Noise-induced Hearing Loss (NIHL)

Australians are in danger of hearing loss

by Daniel Fink, MD, Chair, The Quiet Coalition

This report from the National Acoustic Laboratory at Australia’s Macquarie University found that 1 in 10 Australians used personal listening devices (PLDs) at dangerously high volumes.

Not surprisingly, those who reported using the devices at high volumes also reported more difficulty hearing things.

Only the abstract is available without a subscription, so I can’t comment on details of the study, which would be stronger if actual hearing tests had been done on the subjects, but the final line of the abstract is one that I agree with entirely:

Although PLD use alone is not placing the majority of users at risk, it may be increasing the likelihood that individuals’ cumulative noise exposure will exceed safe levels.

And that’s the problem with studies focusing just on personal listening device use. They are only one small part of the total daily noise dose. Flamme, et al., found that 70% of adults in Kalamazoo County, Michigan received total daily noise doses exceeding the Environmental Protection Agency’s safe noise limit of 70 decibels time weighted average for a day. That’s why the Centers for Disease Control (CDC) recently reported that almost 25% of American adults had noise-induced hearing loss, many if not most without occupational exposure.

As the CDC states, noise-induced hearing loss is preventable. No noise, no hearing loss.

Protect your ears now and you won’t need hearing aids later.

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.

Eric Clapton has tinnitus and is losing his hearing

 

Photo credit: Majvdl licensed under CC BY-SA 3.0

And so he told BBC Radio while promoting his new documentary, “Eric Clapton: Life in 12 Bars.” Every pop culture site has reported some version of this story, but not one asks why or how he has tinnitus and hearing loss, even as the Variety piece linked above notes:

Clapton isn’t the only musician who’s dealt with tinnitus. The Who’s Pete Townshend has also discussed his own problems with the condition and hearing loss.

Townshend did more than that–he pointed his finger squarely at earphones used in studio as the cause of his hearing loss and expresses concern about earbud exposure among the youth.

Perhaps music and entertainment magazine should look into how and why music icons are suffering hearing loss and educate their audience on how to avoid the same fate.

Information is our weapon against noise

by Daniel Fink, MD, Chair, The Quiet Coalition

As this column by Jane Brody discusses, 47 years ago the Center for Science in the Public Interest started informing the public about good nutrition and also influencing public policy about food labeling and nutrition standards.

CSPI’s success has been mixed, but it clearly has had a major impact.

I didn’t realize it at the time, but when I became a noise activist three years ago–after reading this article in The New York Times science section about hyperacusis, which I have–I set out to do the same thing for noise that CSPI has done for food and nutrition.

Everything I do regarding noise is based on scientific and medical evidence. To my surprise, most of the information I have written about has been known since the early 1970s, or even earlier. It just has been forgotten since the Environmental Protection Agency’s Office of Noise Abatement and Control was defunded (pdf) during the Reagan years. I took me a year to learn what a safe noise level is, as I wrote in the American Journal of Public Health. [Hint: it’s not 85 decibels without time limit, as the National Institute for Occupational Safety and Health insists on its website, with the misleading statement “[l]ong or repeated exposure to sound at or above 85 decibels can cause hearing loss.” That’s true, but it’s like the National Cancer Institute saying, “standing out in the sun every day for a long time all summer long can cause skin cancer.”]

So let’s hope that regulators and policy makers will begin to recognize the dangers of noise exposure in the new year. I’m certainly going to do my part to bring this problem to their attention. I hope you will join me.

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.

An interesting report on access + ability

by Daniel Fink, MD, Chair, The Quiet Coalition

Access + Ability is the name of an exhibit open now at the Cooper Hewitt design museum in New York City.

This column in the New York Times discusses some of the many issues involved in designing products and increasingly apps to assist those with disabilities.

The author doesn’t mention one such app which I think will be a great help to those of us with auditory disorders–hearing loss, tinnitus, and hyperacusis–namely, Greg Scott’s free SoundPrint app, which allows measurement of sound levels in restaurants and bars and then posting this information for that specific restaurant or bar on a publicly accessible site.

