Hyperacusis

The health impact of environmental noise

by Jan L. Mayes, MSc, Aud(C), RAud, Audiologist

Environmental noise is damaging and inflicts unwanted sounds into everyday life. In 1984, Gordon Hempton, The Sound Tracker, found 20 natural locations in Washington State with noise-free intervals lasting over 15 minutes. No manmade noise at all. No planes, trains, or traffic. By 1995, only three locations were noise-free. When I employed current sound tracking in my suburban neighbourhood in the Pacific Northwest, I never had noise-free intervals last more than 4 minutes.  And I tried tracking at different times of the day, every day of the week for months.

Sociocusis is high distortion hearing loss caused by loud personal environmental noise (i.e., 75 dB average or higher). The louder the noise, the faster the damage. Noise-induced hidden hearing loss starts first. It begins with permanent rips in hearing nerves for which there are no symptoms, but damage is progressive for months after noise ends. More unprotected noise exposures causes yet more nerve damage leading to temporary or permanent inner ear hearing loss and what I call “hyper ears” (tinnitus and hyperacusis). Presbycusis, or age-related hearing loss, comes from gradual inner ear changes over time. Sociocusis, wrongly called early presbycusis, has a much greater impact on communication and music enjoyment than presbycusis alone.

There are also physical and mental health hazards from chronic environmental noise (i.e., 55 dB – 75 dB average). Health effects include stress, insomnia, learning problems in children, obesity, diabetes, high blood pressure, heart attacks, strokes, dementia, and shorter life. Blood pressure goes up with every 10 dB increase in environmental noise.

Ear protection prevents sociocusis from loud activities like nightclubs, concerts, and stadium events. Imagine if these venues were designated “Noise Hazard Zones”: no ear protection, no entry. Imagine Noise Free Zones like at Comic-Con 2017 in New York City. Imagine architects designing public spaces with quiet acoustics in the first place. Imagine if it was standard for manufacturers to make quiet products, dropping the noise hazard of everything from blenders, lawnmowers, planes, trains, and traffic.

The UK estimates noise pollution related healthcare costs at £1.09 billion annually. The EU is using urban planning and government polices to prevent environmental noise. Noise mitigation strategies include quiet asphalt, low-noise tires, traffic curfews, quieter airplanes, noise-optimized airport take-off and approach procedures, and better infrastructure planning.

But in the U.S., the FAA denies the crippling public health burden of noise pollution, and Congress hasn’t passed the Quiet Communities Act of 2016 or 2017.

Nobel Prize Winner Robert Koch predicted in 1910 that “[o]ne day man will have to fight noise as fiercely as cholera and pest.” I think the day is here.

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

The wrong answer to the restaurant noise problem

Photo credit: Jeremy Keith licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

This report from the United Kingdom discusses expensive new headphones which can help someone understand conversations in a noisy restaurant.

This is the wrong answer to the restaurant noise problem.

Why should someone have to spend £400–about $530 at current exchange rates–just to be able to understand a conversation in a restaurant in London?

The right answer is making restaurants quieter, by reducing background music levels and adding sound-absorbing materials, so everyone can have a conversation without straining to speak or to be heard.

Noisy restaurants are a major disability rights issue for those with hearing loss, tinnitus, and hyperacusis. And it is an important issue for older Americans, many of whom have significant (25-40 decibel) hearing loss.

I will be speaking about the problem of restaurant noise at the December 2017 meeting of the Acoustical Society of America in New Orleans.

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.

Yet another reason to protect your hearing

by Daniel Fink, MD, Chair, The Quiet Coalition

October is National Protect Your Hearing Month, and Jane Brody’s column in the September 26, 2017, New York Times science section gives yet another reason to protect your hearing: hearing loss is tied to cognitive decline. In fact, studies are underway to determine if preventing hearing loss or treating hearing loss will prevent cognitive decline, because the correlation between hearing loss and cognitive decline is well established.

