Tinnitus

“Baby Driver” highlights the problems of tinnitus

Photo credit: leadfoot licensed under CC BY 2.0

Daniel Fink, MD, Chair, The Quiet Coalition

I am not a moviegoer although my wife would say I am a movie critic, but I can’t comment on the new movie “Baby Driver” because I haven’t seen it. What I can say, based on movie reviews and this online article, is that the lead character has tinnitus from head trauma in a motor vehicle crash, and he plays music constantly to mask it.

Although there are many causes of tinnitus, the most common cause is noise, with a strong correlation between noise-induced hearing loss and tinnitus. Most people with tinnitus have at least some hearing loss, and half of people with hearing loss have tinnitus.

So, movie conventions aside, what’s the best way to avoid developing tinnitus? It’s simple–avoid loud noise and wear hearing protection if you can’t.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He serves on the board of the American Tinnitus Association, is the interim chair of Quiet Communities’s Health Advisory Council, and 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.

 

Quiet motorcycles? Tell your neighbor to buy one of these…

Photo credit: Jan Ainali licensed under CC BY 3.0

By David Sykes, Vice Chair, and Jamie Banks, Program Director, The Quiet Coalition

You may be thinking, “quiet motorcycles…how is that possible?” In fact, they already exist—but you might have trouble getting a Harley-riding neighbor to embrace them. For many bikers, noise equals power. But in the case of electric motorcycles there is reason to believe that quiet is powerful too!

Lithium ion battery-powered motorcycles are gaining favor–Consumer Reports is impressed with them. Furthermore, the Department of Defense’s Advanced Research Projects Agency (DARPA) has been working on camo-painted, “stealth” hybrid gas/electric off-road motorbikes.

Motorcycle noise is a serious problem—especially for people who suffer from auditory disorders like partial hearing loss, tinnitus, hyperacusis, and misophonia–for whom the racket from motorcycles can be excruciatingly painful. This may be bikers themselves or people who live in neighborhoods that are regularly exposed to this type of noise. Several years ago, the U.S. National Academy of Engineering (NAE) convened a meeting about the problem of motorcycle noise and issued a report in 2014, though it seems to have fallen on deaf ears outside the NAE.

The noise has become such a problem in so many communities that even Harley-Davidson’s CEO has spoken out about Hog riders who remove their factory mufflers and install ‘straight pipes.’ Officially, the company doesn’t approve of owners tampering with the factory-installed mufflers, but after-market manufacturers are all-too-willing to meet consumer demand for more noise. The best news is that Harley-Davidson is developing an electric-powered motorcycle too.

Motorcycle noise may be a problem that regulation simply cannot fix. Given the current situation, it is unlikely the Environmental Protection Agency will be able to do anything about it. Instead, The Quiet Coalition (TQC) recommends framing motorcycle noise as a public health issue and encouraging a positive, technology-centered approach by businesses:

  • Become familiar with the large body of scientific literature indicating that loud noise is a public health problem. Authorities, including the U.S. Centers for Disease Control, publicize this information on their websites. Like tobacco smoke a generation ago, it will be necessary to engage public health officials before the motorcycle noise be addressed.
  • Urge individuals and groups that oppose motorcycle noise to encourage businesses to develop quieter, electric-powered alternatives. They are cheaper to operate (solar power is getting cheaper by the minute!) and much easier to maintain or repair (fewer moving parts!).

We believe these two steps are the best, most practical way to get action on this contentious issue and can actually lead to results. For example, The Quiet Coalition’s host, non-profit Quiet Communities, has been helping communities make the quiet transition away from fossil-fuel powered devices (namely landscape maintenance equipment) and towards advanced electric equipment and manual tools and emphasizing the compelling business model for users: the new lithium-ion-powered alternatives are cheaper to operate and maintain, they reduce air pollution, and they operate quietly. For some bikers, adopting technologically advanced, non-polluting, quiet alternatives may be appealing, especially if they have had health and hearing problems related to noisy bikes. It would be the start of a movement.

At TQC, we’re cautiously optimistic.

David Sykes chairs/co-chairs four national professional groups in acoustical science: The Acoustics Research Council, ANSI S12 WG44, The Rothschild Foundation Task Force on Acoustics, and the FGI Acoustics Working Group. He is also a board member of the American Tinnitus Association, co-founder of the Laboratory for Advanced Research in Acoustics (LARA) at Rensselaer Polytechnic Institute, lead author of “Sound & Vibration 2.0 (2012, Springer-Verlag), and a contributor to “Technology for a Quieter America” (2011, National Academy of Engineering). 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.

