Tag Archive: depression

The unintended consequences of CDC’s guidelines for preventing hearing impairment

by John Drinkwater, Founding Member, The Quiet Coalition

If you follow the Centers for Disease Control and Prevention (CDC) recommendations to protect your hearing then be prepared for isolation and depression. The CDC’s February 2017 issue of Vital Signs states that continued exposure to unsafe sound levels can cause stress, anxiety, depression, isolation, and other health issues. So in order to protect your hearing, the CDC recommends everyone:

  1. Avoid noisy places.
  2. Use earplugs, earmuffs and noise canceling devices when in noisy places.

Amplified sound levels at restaurants, retail stores, movie theaters, health clubs, nightclubs, and other public places often are unsafe.

Following recommendation No. 1: You don’t go.

Following recommendation No. 2: Your ears can’t function properly.

Imagine if the “solution” to second hand smoke at a restaurant was to wear a protective mask over your nose and mouth. How could you possibly communicate and enjoy your meal? Hearing “protection” simulates the effects of hearing loss and inhibits your ability to communicate and enjoy the event. It also trains your ears to get used to the effects of hearing loss and may inhibit recognizing gradual hearing impairment.

The National Institute for Occupational Safety and Health (NIOSH), a part of the CDC charged with conducting research and making recommendations for the prevention of work-related injury and illness, is highly critical of earplugs and earmuffs and recommends they should only be used when engineering controls are not feasible to reduce noise levels. According to NIOSH, the noise reduction rating system (NRR) used for earmuffs and earplugs greatly overstates “protection” and therefore is not NIOSH approved. Workers often do not use hearing protectors properly, and they interfere with communication. If earplugs are removed for a short period in order to communicate, there can be immediate and irreparable injury. Even double protection (earplugs and earmuffs) is inadequate when exposure exceeds 105 dB.

Manufacturers mislead the public with overstated marketing claims. A Dow Industrial company markets their “Professional Earmuff” as “Our Highest-NRR Rated Earmuff (30 Decibels), Patented Twin Cup Design.” The really small print in the inside of the box states the Company:

[M]akes no warranty as to the suitability of NRR as a measure of actual protection from any noise level since such protection depends on the sound level (loudness), how long you listen to the loud sound, and how well you fit the earplugs (sic) in your ears…The NRR is based on the attenuation of continuous noise and may not be an accurate indicator of the protection attainable against impulsive noise such as gunfire…[Company] recommends reducing the NRR by 50% for estimating the average amount of noise reduction provided.

Furthermore, no type of hearing protection or noise canceling device protects against low frequency sounds, which travel through your body causing stress and may damage unborn children. Accordingly, NIOSH’s primary recommendation of the most effective way to prevent noise-induced hearing loss (NIHL) is to “remove hazardous noise from the workplace or remove the worker from hazardous noise.”

If you follow the primary CDC and NIOSH guideline, avoiding noisy places, it results in the same isolation, depression, and other issues associated with hearing impairment. The only healthy solution is requiring safe amplified sound levels so no hearing protection is necessary–it doesn’t cost anything to Turn Up the Quiet.™ There are many architecturally safe and pleasing ways to reduce sound levels in public places: breaking up an open floor plan, using materials that absorb or diffuse sound on wall and ceiling surfaces, installing carpeting, curtains, and tapestries, and using attractive acoustic panels, to name a few. It is also good for business.

After meeting with a local health club, they agreed to institute a new “quiet” class with no amplified music on a trial basis. Management was surprised to hear positive comments from members who had simply stopped coming to classes due to the unsafe volumes. They learned that some members with hearing aids took them out, put in earplugs, and still found the classes unbearable. In a few months they added two more quiet classes.

It’s OK to ask the grocery store, the clothing store, and other retailers to turn off the amplified music while you are shopping. Many will happily accommodate you, and it encourages others to do the same. Some businesses are establishing regular “quiet” hours of operation and finding more satisfied, and even new, customers who spend more time at the establishment.

In addition, “silent discos” are gaining popularity, where instead of amplifying music through speakers it is “silently” delivered via Wi-Fi to smartphones for patrons to listen without disturbing others. The local mayor wants to try it as part of the Summer Concerts in the Park series. It will allow those who may not want amplification to enjoy the Park, and won’t interfere with nearby businesses or residents. The same technology can be applied to other music events such as outdoor exercise, and speech events, such as public ceremonies, political speakers, and other large public gatherings.

These and other creative ways to avoid unsafe levels will allow all of us to fully participate and enjoy public gatherings without the risk of injury.

John Drinkwater is a composer, musician, and attorney with a background that includes science and architecture studies. He is the founder of secondhandsound.org, and he also owns the trademark Turn Up the Quiet™ All Rights Reserved.

Originally posted at The Quiet Coalition.