I try to lead a healthy life. I never smoked. I walk an hour or more every day. I eat 5-7 servings of fruits and vegetables daily. My BMI is 24.5. I wear a hat and long sleeves to protect me from the California sun. I always use my seat belt when driving or riding in a car. But I knew little about the importance of protecting my hearing.

Unfortunately, my ignorance hurt me. A one-time exposure to loud noise one New Year’s Eve left me with permanent tinnitus and hyperacusis. I started wearing ear plugs at movies and sports events, and dined out rarely because almost all restaurants are painfully noisy for me. Then three years ago, after reading a different piece in the New York Times science section on hyperacusis, I was motivated to become a noise activist and to learn more about preventing auditory damage.

Researchers are working on drugs and other treatments to reverse noise-induced hearing loss, tinnitus, and hyperacusis, but currently the only treatments for hearing loss are hearing aids or, for the most severely affected, cochlear implants. And hearing aids aren’t like eyeglasses or contact lenses for common visual problems. They just don’t work as well as people would like to help them understand speech.

When I learned how bad noise is for the ears, that the only safe noise exposure level to prevent hearing loss is 70 decibels daily average noise exposure, that most Americans are exposed to dangerously high noise levels in everyday life, that many American adults have noise-induced hearing loss because of the excess noise exposure, and that hearing aids don’t work particularly well in helping people with hearing loss understand speech, I realized I had to protect my hearing.

Now I use earplugs at the movies, at sports events, even if I have to go to a noisy restaurant. And if I use a power tool, or even bang in one nail with a hammer, I use ear plugs or ear muff hearing protection. You should, too!

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.

Quiet motorcycles? Tell your neighbor to buy one of these…

Photo credit: Jan Ainali licensed under CC BY 3.0

By David Sykes, Vice Chair, and Jamie Banks, Program Director, The Quiet Coalition

You may be thinking, “quiet motorcycles…how is that possible?” In fact, they already exist—but you might have trouble getting a Harley-riding neighbor to embrace them. For many bikers, noise equals power. But in the case of electric motorcycles there is reason to believe that quiet is powerful too!

Lithium ion battery-powered motorcycles are gaining favor–Consumer Reports is impressed with them. Furthermore, the Department of Defense’s Advanced Research Projects Agency (DARPA) has been working on camo-painted, “stealth” hybrid gas/electric off-road motorbikes.

Motorcycle noise is a serious problem—especially for people who suffer from auditory disorders like partial hearing loss, tinnitus, hyperacusis, and misophonia–for whom the racket from motorcycles can be excruciatingly painful. This may be bikers themselves or people who live in neighborhoods that are regularly exposed to this type of noise. Several years ago, the U.S. National Academy of Engineering (NAE) convened a meeting about the problem of motorcycle noise and issued a report in 2014, though it seems to have fallen on deaf ears outside the NAE.

The noise has become such a problem in so many communities that even Harley-Davidson’s CEO has spoken out about Hog riders who remove their factory mufflers and install ‘straight pipes.’ Officially, the company doesn’t approve of owners tampering with the factory-installed mufflers, but after-market manufacturers are all-too-willing to meet consumer demand for more noise. The best news is that Harley-Davidson is developing an electric-powered motorcycle too.

Motorcycle noise may be a problem that regulation simply cannot fix. Given the current situation, it is unlikely the Environmental Protection Agency will be able to do anything about it. Instead, The Quiet Coalition (TQC) recommends framing motorcycle noise as a public health issue and encouraging a positive, technology-centered approach by businesses:

  • Become familiar with the large body of scientific literature indicating that loud noise is a public health problem. Authorities, including the U.S. Centers for Disease Control, publicize this information on their websites. Like tobacco smoke a generation ago, it will be necessary to engage public health officials before the motorcycle noise be addressed.
  • Urge individuals and groups that oppose motorcycle noise to encourage businesses to develop quieter, electric-powered alternatives. They are cheaper to operate (solar power is getting cheaper by the minute!) and much easier to maintain or repair (fewer moving parts!).

