Tag Archive: American Tinnitus Association

It’s Tinnitus Awareness Week

Photo credit: Frmir licensed under CC BY-SA 3.0

by Daniel Fink, MD, Chair, The Quiet Coalition

As described on this link, it’s Tinnitus Awareness Week from February 5-11, 2018.

Tinnitus is commonly called ringing in the ears, although technically it is the perception of sound when there is no external sound source. Noise exposure–either chronic or a one-time exposure to loud noise–is the most common cause of tinnitus, although there are many other causes.

The American Tinnitus Association has lots of information available on its website. I serve on ATA’s board and have tinnitus myself.

If you have tinnitus, the most important things to know are that help is available–check the ATA website–and that you should protect your ears from noise to keep your tinnitus from getting worse.

And if you don’t have tinnitus, protect your ears from noise so you don’t ever develop it.

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.

Declining prevalence of hearing loss in U.S.? What do the data really show?

by Daniel Fink, MD

On December 16, 2016, an article appeared in the New York Times, Americans’ Hearing Loss Decreases Even With Ubiquitous Headphones, which focused on a study by Howard J. Hoffman, MA, et al. (Hoffman) that appeared in the respected medical journal JAMA Otolaryngology–Head & Neck Surgery. The study found that there was a declining prevalence of hearing loss in U.S. adults. The results were considered surprising, as the study showed that the rate of hearing loss in adults age 20-69 had decreased from 15.9% to 14.1%. The researchers, epidemiologists, and statisticians at the National Institute for Deafness and Other Communication Disorders, who conducted the study, are among the best in the world, and the data came from the Centers for Disease Control and Prevention’s well-respected National Health and Nutrition Surgery.

The results were considered surprising because two other recent federal reports, one in October 2015 from the President’s Council of Advisors on Science and Technology (PCAST) and the other in June 2016 from the National Academy of Science’s Institute of Medicine (IOM) (since renamed the Health and Medicine Division), emphasized that hearing loss, especially in older Americans, was a major national problem. Both of these reports cited an analysis by Frank Lin, MD PhD, Johns Hopkins University, that showed that 48 million Americans suffered significant hearing loss, with the prevalence increasing sharply with age.

I am personally involved in the question of what the facts are, since in an editorial in the January 2017 issue of the American Journal of Public Health I write about the inappropriate use of the 85 decibel occupational noise exposure standard, which should not be applied to the general public, citing Lin’s research and other studies that show increased hearing loss in young people age 12-19.

So, what do the data really show?

I am not an epidemiology expert like Mr. Hoffman and his distinguished co-authors. Their methods appear sound, their data sources as good as one can find in the epidemiology of hearing loss. The first caveat is that this study, as with all studies of the epidemiology of hearing loss in the pubic, is based on survey methodology. A group of 3831 participants are the study population, from which conclusions about the entire U.S. population were drawn. It would be too costly to test hearing in millions of people.

The second caveat is that there are newer techniques, currently only used in research and not yet in clinical use, demonstrating that before hearing loss can be detected by standard hearing tests (called pure tone audiometry), a phenomenon dubbed “hidden hearing loss” may have taken place. Hidden hearing loss has been found in young people and older adults. So while Hoffman’s study is encouraging, it may not be able to completely report what is really happening with Americans’ hearing.

The third point–not a caveat–is that Hoffman et al. studied adults age 20-69 and did not include young people under age 20. Those under age 20 may be the group most at risk of hearing loss due to ubiquitous use of personal music players at loud volumes. Two studies, using lower thresholds for measuring hearing loss than Hoffman et al. or Lin et al. used, found high levels of subclinical hearing loss (hearing loss greater than 15 decibels but less than 25 decibels) in young Americans. One from 1998 found that 15% of young people had measurable hearing loss, and the other from 2010 showed an increase in the prevalence of hearing loss to almost 20%. This is worrisome because studies of auditory acuity in young people traditionally found excellent hearing.

