Hyperacusis

One teen’s efforts to update the Americans With Disabilities Act

by Daniel Fink, MD, Chair, The Quiet Coalition

I recently wrote about Bryan Pollard’s efforts to bring hyperacusis to the attention of the ENT research community, asking the question, “Can one person make a difference?” The answer clearly was, “Yes.”

Today I’m writing about another single-handed effort to bring about change, also about hyperacusis.

Hyperacusis is a condition that causes a person to be unable to tolerate everyday noise levels without discomfort or pain. And a teen named Jemma-Tiffany with this condition is trying to get another section, Title VI, added to the Americans with Disabilities Act.

As she writes, “[t]his addition to the ADA would Require that all services, facilities, activities either provide a person who has a condition who would otherwise be in pain, ill, or unable to participate due to the sensory and other environmental factors with either an accessible virtual option, modify the sensory or other environmental factors to meet their needs, or provide them with a separate specialized environment to meet their needs.*”*

She has met with one of her senators and will meet the other, and her congressional representative, soon.

Environmental modifications intended specifically to help those with disabilities really make life better for all. Two examples are the ADA lever-style door handle, which makes doors easier for everyone to open, and curb cuts and wheelchair ramps that make life easier for parents pushing a baby stroller, or delivery workers with a cart of packages, or repair technicians with heavy equipment on wheels.

And a more accessible or quieter world mandated by an ADA Title VI will be a better and more enjoyable place for all.

We hope Jemma-Tiffany is successful in her efforts.

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.

One person can make a difference

Photo credit: Ave Calvar Martinez from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

I once attended a lecture where the speaker asked the audience, “Can one person make a difference?” He cited examples of Mahatma Gandhi, the Reverend Martin Luther King, Jr., and Nelson Mandela. Peering into the darkened auditorium, he continued, “I don’t see any of them in the audience today. But if you have ever tried to sleep on a summer night while one mosquito buzzes around your head, you know that one tiny little thing can make a difference. If you want to change things, you need to be like that mosquito.”

I didn’t think about that lecture for many years, but when I became a noise activist a Google search for “safe noise level” invariably had the occupationally-derived 85 decibel sound level as the most common search result.

After I published an editorial in the American Journal of Public Health about 70 decibels daily exposure being the only evidence-based sound level to prevent noise-induced hearing loss, that changed. Now a Google search shows many links to that article or publications citing it, including one from Hyperacusis Research with a picture of me and Bryan. It turned out that the speaker was right, one person could make a difference.

But I think what Bryan Pollard has accomplished proves that point even better than anything I have accomplished.

As Bryan writes in the Summer 2020 issue of Hearing Health magazine, the publication of Hearing Health Foundation, he developed hyperacusis some years ago after tree trimmers took down a large tree extending over his house and then used a noisy wood chipper to pulverize the entire tree, thick trunk included. Hyperacusis is a condition that causes a person to be unable to tolerate everyday noise levels without discomfort or pain. I also have hyperacusis, which developed after a one-time exposure to loud noise in a restaurant at a New Year’s Eve party in 2007.

When Bryan found that not much was known about hyperacusis, he started Hyperacusis Research, Ltd. to raise funds to support research into this poorly understood condition. Through his efforts, including organizing a dinner of interested researchers at the annual Association for Research in Otolaryngology meeting, the ENT research community has made great progress in understanding what Bryan has dubbed “noise-induced pain.”

Bryan partnered with Hearing Health Foundation, and then with many others, so his success hasn’t been a solo effort, but it’s clear that nothing would have happened with hyperacusis if Bryan hadn’t taken the initiative to try to do something.

In this summer of our discontent, when demonstrations fill the streets in American cities and cities around the world, it’s clear that public expressions of discontent can make a difference.

If enough individuals make noise about noise, maybe the world can become a quieter, healthier, more peaceful place, 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 loud noise affects your health

by Daniel Fink, MD, Chair, The Quiet Coalition

This article, online and in the print version of Prevention magazine, discusses noise pollution and how loud noise can affect health. Loud noise causes auditory problems–hearing loss, tinnitus, and hyperacusis–but also has less known non-auditory health effects as well. These include sleep disturbances, hypertension, obesity, diabetes, and cardiovascular disease, leading to increased mortality.

It’s relatively easy to protect one’s ears from auditory damage: avoid loud noise or use hearing protection if one can’t.

Protecting populations from the non-auditory health effects of noise will take concerted political effort to get legislation requiring quieter planes, vehicles, and trains passed and enforced.

But I believe if enough people complain to enough elected officials, a quieter world is possible.

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.

Protesting? Take a mask—AND hearing protection!

Photo credit: Z22 licensed under CC BY-SA 3.0

by David M. Sykes, Vice Chair, The Quiet Coalition

Been to a protest rally recently? You may have seen a cop car with a 2ft x 2ft box on the roof….What is it? Likely, it’s a long-range acoustical device, or LRAD, that emits an unbearable and ear-damaging signal intended to induce panic and temporary incapacity. First developed for the military, these devices are now in use by police in some cities to “control”/incapacitate protesters. Lynne Peskoe-Yang, in Popular Mechanics‘ weapons column, wrote an excellent summary of the subject that you should read and circulate to your friends and acquaintances.