We believe these two steps are the best, most practical way to get action on this contentious issue and can actually lead to results. For example, The Quiet Coalition’s host, non-profit Quiet Communities, has been helping communities make the quiet transition away from fossil-fuel powered devices (namely landscape maintenance equipment) and towards advanced electric equipment and manual tools and emphasizing the compelling business model for users: the new lithium-ion-powered alternatives are cheaper to operate and maintain, they reduce air pollution, and they operate quietly. For some bikers, adopting technologically advanced, non-polluting, quiet alternatives may be appealing, especially if they have had health and hearing problems related to noisy bikes. It would be the start of a movement.

At TQC, we’re cautiously optimistic.

David Sykes chairs/co-chairs four national professional groups in acoustical science: The Acoustics Research Council, ANSI S12 WG44, The Rothschild Foundation Task Force on Acoustics, and the FGI Acoustics Working Group. He is also a board member of the American Tinnitus Association, co-founder of the Laboratory for Advanced Research in Acoustics (LARA) at Rensselaer Polytechnic Institute, lead author of “Sound & Vibration 2.0 (2012, Springer-Verlag), and a contributor to “Technology for a Quieter America” (2011, National Academy of Engineering). A graduate of the University of California/Berkeley with graduate degrees from Cornell University, he is a frequent organizer of and speaker at professional conferences in the U.S., Europe, Asia, and the Middle East.

Jamie Banks, PhD, MSc, is the Executive Director of Quiet Communities, Inc.. She is an environmentalist and health care scientist dedicated to promoting clean, healthy, quiet, and sustainable landscape maintenance, construction, and agricultural practices.

Millions of people don’t protect their ears

Photo credit: Quinn Dombrowski licensed under CC BY-SA 2.0

By Daniel Fink, MD

Noise is a medical and public health problem, and yet people ignore it at their own peril. Most of us are exposed to too much noise every day. That may explain why the Centers for Disease Control and Prevention found that about 25% of adults age 20-69 had hearing loss, and that many people with hearing loss didn’t know they had it.

Which is why a recent article by Mark Fischetti in Scientific American,A Loud Warning: Millions of People Do Not Protect Their Ears,” is particularly disturbing. Fischetti reports that while “many people know that they should use earplugs or earmuffs when mowing the lawn or partying at the club,” they don’t protect their ears against noise at home or at work. If you click the link to the article, you’ll see a frightening infographic that very clearly shows that millions of Americans are at risk of losing their hearing or suffering other hearing damage because they fail to protect their ears.

Maybe if people knew that noise caused hearing loss, tinnitus, and hyperacusis–none of which can be cured–they might be motivated to protect their hearing and fight for quiet.

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.

Can teens get tinnitus?

The answer, sadly, is yes. Emily Barker, writing for Redbrick, tells us about how she developed tinnitus from a one-time exposure to loud sound at a night club when she was 19-years-old. Barker says that she “never had any trouble with nights out being too loud, never had any pain or discomfort from loud music.” But after spending the evening at the club, and after she and her friends went back to the hostel they were staying at, she noticed that her ears “were ringing like crazy,” and she remembered “laughing about it with my friends because they were having the same issue and we were unintentionally shouting at each other from across the room.”

The laughter stopped the next day when Barker found that her ears were still ringing even as her friends’ ears had recovered. A couple of months later, she got confirmation that her hearing had been permanently damaged and she had tinnitus. She also was diagnosed with hyperacusis, a sensitivity to sound, so that “[a]pplause, doors or cupboards slamming, and things being dropped on hard floors are all sounds that [she] now find[s] extremely painful.”

Barker writes about the frustration of having developed tinnitus while everyone else she knew at the event did not, particularly since there was no family history of tinnitus. All she was told was that “sensitivity to noise is thought to be partly hereditary,” so her doctor theorized that she was “just an ‘at risk’ person.”

Barker concludes her piece with a warning to other teenagers and young adults, by listing myths about tinnitus, including, most importantly, the belief that you can’t get it from one night of clubbing. As she points out:

This is still the hardest thing for me to accept; it’s difficult to understand how just a few hours that caused me no distress or pain at the time can have had such a permanent impact. But the hairs in your inner ear can be destroyed by mere seconds of noise if it’s loud enough, and they cannot regrow: ergo, no cure.

