Public health

WHO recommends quiet

Photo credit: Leif Jørgensen licensed under CC BY-SA 4.0

by Daniel Fink, MD, Chair, The Quiet Coalition

The World Health Organization just issued its new noise guidelines for Europe (pdf). This poster summarizes the 100+ page report which contains the scientific evidence:

The research was done by many of the world’s leading noise experts, and in turn reviewed by more experts who developed these evidence-based noise exposure guidelines.

There can be no rational doubt that noise is a major health problem in Europe and the United States, causing hearing loss, sleep disruption, cardiovascular disease, and death.

We hope the United States will follow the Europe’s example and start dealing with the noise problem, too.

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.

No one told you drone delivery would be so damn loud

Photo credit: Sam Churchill licensed under CC BY 2.0

But some Australians know firsthand that living next to a drone delivery test site is pure hell. According to Lachlan Roberts, The Riot Act!, residents living near a delivery drone testing site claimed they “were disturbed by the noise and said it was ruining their quality of life.” Said one put upon neighbor, “[t]he drones are unbelievably noisy and they have a really, really loud, high-pitched whining sound.” The situation was particularly galling, the residents point out, because they believe there is no compelling reason for this “service.”

It’s not surprising that the drone operation is attracting complaints. Just last year a NASA study found that “people find the buzzing sound that drones make to be notably more annoying than that of cars or trucks, even when they’re at the same volume.”

The aggrieved residents would likely agree. One of them noted that he had 35 drones fly over his house in one day, adding his concern that there would be many more flights after the trial period ended.

Silicon Valley (or the start-up culture, more generally) rush to impose delivery drones and flying cars and the other shiny objects du jour on the world with the promise of awesome new technology and absolutely no concern about the costs that will be borne by the society at large.

Before imposing the endless whine of delivery drones on the masses, the promoters should be required to answer one question: what compelling need does this technology serve? Because the need should be compelling when a new service or product is launched that will expose the public to unwanted and harmful noise.

Noise is killing us

Photo credit: Genaro Servín from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

This wide-ranging essay from New Zealand discusses the many ways noise hurts our health, from hearing loss to diabetes and death.

A quieter environment is better for us all, and it shouldn’t take a superhuman effort to make it happen. Lowering the volume of music in public spaces is an easy first step.

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.

Headphones for kids: What you should know

Photo credit: ExpectGrain licensed under CC BY-SA 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

This post at SoundGuys discusses choosing headphones for kids. The author discusses a variety of considerations, including many that lead me to my opinion about headphones for kids:

Headphone use should be limited to those old enough to understand the dangers of hearing loss. Giving a younger child a pair of headphones–volume limited or not–is like giving a toddler a beer or a 9-year-old a pack of cigarettes. No one does that.

It takes years to decades of noise exposure to produce hearing loss as measured by standard audiometric techniques, but the reports of hearing loss at very early ages associated with headphone use have already begun to appear. A Dutch study in June 2018 reported increased hearing loss another auditory problems in children as young as 9 to 11, compared to those who didn’t use headphones to listen to personal music devices.

I’m not sure exactly when the idea evolved that everyone, including toddlers as young as 3, needs to entertained by audio or visual material for almost every waking hour, but I can guarantee that generations of children were raised to adulthood quite successfully without these devices. Perhaps headphone use should be regulated like driving, smoking, or drinking, each of which has an age limit at which the behavior is allowed. In the U.S., the age requirement for driving varies from 15 or so to 18 depending on the state, 18 for smoking, and 21 years old for drinking.  Laws are different in Europe and Asia, but to my knowledge there are no laws or regulations restricting headphone use or personal music device use anywhere in the world.

In the old days–whenever that was, but certainly up to a decade or two ago–children either entertained themselves by playing with blocks or toys or dolls, or were entertained by friends, parents, and others. As children got older, they entertained themselves with coloring books, and then by reading. At a meal or waiting in a line or when traveling, parents and children interacted, whether it was the parent making up a story for the toddler, or the slightly older child telling the parent or grandparent a story, or looking at and talking about what was outside the window of the car, bus, train, or airplane. Or people read books. Now I see families sitting in a restaurant with each person wearing earbuds, looking at a smart phone or listening to some content on it, instead of interacting with each other.

