Noise-induced Hearing Loss (NIHL)

Even with noise limits, loud noise at events still causes hearing damage

Photo credit: Wendy Wei from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

This article from the Netherlands reports that even with a regulatory maximum noise level for events and concerts, auditory damage still occurred. The Dutch Ministry of Public Health, Welfare, and Sports set the maximum noise level for events and concerts at 103 decibels (dB).

The U.S. Occupational Safety and Health Administration permissible exposure levels for noise are 1.5 hours at 100 A-weighted decibels (dBA) and one hour at 105 dBA. A-weighting adjusts the frequencies of sound for those heard in human speech. A-weighted sound measurements almost always are lower than unweighted measurements, with the exact difference depending on a variety of factors.

So 103 dB is pretty high, loud enough to cause hearing loss.

The problem with the Dutch noise levels was that the Dutch regulators somehow assumed that those attending loud events would be wearing hearing protection, but neglected to include this important requirement in information distributed to the public. About half of Dutch concertgoers never wear hearing protection, so they must be sustaining auditory damage, including noise-induced hearing loss and tinnitus.

The trade association representing music venues, concert halls, and event organizers maintains that it is the responsibility of those attending events and concerts to protect their own hearing, but I disagree. I think it’s the responsibility of governments and public health authorities to protect the public, or at least to give them complete and accurate information. Not “caveat auditor”!

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.

Warning labels work

Photo credit: Aeveraal licensed under CC BY-SA 3.0

by Daniel Fink, MD, Chair, The Quiet Coalition

Consumers want relevant information about products they buy, and warning labels work. That’s the message inherent in this New York Times report on food warning labels for salt, fat, sugar, and calories in Chile. Chile has one of the highest obesity rates in the world. With health care costs for obesity-related medical care soaring, the government decided to take action and began requiring black octagonal warning labels on the front of food packages. The laws also banned junk food sales in schools, and prohibited television ads for unhealthy food between 6 a.m. and 10 p.m.

Of course, the big multinational food companies who market candy, snacks, sodas, and fruit juices protested and lobbied against the legislation, but it passed and was signed into law.

Guess what? Junk food consumption is down 25% in Chile, and other countries are contemplating passing similar legislation.

I am convinced that if warning labels were required on personal listening devices and accessories like earbuds and headphones, people would use them less. I would suggest the following: WARNING: USE OF THIS DEVICE CAN CAUSE HEARING LOSS.  But I’m sure other wording might be more effective.

It’s obvious that the device manufacturers, like the junk food vendors, don’t care about consumers. All they care about is profits. It’s up to governments to protect their citizens, as Chile has done. That’s their job.

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.

AARP focuses on musicians and hearing loss

Photo credit: Alex G licensed under CC BY 2.0

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

Noise-induced hearing loss afflicts people of all ages, but since it’s cumulative and incurable, the greatest burden falls on older people who have incessantly exposed themselves to loud noise in their careers and due to recreational choices. Such is the case with many stars in music and entertainment. AARP recently reviewed research from Germany that analyzed the heath insurance records of 7 million people from 2004 to 2008 and found that “working musicians are nearly four times more likely to suffer noise-induced hearing loss than those in any other profession”…. and they were “57% more likely to have tinnitus brought on by their work.”

Hearing Health magazine also recently reported on this and included a list of a dozen well-known performers who’ve given up music due to hearing loss.

So if you’re wondering why some of your favorite rock stars aren’t touring any more, it’s possible they simply can’t hear what they’re performing. Sure, everybody knows classical composer Ludwig von Beethoven wrote—and even conducted–some his finest work after he was completely deaf. But if you’ve read about him, you would also know how profoundly unhappy he was about it.

Our ability to hear isn’t self-repairing–once you’ve blown your ears, they’re gone for good. So it’s good news that AARP seems to be awakening to the problem of noise-induced hearing loss. They’re big and powerful enough to get things done in Washington DC, where the health effects of exposure to loud sound was swept under the rug nearly 40 years ago. It’s definitely time for AARP to pay attention!

