Noise-induced Hearing Loss (NIHL)

Noise and air pollution may be preventable causes of dementia

Photo credit: Elina Krima from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

Noise and air pollution may be preventable causes of dementia. This new study from the Alzheimer’s Association International Conference, reported by Med Page Today, discusses risk factors contributing to dementia. Other than rare genetic conditions, most cases of dementia have multifactorial causation. This makes prevention difficult because multiple risk factors must be addressed.

In general, a healthier lifestyle, including not smoking, eating a Mediterranean style diet, daily exercise, and other similar behaviors, have been shown to reduce or delay the onset of dementia. The new study found that risk factors contributing to dementia include hearing loss, social isolation, depression, and air pollution. These factors have now also been added to the Lancet Commission’s list of key modifiable risk factors for dementia.

Although the study doesn’t mention noise explicitly, noise causes hearing loss. Hearing loss in turn is associated, likely causally, with social isolation. People who can’t understand what others are saying tend to avoid social interaction because it’s too stressful or too embarrassing not to understand what others are saying. Social isolation in turn leads to depression.

With regard to hearing loss, researchers think the loss of auditory input caused by hearing loss also causes changes in the brain that contribute to the development of dementia. Previous studies led by researchers from Johns Hopkins have shown that hearing impairment in people 45-65 years old is related to a progressive loss of nerve cells in brain structures and reduced microstructural integrity that may indicate early Alzheimer disease.

The precise mechanisms by which air pollution contributes to dementia are unclear, but there are strong correlations between levels of pollutants and dementia. Much if not most of urban air pollution comes from particulate matter emitted by internal combustion engines. These are also a major cause of urban noise.

Reducing noise will prevent hearing loss and its consequences. And if noise from vehicles and other engines is reduced, air pollution will also be reduced.

As we have been saying for some years now, a quieter world will be a healthier world for all.

And, one hopes, it will also be a world with less dementia.

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.

Age-related hearing loss is almost certainly noise induced

Photo credit: Andrea Piacquadio from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

Hearing loss in old age is often called age-related hearing loss or presbycusis. This implies that hearing loss is part of normal aging, just like the need for bifocals called presbyopia. This article in the Society for Neuroscience’s journal reports that what is commonly called age-related hearing loss is really hair cell loss, indicative of auditory damage caused by noise

That was my conclusion based on a literature review, presented at the 12th Congress of the International Commission on the Biological Effects of Noise in Zurich in 2017.

Another recent report, this time in The Conversation, discusses research in fruit flies that may shed light on what the author calls age-related hearing loss. I don’t know how much noise fruit flies are exposed to–laboratory facilities are not quiet–but I suspect that the effects of whatever molecular changes occur in human ears with aging are compounded by cumulative noise exposure over one’s lifetime

Our ears are like our eye and our knees–we only have two of each. We don’t stare into the sun. We wear sunglasses when outdoors in bright light. In fact, sun exposure causes cataracts. We try not to injure our knees, although these can be surgically replaced.

And we need to protect our ears so they last us a lifetime.

Avoiding noise-induced hearing loss is simple: avoid exposure to loud noise, and if one can’t avoid that, use hearing protection.

Because if a noise 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.

Headphone use causes hearing loss

by Daniel Fink, MD, Chair, The Quiet Coalition

This report from the Sydney Morning Herald discusses headphone use causing hearing loss. It uses a term I hadn’t heard before–“headphone culture”–to describe the ubiquitous use of personal audio systems to provide a continuous soundtrack for daily life. There is mounting evidence that noise exposure in everyday life is loud enough to cause hearing loss in a majority of urban dwellers, and that exposure is exacerbated by using headphones or earbuds to listen to music or podcasts for hours a day.

The only quibble I have with the article is that it cites the occupational noise exposure levels of 80 or 85 decibels as being the safe sound threshold. This just isn’t true. Noise exposure levels that don’t even protect all exposed workers from noise-induced hearing loss certainly aren’t safe for the public!