This can’t be good for personal and social development. It can’t be good for developing ties among family members and others. And I can guarantee that it is not good for hearing–headphone use in children will cause hearing loss in adults.

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 Toronto Star says “Turn down the volume!”

by Daniel Fink, MD, Chair, The Quiet Coalition

This editorial in The Toronto Star discusses the adverse health impacts of noise and Toronto’s efforts to work towards quiet.

The Quiet Coalition’s Bradley Vite is quoted, saying “[i]t took decades to educate people on the dangers of second-hand smoke…[w]e may need decades to show the impact of second-hand noise.”

Mr. Vite may be correct. It took too long for those responsible for protecting public health to take action to clear the air in restaurants, stores, workplaces, and buses, planes, and trains. People can still smoke, but not where others are forced to smell or breathe their exhaled smoke involuntarily.

I am confident that if enough people complain to enough elected officials about noise, laws and regulations will be written and enforced to make the world a quieter place.

The scientific evidence is overwhelming. There can be no rational doubt that noise causes hearing loss and has major non-auditory health effects, including sleep disruption, hypertension, heart disease, stroke, and death.

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.

Should we focus on clinical services or on preventing hearing loss?

Photo credit: Florida Fish and Wildlife licensed under CC BY-ND 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

This viewpoint article in the latest issue of The Journal of the American Medical Association by Frank Lin, MD, PhD, and colleagues at Johns Hopkins University School of Medicine and the Bloomberg School of Public Health, makes the case for expanding Medicare coverage of audiology services to help older Americans with hearing loss.

Dr. Lin and his colleagues are the leading researchers in the epidemiology of hearing loss. They have published a series of reports documenting the prevalence of hearing loss in older Americans and showing that hearing loss is strongly correlated with social isolation, depression, falls, accidents, and other conditions, all of which are associated with increased mortality in older people.

What’s missing from the article? Two things.

First, the report doesn’t explain that devices, whether they are hearing aids or over-the-counter personal sound amplification products, just don’t work as well as preserved normal hearing. The “elephant in the room” for hearing health care is the 30-40% non-usage rate among those who have obtained hearing aids, because in real-life situations, e.g., noisy stores or restaurants, these just don’t work as well as normal ears. The analogy I use is dentures. It really doesn’t matter if one has to have dentures made by a dentist and prosthodontist, or if one could walk into a drugstore or warehouse store and buy them. One’s natural teeth work better.

Second, the report doesn’t discuss the prevention of hearing loss. Continuing the dental analogy, it takes a lifetime of care, with daily brushing and flossing, regular cleanings, and dental work to keep one’s natural teeth one’s entire life. In contrast, avoiding noise-induced hearing loss is easy and costs nothing or very little–simply avoid exposure to loud noise. And if you can’t, wear hearing protection.

Remember: 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.

Airplane noise is an increasing problem in San Francisco

Photo credit: Jim Trodel licensed under CC BY-SA 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

This article discusses the problem of airplane noise from San Francisco International Airport (airport code SFO). One of the people affected was Rep. Jackie Speier (D-CA), who lives near the airport. She was at home, rather than in Washington, because she was recovering from surgery.

As others have found, when they are at home all day rather than in the office, environmental noise pollution really is a problem. Often it’s gas-powered leaf blowers, but this time it’s airplane noise.

Airplane noise isn’t just an annoyance. Aircraft noise causes heart disease, strokes, and death.

Maybe the fact that an elected official is herself affected by airplane noise will lead to some federal action to help solve this problem.