David Sykes chairs several professional organizations in acoustical science: QCI Healthcare Acoustics Project, ANSI Committee S12-WG44, the Rothschild Foundation Task Force on Acoustics, and the FGI Acoustics Committee. He is lead author of “Sound & Vibration 2.0” (Springer, 2012), a contributor to the NAE’s “Technology for a Quieter America” and the GSA’s “Sound Matters,” and co-founded the Laboratory for Advanced Research in Acoustics at Rensselaer Polytech. A graduate of UC-Berkeley with advanced degrees from Cornell, he is a frequent organizer of professional conferences in the U.S., Europe, Asia and the Middle East.

Why are spin classes so loud (and does it matter)?

Photo credit: Aberdeen Proving Ground licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

Why are spin classes so loud? This post on The Cut doesn’t really answer that question, but it does a nice job of explaining the dangers of excessive noise for auditory health.

A few years ago I had email exchanges with two researchers who study the effects of noise on athletic performance. Music with a specific beat can help rhythmic activities, like running or spinning at a constant pace, but despite common belief there is no evidence that loud music makes anyone run faster or lift more weight, or in this case spin faster.

Even if music does improve performance–or people think it improves their performance–those theoretical advantages are outweighed by almost certain auditory damage, including hearing loss and tinnitus.

I’m glad the author of this piece had a best friend who became an audiologist and educated her about the dangers of noise. Because if the noise in your spin class–or any exercise class, or really anywhere at all–sounds too loud, it is too loud.

And if the noise is loud enough to be painful, it’s dangerous for your ears. Period.

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 noise control cure for noise-induced tinnitus and hyperacusis

Photo credit: Owen Barker from Pexels

by Jan L. Mayes, MSc, Audiologist

In a 2019 article titled “Why is there no cure for tinnitus?” the authors looked at whether studies had dentified if participants have a history of significant noise exposure that could cause decreased sound tolerance, like hyperacusis or tinnitus. A cure for noise-induced tinnitus and hyperacusis, the authors noted, could be very different from a cure for tinnitus or hyperacusis from other causes, like aging or head injury.

The article shows that it’s important for research to identify noise sub-types when evaluating potential cures. The underlying hearing health damage for sudden high level noise like acoustic trauma is different than damage from chronic moderate level noise over time. That is, the cure for noise-induced tinnitus and hyperacusis from bomb blasts or firearms is likely different than the cure for noise-induced tinnitus and hyperacusis from being exposed to unhealthy noise at school, on public transit systems, or at noisy workplaces.

High level public noise pollution in daily life can impact hearing health of all ages from babies to elders. Fortunately, the solution for tinnitus and hyperacusis caused by public noise pollution is not a cure–it’s better than a cure, as the solution is preventing the noise from happening in the first place.

How? There must be noise control for human manufactured unhealthy noise sources like personal listening devices, aircraft, road vehicles, railways, consumer products, and even MRI machines. There is no need for a cure if the source noise is never manufactured to be loud enough to cause decreased sound tolerance in the first place.

Controlling the source of noise would have other positive effects. Moderate levels of public noise pollution can significantly affect the quality of life for people with tinnitus and hyperacusis by causing poor sleep and making it significantly harder to understand speech in the presence of background noise. This, in turn, can increase stress levels, making it harder to cope and potentially interferring with available treatment.

Noise control is not impossible. Protecting the general public from unhealthy noise must cost less than the combined healthcare costs of diagnosing and treating tinnitus, hyperacusis, and other hearing health damage. And new noise prevention materials are constantly being invented. Examples include an acoustic material invented by Boston University that silences or cancels out 94% of sound waves without blocking light or airflow. A Canadian company is making noise barriers that absorb noise and air pollution. Quiet electric passenger planes could be in regional operation by 2021.

