Tag Archive: hearing loss

5 ways to protect against hearing loss

Photo credit: Nelson Sosa licensed under CC BY-NC-ND 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

As we have discussed, hearing loss is not an inevitable part of normal aging but largely represents noise-induced hearing loss.

This article from The Covington News discusses five ways to protect your hearing. The article is sensible, though I’m not sure a baseline audiogram is necessary, and cotton ear swabs aren’t recommended but aren’t a problem unless one pokes the eardrum.

The other three suggestions are spot on: turn down the volume, use hearing protection, and avoid loud noise.

Because if it sounds loud, it is too loud, and your hearing is at risk.

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.

Poor hearing associated with brain changes

Photo credit: Andrea Piacquadio from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

Bryan Pollard, founder of Hyperacusis Research, Ltd., is an electrical engineer. Almost every time I have discussed something with him, he asks me an important question: “What’s the cause? What’s the effect?”

It is very easy to make a mistake thinking that an association is causal when it is not.

One of the best ways to avoid making this mistake is to study a phenomenon over time. If a factor in some research subjects is associated with changes over time, and absence of that factor is not associated with the change being examined, causality is more likely.

A good example of this question is the association of hearing loss with the development of dementia. Maybe hearing loss causes dementia because there is decreased nerve stimulation of certain parts of the brain related to auditory and speech processing, but maybe the brain changes are independent of hearing loss or perhaps even the cause of the hearing loss.

This recent report in JAMA Otolaryngology-Head and Neck Surgery, with an accompanying editorial, uses the study of brain changes over time to try to answer this question. The research was done on the well-studied population of the Baltimore Longitudinal Study of Aging. Hearing tests and studies of brain tissue using specialized research techniques were done. Imaging was done by MRI at the National Institute of Aging.

Results showed that poorer hearing at baseline was associated with specific changes in portions of the brain processing auditory input, but not in other areas of the brain. The editorial notes the limitations of the study and its preliminary nature, but the report is another piece of the puzzle linking hearing loss to dementia.

For at least five years, I have been saying, “If it sounds too loud, it IS too loud.” But based on the accumulating evidence of the dangers of noise for hearing loss, and then the impact of hearing loss on social function, economic success, and the development of dementia, I’ve decided to change my advice.

Now I would say, “If it sounds 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.

Could a drug being developed to prevent hearing loss help fight COVID-19?

Photo credit: Martin Lopez from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

As those who follow my writings know, I’m a big believer in the old public health principle that prevention of disease is almost always better and cheaper than treating it. That principle applies to hearing loss. Preserved normal hearing is much better than the best hearing aid, and costs almost nothing–just avoid loud noise or use hearing protection.

But we follow developments in treating or preventing hearing loss caused by noise exposure. The Holy Grail for this research is a drug that people could take after noise exposure, to prevent any lasting auditory consequences. One of these drugs under development is called Ebsalen.

This new report in the peer-reviewed online journal ScienceAdvances discusses repurposing Ebsalen to fight COVID-19 infection.

We think that may be a better use of Ebsalen than its originally intended use.

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.

 

 

 

 

Dementia isn’t inevitable, and neither is hearing loss

Photo credit: Andrea Piacquadio from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

This new study from the Alzheimer’s Cohorts Consortium, published on an open access basis in the medical journal Neurology, reports that dementia rates appear to be on the decline in Europe and North America. Analyzing results from seven different research studies, the Consortium found that the incidence of dementia declined 13% per decade in the last 40 years, with a confidence interval of 7-19% per decade. The decline was more pronounced in men than in women.

It is difficult to find the cause for the decline, but the researchers think it is due to a focus on treating cardiovascular risk factors, including reductions in smoking, better blood pressure control, and the use of antithrombotic medication. The article states, “[w]hile none of these has been specifically intended to halt cognitive decline, decades of cardiovascular risk management have likely had substantial effects on brain health, supported by reduction of small-vessel disease on brain imaging in more recent years.“

Why am I writing about a decline in dementia in a blog about noise issues?

Is it because research shows that hearing loss is a possible contributing factor to the development of dementia? No, although that statement is accurate.

The reason is that dementia used to be thought of as an inevitable part of aging, but that’s not true. Many cases of dementia have a vascular cause, and can be prevented by treating cardiovascular risk factors.

Similarly, hearing loss is thought to be part of normal aging, as shown by the use of the terms “age-related hearing loss” and “presbycusis”.

I presented a paper at the 12th Congress of the International Commission on the Biological Effects of Noise in Zurich in 2017, reviewing literature that showed that hearing loss was not an inevitable part of aging but largely represented noise-induced hearing loss. A recent research paper from the Massachusetts Eye and Ear Infirmary confirms that conclusion using ear tissue from post-mortem specimens.

I’ve said this before, but it bears repeating: If a noise sounds too loud, it is too loud.