Click the link to read the whole thing, and forward it to a teenager you know.  Hey, they might actually read it.

Massachusetts Medical Society: No to noisy leaf blowers

Photo credit: Hector Alejandro licensed under CC by 2.0

By Jamie L. Banks, PhD, MSc, Program Director, The Quiet Coalition

Are health concerns about gas-powered leaf blowers (GLBs) gaining momentum? On April 29th, the Massachusetts Medical Society (MMS) became the second in the nation to approve a resolution against GLBs, following the lead of the Medical Society of the State of New York (MSSNY). Other physician groups, such as Utah Physicians for Healthy Environment and Fresno Madera Medical Society, have also issued warnings on the use of GLBs and other fuel-powered lawn and garden equipment. The resolution brought by the society’s Committee on Environmental and Occupational Health and its chair Heather Alker, MD, MPH, recommends that the MMS:

  • Recognize noise pollution as a public health hazard, with respect to hearing loss;
  • Support initiatives to increase awareness of the health risks of loud noise exposure;
  • Urge the maximum feasible reduction of all forms of air pollution, including particulates, gases, toxicants, irritants, smog formers, and other biologically and chemically active pollutants; and
  • Acknowledge the increased risk of adverse health consequences to workers and general public from gas-powered leaf blowers including hearing loss and cardiopulmonary disease.

The growing concern on the part of the medical community over leaf blower noise is welcome news. Commercial GLBs can produce noise of 95 decibels and higher at the ear of the operator. This noise level exceeds safe occupational levels by an order of magnitude. The close proximity use of these powerful engines exposes both workers and others in the area to prolonged periods of excessive noise, not to mention toxic air pollutants. The presence of a low frequency component in the leaf blower’s frequency band distribution (i.e., the device’s sound signature) enables it to travel over long distances and through walls and windows.

The MMS resolution notes the harms to hearing and health from excessive noise produced by GLBs. Loud noise is known to cause hearing loss, tinnitus, and hyperacusis, as well as other health problems such as high blood pressure and heart disease. In addition, loud noise has negative effects on quality of life, communication and social interaction, work productivity, and psychological well-being.

The burgeoning use of GLBs and other fossil fuel powered equipment around our homes, schools, and other public spaces is a public health hazard, and a growing number of physicians and other health professionals are becoming concerned. The moves made by MMS and MSSNY are to be lauded, and other state societies and medical groups, including the American Lung Association and American Heart Association, need to prioritize this issue.  With the body of scientific evidence on the harms associated with noise and pollution, other state and national medical societies have a critical role to play in educating government officials and the public about the connections between environmental hazards and disease and the actions we can take to reduce risks in our communities.

Jamie L. Banks, PhD, MSc, is the Executive Director of Quiet Communities, Inc. and the Program Director of The Quiet Coalition. She is an environmentalist and health care scientist dedicated to promoting clean, healthy, quiet, and sustainable landscape maintenance, construction, and agricultural practices. Dr. Banks has an extensive background in health outcomes and economics, environmental behavior, and policy.

Source: Quiet Communities

Originally posted at The Quiet Coalition.

On hearing loss and the hope for a cure

In “High-Tech Hope for the Hard of Hearing,” David Owen, The New Yorker, has written an article that gives us a good look at what scientists know about hearing loss and where they are finding possibilities for treatment and, possibly, a cure. He begins his article with a series of personal anecdotes about himself, his family, and friends and the hearing problems they’ve developed due to exposure to loud noise and other factors. Owen’s interest in this story is motivated, at least in part, by his tinnitus, which is marked by a constant high-pitched ringing in his ears.