The fourth point also isn’t a caveat, but a quote from the last line of Hoffman’s abstract: “Despite the benefit of delayed onset of HI (hearing impairment), hearing health care needs will increase as the US population grows and ages.”

It’s great news that the percentage of Americans age 20-69 with hearing loss (the epidemiology term for this is “prevalence”) has decreased from 15.9% to 14.1%. But that still means that there are millions of Americans with hearing loss–and that’s too many! Further, subclinical hearing loss appears to be increasing in young Americans, and, as the Hoffman study notes, hearing loss in older Americans is a significant health problem.

Finally, a point of contention: noise exposure is a major cause of hearing loss, and not aging as is implied in the study. Why would men have nearly twice as much hearing impairment (18.6%) as women (9.6%)? Is it an effect of testosterone levels on the auditory system, in which case one might actually expect hearing to improve as men get older, or is it the result of more noise exposure from work and recreational activities in men than women? Noise and hearing loss are still major problems in the U.S. and in the world, and the non-auditory effects of noise on health, which are coming into greater focus, continue unabated. 

So yes, the prevalence of hearing loss in American adults may be declining, but when Lin’s analysis showed that approximately 25% of adults in their 60s, 33% of adults in their 70s, and half of those over age 80 have significant hearing loss–data cited in the PCAST and IOM Committee reports–it is obvious that there is still a major problem and still much to be done to prevent noise-induced hearing loss here and abroad.

And I and others have said before, but it bears repeating: noise-induced hearing loss is 100% preventable. If people avoid noise exposure and protect their ears from noise, they should be able to preserve natural hearing well into old age, rather than needing to rely on assistive hearing devices. The only evidence-based safe noise level remains a 70-decibel time-weighted average for a 24-hour period.

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.

October is National Protect Your Hearing Month

The Centers for Disease Control and Prevention (CDC) has issued an announcement about National Protect Your Hearing Month, stating that it is “a time to raise awareness about the causes and prevention of noise-induced hearing loss.”  Noise-induced hearing loss “can result from occupational noise exposures, leisure activities such as sporting events or concerts, or use of personal listening devices.”  Whatever the cause, it is permanent and irreversible.  More importantly, noise-induced hearing loss is completely preventable.

The CDC notes that noise-induced hearing loss affects people in all age groups. During 2001 to 2008, one in five Americans over the age of 12 years had hearing loss in at least one ear, and one in eight had hearing loss in both ears.  The CDC adds that prevalence of hearing loss is expected to increase.

To learn more about hearing loss and what you can do to avoid it, click the link for access to resources prepared by the CDC and the National Center for Environmental Health, The National Institute for Occupational Safety and Health, and the National Center on Birth Defects and Developmental Disabilities.

Thanks to Daniel Fink, M.D. for the link.  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 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.

A fascinating read about the weaponization of sound:

When Music Is Violence.  Alex Ross, writing for The New Yorker, reports on the use of extremely loud noise in psychological-operations and warfare.  The American public was introduced to this tactic in December, 1989, when the military employed it in Panama, blasting “non-stop music [to] aggravate [Manuel] Noriega into surrendering” after he was expelled from power and took refuge in the Papal Nunciatura in Panama City.  Although the “media delighted in the spectacle”, both “President George H. W. Bush and General Colin Powell, then the chairman of the Joint Chiefs of Staff, took a dim view of it.”  Despite a lack of enthusiasm for weaponized noise at the top of command, the use of loud music as a weapon has increased. “[D]uring the occupation of Iraq the C.I.A. added music to the torture regime known as “enhanced interrogation,” and the tactic has also been used in Guantánamo.

