Noise-induced Hearing Loss (NIHL)

Univ. of Texas band members now wear ear plugs

Photo credit: Klobetime licensed under CC By-SA 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

This article in The Daily Texan reports that Longhorn Band members now wear earplugs.

Noise-induced hearing loss in musicians of all types is an occupational or recreational hazard, regardless of what instrument or type of music one plays. In fact, music students have been used as subjects in studies of the effect of noise exposure on hearing, compared to those studying other subjects.

My advice is simple: all musicians–in high school and college bands and at the professional level–should use hearing protection.

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.

Controlling the roar of the crowd

Photo credit: Gloria Bell licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

This article in The New York Times describes efforts by the Philadelphia Eagles and other professional and college sports teams to accommodate those with sensory challenges, “who can be most acutely affected by the overwhelming environments.”

Noise levels in many arenas and stadiums are high enough to cause auditory damage. The world record stadium noise is 142.2 A-weighted decibels (dBA)*, which exceeds the OSHA maximum permissible occupational noise exposure level of 140 dBA.

We wish the sports teams and the arenas and stadiums in which they play would do more to protect the hearing of everyone attending the game.

And since they probably won’t do this–crowd noise is weaponized to favor the home team, especially in football where it interferes with the visiting team hearing the quarterback calling the play–the public health authorities should step in.

*A-weighting adjusts sound measurements for the frequencies heard in human speech.

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 revised definition of noise for National Protect Your Hearing Month

Photo credit: Chris Fithall licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

October is National Protect Your Hearing Month, and I am using the occasion to propose a revised definition of noise: noise is unwanted and/or harmful sound.

For many decades, noise has been defined as “unwanted sound,” a phrase usually attributed to the late acoustics pioneer Leo Beranek. The problem with this definition is that it implies that the perception of noise is subjective. This means that those complaining about noise have no real basis for their complaints, other than a personal reaction to noise.

The new definition acknowledges that noise can be harmful to human health and can interfere with human activity. Even if a noise is merely unpleasant, that experience is stressful.  Recent research shows that stress causes vascular inflammation and cardiovascular disease.

The revised definition is supported by my article in the Fall 2019 issue of Acoustics Today, summarizing the evidence-based noise levels affecting human health and function. My article makes it clear that there can be no rational doubt that noise is harmful, and unwanted noise especially so. Sounds as quiet as 30-35 A-weighted decibels (dBA) can disrupt sleep. A good night’s sleep is important for health and function. Forty-five decibel (dB) sound can disrupt concentration and interfere with learning. At 55 dB, non-auditory health impacts of noise begin, including hypertension, cardiovascular disease, and increased mortality. These effects are best studied for transportation noise, but are seen with occupational noise exposure. At 60 dBA ambient noise, people with hearing loss have difficulty understanding speech. At 70 dBA, those with normal hearing also have difficulty understanding speech.

Seventy dB time-weighted average for 24 hours is the only evidence-based noise exposure level to prevent hearing loss, but the actual safe noise level is probably lower than that. And 85 dBA is the occupational recommended noise exposure level, not a safe noise level for the public. And as I notedin my article, the World Health Organization recommends only one hour exposure at 85 dBA daily to prevent hearing loss. Because the decibel scale is logarithmic, this is mathematically the same as 70 dB time-weighted average for a day.

Hearing loss is very common in older people, but I’ve learned that this isn’t part of normal physiological aging. Rather, presbycusis or age-related hearing loss is largely noise-induced hearing loss.

So what can you do to protect your hearing? There are two ways to protect hearing: avoid loud noise, and if you can’t, use hearing protection devices.

We only have two ears, and unlike knees they can’t be replaced. So if a noise sounds too loud, it IS too loud. And if a noise is so loud that one can’t converse without straining to speak or to be heard, the ambient noise is above 75 dBA and your hearing is at risk.

And always remember that noise is unwanted and/or harmful sound

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 searching for ways to quiet the Underground

Photo credit: Skitterphoto from Pexels

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

That the London Underground has been recently cited as producing very loud noises that are disturbing to riders, employees, and nearby neighbors is nothing new to New Yorkers who have complained about New York City’s loud subways and elevated trains for many years.