If you protect your hearing–by avoiding loud noise and using hearing protection when you can’t–you should be able to hear well when you get old. And maybe you’ll reduce your chance of developing dementia, too.

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 use causes hearing loss

by Daniel Fink, MD, Chair, The Quiet Coalition

This report from the Sydney Morning Herald discusses headphone use causing hearing loss. It uses a term I hadn’t heard before–“headphone culture”–to describe the ubiquitous use of personal audio systems to provide a continuous soundtrack for daily life. There is mounting evidence that noise exposure in everyday life is loud enough to cause hearing loss in a majority of urban dwellers, and that exposure is exacerbated by using headphones or earbuds to listen to music or podcasts for hours a day.

The only quibble I have with the article is that it cites the occupational noise exposure levels of 80 or 85 decibels as being the safe sound threshold. This just isn’t true. Noise exposure levels that don’t even protect all exposed workers from noise-induced hearing loss certainly aren’t safe for the public!

The problem with listening to a personal audio device using headphones or earbuds is that to overcome ambient noise so one can hear what one is listening to, as when walking down the street or riding a bus or subway to work, the volume has to be turned up to dangerously loud levels.

For parents, the problem with children using headphones so they can listen to music or watch a video without disturbing others is that the parents can’t monitor the sound level or what their children are listening to.

The article discusses safer headphones with a volume limit, but my conclusion is that listening to music or podcasts or audiobooks using headphones or earbuds is as bad for the ears as smoking is for the lungs and heart.

Most volume limiting headphones use the occupational 85 decibel recommended exposure level as the volume limit and that simply won’t prevent hearing loss.

There is no safe cigarette, and headphones or earbuds with a volume limit may be safer than those without a volume limit, but they are certainly not safe.

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 loud noise affects your health

by Daniel Fink, MD, Chair, The Quiet Coalition

This article, online and in the print version of Prevention magazine, discusses noise pollution and how loud noise can affect health. Loud noise causes auditory problems–hearing loss, tinnitus, and hyperacusis–but also has less known non-auditory health effects as well. These include sleep disturbances, hypertension, obesity, diabetes, and cardiovascular disease, leading to increased mortality.

It’s relatively easy to protect one’s ears from auditory damage: avoid loud noise or use hearing protection if one can’t.

Protecting populations from the non-auditory health effects of noise will take concerted political effort to get legislation requiring quieter planes, vehicles, and trains passed and enforced.

But I believe if enough people complain to enough elected officials, a quieter world is possible.

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.

Is your music making you deaf?

Photo credit: Harrison Haines from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

Is your music making you deaf?  That’s the title of this post from BWorld online.

The answer, technically, is no. Deafness means congenital absence of hearing, or profound hearing loss. Loud music won’t make you deaf. But loud music can certainly cause hearing loss.

Hearing loss and tinnitus are occupational hazards of being a rock musician. And loud music is a threat to auditory health of concert goers and clubgoers and those who listen to loud music on their personal listening devices.

We recommend avoiding loud music all the time. There is no such thing as temporary auditory damage.

If the music (or any other sound) sounds too loud, it IS too loud. Turn down the volume, leave the area, use hearing protection, or accept that you’ll probably need hearing aids in the future.

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.

(Re)learning to run without headphones

by Daniel Fink, MD, Chair, The Quiet Coalition

In this delightful essay in The Atlantic, writer Talmon Joseph Smith describes what happened one day when he was out on a run and his smartphone, the source of the almost constant soundtrack accompaniment to his daily life, died. He titled his essay “Learning to Run Without Headphones,” but my guess is that he knew how to run before he discovered headphones. But he certainly rediscovered the joys of listening to the world around him and thinking his own thoughts without being distracted by a constant soundtrack.

The World Health Organization calls a music player and associated headphones or earbuds a “personal audio system.” A 2017 Nielsen survey reported in Forbes Magazine found that the average American listens to a PAS for 4.5 hours a day, up sharply from 3.8 hours daily in 2016 and only 3.3 hours daily in 2015. And a 2017 report is already out of date.

I can’t access the report myself, so I don’t know if they only surveyed PAS users or the entire population. If the survey group included the entire population, including people like me who never listen to a PAS, the number of hours PAS users listen to their devices is much greater than 4.5 hours daily.

PAS use has already been shown to cause hearing loss and tinnitus (ringing in the ears) in children as young as 11. It’s probably doing the same to adult ears, too.

The tag line on a popular credit card advertisement asks, “What’s in your wallet?” Concerning PAS use, I would ask, “What’s in your ears?” If you’re turning up the volume loud enough to drown out the rumble in the subway car, or other conversations in the bus, on your daily commute, or traffic noise when running or walking, you’re probably damaging your hearing.

And just as important, you’re missing out on important time with your own thoughts, as well as the sounds of nature if you’re outdoors.

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.

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.