Along with tear gas, tasers, flash-bang grenades and rubber bullets, LRADs are serious weapons—sonic weapons—that you need to prepare for because damage to your hearing will be permanent.

How damaging are LRADs? They can inflict serious pain, destroy your hearing, and leave you with permanent hearing damage. But police have been told they’re “harmless.” So expect indiscriminate use.

So be sure to wear or carry good earplugs AND earmuffs when you hit the street to join a protest march or rally. Once your hearing is gone, there’s no way to get it back. And the 16 million Americans who have tinnitus and/or hyperacusis can attest that hearing damage can be very, very painful and disabling.

David Sykes chairs several professional organizations in acoustical science: QCI Healthcare Acoustics Project, ANSI Committee S12-WG44, the Rothschild Foundation Task Force on Acoustics, and the FGI Acoustics Committee. He is lead author of “Sound & Vibration 2.0” (Springer, 2012), a contributor to the NAE’s “Technology for a Quieter America” and the GSA’s “Sound Matters,” and co-founded the Laboratory for Advanced Research in Acoustics at Rensselaer Polytech. A graduate of UC-Berkeley with advanced degrees from Cornell, he is a frequent organizer of professional conferences in the U.S., Europe, Asia and the Middle East.

Why are spin classes so loud (and does it matter)?

Photo credit: Aberdeen Proving Ground licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

Why are spin classes so loud? This post on The Cut doesn’t really answer that question, but it does a nice job of explaining the dangers of excessive noise for auditory health.

A few years ago I had email exchanges with two researchers who study the effects of noise on athletic performance. Music with a specific beat can help rhythmic activities, like running or spinning at a constant pace, but despite common belief there is no evidence that loud music makes anyone run faster or lift more weight, or in this case spin faster.

Even if music does improve performance–or people think it improves their performance–those theoretical advantages are outweighed by almost certain auditory damage, including hearing loss and tinnitus.

I’m glad the author of this piece had a best friend who became an audiologist and educated her about the dangers of noise. Because if the noise in your spin class–or any exercise class, or really anywhere at all–sounds too loud, it is too loud.

And if the noise is loud enough to be painful, it’s dangerous for your ears. Period.

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 noise control cure for noise-induced tinnitus and hyperacusis

Photo credit: Owen Barker from Pexels

by Jan L. Mayes, MSc, Audiologist

In a 2019 article titled “Why is there no cure for tinnitus?” the authors looked at whether studies had dentified if participants have a history of significant noise exposure that could cause decreased sound tolerance, like hyperacusis or tinnitus. A cure for noise-induced tinnitus and hyperacusis, the authors noted, could be very different from a cure for tinnitus or hyperacusis from other causes, like aging or head injury.

The article shows that it’s important for research to identify noise sub-types when evaluating potential cures. The underlying hearing health damage for sudden high level noise like acoustic trauma is different than damage from chronic moderate level noise over time. That is, the cure for noise-induced tinnitus and hyperacusis from bomb blasts or firearms is likely different than the cure for noise-induced tinnitus and hyperacusis from being exposed to unhealthy noise at school, on public transit systems, or at noisy workplaces.

High level public noise pollution in daily life can impact hearing health of all ages from babies to elders. Fortunately, the solution for tinnitus and hyperacusis caused by public noise pollution is not a cure–it’s better than a cure, as the solution is preventing the noise from happening in the first place.

How? There must be noise control for human manufactured unhealthy noise sources like personal listening devices, aircraft, road vehicles, railways, consumer products, and even MRI machines. There is no need for a cure if the source noise is never manufactured to be loud enough to cause decreased sound tolerance in the first place.

Controlling the source of noise would have other positive effects. Moderate levels of public noise pollution can significantly affect the quality of life for people with tinnitus and hyperacusis by causing poor sleep and making it significantly harder to understand speech in the presence of background noise. This, in turn, can increase stress levels, making it harder to cope and potentially interferring with available treatment.

Noise control is not impossible. Protecting the general public from unhealthy noise must cost less than the combined healthcare costs of diagnosing and treating tinnitus, hyperacusis, and other hearing health damage. And new noise prevention materials are constantly being invented. Examples include an acoustic material invented by Boston University that silences or cancels out 94% of sound waves without blocking light or airflow. A Canadian company is making noise barriers that absorb noise and air pollution. Quiet electric passenger planes could be in regional operation by 2021.

But nothing will change about public noise pollution until authorities and decision makers make health and hearing health a priority. This includes real time city and transportation noise mapping and reporting to identify locations with unhealthy noise. Noise prevention and control is necessary to protect public health and it should be mandatory.

Dr. Daniel Fink describes implications for acoustic engineering and design considerations for structures and enforced noise emission regulations and restrictions. Examples could include muffling school and public hand dryers, hour restrictions or night curfews at airports, quieter leaf blowers, quiet defaults on consumer products like microwaves with an option to turn on audible alerts, quiet solutions to replace vehicle back-up beeps, or preventing new imposed noise from delivery drones or noisy audible vehicle alert systems on electric cars. New technology needs to be quietly accessible for everyone.

