Tinnitus

Another possible treatment for tinnitus

Photo credit: This photo is in the public domain.

by Daniel Fink, MD, Chair, The Quiet Coalition

Tinnitus is “ringing in the ears,” or, more technically, the perception of sound when there is no external auditory stimulus. The current theory is that tinnitus is located in the brain, possibly abnormal electrical patterns, although the exact locus and lesion are not known.

This report from Finland describes the use of trans-cranial magnetic stimulation to treat patients with severe tinnitus. Like most similar reports, it is very preliminary.

Tinnitus has many causes, but the most common cause is noise exposure. This may be via a one-time exposure to loud noise or associated with noise-induced hearing loss caused by chronic noise exposure. In either instance, tinnitus can be prevented by avoiding noise exposure.

While it’s exciting that there is a potentially promising treatment for tinnitus in the offing, I must point out that avoiding the need for treatment is always the better option.

So remember: if it sounds too loud, it is too loud. Protect your hearing.

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.

Zoos learn that some visitors need hearing protection

Photo credit: Dj1997 licensed under CC BY-SA 3.0

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

This story by WLNS.com News looks at Potter Park Zoo in Lansing, Michigan, where ear protection is available to visitors who may be bothered by “sensory overload.”

Sensory overload affects many people, including autistic children and adults, and people with auditory conditions such as tinnitus and hyperacusis.

Kudos to the Lansing Zoo! This is a wonderful idea, and we hope many other zoos and public venues will follow their example.

In addition to serving as vice chair of the The Quiet Coalition, David Sykes chairs several professional organizations in acoustical science: The Acoustics Research Council, American National Standards Institute Committee S12, Workgroup 44, The Rothschild Foundation Task Force on Acoustics, and the FGI Acoustics Working Group—a partner of the American Hospital Association. He is the lead author of “Sound & Vibration 2.0 (2012, Springer-Verlag), a contributor to the National Academy of Engineering report “Technology for a Quieter America,” and to the US-GSA guidance “Sound Matters”, and co-founded the Laboratory for Advanced Research in Acoustics (LARA) at Rensselaer Polytechnic Institute. He recently retired from the board of directors of the American Tinnitus Association. A graduate of the University of California/Berkeley with graduate degrees from Cornell University, he is a frequent organizer of and speaker at professional conferences in the U.S., Europe, Asia, and the Middle East.

What to do if you hear sounds that others do not

Photo credit: bruce mars from Pexels

Finally, David M. Sykes, Vice Chair, The Quiet Coalition, addressed a query from a woman who said she heard a sound in her living space that her partner insists wasn’t there:

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

The Quiet Coalition recently received an inquiry from a woman who said she hears “a nearly imperceptible high-pitched sound” in her living space. She states that she can hear the sound, but her partner insists there is no sound. “Could a smartphone-based sound-meter app isolate and identify this sound?” she asked, adding “if so, which one do you recommend?”

First, I must note that the fact that this woman hears noise but her partner does not means nothing at all. Her partner could simply have much less sensitive hearing!

We at The Quiet Coalition agree that the best step is to try to measure the sound. There are free or inexpensive sound meter apps that you can install on your smartphone, so start there. Some are better than others, but thankfully, experts at the U.S. Centers for Disease Control and Prevention have tested and rated smartphone sound-meter apps, which we reported on last year.

But a smartphone app may not be sensitive enough to pick up the sound. What should you do if this is the case? The only alternative could be to find an acoustics engineer to visit your residence and use professional equipment to identify the noise and then help you identify the source. That person can also suggest some ways to address the problem—which could be a neighbor’s electronics. The National Council of Acoustical Consultants offers advice on how to select a professional, licensed acoustical engineer.

There is, however, another possibility that must be considered: hearing a high-pitched sound that no one else hears COULD mean that you have a hearing disorder called tinnitus or an acute sensitivity to sounds called hyperacusis. Tinnitus can be identified by first finding a truly quiet place, such as a library, or on a weekend retreat in the countryside, to see if you still hear the noise when you are away from the circumstances where you are aware of the sound.

40 million Americans have tinnitus (myself included), so it’s quite common. And many of us spent years assuming that the “background noises” we heard were actually coming from the environment and that everybody heard the same thing!

So we recommend that you pursue both of these steps, because exposure to noise can be stressful, can cause sleep loss, and can have other health effects.
First try to determine where an unseen source of high-pitched sound in your environment is coming from. If the sound cannot be isolated, then consider that the cause of the sound could be tinnitus or another hearing disorder that should be attended to.

