Tag Archive: Dr. Daniel Fink

Why can’t you hear?

Photo credit: Helena Lopes from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

This piece in the Canadian edition of Psychology Today asks “Why can’t you hear?,” but a better title might be “Why can’t you understand speech in a noisy room?”

This problem is known in audiology circles as the “speech in noise” problem. People can understand what someone is saying just fine in a quiet room, but can’t follow a conversation in a noisy one. The problem has been known for decades, but now it is thought that the cause is cochlear synaptopathy, also called hidden hearing loss because hearing test results–technically known as pure tone audiometry–are normal despite the patient’s complaints of not being able to hear.

The problem can be assessed clinically by a number of tests, including the Hearing in Noise Test and the QuickSIN test. Now researchers at the Massachusetts Eye and Ear Infirmary have developed two tests, one measuring pupillary responses and the other recording electrical signals from the ear drum.

The inability to understand speech in noise is a frustrating one. Hearing aids usually don’t help much, although newer digital hearing aids with special features claim to do better.

Much better than any hearing aid, though, is preserved natural hearing. Protect your ears. If something sounds too loud, it is too loud. Turn down the volume, use hearing protection, leave the area, or you might have speech n noise difficulty later.

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.

Another young person develops tinnitus from loud music

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by Daniel Fink, MD, Chair, The Quiet Coalition

This report from The Irish News discusses TV personality and actor Jamie Laing, who developed tinnitus at age 31 from listening to loud music. He woke up one morning hearing a loud buzzing noise. He searched his house to see where it was coming from, but then realized that it was inside his own head.

This is called tinnitus, ringing in the ears but technically defined as a perception of noise with no external sound source.

Mr. Laing sought medical attention. His discussion of what his doctor said and his reaction to that is a good summary of what many others have said:

“My GP said there were a number of possible causes but exposure to loud music in nightclubs was the most likely one in my case,” says Jamie, who is dating fellow Made In Chelsea star Sophie ‘Habbs’ Habboo (26).

“My GP explained there was no cure, but it would probably go away eventually on its own as I got used to it. There were treatments available to help me come to terms with it, until it did,” says Jamie.

“At first I couldn’t believe I could have tinnitus, I thought it only affected older people or people who were exposed to loud bangs – but it’s more common than people think. I’d been to festivals and concerts and listened to music on headphones – the louder the better when I was younger.

“But I’d never stood next to the speakers at concerts, or been in a band – I’d probably been to a few too many festivals where the music was loud and never worn ear plugs.

“I wish I had now – protecting your ears against loud noise is so important.”

I’m just back from Geneva, where I spoke about the need for regulation of club and concert noise at the World Health Organization consultation on its Make Listening Safe program. WHO is working on these recommendations, including requirements for sound limits and for warning signs about the dangers of noise, and also requiring offer of free earplugs.

Because as with Mr. Laing, most people, young or old, don’t know that exposure to loud music, whether many times or even only one time, can cause tinnitus for the rest of one’s life.

That’s how I developed tinnitus, after a one-time exposure to loud noise in a restaurant on New Year’s Eve 2007.

I wish I had known the basic rule: if it sounds too loud, it is too loud! Ask for the volume to be lowered, leave the noisy environment, insert earplugs, or possibly face lifelong tinnitus, like me and Jamie Laing and millions of others.

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.

Can hearing aids help prevent dementia?

Photo credit: Vilma Liella licensed under CC BY-SA 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

Can hearing aids help prevent dementia? This comprehensive article in the New York Times magazine section discusses the research suggesting that they might.

Of course, it’s far better to prevent hearing loss in the first place by avoiding loud noise exposure or using earplugs if one can’t avoid the noise. And it’s far cheaper, too.

There are smart phone sound meter apps to measure ambient noise levels, but one doesn’t need a sound meter to know if it’s too loud. If the noise is loud enough to interfere with conversation at the normal social distance of 3 to 4 feet, it’s loud enough to damage your hearing.

Just 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.

Even with noise limits, loud noise at events still causes hearing damage

Photo credit: Wendy Wei from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

This article from the Netherlands reports that even with a regulatory maximum noise level for events and concerts, auditory damage still occurred. The Dutch Ministry of Public Health, Welfare, and Sports set the maximum noise level for events and concerts at 103 decibels (dB).

The U.S. Occupational Safety and Health Administration permissible exposure levels for noise are 1.5 hours at 100 A-weighted decibels (dBA) and one hour at 105 dBA. A-weighting adjusts the frequencies of sound for those heard in human speech. A-weighted sound measurements almost always are lower than unweighted measurements, with the exact difference depending on a variety of factors.

So 103 dB is pretty high, loud enough to cause hearing loss.

The problem with the Dutch noise levels was that the Dutch regulators somehow assumed that those attending loud events would be wearing hearing protection, but neglected to include this important requirement in information distributed to the public. About half of Dutch concertgoers never wear hearing protection, so they must be sustaining auditory damage, including noise-induced hearing loss and tinnitus.

The trade association representing music venues, concert halls, and event organizers maintains that it is the responsibility of those attending events and concerts to protect their own hearing, but I disagree. I think it’s the responsibility of governments and public health authorities to protect the public, or at least to give them complete and accurate information. Not “caveat auditor”!

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.

