Hyperacusis

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.

 

Despite complaints, restaurant noise continues unabated

by Daniel Fink, MD

Ever since I developed tinnitus and hyperacusis from a one-time exposure to loud restaurant noise, I have been looking for a quiet restaurant (see the Acknowledgements section at the end of my editorial in the January 2017 American Journal of Public Health, “What Is a Safe Noise Level for the Public?“).

It turns out I’m not the only one complaining about restaurant noise.

Restaurant noise is the number one complaint of diners in New York, San Francisco, Portland OR, and Boston.  In fact, the Boston Globe just recently wrote about diners’ dislike of restaurant noise in a piece titled, “Listen up: Restaurants are too loud!

Restaurant owners may think that noise increases food and beverage sales, and decreases time spent at the table, and they are right.  But what they cannot measure is how many meals are lost because people like me don’t go to noisy restaurants with family or friends, choosing to dine at home, instead, where we can converse as we enjoy our meal. Perhaps restauranteurs should consider that we middle-aged folks are more likely to spend money in restaurants than other demographic groups.  After all, for many of us our kids are done with college, our mortgages are paid off, we’ve been saving for retirement, and we have the disposable income to enjoy a nice meal out more frequently than in our youth.  If there were quieter restaurants, we might dine out more often instead of avoiding them because we would rather not have a side of hearing loss with our steak frites.

I guess that as long as the restaurants are busy, they will stay noisy. But if enough of us speak up–in the restaurants and to our elected representatives, asking them to pass laws requiring some limits on indoor noise–restaurants will eventually get quieter.

Dr. 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 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.

Age doesn’t matter,

you could have hidden hearing loss (and not know it). WMAR Baltimore reports on hidden hearing loss, a relatively recently discovered hearing breakthrough that explains how people who pass hearing tests have problems hearing in noisy environments.  WMAR interviewed audiologists about this breakthrough, who said that “why patients can’t decipher speech in noisy situations has been unexplained, but a new breakthrough is changing that.”  The researchers who made the hidden hearing loss breakthrough studied young adults who were regularly overexposed to loud sounds, and found that “hidden hearing loss is associated with a deep disorder in the auditory system.”

It’s never too late to protect the hearing you have.  Exposure to loud sounds damages hearing.  Period.

 

Why is Big Pharm focusing on new treatments for hearing loss and other auditory disorders?

Because they smell money, of course.  And because they sniff a potentially big money-making opportunity, the pharmaceutical industry is racing to find treatments for a host of auditory disorders.  It’s a shame there’s no money in prevention, because noise-induced hearing loss and most cases of tinnitus and hyperacusis are 100% preventable.  So if you don’t have hearing loss, tinnitus, or hyperacusis yet, save yourself some cash and limit your exposure to noise now.  Or try your luck and hope that at least one pharmaceutical company finds a cure before you experience symptoms.

 

 

What is America’s most common workplace injury?

Hearing loss.  Zhai Yun Tan, Kaiser Health News, writing for PBS News Hour, examines hearing loss, which the Centers for Disease Control and Prevention has identified as “the most common work-related injury with approximately 22 million workers exposed annually to hazardous levels of occupational noise.”  ‘[I]n an effort to reduce these numbers,” she writes, “the Labor Department launched a challenge earlier this summer called ‘Hear and Now,’ in which it is soliciting pitches for innovative ideas and technology to better alert workers of hazardous noise levels.”

Critics have countered that technology to address the problem already exists.  The real problem, they claim, is that the maximum noise exposure level and Occupational Safety and Health Administration (OSHA) regulations are outdated.  Among other things, the OSHA regulations “use sound level limits that don’t factor in the noise exposures that occur beyond the workplace — at restaurants, concerts and sporting venues, for instance — that can add to workers’ cumulative risks of harm.”  OSHA officials offered that “the agency will issue a request for information later this year about current regulations at construction sites to figure out if more stringent protections are needed and how companies are complying,” but Tan notes that “[a] similar call for information was issued in 2002, but no changes resulted from the action.”

Tan suggests that employers will have to assume more responsibility in educating workers, as some workers do not use hearing protection at work because they are not aware of the risk.  Click the link above to learn more, including Tan’s report about Jeff Ammon, a former construction worker who can no longer work due to hearing loss and hyperacusis, a condition marked by sensitivity to environmental noise.

 

 

Animals are responding to human noise:

Bats are adapting their hunting strategies to the noise of our cities.  The good news is that a study published in Science shows that bats appear to be successfully adapting to human noise.  But as a researcher not involved in that study notes, “[s]ome animals probably can’t [adapt].”  So what happens to them?  And what about humans?  As the world gets noisier, how will we cope?  Or not?  It’s certainly something that should be addressed sooner rather than later, because, as the article reports:

“This is way beyond bats now. This is about thinking about any animals,” says Paul Faure, the director of the Bat Lab at McMaster University, who was not involved in the study. “We are domesticating our planet, we’re creating noise pollution, we’re creating light pollution. We’re fundamentally altering the world that we live in.”

Noise and its effect on all animals, including humans, has been ignored for too long.  It’s more than just a nuisance.  Among other things, noise can damage hearing with one exposure.  It’s time that the federal, state, and local governments step up and regulate noise much as they regulate air or water pollution, treating noise as the public health hazard that it is.  It also is time for adults to assume some responsibility for their hearing and their children’s hearing by protecting themselves and others through the use of ear plugs and ear muff protectors, or by the simply lowering the volume when they can, and leaving a loud space when they cannot.  It’s time that we take noise-induced hearing loss and other noise-induced hearing injuries seriously.  Because until we do, people will continue to suffer permanent hearing injuries for which there is no cure, a particularly galling situation when one considers that noise-induced hearing injuries are 100% preventable.