Ross looks at the intersection of music and violence, noting that when “music is applied to warlike ends, we tend to believe that it has been turned against its innocent nature.”  He states, “[s]ound is all the more potent because it is inescapable,” and notes how technological development has led to long-range acoustic devices that “send out shrill, pulsating tones of up to a hundred and forty-nine decibels—enough to cause permanent hearing damage.”  The discussion turns darker as Ross examines the “music sadism” pioneered by the Nazis, and draws the thread to Abu Ghraib, Bagram, Mosul, and Guantánamo, where “the loud-music tactic displays a chilling degree of casual sadism: the choice of songs seems designed to amuse the captors as much as to nauseate the captives.”  And there is more.

Do click the link above.  The article is thought provoking, disturbing, and absolutely worth reading.

Thanks to Daniel Fink, M.D. for the link.  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 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.

A common lament:

Dyckman’s deafening daily drumbeat: A local resident is sick of the noise.

Ann Votaw writes about New Yorker’s number one complaint: noise.   Trying to understand out how to stop the noise in her neighborhood, she contacted Arline Bronzaft, a leading environmental psychologist who advised five mayors on the consequences of noise pollution, who stated that “[n]o other city in the United States is more aware of intrusive sound than New York.”  Ms. Bronzaft lauded the city’s 311 system, the Department of Environmental Protection, and the police department “for their dedication to the New York City Noise Code,” she acknowledged that 311 was effective at collecting metrics but was unsure of “how the system executes solutions leading to relief.”

New York City’s Noise Code and 311 system are good steps in combating noise pollution, but the focus must shift to enforcing the code and punishing offenders.  Until noise polluters understand that there are consequences for their actions, they will continue to make life hellish for those around them.

Thanks to Daniel Fink, M.D., a noise pollution activist in the Los Angeles area, for the link.  Dr. Fink serves on the board of the American Tinnitus Association and is the interim chair of Quiet Communities’ Health Advisory Council.

Quiet fireworks? Must be an oxymoron, no? No:

Oh, Say, Can You See (but Not Hear) Those Fireworks?

Why would someone want quiet fireworks, you may ask?  Pet owners know that cats and particularly dogs can be adversely affected by fireworks, but humans are at risk as well:

For people, loud fireworks can lead to hearing loss. The World Health Organization lists 120 decibels as the pain threshold for sound, including sharp sounds such as thunderclaps. Fireworks are louder than that.

“They’re typically above 150 decibels, and can even reach up to 170 decibels or more,” said Nathan Williams, an audiologist at Boys Town National Research Hospital in Nebraska.

Dr. Williams also sees higher traffic to his clinic after Independence Day. “We usually see a handful of people every year,” he said. “In these cases, hearing loss is more likely to be permanent.”

And Dr. Williams added that children are more vulnerable to hearing loss from fireworks because they have more sensitive hearing.  So if you are going to a fireworks display this weekend, enjoy it safely and bring ear plugs for the whole family.

Thanks to Daniel Fink, M.D., a noise pollution activist in the Los Angeles area, for the link.  Dr. Fink serves on the board of the American Tinnitus Association and the Health Advisory Council of Quiet Communities.

New York City reconsiders taxi tv screens

The New York Times reports that after almost a decade of being bombarded by unnecessary noise, taxi passengers may be given a reprieve.  Namely, it appears common sense may reign as the City’s Taxi and Limousine Commission may adopt a pilot program to remove the ubiquitous and annoying “Taxi TV from some cabs and replace it with more modern — and less intrusive — technology.”  This is welcome news for those of us who spend the first minutes in a cab struggling to find the right button to shut the tvs off.  One hopes that the pilot program will be successful and one less layer of noise and distraction will litter the city.

And no surprise, the cabbies are happy with the news too.  The New York Times reports that, “Bhairavi Desai, the executive director of the New York Taxi Workers Alliance, said the mood among drivers over the change was ‘utter elation.’  ‘The T.L.C. is eight years late in reversing a horrible decision,’ she said, ‘but we’re glad the time has finally come.’”

Thanks to Daniel Fink, M.D., a noise pollution activist in the Los Angeles area, for the link.  Dr. Fink serves on the board of the American Tinnitus Association.