Over forty years ago, I published a paper that found that nearby elevated train noise impacted adversely on the classroom learning of students in a school next to the elevated tracks.  The findings of this study resulted in the placement of resilient rubber pads on the nearby tracks to lessen the noise and the installation of acoustical ceilings in classes near the tracks.  A second study, after noise abatement, found that children in classrooms near the tracks were now reading at the same level as those on the quiet side of the building. The New York City Transit Authority then instituted a program to install these resilient rubber pads along the entire elevated track system.

After working with the Transit Authority on two occasions on its noise issues, I learned that transit noise is not only disturbing to all those subjected to these sounds but transit noise is often the result of poor maintenance and as a result can lead to potential breakdowns in the system. I wrote a paper linking transit noise to breakdowns in the system and explained that correcting transit noise is not a matter of knowing what to do but rather of not being willing to do it.  This is true for cities other than New York.

In reading that London is searching for technology to quiet its system, I noted that the same procedures that have existed for years to lessen the noise are being considered.

One would think that such procedures should have been examined at the first sign that the system was getting louder.  Actually, that they weren’t should not be surprising because my work on noise issues has taught me that for actions to be taken, those in charge have to be “hit on the head” before something is done to reduce noise.

A group of London campaigners concerned about transit noise has asked Transport for London to put up signs warning people about the noise. One would assume that hearing protection could then be used by transit riders. Transport for London’s response was that the transit system’s noise was ‘highly unlikely to cause long-term hearing damage.”

Really? What about the impacts on the hearing of employees who are exposed to these high sounds for many hours daily? What about the health of people living near the tracks who have been complaining? What about the discomfort to riders who use the system regularly? I would suggest that Transport for London learn more about the impacts of noise pollution which affects more than our ears—noise adversely impacts on our health and well-being. I would also urge that the noise issue be addressed with haste.

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.

 

Animal study may have implications on human hearing issues

Photo credit: Батяшев Александр licensed under CC BY-SA 3.0

by Daniel Fink, MD, Chair, The Quiet Coalitionhttps://creativecommons.org/licenses/by-sa/3.0/deed.en

I’ve only read the press release and the abstract for this paper in JNeurosci but the findings are interesting. In chinchillas–a common animal model for hearing research–scientists at the University of Rochester and Purdue University found that mild noise-induced hearing loss also caused changes in nerve processing of auditory signals.

This may have implications for humans in terms of the very common “speech in noise” problem, in which people with normal audiograms complain that they can’t understand a conversation if the ambient noise level is moderate to high.

But to me, the most important implication of this study is that it emphasizes how important it is to protect our ears.

The only evidence-based noise exposure level to prevent hearing loss is a time-weighted average of 70 decibels a day and even that low level of noise exposure may be too high.

According to the World Health Organization, only one hour at 85 A-weighted decibels is enough to cause hearing loss.

The CDC states that noise-Induced hearing loss is entirely preventable.  Avoid exposure to loud noise, or wear hearing protection if one can’t.

Because if something sounds too loud, it IS too loud.

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.

Study urges efforts to prevent noise-induced hearing loss

This image is in the public domain

by Daniel Fink, MD, Chair, The Quiet Coalition

This report from Purdue University highlights research done there with the University of Rochester that shows noise-induced hearing loss has worse effects on hearing than hearing loss caused by age-related metabolic loss. Specifically, the researchers found that “noise trauma causes substantially greater changes in neural processing of complex sounds compared with age-related metabolic loss,” which the researchers think may explain why there are “large differences in speech perception commonly seen between people with the same clinically defined degree of hearing loss based on an audiogram.”

According to the CDC, noise-induced hearing loss is 100% preventable. In public health, prevention of disease is almost always better and cheaper than treatment of a disease or condition.  For hearing, natural hearing preserved into old age is much better and much cheaper than costly hearing aids.

So remember: if it sounds too loud, it IS too loud.  Avoid excessive noise exposure and use hearing protection now, or need hearing aids later.

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.

Want a quieter town? Urge local government to “Buy Quiet”

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

These two 5-minute videos from the U.S. Centers for Disease Control and Prevention spell out how business owners can reduce noise-induced hearing loss by creating “Buy Quiet” programs as a first step when purchasing or renting machinery or tools.  The Buy Quiet program “encourages companies to purchase or rent quieter machinery and tools to reduce worker noise exposure” when they first start up or when older machinery and tools are replaced. You can make your town or neighborhood quieter by getting your local government to encourage it’s own departments–as well as area businesses–to Buy Quiet.