Frankly, the best result would be that there really is an unseen source of high-pitched sound in the immediate environment. Why? Because that can be fixed once the source is identified. But tinnitus cannot be cured, though there are techniques for managing it—which include avoiding the kinds of exposures that may have caused it in the first place. And know that the onset of tinnitus can be quite sudden.

To learn more about tinnitus check out the American Tinnitus Association‘s website and the Clinical Practice Guideline for Tinnitus published in 2014 by the American Academy of Otolaryngology–Head & Neck Surgery.

In addition to serving as vice chair of the The Quiet Coalition, David Sykes chairs several professional organizations in acoustical science: The Acoustics Research Council, American National Standards Institute Committee S12, Workgroup 44, The Rothschild Foundation Task Force on Acoustics, and the FGI Acoustics Working Group—a partner of the American Hospital Association. He is the lead author of “Sound & Vibration 2.0 (2012, Springer-Verlag), a contributor to the National Academy of Engineering report “Technology for a Quieter America,” and to the US-GSA guidance “Sound Matters”, and co-founded the Laboratory for Advanced Research in Acoustics (LARA) at Rensselaer Polytechnic Institute. He recently retired from the board of directors of the American Tinnitus Association. A graduate of the University of California/Berkeley with graduate degrees from Cornell University, he is a frequent organizer of and speaker at professional conferences in the U.S., Europe, Asia, and the Middle East.

Consumer Reports tackles tinnitus

Photo credit: Frmir licensed under CC BY-SA 3.0

by Daniel Fink, MD, Chair, The Quiet Coalition

This article by Hallie Levine in Consumer Reports discusses tinnitus. The advice is generally sound, with one exception–the article states that “any noise over 85 decibels can damage hearing.” This isn’t accurate.

The auditory injury threshold is only 75-78 A-weighted decibels (dBA), and 85 dBA is the National Institute for Occupational Safety and Health Recommended Exposure Level for occupational noise, not a safe noise exposure level for the public. I wrote about this in the American Journal of Public Health and the NIOSH Science Blog also covered this topic.

But the basic message is correct: avoid loud noise, protect your hearing, and you won’t develop tinnitus from noise exposure.

And 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.

Hearing noise? Here’s how to find out where it’s coming from

Photo credit: bruce mars from Pexels

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

The Quiet Coalition recently received an inquiry from a woman who said she hears “a nearly imperceptible high-pitched sound” in her living space. She states that she can hear the sound, but her partner insists there is no sound. “Could a smartphone-based sound-meter app isolate and identify this sound?” she asked, adding “if so, which one do you recommend?”

First, I must note that the fact that this woman hears noise but her partner does not means nothing at all. Her partner could simply have much less sensitive hearing!

We at The Quiet Coalition agree that the best step is to try to measure the sound. There are free or inexpensive sound meter apps that you can install on your smartphone, so start there. Some are better than others, but thankfully, experts at the U.S. Centers for Disease Control and Prevention have tested and rated smartphone sound-meter apps, which we reported on last year.

But a smartphone app may not be sensitive enough to pick up the sound. What should you do if this is the case? The only alternative could be to find an acoustics engineer to visit your residence and use professional equipment to identify the noise and then help you identify the source. That person can also suggest some ways to address the problem—which could be a neighbor’s electronics. The National Council of Acoustical Consultants offers advice on how to select a professional, licensed acoustical engineer.

There is, however, another possibility that must be considered: hearing a high-pitched sound that no one else hears COULD mean that you have a hearing disorder called tinnitus or an acute sensitivity to sounds called hyperacusis. Tinnitus can be identified by first finding a truly quiet place, such as a library, or on a weekend retreat in the countryside, to see if you still hear the noise when you are away from the circumstances where you are aware of the sound.

40 million Americans have tinnitus (myself included), so it’s quite common. And many of us spent years assuming that the “background noises” we heard were actually coming from the environment and that everybody heard the same thing!

So we recommend that you pursue both of these steps, because exposure to noise can be stressful, can cause sleep loss, and can have other health effects.
First try to determine where an unseen source of high-pitched sound in your environment is coming from. If the sound cannot be isolated, then consider that the cause of the sound could be tinnitus or another hearing disorder that should be attended to.

Frankly, the best result would be that there really is an unseen source of high-pitched sound in the immediate environment. Why? Because that can be fixed once the source is identified. But tinnitus cannot be cured, though there are techniques for managing it—which include avoiding the kinds of exposures that may have caused it in the first place. And know that the onset of tinnitus can be quite sudden.