Warning labels work

Photo credit: Aeveraal licensed under CC BY-SA 3.0

by Daniel Fink, MD, Chair, The Quiet Coalition

Consumers want relevant information about products they buy, and warning labels work. That’s the message inherent in this New York Times report on food warning labels for salt, fat, sugar, and calories in Chile. Chile has one of the highest obesity rates in the world. With health care costs for obesity-related medical care soaring, the government decided to take action and began requiring black octagonal warning labels on the front of food packages. The laws also banned junk food sales in schools, and prohibited television ads for unhealthy food between 6 a.m. and 10 p.m.

Of course, the big multinational food companies who market candy, snacks, sodas, and fruit juices protested and lobbied against the legislation, but it passed and was signed into law.

Guess what? Junk food consumption is down 25% in Chile, and other countries are contemplating passing similar legislation.

I am convinced that if warning labels were required on personal listening devices and accessories like earbuds and headphones, people would use them less. I would suggest the following: WARNING: USE OF THIS DEVICE CAN CAUSE HEARING LOSS.  But I’m sure other wording might be more effective.

It’s obvious that the device manufacturers, like the junk food vendors, don’t care about consumers. All they care about is profits. It’s up to governments to protect their citizens, as Chile has done. That’s their job.

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.

Why are spin classes so loud (and does it matter)?

Photo credit: Aberdeen Proving Ground licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

Why are spin classes so loud? This post on The Cut doesn’t really answer that question, but it does a nice job of explaining the dangers of excessive noise for auditory health.

A few years ago I had email exchanges with two researchers who study the effects of noise on athletic performance. Music with a specific beat can help rhythmic activities, like running or spinning at a constant pace, but despite common belief there is no evidence that loud music makes anyone run faster or lift more weight, or in this case spin faster.

Even if music does improve performance–or people think it improves their performance–those theoretical advantages are outweighed by almost certain auditory damage, including hearing loss and tinnitus.

I’m glad the author of this piece had a best friend who became an audiologist and educated her about the dangers of noise. Because if the noise in your spin class–or any exercise class, or really anywhere at all–sounds too loud, it is too loud.

And if the noise is loud enough to be painful, it’s dangerous for your ears. Period.

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.

Sarasota restaurants are getting louder, too

by Daniel Fink, MD, Chair, The Quiet Coalition

Restaurant noise is a major problem for diners, now being the leading complaint in the latest Zagat restaurant survey. And this article from Sarasota Magazine says it’s a problem there, too.

The writer makes the common error citing the 85 decibel occupational noise exposure limit as the sound level at which auditory damage begins, noting restaurant noise levels of 92 decibels at one popular restaurant. Eighty-five decibels is not a safe noise level to prevent hearing loss.

The World Health Organization recommends only one hour of exposure at 85 A-weighted decibels* to prevent hearing loss. And a typical restaurant meal lasts 90-120 minutes, depending on the speed of the service, the dining choices, and whether one lingers beforehand over drinks or afterwards for coffee and dessert. So all diners at the restaurant were at risk of hearing loss.

Is this a real problem? Yes! In 2017 the CDC reported that 24% of American adults had noise-induced hearing loss, most without significant occupational noise exposure.

Choosing a quieter restaurant, as an economist friend suggested, isn’t a realistic option. In most cities, there are few if any quiet restaurants, and a less noisy one is the only option if one wants to eat a restaurant meal.

It’s clear that restaurant noise is an example of market failure, and that regulator action is needed to protect diners’ auditory health.

*A-weighting adjusts sound measurements to reflect the frequencies 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.

Nature’s sounds calm urban anxiety

Photo credit: Gabriela Palai from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

In this personal essay, printed in the Washington Post, writer Paige Towers discusses how New York City’s noise worsened her anxiety, but a move to Milwaukee, where nature’s quiet was more accessible, helped her regain her calm.

Some people claim to love urban noise. New York City is famously “the city that never sleeps.” But its noise is loud enough to cause hearing loss and for many people, noise is stressful.

In Japan, doctors can prescribe nature therapy, which they call forest bathing.

But you don’t need a doctor’s prescription to go out and enjoy nature’s quiet on your own. Try it!

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.

Lip reading: “I can’t hear you in the dark”

Photo credit: mail_collector licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

The only treatments for hearing loss are hearing aids with cochlear implants reserved for the profoundly hearing impaired or those born deaf. The only rehabilitation for hearing loss is lip reading or sign language. Most people with severe hearing loss use lip reading to understand speech. Learning American sign language won’t help because few other than the deaf speak it.

This insightful essay by someone who wears hearing aids but largely uses lip reading to understand what people are saying offers a wonderful insight into what it’s like to use lip reading. Understanding comes from looking at the speaker’s mouth, facial expression, body movements, and of course hand and arm motions and position.

But the room can’t only be quiet. It has to be well-lit, too.

I don’t know that I could learn to lip read. I’ve tried, and it’s very difficult for me. Even more reason for me to protect my hearing by avoiding loud noise or inserting ear plugs if I can’t.

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.

How Mumbai solves its horn problem

Photo credit: CommGlobal UVA licensed under CC BY-SA 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

In India, a saying goes, you need four things to drive: a good car, good eyes, good luck, and a good horn. Honking horns are ubiquitous in the sprawling city of Mumbai. When the traffic light turns red, drivers honk their horns to get the drivers in front of them ready to move when it turns green.

The local police have figure out a solution to this noisy problem, though. They’ve hooked up decibel meters to the lights. If the drivers honk their horns, the light stays red.

The New York Times reports that other Indian cities are considering installing the same equipment.

Maybe the traffic folks in New York City will consider doing the same?

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.