Tag Archive: headphones

What are the best workout headphones?

Photo credit: CherryPoint licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

What are the best workout headphones? In my considered opinion, none. This review of workout headphones mentions noise-induced hearing loss, but misuses the 85 decibel (dBA, A-weighted decibels) occupational noise exposure as the safe listening limit.

There is a common belief that music improves athletic performance, and the louder the music the better the effort. But I have been unable to find any scientific articles supporting this belief, unless it is music with a particular beat or rhythm which, for example, might help a runner keep a steady pace.

On the other hand, the dangers of noise for hearing loss are supported by decades of scientific work and thousands of articles in peer-reviewed journals.

So skip the headphones–you can be very fit without losing your hearing.

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.

Headphones for kids: What you should know

Photo credit: ExpectGrain licensed under CC BY-SA 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

This post at SoundGuys discusses choosing headphones for kids. The author discusses a variety of considerations, including many that lead me to my opinion about headphones for kids:

Headphone use should be limited to those old enough to understand the dangers of hearing loss. Giving a younger child a pair of headphones–volume limited or not–is like giving a toddler a beer or a 9-year-old a pack of cigarettes. No one does that.

It takes years to decades of noise exposure to produce hearing loss as measured by standard audiometric techniques, but the reports of hearing loss at very early ages associated with headphone use have already begun to appear. A Dutch study in June 2018 reported increased hearing loss another auditory problems in children as young as 9 to 11, compared to those who didn’t use headphones to listen to personal music devices.

I’m not sure exactly when the idea evolved that everyone, including toddlers as young as 3, needs to entertained by audio or visual material for almost every waking hour, but I can guarantee that generations of children were raised to adulthood quite successfully without these devices. Perhaps headphone use should be regulated like driving, smoking, or drinking, each of which has an age limit at which the behavior is allowed. In the U.S., the age requirement for driving varies from 15 or so to 18 depending on the state, 18 for smoking, and 21 years old for drinking.  Laws are different in Europe and Asia, but to my knowledge there are no laws or regulations restricting headphone use or personal music device use anywhere in the world.

In the old days–whenever that was, but certainly up to a decade or two ago–children either entertained themselves by playing with blocks or toys or dolls, or were entertained by friends, parents, and others. As children got older, they entertained themselves with coloring books, and then by reading. At a meal or waiting in a line or when traveling, parents and children interacted, whether it was the parent making up a story for the toddler, or the slightly older child telling the parent or grandparent a story, or looking at and talking about what was outside the window of the car, bus, train, or airplane. Or people read books. Now I see families sitting in a restaurant with each person wearing earbuds, looking at a smart phone or listening to some content on it, instead of interacting with each other.

This can’t be good for personal and social development. It can’t be good for developing ties among family members and others. And I can guarantee that it is not good for hearing–headphone use in children will cause hearing loss in adults.

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 to prevent hearing loss when using headphones

by Daniel Fink, MD, Chair, The Quiet Coalition

Here is another article about the dangers of using headphones for hearing. I disagree with the author’s statement that “[t]here’s nothing inherently dangerous about using headphones.” That reminds me of statements in the 1950s and early 1960s that asserted there was nothing inherently dangerous about smoking cigarettes.

I think headphones and earbuds are inherently dangerous and shouldn’t be used except for noise-cancelling headphones used in noisy situations such as aircraft cabins.

Very few headphone users worry much about the sound volume when listening to music or a podcast or book, and the natural tendency is to turn up the volume enough to be able to hear what one is listening to. There is no meter on the personal audio device to let one know what the audio output is in decibels. And there is no audio dosimeter installed on most personal audio devices, be they MP3 players or smart phones, to let the user know the time-weighted average sound exposure that day or week from the device. Even if one has this type of dosimeter–several are reportedly in the development stage–they don’t measure all noise exposure, so they may give a false sense of security.

The other quibble with this article, from the UK, is that it uses the UK and EU occupational noise exposure standard of 80 decibels as a safe noise exposure level. The UK standard is technically 80 dBA, which is safer than the 85 dBA standard used in the U.S., but it is not a safe noise exposure level to prevent hearing loss. The only evidence-based safe noise exposure level to prevent hearing loss is a time-weighted average of 70 dB for 24 hours, and even that may be too high.

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.