To learn more about tinnitus check out the American Tinnitus Association‘s website and the Clinical Practice Guideline for Tinnitus published in 2014 by the American Academy of Otolaryngology–Head & Neck Surgery.

In addition to serving as vice chair of the The Quiet Coalition, David Sykes chairs several professional organizations in acoustical science: The Acoustics Research Council, American National Standards Institute Committee S12, Workgroup 44, The Rothschild Foundation Task Force on Acoustics, and the FGI Acoustics Working Group—a partner of the American Hospital Association. He is the lead author of “Sound & Vibration 2.0 (2012, Springer-Verlag), a contributor to the National Academy of Engineering report “Technology for a Quieter America,” and to the US-GSA guidance “Sound Matters”, and co-founded the Laboratory for Advanced Research in Acoustics (LARA) at Rensselaer Polytechnic Institute. He recently retired from the board of directors of the American Tinnitus Association. A graduate of the University of California/Berkeley with graduate degrees from Cornell University, he is a frequent organizer of and speaker at professional conferences in the U.S., Europe, Asia, and the Middle East.

My 4th Noise Activist Anniversary

by Daniel Fink, MD, Chair, The Quiet Coalition

Anniversaries are special. We celebrate wedding anniversaries. Alcoholics Anonymous celebrates the anniversaries of those who are in recovery. Wounded military veterans celebrate their Alive Day, the day on which they were wounded. And yesterday was my anniversary, the fourth anniversary of my becoming a noise activist.

I developed tinnitus and hyperacusis after a one-time exposure to loud noise in a restaurant on New Year’s Eve, 2007. As midnight approached, they kept turning up the music louder and louder. My wife could tell that the noise was bothering me and suggested that we leave, but I didn’t want to offend our friends who had arranged the dinner. As soon as it was polite to leave, maybe 12:30 a.m., we did. My ears were ringing when we left, and the ringing never stopped.

I also found that noise that didn’t bother others hurt my ears: Movie soundtracks, the grind of a food processor, loud exhausts and sirens, and especially noise in restaurants. I’m a doctor and have always done what I could to stay healthy. But I had no idea that a one-time exposure to loud noise could cause tinnitus and hyperacusis for the rest of my life. When my wife would suggest an evening out, I would ask, “Can’t we eat at home?”

On December 2, 2014, I read an article about hyperacusis in the New York Times science section, written by journalist Joyce Cohen, who has since become a friend. I circled it in red and gave it to my wife, saying, “Honey, this is why I don’t want to go to restaurants any more. They are all too noisy. The noise hurts my ears. Just like it says in this article.” My wife finally understood that while I might have been getting grumpier with age, my dislike of noisy restaurants was caused by an auditory disorder.

So I decided to do something to make the world a quieter place. I reached out via email to the four experts cited in Joyce’s article. One thing led to another, and I ended up serving on the board of the American Tinnitus Association and helping create The Quiet Coalition, where I am the board chair.

I learned that I wasn’t the only person in the world with auditory disorders. Hearing loss, tinnitus, and hyperacusis are all too common. But auditory disorders are invisible, and largely occur in older people, who themselves are largely invisible in our society. Except for congenital deafness, auditory disorders tend to be ignored.

It’s been quite an odyssey. I found that via the internet, I could communicate with experts in various areas of noise, across the country and even around the world. At the urging of one of them, I submitted abstracts to scientific meetings about noise. Those were accepted for presentation, and I spoke at national and international scientific meetings. I have had publications based on my talks appear in peer-reviewed medical and scientific journals, and I have been quoted in articles and have advised national and international health authorities about noise. And I have learned, through the nonprofit Hyperacusis Research, how truly life-limiting noise-induced hearing problems can be. All because I read an article and decided to do something to make the world quieter.

The world is still too noisy, and I still can’t find a quiet restaurant, but apps like iHEARu and SoundPrint are now available.

And as more evidence becomes available about noise as a health and public health hazard, I am confident that an informed public will push legislators and public health officials to eliminate unnecessary 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.

Tinnitus and what to do about it

Photo credit: erik forsberg licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

I think the title of this report from the Harvard Medical School is misleading. I have tinnitus so part of my response is a personal one. To me, the most important sentence in the report is this: “There are no FDA approved treatments for tinnitus.” That means that none of the many proposed treatments for tinnitus–from a variety of vitamins and drugs, to various auditory training programs–has been demonstrated to be safe and effective, the FDA’s standard for approval. Cognitive behavior therapy may improve the ability to accept or deal with a constant ringing in the ears, but it doesn’t change the underlying symptoms.