Preventing public noise pollution won’t stop all cases of tinnitus and hyperacusis, but it could stop millions of cases around the world. Safe soundscapes without unhealthy noise are best for everyone from newborns to elders. And prevention is always better than trying to treat the problem or find a cure for noise-induced hearing damage after it occurs.

Jan L. Mayes is an international Eric Hoffer Award winning author in Non-Fiction Health. She is also a blogger and newly retired audiologist still specializing in noise, tinnitus-hyperacusis, and hearing health education. You can read more of Jan’s work at her site, www.janlmayes.com.

 

 

Motorcycle noise can damage riders’ hearing

Photo credit: Sourav Mishra from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

Motorcycle noise is a problem for people in many cities, interrupting conversations, disrupting sleep, and being loud enough to cause auditory damage. But motorcycle noise is also a problem for riders. This online piece from a UK insurance agent discusses the dangers of motorcycle noise for riders’ hearing.

Noise comes from both the engine and from air moving past the riders’ ears. Wind screens reduced the noise somewhat, but it is still loud enough to cause hearing loss.

Many motorcycle riders aren’t aware that the noise can damage their hearing. But many of those who know about the dangers of wind and engine noise on their ears don’t want to wear earplugs because they want to hear what’s going on around them.  Riding a motorcycle is hazardous, and riders want to hear other vehicles that may or may not see them.

Filtered ear plugs, which allow transmission of lower frequency sounds while blocking high frequency wind noise, might be a good solution.  The best solution, of course, is to avoid the source of damaging noise, which will also benefit anyone who would rather not be exposed to motorcycle 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.

How to treat people with disabilities, visible and invisible

Photo credit: Anas Aldyab from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

Having tinnitus and hyperacusis has made me more aware of what it’s like to have a disability. I am fortunate that my symptoms are mild and not life-limiting, but noise does bother me. When my wife asks for a quiet table at a restaurant, “because my husband has issues with noise” or “because noise bothers my husband,” I feel embarrassed and different. That gives me a very small insight into how difficult life can be for those with serious disabilities.

This piece by David Pogue in the New York Times discusses what different-looking people would like us to know before we stare. The bottom line, it seems, is that except for children it’s not okay to make comments about someone’s disability. It is okay if it appears that someone needs help to ask, “May I help you? If so, what can I do to help?”

Reading the article made me think about what those of us who have invisible disabilities, including auditory disorders like hearing loss, tinnitus, and hyperacusis, as well as disorders like PTSD or autism spectrum disorder, might like others to know.

For those of us with tinnitus and hyperacusis, I think we would like people to know that noise bothers us. It makes our symptoms worse, and can be downright painful.

For those with hearing loss, we need low ambient noise levels to be able to understand speech. Please look at us when you speak with us. Adequate lighting helps those who lip read understand what is being said. Speak slowly and distinctly, but don’t shout. That doesn’t help us understand what you are trying to say, and it can also be painful.

For those with PTSD and other psychological or psychiatric or developmental disorders, and indeed for anyone with a disability and actually for everyone, with or without a disability, just be gentle and kind.

And the world will be a better place for all.

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.

Doctors with disabilities? Yes, we are people too

by Daniel Fink, MD, Chair, The Quiet Coalition

This piece from NPR discusses how doctors and researchers with disabilities are changing medicine. When a problem is a secret, it is a source of shame and can’t be dealt with. If it is disclosed and discussed, however, it may still be a problem, but it can be dealt with and it is less of a source of shame.

When I spoke at the 2017 meeting of the Institute for Noise Control Engineering in Grand Rapids, Michigan, across the river from the Gerald R. Ford Presidential Library, I noted that his wife Betty Ford was a pioneer in discussing two formerly kept secrets–that she had breast cancer and had developed an addiction to prescription drugs. She fortunately survived her breast cancer to live many years more, and successfully dealt with her addiction. I then noted that I would publicly disclose that I had two auditory disabilities, tinnitus and hyperacusis, both fortunately mild and not life-limiting, but disabilities nonetheless.

I have mild hearing loss, too, again fortunately not life-limiting except in terms of understanding speech in a noisy environment.  Prof. Margaret Wallhagen in San Francisco has written about the stigma of hearing loss. Hearing loss should be destigmatized.

More importantly, noise-induced hearing loss should be prevented.

So avoid noise or use hearing protection if you can’t avoid it, because noise-induced hearing loss is 100% preventable.

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.

New NIDCD Director announced

Photo credit: Debara L. Tucci, M.D., M.S., M.B.A. courtesy of the National Institutes of Health

by Daniel Fink, MD, Chair, The Quiet Coalition

This blog post from the American Speech-Hearing-Language Association contains an interview with the incoming Director of the National Institute on Deafness and Other Communication Disorders (NIDCD), Dr. Debara Tucci.  We hope that prevention of hearing loss, tinnitus, and hyperacusis will be among Dr. Tucci’s priorities for NIDCD.

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.