The problem with listening to a personal audio device using headphones or earbuds is that to overcome ambient noise so one can hear what one is listening to, as when walking down the street or riding a bus or subway to work, the volume has to be turned up to dangerously loud levels.

For parents, the problem with children using headphones so they can listen to music or watch a video without disturbing others is that the parents can’t monitor the sound level or what their children are listening to.

The article discusses safer headphones with a volume limit, but my conclusion is that listening to music or podcasts or audiobooks using headphones or earbuds is as bad for the ears as smoking is for the lungs and heart.

Most volume limiting headphones use the occupational 85 decibel recommended exposure level as the volume limit and that simply won’t prevent hearing loss.

There is no safe cigarette, and headphones or earbuds with a volume limit may be safer than those without a volume limit, but they are certainly not safe.

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.

 

Early signs of hearing damage seen in young concert goers

Photo credit: Thibault Trillet from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

This report in The Conversation, a UK website, discusses research showing that young adults who regularly attend loud clubs and rock concerts have evidence of hearing loss. The hearing loss found falls into the “hidden hearing loss” category, so-called because it is not detected by standard hearing tests (“pure tone audiometry”), but only by techniques currently used only in research. These tests found subtle hearing loss and decreases in auditory signals sent to the brain. There were equal amounts of damage in musicians and non-musicians alike. It looks like all the young adults had too much noise exposure.

Hidden hearing loss is now thought to be the cause of the “speech in noise” problem, where middle-aged and older adults have difficulty following one conversation among many in a noisy environment. That’s a complex task for the ear and the brain, requiring lots of auditory information to be processed centrally. When the ear and brain are damaged, that doesn’t happen.

The only quibble I have with The Conversation’s report is that the authors make the common mistake of citing occupational noise exposure levels when talking about noise exposure in the public. Occupational noise exposure limits don’t protect workers from noise-induced hearing loss, and the UK’s 85 decibel exposure limit cited is certainly not safe for hearing.

The only noise exposure level that prevents hearing loss is a daily average of 70 decibels, which is much less noise than most urban dwellers around the world get every day.

Prevention of noise-induced hearing loss–hidden or not–is simple: avoid loud noise exposure and use hearing protection if you can’t.

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.

More about fireworks and hearing loss

Photo credit: ViTalko from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

WTOP is an all-news radio station in the Washington, D.C. metropolitan area. They recently ran this report on fireworks and hearing loss, citing the president of the American Academy of Audiology.

July 4th may be past, but according to the Consumer Product Safety Commission almost 200 people go to emergency rooms with injuries from fireworks every day in July.

Fireworks are dangerous for the ears, as well as for the fingers and eyes. The impulsive noise from fireworks can cause permanent hearing loss after only one exposure.

I agree with most fire chiefs and emergency room physicians and think it’s best to leave fireworks displays to professionals.

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 CDC says “Protect your hearing”

by Daniel Fink, MD, Chair, The Quiet Coalition

The National Center for Environmental Health at the Centers for Disease Control and Prevention advises everyone to protect his or hearing during July, which is Fireworks Safety Month:

Of course, we agree.

We only have two ears, and unlike our knees, they can’t be replaced.

I’ll go one step further and recommend that fireworks on July 4th be left to professionals and not used at home. Every year, people lose fingers or eyes because they or someone who loves them sets off fireworks at home, with disastrous consequences.

Please stay safe this fireworks season and protect your ears, too.

Thanks to the CDC for helping educate Americans about how to protect our auditory health.

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.

Fireworks noise can damage your ears

Photo credit: ViTalko from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

This report from KCBD in Texas discusses the dangers of fireworks noise for auditory health. The audiologist interviewed, Leigh Ann Reel, Ph.D., is especially concerned about impulsive noise, as from an explosion. One exposure at close range can cause permanent hearing loss, tinnitus, or hyperacusis.

Fire departments and public health authorities generally recommend leaving fireworks displays to the professionals, but in many states and localities personal use of fireworks is legal and enforcement of fireworks bans is spotty.

I would prefer quiet fireworks, as have been mandated in many parts of Europe, both for people and for their pets.

