Tag Archive: Dr. Daniel Fink

Transit noise can damage your hearing

Photo credit: G.M. Briggs

by Daniel Fink, MD, Chair, The Quiet Coalition

This article out of Toronto reports that transit noise can make you deaf. The author of the article, and the underlying study on which it’s based, are right. And not just in Toronto, but in other cities with noisy public transit systems, especially New York City.

But there is one statement in the article with which I disagree:

Lin said the concern is with peak exposures, which in some of the testing, measures way above the 85-decibel limit for safe prolonged exposure with some occurrences checking in as high as 115 decibels.

Simply put, 85 decibels is not a safe limit for prolonged noise exposure. At that exposure level, after 40 years of occupational exposure–8 hours a day, 240 days a year, for 40 years–at least 8% of workers will have excess hearing loss.

As I wrote in the January 2017 issue of the American Journal of Public Health, 85 decibels is not a safe noise level for the public. And the concept of excess hearing loss assumes that hearing loss with age is normal, when it isn’t. Without noise damage, good hearing should be preserved well into old age. The only evidence-based safe noise exposure level is a time-weighted average of 70 decibels for 24 hours. The NIOSH Science Blog on February 8, 2016, also addressed this topic.

Auditory damage starts at noise exposure levels as low as 75 A-weighted decibels. This is called the auditory injury threshold. I don’t know about Canadians, but most U.S. citizens get deafening total daily noise doses, as reported by Flamme and colleagues. This is the reason the Centers for Disease Control reported in February 2017 that 24% of U.S. adults age 20-69 have noise-induced hearing loss.

I am convinced that there is already an epidemic of noise-induced hearing loss that is only going to get worse when today’s young people reach middle age. The occupational noise exposure studies on which the 85 decibel occupational noise exposure standard used a 40 year occupational exposure. When toddlers as young as 3 years old use headphones marketed as safe for hearing using the 85 decibel occupational standard as a safe noise exposure level, they are likely to be severely hard of hearing when only in their 40s, if not earlier.

Hearing is an important sense, and hearing aids don’t work as well at helping users understand speech as many think. And the consequences of suffering hearing loss are severe and life changing. As Helen Keller said, “[b]lindness separates people from things, [but] deafness separates people from people.”

Transit riders and everyone else should protect their hearing now.

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.

Good advice about how to protect your hearing

by Daniel Fink, MD, Chair, The Quiet Coalition

This report on Fox News, originally posted on AskDrManny.com, contains sound advice about protecting your hearing. Fox (or Dr. Manny) titled it “5 Ways You’re Damaging Your Hearing.”

There is a whole body of research in communications and specifically in health communications about how to transmit information–positive messages, negative messages, warnings, etc. It’s not clear to me that any of it really works, because no health communication effort works particularly well.

Sure, they may work a bit, but if communicating health information changed human behavior no one would smoke, everyone would exercise, and there would be no HIV transmission from unprotected sex.

But at least the information in the report linked above is there. And by writing this short introduction to what Dr. Manny wrote and Fox News reported, I’m doing my part to help people protect their hearing. So do yourself a favor and click the link above and spend two minutes learning how you can protect your hearing.

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.

Hearing Loss Hits A Younger Generation

Photo credit: flattop341 licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

Hearing loss is commonly seen only as a problem for older people, not younger ones.

As I have written before, it’s seen as part of normal aging even when the scientific evidence shows that good hearing should be preserved into old age.

But when children start listening to music with headphones or earbuds before they start kindergarten, and those in their teens and twenties listen to personal music players for hours each day, earlier hearing loss is inevitable.

I think there already is an epidemic of noise-induced hearing loss that will only get worse in coming decades, when those children reach their 40s or 50s.

Media observers don’t seem to be as concerned as I am, but this article in the Chicago Tribune gets it right.

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.

Madrid’s noisy nightlife is keeping residents awake

Photo credit: Jorge Díaz licensed under CC BY-SA 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

This interesting report documents complaints about noise in Spain’s capital city, Madrid.

It turns out that in Madrid making noise when and where one wants has an aspect of political expression that may be present in other cities and other countries but has special relevance in Spain. Franco’s Minister of the Interior coined the phrase, “[t]he street is mine.”  And the police dispersed any group of more than three people.

When democracy returned to Spain, leaders in Madrid made a lively street scene part of their newfound freedom. The mayor coined the phrase, “Madrid nunca duerme”- Madrid never sleeps.

And now that’s a problem.

All regulations restrict someone’s freedom. But if we are to live in increasingly dense and crowded environments, people can’t be free to do something that adversely affects others. After all, everyone must sleep sometime.