I think it’s great that people with disabilities are being helped both by laws requiring modifications to make public places accessible to them, and now by new technologies. But it’s better to avoid a disability if one can. Driving safely in a safety-rated vehicle and wearing a seat belt is one way of reducing the likelihood of serious physical injury from a motor vehicle crash. Avoiding loud noise and wearing hearing protection reduces the danger of noise-induced hearing loss, the most common type of hearing loss.

Protect your ears. Like your eyes and knees, God only gave you two of them!

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 is the next great public health crisis

Photo credit: Loozrboy licensed under CC BY-SA 2.0

by Daniel Fink, MD, Chair, The Quiet Coaltion

This wonderful article from Futurism.com discusses the major problem of noise pollution as the nation and the world become increasingly urbanized.

Few remember that the U.S., government policy, as voted by Congress and signed into law in 1972, is “to promote an environment for all Americans free from noise that jeopardizes their health and welfare.”

The article’s author, Neel V. Patel, cites extensively noise pioneer and The Quiet Coalition co-founder and board member Arline Bronzaft, PhD, who 45 years ago showed that environmental noise interfered with children’s learning.

As Patel writes:

It’s impossible to overstate how much noise pollution can wreak havoc on human health and safety. High noise levels can exacerbate hypertension, cause insomnia or sleep disturbances, result in hearing loss, and worsen a plethora of other medical conditions. All of these problems can aggravate other health issues by inducing higher levels of stress, which can cascade into worsened immune systems, heart problems, increased anxiety and depression — the list just goes on and on.

We at The Quiet Coalition agree.  So click the first link, read Patel’s article, and learn how the U.S. government’s active failure to regulate noise since 1981 all but guarantees that noise is the next great public health crisis.

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.

Loud music is just as addictive as smoking

by Daniel Fink, MD, Chair, The Quiet Coalition

This report from New Zealand states that loud music is just as addictive as smoking.

The only quibble I have with the report is that it states that hearing loss begins at an 85 decibel exposure and that 85 decibels is a safe volume limit for children. Neither statement is correct. Both I and the NIOSH Science Blog have written about how the 85 decibel standard is an occupational standard that should not be used a a safe noise exposure standard for the general public.

But the basic premise of the report–that noise exposure from personal music player use by children is causing hearing loss–is sound.

So break the habit, and lower the volume. Your ears will thank you.

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.

Four in 10 UK adults unknowingly endanger their hearing on a daily basis

Photo credit: Gary J. Wood licensed under CC BY-SA 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

This report states that 40% of adults in the United Kingdom (England, Scotland, Wales) unknowingly endanger their hearing on a daily basis.

This finding fits neatly with Dr. Gregory A. Flamme’s report that 70% of U.S. adults get total noise doses exceeding safe limits and Dr. Richard Neitzel’s similar finding in a Swedish population.

This isn’t rocket science–noise exposure for the ear is like sun exposure for the skin. If you don’t want deep wrinkles, age spots, and skin cancers when you get older, wear a hat, long sleeves, sunscreen, and avoid the sun.

If you don’t want hearing aids when you get older, avoid noise exposure.

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.

Why a Toronto study on commuter noise is relevant to New York City

Photo credit: Dennis Jarvis licensed under CC BY-SA 2.0

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

In their recently published article “Noise exposure while commuting in Toronto – a study of personal and public transportation in Toronto,” Dr. Yao and his associates concluded that the sound levels associated with mass transit were intense enough to potentially cause some hearing loss. The authors found that while average noise levels in subway cars and on the subway stations were high, peak noise levels in the subway system exceeded 100 dBA. They also reported noise levels for buses and street cars with subways and bus average noise levels exceeding the average noise level for street cars. Recognizing that the mass transit system in Toronto is likely to expand, the authors suggested that “…engineering noise-control efforts should continue to focus on materials and equipment that confer a quieter environment.”