Please stay safe.

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.

If it makes more noise than a rake, protect your hearing

by Daniel Fink, MD, Chair, The Quiet Coalition

The Centers for Disease Control and Prevention just published this fact sheet about protecting your hearing when doing yard care. All power tools, whether gasoline or electric, make enough noise to damage hearing. In general, electric tools are quieter than those powered by two-stroke gasoline engines, and they also don’t produce noxious and toxic gaseous emissions.

One of the big technological advances in yard care in the last year or two is the widespread availability of powerful battery-powered yard care equipment, including leaf blowers, hedge trimmers, even lawnmowers. These are now available online or in any of the big-box home improvement stores. There’s no need to worry about extension cords or shock hazards.

Other than my wife, children, and grandchildren, gardening is my first love. From 2005-2014 I served on the board of the Theodore Payne Foundation for Wild Flowers and Native Plants, Inc. When I was termed out from that service, I became a noise activist, focused on trying to make the world a quieter place. But I’d much rather be quietly working in my garden.

Raking leaves, trimming a plant, or pulling a weed, using hand tools as gardeners have done for centuries, is quiet and contemplative.

Only rarely will I use an electric pole trimmer to cut pesky branches that I can’t reach without getting on a ladder, but I’ll put in my earplugs first. Because if a yard care tool is louder than a rake or a pruning shears, it’s loud enough to cause hearing loss.

So when you are doing yard work, use earplugs or earmuff hearing protection now to avoid hearing aids later. And if you hire someone to maintain your landscape, insist that the workers are provided hearing protection. They are at special risk for hearing loss as well as other noise-related health problems.

Thanks to our friends at the CDC for helping educate the public about the dangers of noise.

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 truth about children’s headphones

Photo credit: Andrea Piacquadio from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

In this piece for The New York Times parenting column, Joyce Cohen tells the truth about children’s headphones. The 85 decibel standard is not a safe listening volume for children, especially not without a specified exposure time.

In her article, Cohen cited The Quiet Coalition’s Rick Neitzel, PhD, associate chair of environmental health sciences at the University of Michigan, who said that “[t]reating 85 decibels as a safe level makes no sense at all,” adding that “[t]he 85-decibel number has achieved mythical status not because it is safe but because it is one of the few ways that occupational noise is regulated.”

I would add that a noise exposure standard that doesn’t even protect factory workers or heavy equipment operators from hearing loss is far too loud for a child’s delicate ears, which have to last her a whole lifetime. And an unknown factor is individual susceptibility. It’s impossible to predict whose ears are tough and whose ears are tender.

“The same noise dose has no apparent impact on some and a life-altering impact on others,” Bryan Pollard, president of the nonprofit Hyperacusis Research, told Cohen.

Consequences include not just hearing loss, but tinnitus, hyperacusis, and a sense of aural fullness. In her piece, Cohen interviewed pediatric audiologist Brian Fligor Ph.D. who summed things up: “We have done an atrocious job of teaching people to value their hearing.”

I hope Ms. Cohen’s writing will help parents know how dangerous headphones are for their children.

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.

Masks interfere with understanding speech for people with hearing loss

Photo credit: Cleyder Duque from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

Understanding speech can be difficult for people with hearing loss, and the requirement for wearing masks during the current COVID-19 pandemic exacerbates this problem. Mask wearing muffles speech, and it makes understanding difficult even for people without hearing loss, as many people with hearing loss consciously or unconsciously use lip reading and interpretation of expressions to help understand what is being said.

And sound decays according to the inverse square law, so the 6-foot social distancing requirement reduces sound volume compared to standing closer to the person one is conversing with.

As noted in this piece from CNN, there are things we can do to help communicate with people with hearing loss:

  • Face them and maintain eye contact when speaking.
  • Speak slowly and carefully.
  • Ask them to repeat back what they heard, so you can be sure they heard it correctly.

And If that doesn’t work, now there are masks being made with clear windows to allow the listener to see the speaker’s lips!

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.