Smoking may be a useful example. People in the U.S. and Europe still have the right to smoke, but they can’t smoke where others have to smell and breathe their smoke.

And that’s how it should be with noise. People should have to right to deafen themselves with personal music players, or attend rock concerts, or patronize noisy clubs. They can ride loud motorcycles, too, but not where others can hear them.

Because people shouldn’t have the right to disrupt the lives of others with their noise.

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.

It’s time to change our definition of “old”

Annual National Veterans Golden Age Games | Defense Department photo/Army Sgt. 1st Class Michael J. Carden

by Daniel Fink, MD, Chair, The Quiet Coalition

According to Joseph Coughlin, director of the AgeLab at MIT and author of “The Longevity Economy,” a new book about marketing to aging baby boomers, it’s time to change our definition of “old.”

Coughlin claims that old age is a made-up social construct invented 150 years ago.

I’m not sure I agree with him completely, but he’s right about something. Much of what we think of as normal aging–obesity, hypertension, diabetes, weakness, disability, and early demise–isn’t normal aging but pathological aging.

I’d add hearing loss to that list.

Pathological aging stems from four factors:

  1. Abnormal exposures, e.g., sun, cigarette smoke, or noise;
  2. Poor quality nutrition, i.e. too much of the wrong nutrients (including calories) and not enough of the right nutrients;
  3. Disuse atrophy, especially for the musculoskeletal system; and
  4. Medical care based on inadequate knowledge about the best treatments for common conditions.

The treatment of hypertension is one example of the fourth factor. In the 1970s, it was thought that a normal systolic blood pressure was 100 plus the patient’s age, and that treating hypertension in the elderly was dangerous. Then a randomized trial–the Systolic Hypertension in the Elderly Program–showed that treatment of high blood pressure in older people prevented stroke. Two more recent examples are studies showing that treatment of cardiac risk factors prevents what was once thought to be inevitable heart disease as people age and then was found to reduce dementia risk, too.

Hearing loss in old age is very common. It’s called presbycusis, or age-related hearing loss. But the world’s literature–which I reviewed for a presentation I gave at the 12th Congress of the International Commission on the Biological Effects of Noise in Zürich, on June 20, 2017–shows that it isn’t normal. Without exposure to loud noise, good hearing is preserved well into old age.

In his book Coughlin discusses “transcendent design”–not just accessible design, or universal design, but:

[A]nother, even higher level of accessibility that I believe has been mistakenly lumped in with universal design: transcendent design. It’s essentially universal design that has been dialed up to 11 on a 10-point scale, with accessibility attributes so useful that they turn out to be highly desirable—even aspirational—for people with and without disabilities. If the defining, narrative-shaping forces in our older future will be those that make it easy for older adults to achieve their jobs as consumers, transcendent products and design features will be at the vanguard of this process.

Coughlin highlights, as an example of transcendent design, the OXO line of kitchen utensils, initially designed by entrepreneur Sam Farber because his wife couldn’t grip standard utensils due to arthritis. People buy OXO utensils not necessarily because they have arthritis or other grip issues, but because OXO utensils they are so good-looking and easy to use. The iPhone and Apple watch are other examples.

People with mobility, musculoskeletal, or auditory disorders don’t need special designs. They and everybody need well-designed utensils, tools, garments, furniture, and spaces that meet needs as people age and suffer inevitable temporary or sometimes permanent impairments.

Perhaps one day architects and interior designers can come up with transcendent designs for quiet restaurants, to make it possible to carry on normal conversations without straining to speak or to be heard, while enjoying the food and the company of our dining companions.

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 a machine learn to solve our speech in noise problem?

by Daniel Fink, MD, Chair, The Quiet Coalition

This piece in The Hearing Journal asks, “Can a Machine Learn to Solve our Speech in Noise Problem?”

Maybe yes, maybe no.

The “speech in noise” problem is the difficulty many people with hearing loss–and even people with normal hearing as tested by pure tone audiometry–have  following a conversation if the room (often a restaurant or party) is noisy.

I have that problem, as many adults do, and I also have three problems with this article.

First, talking about a technological solution to the speech in noise problem without discussing how we can interfere with the development of this condition by simply making the world quieter to prevent hearing loss is irresponsible. Imagine public health officials in the 1950s focusing on making better wheelchairs, braces, and crutches for those affected by polio without also working to prevent polio by developing a vaccine. You can’t, because that would have be absurd. To prevent noise-induced hearing loss, we don’t need more research. We don’t need a vaccine. All we need is to make a quieter world, something that has been known for decades.

Second, an even better solution to the speech in noise problem would be to require quieter indoor spaces.