Headphone volume may cause harm to hearing

Photo credit: Kaboompics .com from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

Here is yet another report, this time from Baylor University, that headphone use may cause harm to hearing.

I agree with everything stated in the report except for the assertion that 85 decibels is the dangerous sound level. This standard is derived from occupational noise exposure levels, and in 2016, NIOSH reiterated that this is not a safe noise exposure level for the public.

And headphone use may be different because the sound source is only millimeters away from the ear drum, with the external auditory canal being even shorter in children than in adults.

Personally, I would advise against the use of headphones and ear buds, period.  If you insist on using them keep in mind that if you can’t hear ambient noise when listening to content or music using headphones or earbuds, the volume is too high and is almost certainly causing hearing loss.

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.

It’s surprisingly easy for headphones to damage hearing

by Daniel Fink, MD, Chair, The Quiet Coalition

This article in Popular Science discusses noise-induced hearing loss caused by headphone use.

If headphone volume is high enough to block out noise from traffic or others speaking, it’s probably loud enough to cause hearing loss. If you use headphones or earbuds, that’s an important thing to know.

But also know that the sound levels cited in the article by audiologist Tricia Ashby at the American Speech-Language-Hearing Association aren’t safe. The 85 A-weighted decibel standard she mentions is an occupational noise exposure standard that even with limited exposure–8 hours a day, 250 days a year at work, for 40 years in the factory–allows 8% of workers to suffer “excess” hearing loss.

Noise is different from other occupational exposures, e.g., toxic solvents or ionizing radiation, because we are exposed to noise all the time, all day long, all year long, for an average whole lifetime now approaching 80 years.

As I wrote in the American Journal of Public Health, the only evidence-based noise exposure level to prevent hearing loss is a time-weighted average of 70 decibels for 24 hours. I discussed the reasons why even 70 decibels is probably too loud in this blog post for the AJPH. Well, just two hours exposure to 85 decibel noise makes it mathematically impossible to average below 70 decibels for the day.

Ms. Ashby is correct that a recent study reported a declining prevalence of hearing loss in American adults, but the Centers for Disease Control reported that 25% of American adults have hearing loss, many without any occupational noise exposure.

I have been predicting an epidemic of noise-induced hearing loss in young people using headphones, and now the preliminary evidence is beginning to appear in scientific journals.

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.

Loud music listened to on headphones is causing hearing loss in children

Photo credit: Gordon licensed under CC BY-SA 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

My main noise issue is restaurant noise, but I have learned about other noise issues, too. When I figured out that the oft-cited 85 decibel standard is an occupational noise exposure standard, and not a safe noise exposure standard for the public, I sent emails and letters to the audiologists quoted in media reports. When I realized that 85 decibels was used as a safe volume limit for headphones marketed for toddlers as young as 3 years, I called this to the attention of pediatricians, the Federal Trade Commission, the Consumer Product Safety Commission, and the Centers for Disease Control. My efforts, sadly, have thus far been unsuccessful.

My worries were based on theoretical concerns. There was no way that loud noise without a time exposure limit could be safe for children. Now this report documents that the hearing loss I was worried about isn’t a theoretical concern any more. Namely, the news article writes about a study conducted by Erasmus Medical Centre in Holland, in which scientists “studied more than 5,000 children aged nine to 11-years-old over three years, found one in seven of the youngsters had suffered some hearing loss.”

The study is preliminary. The hearing tests were done as part of a study of normal child development in Rotterdam, but not specifically to determine whether personal music player use caused hearing loss. More than 5,000 children were enrolled in the study, but complete hearing tests were available for only about 3,000, and personal music player use was assessed by parental report. Despite these limitations, the study found that 14% of the children, now just under 11 years old, had some type of hearing impairment.

That said, one must ask what is causing this early onset hearing loss. The researchers believe the cause may be children’s use of headphones to listen to portable music players.

Maybe this will spur regulatory authorities into action. At the very least, parents and grandparents can take these headphones away from their little darlings, and give them instead the gift of continued good hearing.

The problem with headphones isn’t just hearing loss. As a parent and soon to be grandparent, I know that talking with children and listening to what they say–almost from the time they are born–is one of the most important ways to teach them words and language, to establish a relationship with them, and to educate them about the world. Giving the child a personal music player or video player and headphones can occupy the child for hours–it’s certainly easier than carrying books and reading them to the child, or giving the child a paper and crayons, or playing with dolls or trucks or Legos–and it allows the parent to watch or listen to his or her own cellphone or personal electronic device, but it probably isn’t the best thing for the child, either.

