Public health

Can noise exposure influence the risk of dementia?

Photo credit: Oleg Magni from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

Can noise exposure influence late-life cognition and the risk of developing dementia? That the answer might be “Yes” is suggested by a study in the latest issue of the medical journal Alzheimer’s & Dementia, the journal of the Alzheimer’s Association. I have read the article, although only the abstract is available at the link.

Researchers analyzed data collected from the Chicago Health and Aging Project, looking at 5,227 participants in the study. Noise exposure levels were estimated using accepted modeling techniques, and cognitive performance was measured using standardized tests. The populations in the four quartiles of noise exposure were largely similar in terms of ethnicity, socioeconomic status, smoking, alcohol consumption, physical activity, and body mass index.

Noise exposure level was correlated with mild cognitive impairment and Alzheimer’s disease. An increment of 10 A-weighed decibels* in noise corresponded to 36% higher odds of mild cognitive impairment and 29% higher odds of a diagnosis of Alzheimer’s disease.

It is important to note that this is among the first studies of community noise and cognitive decline, the first such study done in the United States, and perhaps most importantly, that correlation does not mean causation.

But as the authors note, there are animal studies showing brain changes with noise exposure, and as I have noted many times, there is no evidence that unwanted noise exposure has any beneficial effects on humans or animals.

*A-weighting adjusts the frequencies in sound to match those 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.

What I did during the COVID-19 lockdown (and before and after)

Photo credit: Bidvine from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

When I was in elementary school, a common assignment during the first days or weeks of school was to write an essay on the topic, “What I did during summer vacation.” I don’t know if schoolchildren today will be asked to write essays about “What I did during the COVID-19 lockdown” when they return to school in person, but this is my report, with a nod to October’s being National Protect Your Hearing Month.

What did I do during my abundant free time during lockdown? When I wasn’t working on noise activities I worked home-improvement or repair projects at our home, with a major project at my in-laws’ home as well. I won’t bore you with the entire list, but it includes:

  • Removing shelving and flooring from two large closets, patching the walls, repainting them, and installing new shelves and flooring.
  • Removing carpet from one room, patching the walls, repainting the walls, and installing new flooring.
  • Removing a warmer drawer in the kitchen, modifying the cabinet to fit the new warmer drawer, refinishing that side of the kitchen island, and installing the new warmer drawer.
  • Removing a trash compactor, finishing the inside of the cabinet, and installing the new trash compactor.
  • Cutting out wood rot in an exterior door frame, installing a new piece of wood, patching and filling the repair, sanding it smooth, and repainting the door frame.
  • Repainting the interior and exterior of the front door and the windows surrounding it.
  • Removing six exterior lights in front of the house and installing new exterior light fixtures.
  • Removing old water feeds for all toilets and sinks and replacing them with new shutoff valves and braided stainless steel water feeds.
  • Repaired the washing machine and replacing a leaking hose.
  • Reconstructing a large trellis at my in-laws’ house.

What’s the connection to National Protect Your Hearing Month? Every project was noisy. Demolition work is noisy. Power tools are noisy. And many hand tools, perhaps with the exception of a pliers or screwdriver, are noisy when used. Among the power tools used were a circular saw, a sliding compound miter saw, hand saws, drills, a nut driver, a hammer drill, a multitool, two different reciprocating saws, and a quarter-sheet sander. Hand tools included hammers, pry bars, crowbars, screwdrivers, chisels, scrapers, paint brushes and rollers, etc. Painting is quiet and plumbing is quiet, but all the other tasks were noisy. The only time I didn’t have my earplugs in was when I was painting or using pliers, a wrench, or a screwdriver.

And that’s my advice to you: If like many other Americans you’re doing repair and home improvement projects during the COVID-19 lockdownHome improvement projects are underway during COVID-19 please protect your hearing!

There is no such thing as temporary auditory damage, and the cumulative effect of loud noise will eventually cause hearing loss.

So even if you’re hammering in only one nail or cutting one board with your circular saw, wear hearing protection.

That’s my advice before, during, and after October, National Protect Your Hearing Month.

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 deploys noise cameras to combat “antisocial supercar drivers”

Photo credit: Adrian Dorobantu from Pexels

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

The BBC reports that “[m]ore than a hundred people have been threatened with fines after London’s first noise cameras were set up to combat antisocial supercar drivers.”  Drivers who have been using Knightsbridge streets as racetracks will first receive warnings but second offenses will carry fines. The cameras identify cars exceeding a threshold of 74 decibels, and fines are imposed ranging from $130 to $3,230 (U.S. equivalent of pounds noted in article)–persistent offenders may have their vehicles taken. It should be noted that the Council member of Transport recognized that most drivers are considerate.