Third, requiring quieter public spaces is exactly what the Americans with Disabilities Act (ADA) requires. People with hearing loss clearly meet the ADA definition of having a disability, and they require “reasonable accommodations” to allow them to fully enjoy (yes, this is the legal standard in ADA) places open to the public. I will be speaking about “Disability Rights of Ambient Noise for People with Auditory Disabilities Under the Americans with Disabilities Act” at the December meeting of the Acoustical Society of America, in New Orleans. I recent learned that my talk will be broadcast live over the internet. Details of how to listen will be posted when they become available.

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.

Being able to hear the music

by Daniel Fink, MD, Chair, The Quiet Coalition

My father used to say that people don’t know how important some things are until we don’t have them. He wasn’t talking about physical things, but about health, love, and security. Well, money and food, too.

The same is true of music. Those of use born with normal hearing don’t appreciate how wonderful it is to enjoy music, whatever type of music we like to listen to.

But for someone born with profound hearing loss, cochlear implants offered her the opportunity to hear music for the first time.

After seven years, she wrote this wonderful essay, which we want to share with you.

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.

Another reason to avoid fast food and chain restaurants

Photo credit: Mike Mozart licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

My wife and I don’t eat in restaurants much anymore–the vast majority are just too noisy to enjoy both the meal and the conversation–and we don’t patronize fast food or chain restaurants. Burgers and fries and sodas are just not healthy food, and I try to stay healthy.

But for those who do, according to Culture Cheat Sheet noise is a major problem, joining a list of complaints that includes dirty spaces, bad service, and bad food. Culture Cheat Sheet cobbled together survey results from Consumer Reports, the American Customer Satisfaction Index, and Temkin Experience Ratings to come up with their report on the most hated restaurant and fast food chains.

Most fast food and chain restaurants use a formula of tasty but unhealthy food with too much fat, too much sugar, too much salt, and too many calories at a relatively low price to lure customers.

Research shows a clear correlation between the density of fast food restaurants in neighborhoods–largely poor neighborhoods populated by African-American and Hispanic people–and obesity. The epidemic of obesity in the U.S. is related to changes in eating patterns–fast food, sugary sodas, bigger portions–and decreased exercise.

But now it appears that these restaurants also serve up a side order of hearing loss with their food. Because noise is causing an epidemic of noise-induced hearing loss, too.

And that’s another reason to avoid these restaurants.

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.

What’s better than a cheap hearing aid?

Photo credit: ReSound licensed under CC BY 3.0

by Daniel Fink, MD, Chair, The Quiet Coalition

The New York Times asked recently why hearing aids are so expensive. They should have stepped back and asked a more important question: What’s better than a cheap hearing aid?

A: Preserved natural hearing.

As a paper I presented at the 12th Congress of the International Commission on the Biological Effects of Noise discussed, the scientific evidence suggests that significant hearing loss (25-40 decibel hearing loss) is probably not part of normal aging, but is actually noise-induced hearing loss in the vast majority of cases. Research supporting this conclusion includes studies of hearing done in populations not exposed to noise, different rates of hearing loss in males vs. females, decades of occupational studies correlating increased noise exposure with greater hearing loss, and recent laboratory experiments showing the molecular, genetic, and sub-cellular structural mechanisms by which noise damages the auditory system.

If you protect your hearing now–by avoiding noise exposure or using hearing protection (ear plugs and ear muffs) if you can’t–you shouldn’t need a hearing aid in the future.

Preserved natural hearing…it’s better than a cheap hearing aid!

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.

Coping with hearing loss and noisy restaurants is not a game

by Daniel Fink, MD, Chair, The Quiet Coalition

This report from CNN discusses a novel strategy to help people with hearing loss understand speech: a game to train the brain to process speech better.

This is a widely known but poorly understood problem–sometimes called the “Speech in Noise problem”–with people with hearing loss, but it can also affect people with normal or adequate hearing as tested by standard hearing tests (“pure tone audiometry”) who nonetheless can have problems understanding speech.

The problem is worse for those with hearing aids, which is probably why up to 40% of people with hearing aids don’t use them–they just don’t help understand speech in everyday situations. As hearing loss blogger Shari Eberts has written, hearing aids just are not like eyeglasses.

Some research supports a central cause for this, i.e., deficiencies in brain processing of auditory signals as people age. Other research puts the problem in the periphery, i.e., the ear. And the research on hidden hearing loss puts the problem in between, in the nerves connecting the ear to the brain. Most likely the explanation involves all three.

Even though the computer game reported in this story may eventually help people who struggle to understand speech, dealing with hearing loss and noisy restaurants isn’t a game.

The real answer isn’t brain training. It’s quieter restaurants, stores, and other public places.

Quieter indoor places will not only help those who already have hearing loss understand speech, they will prevent hearing loss in those still with good hearing.

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.