But nothing will change about public noise pollution until authorities and decision makers make health and hearing health a priority. This includes real time city and transportation noise mapping and reporting to identify locations with unhealthy noise. Noise prevention and control is necessary to protect public health and it should be mandatory.

Dr. Daniel Fink describes implications for acoustic engineering and design considerations for structures and enforced noise emission regulations and restrictions. Examples could include muffling school and public hand dryers, hour restrictions or night curfews at airports, quieter leaf blowers, quiet defaults on consumer products like microwaves with an option to turn on audible alerts, quiet solutions to replace vehicle back-up beeps, or preventing new imposed noise from delivery drones or noisy audible vehicle alert systems on electric cars. New technology needs to be quietly accessible for everyone.

Preventing public noise pollution won’t stop all cases of tinnitus and hyperacusis, but it could stop millions of cases around the world. Safe soundscapes without unhealthy noise are best for everyone from newborns to elders. And prevention is always better than trying to treat the problem or find a cure for noise-induced hearing damage after it occurs.

Jan L. Mayes is an international Eric Hoffer Award winning author in Non-Fiction Health. She is also a blogger and newly retired audiologist still specializing in noise, tinnitus-hyperacusis, and hearing health education. You can read more of Jan’s work at her site, www.janlmayes.com.

 

 

What’s the Guinness World Record for the most destructively stupid event?

Photo credit: Harmony licensed under CC BY-ND 2.0

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

Americans are famous abroad for being loud. Maybe it’s because we’re all going deaf from exposing ourselves to environmental noise? Doesn’t help that Guinness, the irish brewery, has been sponsoring the “loudest stadium” competition for years now, goading American football fans to make as much noise as possible. Why? Two reasons, of course:

  1. To confuse the home team’s competition by making it impossible for their players to hear the plays being called, (otherwise known as poor sportsmanship), and
  2. To compete for the Guinness Record for “loudest stadium crowd noise.”

I understand the allure of setting a world record in something, anything, however dumb. But why make yourself deaf in the process? The article above says the loudest they’ve recorded so far in the stadium hosting the upcoming Super Bowl was 128 decibels—that’s enough to permanently damage your hearing.

So is Guinness legally responsible for inciting the loud behavior by offering the Guinness World Record for loudest stadium? Or are stadium owners responsible for promoting the effort?

And who should be filing law suits? How about the players’ union? For players—the focus of that noise–hearing loss from stadium noise–is a genuine, recognized occupational hazard, though one that OSHA may not be attending to yet. Or should fans–including children–seek compensation for being unwittingly exposed to destructive noise without being informed or offered adequate ear protection?

We wonder how much longer this pointless and destructive Guinness record will continue to be promoted. It needs to stop but probably won’t until somebody takes Guinness and local stadium owners to court. Noise exposure is a serious public health threat, and far too many Americans are completely unaware of it or are complacent.

I hope you’ll enjoy the SuperBowl this year—without threatening your hearing!

David Sykes chairs several professional organizations in acoustical science: QCI Healthcare Acoustics Project, ANSI Committee S12-WG44, the Rothschild Foundation Task Force on Acoustics, and the FGI Acoustics Committee. He is lead author of “Sound & Vibration 2.0” (Springer, 2012), a contributor to the NAE’s “Technology for a Quieter America” and the GSA’s “Sound Matters,” and co-founded the Laboratory for Advanced Research in Acoustics at Rensselaer Polytech. A graduate of UC-Berkeley with advanced degrees from Cornell, he is a frequent organizer of professional conferences in the U.S., Europe, Asia and the Middle East.

Loud fitness classes compromise instructors’ voices

Photo credit: Aberdeen Proving Ground licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

This article in The New York Times discusses how loud fitness classes are requiring instructors to shout over the motivational music and noise from gym equipment causing vocal cord damage. The article doesn’t discuss how the loud environment causes noise-induced hearing loss in instructors or those attending the exercise classes, but that’s a problem, too. Dangerous decibels at fitness centers may lead to hearing loss.