In an earlier post, I wrote about a group in Washington Heights and Inwood who has set up a task force to address the increase in noise levels in the community, including noise from drag racing. I have also spoken with other groups in New York City and Westchester that have noted an uptick in noisy vehicles racing down their streets. These groups, as well as many other New Yorkers, would welcome legislation calling for noise cameras on their streets to combat noise that is increasing and detrimental to their health and well-being.

New York bill S.B. 9009, introduced by State Senator Andrew Gounardes, would increase fines for loud car and motorcycle exhaust systems and mufflers. This law would require police vehicles to be equipped with decibel meters to measure the sounds of passing vehicles and would issue violations in excess of decibel limits set by the law. The current law sets a fine of a maximum of $150 for after-market violations but this bill would increase the maximum fine to $1,000. Also, under the current law police officers are to determine whether noise is excessive, but under the proposed bill police officers would be equipped with decibel meters to measure the actual sound levels.

State Senator Gournades’ legislation clearly indicates an awareness of the hazards to health brought about by loud vehicle equipment as well as a desire to remedy this problem. But enforcement of legislation is key and enforcement of noise regulations often falls seriously short as underscored by New York State Comptroller DiNapoli’s 2018 report regarding the New York City’s Noise Code. I would suggest that New York State legislators look into the UK program and consider a pilot project to identify loud vehicles by cameras which might make enforcement easier, and, more importantly, curb a dreadful noise pollutant.

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.

Could wearing a mask protect your hearing?

Photo credit: Anna Shvets from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

COVID-19 (technically SARS-CoV-2) is a novel coronavirus first detected less than a year ago. Because it is new, no one has immunity to it, leading to a worldwide pandemic. And also because it is new, physicians, public health experts, virologists, and many others have much to learn about it.

Two recent articles add to this knowledge.

One, in JAMA Otolaryngology-Head and Neck Surgery, reports that COVID-19 was isolated from mastoid bone and middle ear tissue. The other, in BMJ Case Reports, described a case of sudden irreversible hearing loss ascribed to COVID-19 infection.

It is well known that respiratory viruses can affect the middle and inner ear. Now we know this is also true for COVID-19.

Could wearing a mask to protect yourself and others from COVID-19 also protect your hearing?

Based on these two articles, I think the answer is, “Yes.”

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.

An international perspective on National Protect Your Hearing Month

by Daniel Fink, MD, Chair, The Quiet Coalition

As I recently wrote, October is National Protect Your Hearing Month. In that blog post, I noted that hearing loss with age is not part of normal physiological aging but in the U.S. largely represents noise-induced hearing loss. That is also likely true in other major industrialized countries, e.g., those of the European Union and the UK.

An international perspective on the importance of hearing protection is provided by the Global Burden of Disease report recently published in the British medical journal, The Lancet.

As NPR reported, “the key to health … is wealth. (And education … and women’s rights),” with the latter two factors assuming much greater importance in developing nations. Additionally, as infectious diseases and starvation become smaller relative problems as national incomes improve, non-communicable diseases such as obesity, hypertension, diabetes, and cancer become more important. Ironically, in many cases these “diseases of civilization” are specifically caused by improvements in daily living and dietary intake.

The analysis was coordinated by the Institute for Health Metrics and Evaluation in Seattle, which recently has received notice because of its coronavirus predictions for the U.S. One of the measures examined was the “healthy life expectancy,” abbreviated HALE. Another was Disability-Adjusted Life Years, or DALYs.

Sadly, when it comes to hearing, the IMHE and The Lancet’s editors still use the term “age-related hearing loss,” which wrongly implies that hearing loss is part of normal aging. As people live longer, hearing loss becomes a greater problem in all societies, including developing ones.

As shown in the Table in The Lancet article, DALYs from hearing loss increased for all populations, and especially for adult populations, since 1990.

This is a shame. Noise-induced hearing loss is entirely preventable, and no country, not even wealthy countries such as the U.S. or Switzerland, can afford to provide hearing aids to everyone who could benefit from them. Moreover, preventing noise-induced hearing loss is simple: avoid loud noise or use hearing protection if one can’t.

Because if it sounds loud, it is too loud and one’s auditory health is at risk.

This is true in the U.S. and in every country in the world during October, National Protect Your Hearing Month.

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.

October is National Protect Your Hearing Month

by Daniel Fink, MD, Chair, The Quiet Coalition

October is National Protect Your Hearing Month!