Jamie Banks, PhD, MSc, is the Executive Director of Quiet Communities, Inc.. She is an environmentalist and health care scientist dedicated to promoting clean, healthy, quiet, and sustainable landscape maintenance, construction, and agricultural practices.

Millions of people don’t protect their ears

Photo credit: Quinn Dombrowski licensed under CC BY-SA 2.0

By Daniel Fink, MD

Noise is a medical and public health problem, and yet people ignore it at their own peril. Most of us are exposed to too much noise every day. That may explain why the Centers for Disease Control and Prevention found that about 25% of adults age 20-69 had hearing loss, and that many people with hearing loss didn’t know they had it.

Which is why a recent article by Mark Fischetti in Scientific American,A Loud Warning: Millions of People Do Not Protect Their Ears,” is particularly disturbing. Fischetti reports that while “many people know that they should use earplugs or earmuffs when mowing the lawn or partying at the club,” they don’t protect their ears against noise at home or at work. If you click the link to the article, you’ll see a frightening infographic that very clearly shows that millions of Americans are at risk of losing their hearing or suffering other hearing damage because they fail to protect their ears.

Maybe if people knew that noise caused hearing loss, tinnitus, and hyperacusis–none of which can be cured–they might be motivated to protect their hearing and fight for quiet.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area.  He serves on the board of the American Tinnitus Association, is the interim chair of Quiet Communities’s Health Advisory Council, and 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.

Can teens get tinnitus?

The answer, sadly, is yes. Emily Barker, writing for Redbrick, tells us about how she developed tinnitus from a one-time exposure to loud sound at a night club when she was 19-years-old. Barker says that she “never had any trouble with nights out being too loud, never had any pain or discomfort from loud music.” But after spending the evening at the club, and after she and her friends went back to the hostel they were staying at, she noticed that her ears “were ringing like crazy,” and she remembered “laughing about it with my friends because they were having the same issue and we were unintentionally shouting at each other from across the room.”

The laughter stopped the next day when Barker found that her ears were still ringing even as her friends’ ears had recovered. A couple of months later, she got confirmation that her hearing had been permanently damaged and she had tinnitus. She also was diagnosed with hyperacusis, a sensitivity to sound, so that “[a]pplause, doors or cupboards slamming, and things being dropped on hard floors are all sounds that [she] now find[s] extremely painful.”

Barker writes about the frustration of having developed tinnitus while everyone else she knew at the event did not, particularly since there was no family history of tinnitus. All she was told was that “sensitivity to noise is thought to be partly hereditary,” so her doctor theorized that she was “just an ‘at risk’ person.”

Barker concludes her piece with a warning to other teenagers and young adults, by listing myths about tinnitus, including, most importantly, the belief that you can’t get it from one night of clubbing. As she points out:

This is still the hardest thing for me to accept; it’s difficult to understand how just a few hours that caused me no distress or pain at the time can have had such a permanent impact. But the hairs in your inner ear can be destroyed by mere seconds of noise if it’s loud enough, and they cannot regrow: ergo, no cure.

Click the link to read the whole thing, and forward it to a teenager you know.  Hey, they might actually read it.

On hearing loss and the hope for a cure

In “High-Tech Hope for the Hard of Hearing,” David Owen, The New Yorker, has written an article that gives us a good look at what scientists know about hearing loss and where they are finding possibilities for treatment and, possibly, a cure. He begins his article with a series of personal anecdotes about himself, his family, and friends and the hearing problems they’ve developed due to exposure to loud noise and other factors. Owen’s interest in this story is motivated, at least in part, by his tinnitus, which is marked by a constant high-pitched ringing in his ears.

Among the advances that Owen examines, he discusses the discovery of hidden hearing loss and introduces us to Charles Liberman, who, with his colleague Sharon Kujawa, “solved a mystery that had puzzled some audiologists for years: the fact that two people with identical results on a standard hearing test, called an audiogram, could have markedly different abilities to understand speech, especially against a background of noise.” He writes that “[s]cientists had known for a long time that most hearing impairment involves damage to the synapses and nerve fibres to which hair cells are attached, but they had assumed that the nerve damage followed hair-cell loss, and was a consequence of it.” What Liberman and Kujawa discovered is that “the connections between the sensory cells and the nerve fibres that go first.” And the reason this early damage isn’t picked up by a standard hearing test is because it measures “the ability to detect pure tones along a scale of frequencies [which] requires only functioning hair cells…and is unaffected by nerve damage until more than eighty per cent of the synapses are gone.”

