largely represents noise-induced hearing loss.

This article from The Covington News discusses five ways to protect your hearing. The article is sensible, though I’m not sure a baseline audiogram is necessary, and cotton ear swabs aren’t recommended but aren’t a problem unless one pokes the eardrum.

The other three suggestions are spot on: turn down the volume, use hearing protection, and avoid loud noise.

Because if it sounds loud, it is too loud, and your hearing is at risk.

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.

Preventing hearing loss from recreational noise exposure

Photo credit: D Coetzee has dedicated this photo to the public domain

by Daniel Fink, MD, Chair, The Quiet Coalition

As I have written often, in public health prevention of disease is almost always cheaper and better than treating it after it affects someone. This is certainly true for noise-induced hearing loss, where the only current treatment is amplification using hearing aids or newer personal sound amplification products.

BioMed Central, one of the world’s leading open-access publishers of medical and scientific journals, published a recent blog post about public health interventions to prevent NIHL. A literature review found only eight studies on the subject, with effectiveness of public health interventions at encouraging use of earplugs before noise exposure being statistically significant in terms of effectiveness, but in my opinion not great enough to really protect the public.

Michael Loughran, the author of the blog post, concluded:

Overall the results tell us there are very few hearing protection interventions addressing recreational noise exposure, a global hearing health concern, and those that have tackled the issue have had mixed success. Further intervention studies should be conducted that employ randomized controlled designs, with use of systematic approaches to intervention development (e.g. the behavior change wheel), as this will help target specific behavior change techniques in an effort to increase hearing protection behaviors and raise effect sizes.

I’m a big believer in scientific research. There usually is no giant breakthrough from most research studies, but taken together they help provide useful information on which to base both public policy and personal behavior.

For prevention of NIHL, the science is clear and no further research is needed. Noise exposure causes hearing loss, which can be prevented by avoiding loud noise and prevented or reduced by wearing OSHA-rated hearing protection with a Noise Reduction Rating of 25 or greater.

More research on how best to encourage people to protect their hearing would be a good thing. But an even better thing would be for federal and state agencies to issue detailed guidelines for reducing noise exposure to prevent hearing loss, as it has been done for preventing skin cancer, and for federal, state, and local health agencies to issue regulations requiring quieter malls, stores, restaurants, concerts, sports events, vehicles, and aircraft.

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.

Early signs of hearing damage seen in young concert goers

Photo credit: Thibault Trillet from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

This report in The Conversation, a UK website, discusses research showing that young adults who regularly attend loud clubs and rock concerts have evidence of hearing loss. The hearing loss found falls into the “hidden hearing loss” category, so-called because it is not detected by standard hearing tests (“pure tone audiometry”), but only by techniques currently used only in research. These tests found subtle hearing loss and decreases in auditory signals sent to the brain. There were equal amounts of damage in musicians and non-musicians alike. It looks like all the young adults had too much noise exposure.

Hidden hearing loss is now thought to be the cause of the “speech in noise” problem, where middle-aged and older adults have difficulty following one conversation among many in a noisy environment. That’s a complex task for the ear and the brain, requiring lots of auditory information to be processed centrally. When the ear and brain are damaged, that doesn’t happen.

The only quibble I have with The Conversation’s report is that the authors make the common mistake of citing occupational noise exposure levels when talking about noise exposure in the public. Occupational noise exposure limits don’t protect workers from noise-induced hearing loss, and the UK’s 85 decibel exposure limit cited is certainly not safe for hearing.

The only noise exposure level that prevents hearing loss is a daily average of 70 decibels, which is much less noise than most urban dwellers around the world get every day.

Prevention of noise-induced hearing loss–hidden or not–is simple: avoid loud noise exposure and use hearing protection if you can’t.

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.

Chemical earmuffs to prevent hearing loss?

Photo credit: Ben Dracup licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

Perhaps I shouldn’t be surprised when researchers try to develop a more complicated way of doing something that can already be done much more easily and much more cheaply. This article in The Hearing Journal reports research on chemicals that appear to prevent noise-induced hearing loss in an experimental animal model. The hope is that in the future chemicals can be developed that when taken by humans will prevent hearing loss after noise exposure.

Such a chemical might be helpful for those who can’t avoid loud noise, e.g., soldiers or police officers, or perhaps for those inadvertently exposed to loud noise.

For the rest of us, that may or may not ever come to fruition. But a much easier and cheaper way to prevent noise-induced hearing loss already exists. What is it? Simply this: Avoid exposure to loud noise, and if that can’t be done, use hearing protection like earplugs or earmuffs!

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.