And here’s the funny thing: as best as I can tell, there are no studies in the sports medicine or exercise physiology literature showing that loud music increases performance, in any sport or exercise activity. Everyone thinks that loud music improves athletic performance, but that’s just a myth. Music with the right beat may help exercisers maintain a rhythm in sports where that’s important, such as rowing or running, but it doesn’t appear to help one lift more weight. So both the vocal damage and the auditory damage caused by loud gym music are completely unnecessary.

Both instructors and students should remember a simple rule: if it sounds too loud, it is too loud. If they can’t carry on a normal conversation without straining to speak or to be heard, the ambient noise is above 75 A-weighted decibels*, and that’s loud enough to cause auditory damage.

*A-weighting adjusts sound measurements to reflect 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.

Keep your brain healthy by protecting your hearing

Photo credit: Silver Blu3 licensed under CC BY-SA 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

Jane Brody’s recent column in The New York Times discusses the importance of good hearing for brain health. The exact mechanism isn’t understood, but the evidence is clear: even slight hearing loss has significant effects on brain function.

Research is under way to learn if using hearing aids prevents or delays the onset of dementia in those with hearing loss. In the meantime, we recommend avoiding loud noise exposure to prevent hearing loss, because noise-induced hearing loss is 100% preventable.

Remember: if a noise sounds too loud, it is too loud. Leave the noisy environment or protect your hearing now, or wear 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.

Have electronics manufacturers hooked a generation on sound?

Photo credit: thekirbster licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

This article in The New York Times describes how Juul hooked a generation on nicotine, while regulators slept. Now millions are addicted and hundreds have died from vaping.

The Walkman was first marketed in 1979, followed by the iPod in 2001, the iPhone in 2007, and a host of similar devices shortly thereafter. Very effective advertising convinced people–young people especially–that they needed a constant sound track in their lives. Now people use their personal listening devices about 5 hours a day, often at high volumes.

Have electronics manufacturers hooked a generation–or two–on a constant stream of loud sound? Will the result be an epidemic of noise-induced hearing loss when today’s young people reach mid-life?

I hope someone will remember this warning if I’m not around. But if I am around, I will have no pleasure in saying “I told you so” to the millions of Americans coping with hearing loss.  We still have time to prevent today’s teenagers from suffering untreatable noise-induced hearing loss, but we have to act now.

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.

Hearing loss from recreational sound exposure

Photo credit: Brett Sayles from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

RECOMMENDATIONS TO REDUCE HEARING LOSS FROM RECREATIONAL SOUND EXPOSURE

This detailed review article by Richard Neitzel, PhD, and Brian Fligor, PhD, in the Journal of the Acoustical Society of America discusses the risk of noise-induced hearing loss from recreational sound exposure.

The abstract contains the important conclusions, which are amply supported by the article itself. They are:

  1. The recommended occupational exposure limit is 85 A-weighted decibels (dBA)*. Some exposed workers will develop hearing loss from this noise exposure. To eliminate the risk of hearing loss, a 24 hour average of 70 dB is recommended.
  2. It is possible that occupational noise exposure may have worse impacts on hearing than equal exposures to recreational noise. But the application of statistical hearing loss models developed from occupational noise data to estimate the impacts of recreational noise exposure is nevertheless warranted.
  3. A recreational noise exposure limit of 80 dBA for 8 hours, equivalent to 75 dBA for 24 hours, should prevent hearing loss for adults. For children and other vulnerable individuals, e.g., those who already have hearing loss, the lower exposure level of 75 dBA for 8 hours, or 70 dBA for 24 hours, is appropriate.

Common non-occupational noise exposure sources include public transit, appliances, power tools, personal music players and other personal listening devices, musical instrument practice and performance, concerts, sports events, and parties.

Protecting hearing is simple. Eliminate high noise exposures where possible, increase the distance between you and noise sources around you, and use hearing protection (earplugs or ear muffs).

Because if something sounds too loud, it is too loud, and your hearing is at risk.

*A-weighting adjusts noise 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.