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 is trying to prevent heart attacks. When will it try to prevent hearing loss?

by Daniel Fink, MD, Chair, The Quiet Coalition

The Centers for Disease Control has embarked on a public education campaign to reduce preventable cardiovascular mortality. They are calling it Million Hearts. Among the things people can do to prevent heart disease and fatal heart attacks are what CDC is calling “the ABCs”: a daily baby aspirin (unless there are medical reasons not to take it), blood pressure control, cholesterol control, and not smoking. Other actions include exercising, maintaining an ideal body weight, and eating a healthy diet.

Thanks to the Framingham Study, we know that heart disease and stroke are not part of normal aging but are largely preventable. Similarly, hearing loss is not part of normal aging but largely represents noise-induced hearing loss.

So when will CDC embark on a similar campaign to educate the public about preventing hearing loss? I suggest calling it the Million Ears campaign. Maybe Ten Million Ears.

A common saying is “nobody dies from going deaf,”* but that isn’t true. Hearing loss is associated with social isolation, falls, depression, and dementia in older people, all of which in turn are correlated and most likely causally related to increased mortality. Hearing loss also has major impacts on enjoyment of life and social function.

And unlike preventing heart disease and stroke, preventing noise-induced hearing loss is much easier–just avoid loud noise and wear hearing protection if you can’t.

Remember: If it sounds too loud, it IS too loud.

* The phrase “nobody dies from going deaf” is what is commonly said. The word “deaf,” however, usually denotes congenital hearing loss or severe hearing loss. The term “hearing loss” is more appropriately used for mild to moderate noise-induced hearing loss.

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.

How to prevent hearing loss when using headphones

by Daniel Fink, MD, Chair, The Quiet Coalition

Here is another article about the dangers of using headphones for hearing. I disagree with the author’s statement that “[t]here’s nothing inherently dangerous about using headphones.” That reminds me of statements in the 1950s and early 1960s that asserted there was nothing inherently dangerous about smoking cigarettes.

I think headphones and earbuds are inherently dangerous and shouldn’t be used except for noise-cancelling headphones used in noisy situations such as aircraft cabins.

Very few headphone users worry much about the sound volume when listening to music or a podcast or book, and the natural tendency is to turn up the volume enough to be able to hear what one is listening to. There is no meter on the personal audio device to let one know what the audio output is in decibels. And there is no audio dosimeter installed on most personal audio devices, be they MP3 players or smart phones, to let the user know the time-weighted average sound exposure that day or week from the device. Even if one has this type of dosimeter–several are reportedly in the development stage–they don’t measure all noise exposure, so they may give a false sense of security.

The other quibble with this article, from the UK, is that it uses the UK and EU occupational noise exposure standard of 80 decibels as a safe noise exposure level. The UK standard is technically 80 dBA, which is safer than the 85 dBA standard used in the U.S., but it is not a safe noise exposure level to prevent hearing loss. The only evidence-based safe noise exposure level to prevent hearing loss is a time-weighted average of 70 dB for 24 hours, and even that may be too high.

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.

Reducing Loud Sounds and Noise: A Health Matter

Photo credit: Paul Sableman licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

The Quiet Coalition’s board member and co-founder Arline Bronzaft, PhD, has an important article in the latest issue of The Hearing Journal.

Noise bothers people but it’s more than a nuisance. It is a public health hazard causing auditory disorders, such as hearing loss, tinnitus, hyperacusis, and non-auditory health problems, like hypertension, diabetes, heart disease, stroke, and death.

The scientific data about these problems and the causal nature of the relationships between noise and human disease is overwhelming.

There is always a need for more research, but there can be no rational doubt about the data. And the engineering techniques to make things quieter have been known since the 1960s. Making the world quieter is a political problem, not a scientific problem.

Those of us old enough to remember when restaurants, offices, planes, trains, and buses were filled with unwanted cigarette smoke know that banning smoking in public spaces has made the air we breathe cleaner, with dramatic impacts on health and well-being.

As with smoke, it will be with noise. If enough people complain to enough elected officials, or run for public office on a platform of making the world a quieter place, it can be made quieter, too.

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.