“A disturbing implication of [Liberman and Kujawa’s] finding is that hearing can be damaged at decibel levels and exposure times that have traditionally been considered safe,” writes Owen, but he is reassured by the researchers that the discovery of hidden hearing loss is cause for optimism. Why? “[B]ecause reconnecting nerve synapses is almost certain to be easier than regenerating functioning hair cells inside human ears.” In fact, Owen tells us that Liberman and others “have successfully restored some damaged connections in lab animals, and [Liberman] believes that far greater advances are to come.”

While cause for optimism is welcome, Owen notes something early in his article that is particularly frustrating to those advocating for regulation of noise:

There are also increasingly effective methods of preventing damage in the first place, and of compensating for it once it’s occurred. The natural human tendency, though, is to do nothing and hope for the best, usually while pretending that nothing is wrong.

Click the link above to read this interesting and hopeful article in full.

 

 

Despite complaints, restaurant noise continues unabated

by Daniel Fink, MD

Ever since I developed tinnitus and hyperacusis from a one-time exposure to loud restaurant noise, I have been looking for a quiet restaurant (see the Acknowledgements section at the end of my editorial in the January 2017 American Journal of Public Health, “What Is a Safe Noise Level for the Public?“).

It turns out I’m not the only one complaining about restaurant noise.

Restaurant noise is the number one complaint of diners in New York, San Francisco, Portland OR, and Boston.  In fact, the Boston Globe just recently wrote about diners’ dislike of restaurant noise in a piece titled, “Listen up: Restaurants are too loud!

Restaurant owners may think that noise increases food and beverage sales, and decreases time spent at the table, and they are right.  But what they cannot measure is how many meals are lost because people like me don’t go to noisy restaurants with family or friends, choosing to dine at home, instead, where we can converse as we enjoy our meal. Perhaps restauranteurs should consider that we middle-aged folks are more likely to spend money in restaurants than other demographic groups.  After all, for many of us our kids are done with college, our mortgages are paid off, we’ve been saving for retirement, and we have the disposable income to enjoy a nice meal out more frequently than in our youth.  If there were quieter restaurants, we might dine out more often instead of avoiding them because we would rather not have a side of hearing loss with our steak frites.

I guess that as long as the restaurants are busy, they will stay noisy. But if enough of us speak up–in the restaurants and to our elected representatives, asking them to pass laws requiring some limits on indoor noise–restaurants will eventually get quieter.

Dr. Fink is a leading noise activist based in the Los Angeles area.  He serves on the board of the American Tinnitus Association, is the interim chair of Quiet Communities’s Health Advisory Council, and 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.

Age doesn’t matter,

you could have hidden hearing loss (and not know it). WMAR Baltimore reports on hidden hearing loss, a relatively recently discovered hearing breakthrough that explains how people who pass hearing tests have problems hearing in noisy environments.  WMAR interviewed audiologists about this breakthrough, who said that “why patients can’t decipher speech in noisy situations has been unexplained, but a new breakthrough is changing that.”  The researchers who made the hidden hearing loss breakthrough studied young adults who were regularly overexposed to loud sounds, and found that “hidden hearing loss is associated with a deep disorder in the auditory system.”

It’s never too late to protect the hearing you have.  Exposure to loud sounds damages hearing.  Period.

 

Why is Big Pharm focusing on new treatments for hearing loss and other auditory disorders?

Because they smell money, of course.  And because they sniff a potentially big money-making opportunity, the pharmaceutical industry is racing to find treatments for a host of auditory disorders.  It’s a shame there’s no money in prevention, because noise-induced hearing loss and most cases of tinnitus and hyperacusis are 100% preventable.  So if you don’t have hearing loss, tinnitus, or hyperacusis yet, save yourself some cash and limit your exposure to noise now.  Or try your luck and hope that at least one pharmaceutical company finds a cure before you experience symptoms.

 

 

One simple accommodation to help those with hearing disabilities:

Dr. Daniel Fink, a leading noise activist, responds to New York Times’s article, “Becoming Disabled,” by offering a simple, effective, and no-cost accommodation to assist those with hearing loss, tinnitus, and hyperacusis: turn down the volume of the amplified sound!  As Dr. Fink points out, “[d]isability accommodations benefit everyone, not just those with disabilities.”  Turning down the volume in places of public accommodation will make them more accessible to those with hearing disabilities, provide a quieter environment for everyone present, and could, in fact, protect those not afflicted from joining the ranks of people with hearing injury.

Dr. Fink encourages anyone with a hearing disability whose request for accommodation was ignored to file a complaint with the local agency charged with protecting the rights of the disabled.  In New York City residents can file a complaint with the Commission on Human Rights.