Among the advances that Owen examines, he discusses the discovery of hidden hearing loss and introduces us to Charles Liberman, who, with his colleague Sharon Kujawa, “solved a mystery that had puzzled some audiologists for years: the fact that two people with identical results on a standard hearing test, called an audiogram, could have markedly different abilities to understand speech, especially against a background of noise.” He writes that “[s]cientists had known for a long time that most hearing impairment involves damage to the synapses and nerve fibres to which hair cells are attached, but they had assumed that the nerve damage followed hair-cell loss, and was a consequence of it.” What Liberman and Kujawa discovered is that “the connections between the sensory cells and the nerve fibres that go first.” And the reason this early damage isn’t picked up by a standard hearing test is because it measures “the ability to detect pure tones along a scale of frequencies [which] requires only functioning hair cells…and is unaffected by nerve damage until more than eighty per cent of the synapses are gone.”

“A disturbing implication of [Liberman and Kujawa’s] finding is that hearing can be damaged at decibel levels and exposure times that have traditionally been considered safe,” writes Owen, but he is reassured by the researchers that the discovery of hidden hearing loss is cause for optimism. Why? “[B]ecause reconnecting nerve synapses is almost certain to be easier than regenerating functioning hair cells inside human ears.” In fact, Owen tells us that Liberman and others “have successfully restored some damaged connections in lab animals, and [Liberman] believes that far greater advances are to come.”

While cause for optimism is welcome, Owen notes something early in his article that is particularly frustrating to those advocating for regulation of noise:

There are also increasingly effective methods of preventing damage in the first place, and of compensating for it once it’s occurred. The natural human tendency, though, is to do nothing and hope for the best, usually while pretending that nothing is wrong.

Click the link above to read this interesting and hopeful article in full.

 

 

How an inadvertent punch to the jaw changed one woman’s life forever

Bryan Pollard, President of Hyperacusis Research and a founding member of The Quiet Coalition, writes about Katrina Caro, a nightclub waitress who was trying to break into modeling when an inadvertent punch to her jaw during a brawl changed her life. He tells us about Caro’s injury and its aftermath, explaining how a dental injury suddenly “turned out to be far worse,” as Caro’s “jaw pain spread to her ears, causing hyperacusis.”  As the founder and president of Hyperacusis Research, Pollard is particularly knowledgeable about the severe form of hyperacusis that plagues Caro.  Click the link above to learn more.

A sobering article on a severe form of hyperacusis:

Photo credit: Epic Fireworks

When even soft noises feel like a knife to the eardrums. Joyce Cohen, writing for Statnews.com, introduces us to Tom Maholchic, who suffers from a severe form of hyperacusis where noise is felt as physical pain. Most people who have hyperacusis find ordinary environmental sounds to be uncomfortably loud, but a more severe form, like that which Maholchic has, is far more debilitating. For Maholchic “routine sounds — the sizzle of bacon, the ring of a phone, the rush of running water,” feels “like a knife stabbing his eardrums.”

Cohen explains that while researchers have known about hyperacusis for years, very little was know about the more severe form, until very recently:

Using new lab tools and techniques, pioneering scientists have identified what appear to be pain fibers in the inner ear, or cochlea. They are coining new terms, including “noxacusis” and “auditory nociception,” for this newly recognized sensation of noise-induced ear pain.

Cohen gives us an overview of the difficulties researchers confronted in attempting to learn more about nerve fibers within the cochlea, “a tiny sensory organ buried within a skull bone [that is] tough to reach and impossible to biopsy.”  But, nonetheless, advances have been made.  And for sufferers like Maholchic these new findings will help them get some understanding about a condition that “[f]ew doctors or audiologists are even aware of.”

Most importantly, as the research continues and hyperacusis becomes more generally known within the medical community, one hopes that general practitioners and other medical professionals will advise their patients to avoid exposure to loud sound. As Cohen writes, noise loud enough to cause immediate pain is rare, “[b]ut exposure over time to more modest noise — from music, movies, sirens, lawnmowers, and a thousand other everyday things — can damage hearing and set off the pain fibers.”  Maholchic didn’t think his noise exposure was unusual–he said he listened to his ipod while vacuuming, played in a garage band, and worked at a lively restaurant–but one day his ears started ringing and shortly thereafter the pain began.  Even if the research advances quickly and a treatment or cure is found in Maholchic’s lifetime, no doubt he would agree that preventing the condition would have been the better option.