As a New Yorker and regular subway rider, I have long been aware of the impacts of New York City subway and elevated train noise on the health and well-being of its employees and riders as well as those who live, work, and attend school near the elevated train tracks. Yet, it was my research, done over forty years ago, on the adverse effects of elevated train noise on the reading ability of children attending classes near the elevated train tracks that led to my greater involvement in advocating for a “quieter” transit system. It was this advocacy that resulted in the Transit Authority installing rubber resilient pads on the tracks adjacent to the classrooms to lessen the train noise in these classes. The Board of Education also installed acoustical ceilings in these same classrooms.

The follow-up study of reading scores in these classrooms after the abatements were in place found that the children in classrooms adjacent to the track were now reading at the same level as those on the quiet side of the building. To me, these studies yielded another important finding–transit noise can be reduced.

It is within the context of my many years of writing about transit noise and its adverse impacts on mental and physical health that I will address the findings of the above Toronto study. For the purposes of this review, I will not be addressing bus noise which I have also examined in the past.

My research on subway noise impeding classroom learning received a great deal of attention and it led to my being given the opportunity to examine Transit Authority records on noise complaints and actions. I learned that back to 1878 when the Third Avenue El was opened, the noise from passing trains disturbed students attending Cooper Union College and the school had to relocate a dozen classrooms to the other side of the school building. The Transit Authority compensated the college for the move by paying them $540.00.

In the years that followed this first complaint, there were other complaints to which the Transit Authority responded by abating the noise on the tracks. In fact, as early as 1924, the then Transit Commission acknowledged the potential harm of noise on its employees and attempted to set up noise abatement programs for its existing lines as well as its future ones. In looking at how the New York Transit Authority responded to noise complaints, I found that complaints led to attempts to reduce noise but within a short time transit noises returned only to have the Authority respond again with noise abatements. My paper “Rail noise: The relationship to subway maintenance and operation,” published in Urban Resources in 1986, presents a historical overview of how subway noise has been addressed by those in charge of the New York City transit system.¹

Of particular note is the year 1982, when the State of New York decided to pass a Rapid Rail Transit Noise Code requiring the Transit Authority to develop a comprehensive plan to address its noise problems and to report annually to the State Legislature about its efforts to abate noise. The impetus for this bill came from community activists who lived near a rail curve in Coney Island that led to loud screeches as trains navigated the curve. The citizen group, The Big Screechers, led by Carmine Santa Maria, lobbied their legislators to pass the Rail Transit Noise Code.

My 1986 paper discussed how the Transit Authority at this time coordinated its noise abatement project with ongoing capital purchases and maintenance demonstrating its awareness that decreased transit noise is a sign of a poorly functioning system. Just as an automobile owner would bring in a noisy car to the repair shop recognizing that attending to the noise would very likely prevent more serious trouble ahead, the Transit Authority acknowledged that noise is very likely a clue to potential breakdowns.

With the primary sources of subway train noise involving the wheel, the rail, and the subway car’s propulsion system, noise abatement measures included wheel truing, rail welding, rubber resilient pads, track lubrication, and acoustic barriers—all of which also contribute to the proper operation of the system. These noise abatement measures lessen noise but also facilitate the integrity of the transit system while providing a smoother and quieter ride for the passengers as well as a quieter system for its employees. The Transit Authority also purchased quieter traction motors for their subway cars, demonstrating an awareness that quiet can be built into the original design.

The 1982 Rail Transit Noise Code was indeed effective in getting the Transit Authority to reduce its noise but, unfortunately, someone interpreted the law as having a “12 year life span” and, by 1995, the Transit Authority no longer had to report annually to the State on its efforts to lessen transit noise. With the Transit Authority no longer having to report annually on efforts to reduce noise, one might expect the subway system to grow louder in the following years. Indeed, a 2009 study examining sound levels of the New York City subway system, like the one carried out in Toronto, similarly concluded that the subway system’s loud sound levels have the potential to cause noise-induced hearing loss among its riders.