Buy Quiet programs originated at NASA, where they were concerned about astronauts who, it turns out, were exposed to excessive and dangerous noise level when they were floating around in space.

But Buy Quiet gradually expanded to other federal agencies, for instance the National Park Service, eventually reaching the CDC, which realized that exposing the public to excessive noise levels from construction, traffic, airports, etc. was actually a dangerous public health problem. At that point, the CDC and other federal agencies began publishing the kind of public education materials linked above and much more.

It’s time for all of us to take the noise problem seriously. Remember, as our chairman Dr. Fink says, “if it sounds too loud, it IS too loud!”

In addition to serving as vice chair of the The Quiet Coalition, David Sykes chairs several professional organizations in acoustical science: The Acoustics Research Council, American National Standards Institute Committee S12, Workgroup 44, The Rothschild Foundation Task Force on Acoustics, and the FGI Acoustics Working Group—a partner of the American Hospital Association. He is the lead author of “Sound & Vibration 2.0 (2012, Springer-Verlag), a contributor to the National Academy of Engineering report “Technology for a Quieter America,” and to the US-GSA guidance “Sound Matters”, and co-founded the Laboratory for Advanced Research in Acoustics (LARA) at Rensselaer Polytechnic Institute. He recently retired from the board of directors of the American Tinnitus Association. 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.

Restaurant servers and bartenders warned about noise

Photo credit: Daria Sannikova from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

This article in the Tricity News reports that the Canadian provincial equivalent of a state occupational safety and health organization in the U.S., WorkSafe BC, just issued a warning on noise to restaurant servers and bartenders. Specifically, WorkSafe BC warned that “[h]earing loss in the workplace can be just as damaging in the service industry as it is in heavy industrial settings.”

Patrons are only in a restaurant or bar for an hour or two, but the workers may be there for an 8-hour shift, and often the noise exposure is loud enough for a long enough period to damage hearing. No surprise then that WorkSafe BC issued the warning. One wonders what it would take for OSHA–or a state or local government health agency–to act to protect the hearing of service industry workers.

Additional information is available on the WorkSafe BC website.

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.

The best headphones for children? None!

by Daniel Fink, MD, Chair, The Quiet Coalition

This post on the Parentology.com site discusses the best headphones for children in 2019. I disagree strongly. The best headphones for children are none at all! Why? Two reasons, one for auditory health and one for the child’s social and intellectual development.

First, for auditory health, headphones using the industrial-strength 85 decibel noise exposure level as a “safe” volume limit for a child’s tender ears isn’t safe. The UK’s Advertising Standards Authority ruled again Amazon advertising these headphones as safe for hearing because they’re not.

Second, allowing a child to isolate him or herself with headphones, first while watching a video on a device and then when listening to music when older, doesn’t allow the child to interact or communicate with others. And for the older children, the parent has no idea what the children are listening to.

Audiologists already report seeing younger patients with hearing loss and tinnitus instead of the senior population they are used to caring for.

And an epidemic of noise-induced hearing loss and other auditory problems appears to be certain in the near future.

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.

Why you temporarily hear muffled sound after a loud noise

Photo credit: Katie Tegtmeyer licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

Noise-induced temporary threshold shift, or NITTS, describes the temporary muffling of sound after a person is exposed to loud noise. This article from the American Association for the Advancement of Science’s Eureka Alert details a report in the prestigious scientific journal Proceedings of the National Academy of Sciences, that provides an explanation for NITTS. Namely, researchers in Sweden found changes in calcium ions in the tectorial membrane of the cochlea.

While NITTS is a real and observable finding, the idea that auditory damage from noise is temporary is most likely false. Research by Liberman and Kujawa and colleagues at the Massachusetts Eye and Ear Infirmary strongly suggests that there is no such thing as temporary auditory damage. And decades of occupational noise exposure studies show that NITTS eventually becomes NIPTS, noise-induced permanent threshold shift, i.e., noise-induced hearing loss. That is, your awareness of muffled hearing following exposure to loud noise is temporary, but the damage caused by the loud noise is permanent.

Noise-induced hearing loss is 100% preventable. Avoid noise exposure and if one can’t avoid noise exposure, use hearing protection devices.

Because if it sounds too loud, it IS too loud!

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.