As I have noted before, I’m not a big believer in special months or days to celebrate or honor or remind us of people or things that should be celebrated or honored or observed every day, but the special days and months may serve as a useful reminder of the people or things. Hearing protection is one of those things that should be observed every day.

Hearing loss represents the cumulative impact of a lifetime of noise exposure, just as skin discoloration, deep wrinkles, and skin cancers represent the cumulative impact of a lifetime of sun exposure.

The basics of hearing protection are very easy:

  1. Avoid noise exposure, or wear hearing protection (ear plugs or ear muffs) if you can’t.
  2. The only evidence-based noise exposure level to prevent hearing loss is a daily average of 75 decibels.
  3. If a noise sounds loud, it is too loud and your hearing is at risk.

I would add a caveat and some scientific information to support my three points.

The caveat: The commonly cited 85 decibel noise level is not a safe noise exposure level for the public, but an occupational noise exposure level that doesn’t protect all exposed workers from hearing loss. Don’t believe the National Institute on Deafness and Other Communication Disorders or misinformed audiologists when they promulgate dangerous misinformation with statements like, “[l]ong or repeated exposure to sounds at or above 85 dBA can cause hearing loss (dBA means A-weighted decibels. A-weighting adjusts sound measurements for the frequencies heard in human speech.) Auditory damage probably begins at sound exposure levels far below 85 decibels, and after only one hour of exposure to 85 decibel sound it’s impossible to achieve the safe daily average of 70 decibels for 24 hours.

The science: A literature review, now confirmed by research published this year, demonstrates that there is no such thing as age-related hearing loss. Hearing loss is not part of normal aging but largely represents noise-induced hearing loss.

More science: Noise exposure in daily life is loud enough to cause hearing loss. A 2017 CDC study showed that about 25% of American adults age 20-69 had noise-induced hearing loss, many without significant occupational exposure to noise.

Your ears are like your knees–you only have two of them. So protect them, because unlike your knees, your ears can’t be replaced.

Protect your ears and protect your hearing during National Protect Your Hearing Month, and during every month!

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.

COVID-19 and the city soundscape

Photo credit: Craig Adderley from Pexels

by Daniel Fink, MD, Chair, and David M. Sykes, Vice Chair, The Quiet Coalition

The Quiet Coalition’s Arline Bronzaft, PhD, wrote a very nice essay about COVID-19 and the city soundscape, which was published in New York City’s Our Town, the local paper for the Upper East Side neighborhood of Manhattan.

Dr. Arline Bronzaft is known and published worldwide for her expertise and teaching on community noise. But noise is personal too, a cause. So she’s never lost sight of its impact on her own home town, New York City, where she has been an adviser to five mayors. Nor the effect it has on her own neighbors on the upper east side of Manhattan, even during the recent COVID lockdown that brought life to a standstill an an eery quiet punctuated only by the frightening sounds of ambulance and police sirens at any hour of the day or night.

In her essay, Dr. Bronzaft notes that sound and noise received a great deal of attention during the first months of the coronavirus pandemic. In the absence of the usual hustle and bustle of noisy New York City, she writes:

There was talk about hearing and seeing more birds; not being awakened by overhead jets in the early morning hours; not being subjected to loud construction noises; and no music from nearby bars. However, an increase in loud ambulance sirens disturbed our ears and upset our minds because this meant more people were likely suffering from COVID-19.

She goes on to discuss possible future outcomes as urban activities return to normal, and expresses the hope that everyone–including city officials–will remember, when normality returns, what this period of calm and quiet was like.

Dr. Bronzaft’s piece dovetails very nicely with an editorial by Dr. Antonella Radicchi in a special issue of Cities & Health about sound and the healthy city.

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.

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.

Sound and the healthy city

Image © Marcus Grant 2018

by Daniel Fink, MD, Chair, The Quiet Coalition

This wonderful and thought-provoking editorial from Antonella Radicchi and colleagues appears in the special issue of Cities & Health about sound and the healthy city. Dr. Radicchi was the lead guest editor for this issue and the Quiet Coalition acts as special issue partner.

One of the many things I was reminded of reading the editorial is that although urban noise has serious and well-recognized health consequences, a broader perspective on the urban soundscape is needed.

Perhaps my single-minded focus on decibel levels is misplaced? After all, I like the sounds of birdsong or fountains or many street entertainers just as much as anyone else.