It can be difficult to live with a constant ringing in the ears. I haven’t tried any of these unapproved treatments because I believe in evidence-based medicine, both for patients and for myself. Also, I am fortunate–my tinnitus is relatively low volume, and the only time it really bothers me is when I wake at night and it’s loud enough to cause difficulty in falling back to sleep–but the symptoms can be so bad that people commit suicide because of them. I suppose that if my symptoms were worse, I might be willing to try some of the treatments mentioned. And I would add that I know people who have had success using some of them.

Perhaps most significantly, the report neglects to mention three important facts:

1. The overwhelming cause of tinnitus is noise exposure, not the many other possible causes listed in the report. I haven’t been able to find a percentage, but my estimate is at least 80% and probably 90 or 95%.

2. The article implies that temporary tinnitus after noise exposure is a normal thing. No, temporary tinnitus indicates that one has been exposed to too loud noise, and that auditory damage has occurred.

3. Avoiding loud noise exposure will most likely prevent tinnitus from ever developing.

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.

Noise kills

Photo credit: Pete G licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

Most people, including most doctors, don’t know that noise causes both hearing damage–hearing loss, tinnitus and hyperacusis–as well as a whole host of non-auditory health problems, including hypertension, diabetes, obesity, heart attack, stroke, and death.

These non-auditory health effects are discussed in this article that reviews the current literature.

The European Union understands the dangers that noise exposure poses, and it is taking steps to protect the public via the Environmental Noise Directive.

If enough Americans make sure their elected representatives know that they are worried about how noise affects us, maybe the U.S. will become quieter and healthier, 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.

Justice prevails: Federal court rules sound cannon can be excessive police force

Alex Pasternack, Fast Company, reports on a recent U.S. Court of Appeals for the 2nd Circuit decision that ruled “[a] powerful speaker that’s capable of causing hearing damage and is used by a growing number of police around the world isn’t merely a ‘communication device’ but, potentially, an instrument of excessive force.” The court was addressing the appeals of two New York City police officers who were seeking qualified immunity in a lawsuit that accused “them of using unconstitutionally excessive force when they deployed a Long Range Acoustic Device (LRAD) at a Black Lives Matter protest in 2014.”

The 2nd circuit affirmed a decision last June in which District Court Judge Robert Sweet, of the southern district of New York, ruled that the sound emitted by a long-range acoustic device (LRAD) used by the New York City Police Department to order protestors onto sidewalks “could be considered a form of force.”

Chief Judge Robert Katzmann, writiing for the 2nd circuit, found that “purposely using an LRAD in a way that can cause serious injury in order to move non-violent protesters violates the Fourteenth Amendment.” Judge Katzmann added that, “this Court’s longstanding test for excessive force claims teaches that force must be necessary and proportionate to the circumstances … [T]he problem posed by protesters in the street did not justify the use of force, much less force capable of causing serious injury, such as hearing loss.”

It is never acceptable for any police force to use sound cannons against non-violent protestors. Period.

How a YouTube-inspired prank ruined a young girl’s life

 

photo credit: Edvvc licensed under CC BY-SA 3.0

Laurie Redmond writes about how a stupid prank by YouTube “trickster” Rick Lax inspired a miscreant to copy a video the aptly named Lax posted of his “prankster pal,” Ryan Hamilton, blasting his girlfriend with an air horn to get her to put down her phone.  Redmond notes that the video “entitled ‘How to get your girlfriend to put her phone down,’ has an astounding 246m views.” Sadly, one of the viewers was her 12-year old daughter Cindy’s friend’s ex-stepfather, who decided to play the prank on Cindy.

But after this miscreant played his prank, things fell apart for Cindy who eventually was diagnosed with “hyperacusis, or noise-induced pain.” As a result of this “prank,” Cindy has a “burning pain in her ears all the time…[and] [w]ith all noise louder than ordinary conversation, she feels like she is being stabbed in the ear. Her ears ring.”

Redmond has since learned that another “YouTube prankster, an F-list celebrity named Jake Paul, was sued for wrecking someone’s ears with an air horn.”  And yet the air horn “prank” videos remain on YouTube and Facebook, even though they “recently removed Tide Pod challenge videos so as not to encourage dangerous stunts.” Redmond asks what it will take to have these dangerously stupid and vile videos off of social media.  We would suggest litigation might do the trick, while recognizing how terrible things are when the only option is litigation.