Text Copyright 2017 John Drinkwater
Photo Copyright 2014 secondhandsound.org
All rights reserved

Consumer Reports looks at affordable solutions to hearing loss:

No More Suffering in Silence? Julia Calderone, Consumer Reports, has written a thoughtful piece about hearing loss and the toll it takes on those who suffer from it.  Calderone states that hearing loss “has long been thought of as an inevitable part of getting older, more a nuisance than a life-altering medical condition—at least by those not experiencing it.”  But that opinion is changing, she asserts, as “the President’s Council of Advisors on Science and Technology (PCAST) and the National Academy of Sciences (NAS) have published reports calling untreated hearing loss a significant national health concern­, one that’s associated with other serious health problems, including depression and a decline in memory and concentration.”

Calderone not only treats hearing loss with the seriousness it deserves, she offers solutions to sufferers, particularly those who can’t afford to buy hearing aids, which “cost an average of $4,700 per pair in 2013.”  This is a very steep price, particularly since hearing aids are usually not covered by health insurance or Medicare.  To help with those who need hearing aids but can’t afford them, Calderone reviews a handful of hearing aid alternatives, namely personal sound amplification products (PSAPs), to see if they can fill the gap for those who need hearing aids but can’t afford to buy them.

Two PSAPs not covered in Calderone’s review are also worth considering: Doppler Labs HERE One and Nuheara’s IQbuds.  Neither company markets their PSAPs as a hearing aid or hearing aid substitute, but at around $300 a pair they offer personal amplification and soundscape management to people who might have no other options.

And a final thought about the sorry state of hearing health in the U.S.: For people who are suffering noise-induced hearing loss (NIHL), the personal and economic costs could have been avoided in the first place because NIHL is 100% preventable.

 

The CDC issues report on noise-induced hearing loss

and the facts are frightening. The Centers for Disease Prevention and Control’s (CDC) current issue of Vital Signs focuses on the dangers of noise on hearing health.  Among other things, the report states that:

  • 40 million Americans aged 20-69 years old have noise-induced hearing loss (NIHL). Hearing loss is the third most common chronic health condition in the US, and almost twice as many people report hearing loss as report diabetes or cancer.
  • 1 in 2 American adults with hearing damage from noise did not get it exposure to noise at work. Noise outside of work can be as damaging as workplace noise.
  • Too much loud noise, whatever the source, causes permanent hearing loss.
  • 1 in 4 Americans who report excellent hearing have hearing damage.  You can have hearing loss without knowing it.
  • The louder the sound, and the longer you are exposed to it, the more likely it will damage your hearing permanently.
  • Continual exposure to noise can cause stress, anxiety, depression, high blood pressure, heart disease, and many other health problems.

This fascinating if distressing report comes with easy to understand graphs and charts that clearly explain the dangers of noise exposure, who is most at risk, the high cost of hearing loss, how hearing loss occurs, and, most importantly, what can be done to prevent NIHL.  Because, in the end, one point is crystal clear: noise-induced hearing loss is 100% preventable.

The costs of hearing loss:

The New York TIme’s Jane Brody writes about the high cost of hearing loss in Hearing Loss Costs Far More Than Ability to Hear.

Brody’s post focuses on a psychologist, Mark Hammel, who addressed his hearing loss by (finally) getting hearing aids.  Dr. Hammel provides insights into how hearing loss inflicts real and profound costs on sufferers, many of whom become socially isolated as a result of their condition.  But the post highlights the other costs as well, noting that “30 to 48 million Americans have hearing loss that significantly diminishes the quality of their lives — academically, professionally and medically as well as socially.”  Brody adds that hearing loss can affect physical health (e.g., increased risk of dementia, stress, fatigue), as well as create safety and financial risks.  And those around the hearing impaired suffer as well, as “[m]any who are hard of hearing don’t realize how distressing it is to family members, who typically report feeling frustrated, annoyed and sad as a consequence of communication difficulties and misunderstandings.”

Loud noise causes hearing loss, a preventable medical problem that will continue until and unless people understand the consequences of ignoring it.  The first step to implementing protections against excessive noise is getting poeple to recognize the real and significant costs to the sufferer, his or her family and friends, and society as a whole.  Kudos to Brody for her thoughtful post.

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.

10/07/2015 Update: Brody follows through with a companion piece that discusses the literal cost of hearing loss in The Hurdles to Getting Hearing Aids.  Among other things, Brody notes that while a failure to recognize hearing loss is one reason why people do not get hearing aids when needed, “the more important reason people fail to get hearing aids when they are needed is the cost, which is rarely covered by insurance and not at all by Medicare, unless the device is for a child.”  Given that the cost for one hearing aid (and most people need two) range from about $1,200 to $2,800,  it’s clear that the high cost of hearing aids keeps them out of the hands of the people who made need them the most.