As Dr. Radicchi and her colleagues write:

We hope that through a soundscape approach we can encourage fresh thinking about urban sound, including how people perceive and relate to their sonic environments, and show how sound can contribute to health. We believe that this approach can provide a collaborative platform for sound artists, sound technologists, urbanists and local people to work together with public health and create healthier urban environments.

They certainly encouraged some fresh thinking and self reflection for me!

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.

Community to vote on noise control cost

Photo credit: Andy Nystrom licensed under CC BY-NC-ND 2.0

by Jan L. Mayes, MSc, Audiologist

What happens when citizens want highway noise control but the financial cost is high? The Canadian community of Beaconsfield, Quebec is facing skyrocketing noise control estimates for a long awaited concrete sound barrier. Since the need was identified in 2010, cost estimates have risen from $25.5 million to $46 million putting the entire project at risk.

Beaconsfield’s sound energy is above World Health Organization noise limits recommended to prevent health damage in pregnant women, newborns to teens, elders, and other groups-at-risk. This doesn’t mean the noise control budget should be unlimited. But a $46 million sound barrier may not be the only solution. Modern options include different sound barrier designs, lower speed limits, quiet asphalt, and greenscaping between residences and the highway. There are new technology sound barriers designed to cut noise and chemical air pollution that are as effective as other barrier styles, and might be less expensive.

While there is no doubt this highway noise is a public health risk, authorities have decided to let community members vote on whether to pay for noise control or not. This will pit resident against resident, leaving the outcome in the control of many people who don’t live near the highway.

If this was a contaminated water supply, there would be no vote on whether to pay what is needed to protect public health. Unfortunately, noise isn’t treated with the same seriousness even though exposure is linked to communication breakdowns, reading delays, and increased risk of impaired health like anxiety, depression, heart disease, Type 2 diabetes, obesity, hearing loss, and dementia.

One of the root causes of this Canadian noise control problem is lack of community planning. Highways and infrastructure were built and expanded too close to homes, schools, playgrounds, and parks. Now there is a $46 million price tag to fix the problem.

In the U.S., the Quiet Community Act of 2019 would include limiting vehicle source noise emissions and better infrastructure planning to prevent community noise. This Act needs senate funding at a cost of $21 million a year. Experts estimate for every $1 spent on noise control, there will be an estimated $1.29 in future savings by eliminating preventable diseases and other adverse social effects of noise.

When it comes time to vote, one hopes the community in Quebec will vote so everyone has equal health protection from harmful noise no matter where they live. When it comes time to vote in the U.S., one hopes citizens will vote for senators who support funding the Quiet Community Act. Prevention will improve public health equality and cost less than noise control after the fact.

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.

 

Birds changed their tune during the Covid lockdown

Photo credit: Paul Knittel from Pexels

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

In several blogs I have written recently, I commented that the pandemic’s effect on the soundscape did not just impact humans but other species as well, e.g. birds, whales. A recent article on a study of birds in San Francisco found that birds started singing differently during the silence of the COVID-19 Lockdown, noting that male white-crowned sparrows in San Francisco have begun to sing more softly and with an improved vocal range. The article says this change in singing may make them “sexier to females.”

The article cites a paper that has studied how animals, including whales and birds, have changed their behaviors during the pandemic shutdown. Before the pandemic, cities characterized by loud noises, especially from traffic, forced birds to sing louder to be heard by other birds. The authors reached this finding by comparing birdsong data collected previous years at the same sites they collected data during April and May 2020. Their data allowed them to conclude that birds “can adapt to changing environments.”

Erik Stokstad, writing for Science, states that birdsong “recaptured its former glory,” referring to the white-crowned sparrows of San Francisco. He adds that when birds sing louder in noisy environments the stress created “can speed aging and disrupt their metabolisms.” With the noise also preventing birds from hearing their own chicks, there is the possibility that bird diversity is less in many cities. Furthermore, by demonstrating that some birds can adjust their songs to their environment, it might be that birds who could not adjust, and as a result left noisier cities, might return to places that are now quieter. But the quieter time of the pandemic has passed as cities have been returning to noisier times. Thus, the birds that have quieted down will very likely have to increase the volume of their songs. Also, may I add, that it is unlikely the birds who left will return.

Stokstad interviewed Elizabeth Danberry and her behavioral ecologists who have studied white-crowned sparrows in and around San Francisco for more than twenty years. Their research has clearly demonstrated the impact of noise pollution on the health and well-being of these sparrows. Similarly, long standing research has also clearly found that noise is hazardous to human hearing, health, and well-being. So I ask, how much more research do we need linking noise to adverse effects on humans and other species before we begin to lower decibel level in our environment?

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.