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’s Health Advisory Council, and he served on the board of the American Tinnitus Association board from 2015-2018.

 

Hearing Loss Is Growing


From the book The Human Body and Health Revised by Alvin Davison, 1908 / Public Domain

And Experts Say Earphones Are Part Of The Problem.

Mack interviews audiologist Michele Abrams who spoke about limiting exposure to damaging sound:

When we think about decibel levels, when we think of loudness levels, it’s really incremental.  It’s a logarithmic scale. It’s not a linear scale. So we know that 85 db is that critical level. Eighty-five db, eight hours a day, that’s your maximum. If it’s 90 db — five db greater — you have to cut your time in half.

While generally informative, Abrams’ comment unfortunately identifies 85 db, eight hours a day as the “critical level.”  But this noise exposure level is too high.  It was developed solely as an occupational noise exposure standard and should never be applied to the general public, certainly not to children.  As Dr. Daniel Fink, a noted noise activist, wrote in, “What Is A Safe Noise Level For The Public?”:

In the absence of a federal standard, an occupational standard meant to prevent hearing loss appears to have become the de facto safe level for all public noise exposures. This is demonstrated by the use of 85 decibels as a safe sound level by hearing health professionals and their organizations, in media reports, and in publications, most often without time limits; by its use as a volume limit for children’s headphones marketed to prevent hearing loss, again without exposure times; and by general acceptance of higher indoor and outdoor noise levels in the United States.

*   *   *
Eighty-five decibels is not a safe noise exposure level for the public. In 1972, the National Institute for Occupational Safety and Health developed an 85 A-weighted decibel recommended exposure level to reduce the risk of hearing loss from occupational noise exposure. … Even with strict time limits, this standard does not protect all workers from hearing loss.

So what is a safe noise level for the public?  Dr. Fink states:

In 1974 the Environmental Protection Agency’s (EPA’s) Office of Noise Abatement and Control (ONAC) adjusted the National Institute for Occupational Safety and Health recommendation for additional exposure time: 24 instead of 8 hours daily and 365 instead of 240 days annually.  The EPA calculated the safe noise level for the public to prevent hearing loss to be a 70-decibel time-weighted average for a 24-hour period… The EPA did not adjust for lifetime noise exposure, now almost 80 years versus 40 work-years, so the real average safe noise level to prevent hearing loss is probably lower.

One thing is clear, allowing children to use earbuds or headphones without limiting volume and time exposure is a recipe for hearing loss.  Since the federal government has abdicated its authority to regulate noise, and manufacturers are unlikely to design products that limit the user’s ability to deliver as many decibels as he or she wants, parents must step in to protect their children’s hearing.  Here’s something that will help: Don’t allow your children to wear earbuds and headphones.  Tell them that if they want to listen to music they must play it through a speaker.  While this may be unpopular, know that you will be giving your children an important gift–the ability to listen to and enjoy music throughout their lifetimes.

 

 

Now showing at the Consumer Electronics Show 2017:

Orosound’s Tilde Noise Management Earphones

Orosound’s ‘noise-managing’ earphones hush unwanted sounds. While we appreciate tech startups that focus how we can manage noisy environments, we can’t help but to point out the obvious: Instead of developing gadgets that allow people to limit the noise invading their personal soundscape, why not limit the noise at its source? Just a thought.

Until that happens–in our lifetimes, one hopes–we will report on the products and services you can use to keep unwanted sound at bay and control the soundscape of your slice of the world.

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.

The Best Music for Productivity?

Silence.  Olga Khazan, writing for The Atlantic, wonders whether wearing headphones and listening to music to avoid the noise in an open plan office is “just replacing one distracting noise with another.”  And her research, unsurprisingly, leads her to the inescapable conclusion that music interferes with concentration.  Khazan notes that the more engaging the music is, the worst it is for concentration, adding that “[m]usic with lyrics is dreadful for verbal tasks.”

So the next time your boss tells you to don a pair of headphones to drown out the noise of your fellow open plan toilers, send him or her the link to Ms. Khazan’s article along with a request for an office.

Thanks to @QuietEdinburgh for the link.