Hyperacusis

MRIs are dangerously noisy

Photo credit: liz west licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

MRI noise is in the news in two recent reports.

People magazine reported the story of a woman who suffered permanent auditory damage from an MRI, developing hyperacusis (a sensitivity to noise, which causes pain) and tinnitus. The Quiet Coalition’s Bryan Pollard, an expert on hyperacusis, is quoted in the article.

And researchers from SUNY Buffalo and China wrote about MRI noise in The Hearing Journal.

Standard MRIs produce noise in the 110-115 decibel range, and newer more powerful MRIs are even louder. Knowing this, I have several quibbles with the information in The Hearing Journal article. Namely, the article cites occupational noise exposure standards, but these use A-weighted decibels (dBA) to reflect the frequencies of human speech. MRI noise is low frequency noise, so occupational noise limits may not protect hearing adequately. And occupational standards are not safe standards for the public. At least 25% of workers exposed to sound at occupational noise exposure standards will develop hearing loss.

Most importantly, for many people the auditory damage caused by MRI noise isn’t hearing loss but tinnitus and hyperacusis, as in the People magazine article. Exactly how noise causes tinnitus and hyperacusis isn’t yet known, but the mechanisms are likely different from cochlear hair cell damage causing noise-induced hearing loss.

Finally, the authors talk about temporary auditory damage, but many researchers think that any temporary auditory changes indicate that permanent damage has been done.

I can’t find any large-scale studies of auditory problems after MRIs–the equipment manufacturers wouldn’t be excited about funding such a study, and radiologists are interested in the image, not in the patient’s hearing–but anecdotal reports from audiologists indicate that this is a problem for too many people undergoing diagnostic MRIs.

So if you need an MRI, be sure to ask for “dual protection”– ear plugs and ear muffs. NIOSH recommends dual protection for noise exposure over 100 dBA.

And if you suffer auditory damage from an MRI, be sure to file a report with the FDA. That’s the only way the government will be induced to issue appropriate patient safety regulations.

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.

Musician wins landmark case over damaged hearing

Photo credit: MITO SettembreMusica licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

The BBC reports that a viola player who suffered a life-changing hearing injury at a rehearsal of a Wagner opera is entitled for compensation for his injury.

This is the first time that acoustic shock has been recognized as a compensable work-related condition.

A one-time exposure to extremely loud noise–often caused by a blast injury but possible from other loud noise–physically disrupts the structures in the inner ear. In many if not most cases, they can’t recover from the trauma.

Even if the noise isn’t 130 decibels, it can still cause lifelong hearing loss, tinnitus, or hyperacusis.

I have been unable to find more than anecdotal reports in the medical literature of this type of auditory damage, and in science the operative phrase is “the plural of anecdotes isn’t data,” but we all need to be aware of the dangers of noise.

As violist Chris Goldscheider unfortunately learned, if it sounds too loud, it is too loud.

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.

 

Noise sensitivity is all in your head–and this report proves it!

Photo credit: Allan Ajifo licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

I developed tinnitus (ringing in the ears) and hyperacusis (a sensitivity to noise, characterized by discomfort and pain to noise levels that others don’t have a problem with) ten years ago after a one-time exposure to loud noise.

It was at a New Year’s Eve dinner in a restaurant. As midnight approached, they kept cranking the music up louder and louder. My wife could tell I was uncomfortable and suggested that we leave, but I didn’t want to offend her or the friends who had arranged the dinner.

We left as soon after midnight as we could, but my ears were ringing when we left and the ringing never stopped. And I found that sounds that didn’t bother others bothered me.

For years hyperacusis was thought to be purely psychosomatic and those with it to have some sort of psychiatric disorder. Then pain fibers were discovered in the auditory system. And now this report from Finland shows that there are differences in the brains of people with noise sensitivity.

So yes, hyperacusis is all in our heads. But it’s not as a psychiatric problem, it’s a central nervous system difference.

Science marches on!

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.

Are we placing people with hearing loss at the heart of the design process?

by Daniel Fink, MD, Chair, The Quiet Coalition

That’s the question asked in this report from the UK publication Planning & Building Control Today.

And the answer? In a word, “No.”

The needs of those with auditory disorders–hearing loss, tinnitus, and hyperacusis–and other conditions such as dementia, autism, attention disorders, and neurocognitive disorders, are not considered in most building projects.

Acoustic consultants are only called in afterwards, when a problem becomes apparent, if at all.

In the U.S., the Facilities Guidance Institute does provide some criteria for acoustic issues in health care facilities but much more needs to be done, in restaurants, malls, retail stores, and transportation hubs, for those with auditory and other problems affected by ambient 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.

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.