A paper I wrote in 2010 entitled “Abating New York City transit noise: A matter of will not way,” again highlighted the fact that subway noise abatement techniques exist and that addressing the noise issue would not only benefit the operation of the system, potentially leading to fewer breakdowns, but a quieter system would be beneficial to the health and welfare of New Yorkers. A few years after this paper was published, I was pleased to learn that the State assembly and State Senate delivered to the Governor an updated Rail Transit Noise bill in December 2014. Sadly, this bill was vetoed by Governor Cuomo on December 17, 2014 [pdf link]. Had this bill been passed, encouraging the Transit Authority to address its subway noise problems, I believe the subway system today would be quieter, better maintained, and running more efficiently. Without having measured the sound levels of the subway system these past three years, my ear seems to indicate that the subways are now noisier and the many media stories speak volumes to the lack of proper subway maintenance and the deteriorating service.

Let me turn back to the Toronto noise study and comment on its relevance to the New York transit noise issue. According to a research memorandum from Toronto in 1983, that the New York City Transit Authority shared with me,¹ Toronto indicated that the city spent a considerable amount of money in the testing and application of noise control procedures. The memorandum stated that rail sections were continuously welded, acoustical material was used throughout the system, floating slabs were installed on tracks near noise-sensitive buildings, and wheel ring-dampers were being tested on their subway cars. The Toronto subway system, considerably younger than New York’s system, having opened in 1954, appeared to be led by people who were well aware of the importance of transit noise abatement.

In light of the media headlines following the release of Dr. Yao’s article noting excessive transit noise in the Toronto subway system is putting commuters’ health at risk, I would expect that the head of the Toronto Transit Commission, Andrew Byford, is now preparing a response to the publication. Why should his response be relevant to New Yorkers? Because Andrew Byford will soon be the President of the New York City Transit Authority and his response to the noise report might clue us in as to whether he will address what my “ear” seems to indicate. Namely, that our system is growing louder. It would also let New York transit riders know if he, like several former Transit Authority leaders, understands the relationship among noise levels, transit maintenance, and subway performance, and would also tell us as to whether he fully understands that a quieter subway would positively impact the mental and physical health of New Yorkers.

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.

¹Bronzaft, A. L. (1986). Rail noise: The relationship to subway maintenance and operation. Urban Resources, 4, 37-42.

Will earbuds ruin my hearing?

Photo credit: Marcus Quigmire licensed under CC BY-SA 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

The headline for this article in Time magazine is “Will earbuds ruin my hearing?” The short answer is that it’s not the earbuds or headphones that damage hearing, but the noise emanating from them. The longer answer follows.

The article widely cites Dr. Robert Dobie at the University of Texas Health Science Center at San Antonio who says that earbud use isn’t a problem.

It also cites Harvard researcher Dr. M. Charles Liberman, who, with Dr. Sharon Kujawa, discovered the phenomenon now known as hidden hearing loss. This is damage to nerve junctions (synapses) in the ear, called hidden because it is not detected by standard hearing tests.

Dr. Liberman says that earbud use might be a problem.

Dr. Dobie’s assertion that earbud use isn’t a problem sounds just like the doctors in the 1950s and 1960s who insisted that smoking cigarettes wasn’t harmful to health. We now know differently.

My conclusion is that noise causes hearing loss. The human ear was not designed to withstand loud noise exposure because such a tolerance offered no evolutionary advantage. As I wrote in the January 2017 American Journal of Public Health, the only evidence-based safe noise exposure level to prevent hearing loss is 70 decibels time-weighted average for a day. I further explained, in a requested blog post for AJPH, that the real safe noise exposure level is probably lower than that.

We know, from decades of research on occupational noise exposure that led to the occupational safety criteria for noise exposure, from the work of Liberman and colleagues, and from hundreds or thousands of studies showing that noise damages hearing in animals and humans with the cellular and sub-cellular mechanisms of how this occurs now precisely understood that noise causes hearing loss.

If you believe Dr. Dobie, continue to listen to your personal music player using earbuds or headphones.

If you don’t want hearing aids when you are older (and I don’t think hearing loss is part of normal aging, as I said at the 12th Congress of the International Commission on the Biological Effects of Noise in Zürich in June 2017) my advice is not to use earbuds.

Your ears are like your eyes or your knees. God only gave you two of them. Protect them and keep them safe and working well your entire life.

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.