Tag Archive: hearing loss

How to help protect teens’ hearing while at school

Photo credit: Thomas Cizauskas licensed under CC BY-NC-ND 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

Our friends at the CDC’s National Center for Environmental Health recently released data on the use of personal hearing protection among young people at loud school events, such as sports events or band practice. There are probably fewer in-person events at schools these days due to the COVID-19 pandemic with most students learning remotely, but some school districts still have sports events and with the forthcoming availability of vaccine, school will return to normal eventually.

The CDC found that 46.5% of teenage students are regularly exposed to loud sound at school but almost none are given information about hearing protection or hearing protection devices.

Please help CDC spread the word. Forward this information to teachers, school administrators, boards of education, and others responsible for educating our students.

And if you have teenage children or grandchildren, forward this to them, too.

Noise-induced hearing loss is entirely preventable. Tell them, ‘Wear earplugs now, or need hearing aids 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.

A COVID silver lining? Mask use in Korea reveals hearing loss

Photo credit: Jens-Olaf Walter licensed under CC BY-NC 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

This report from The Korea Biomedical Review notes that mask wearing during the COVID-19 pandemic is making many Koreans recognize that they have hearing loss. We all use facial expressions and gestures to help us understand what others are saying, and many people unconsciously lip read as well. But when we are wearing masks, awareness of facial expression is limited to the eyes and forehead and it’s impossible to lip read, so we are left dependent only on our hearing to understand what others are saying.

South Korea had an effective government response to the COVID-19 pandemic, involving universal mask wearing, social distancing, an early testing program, and effective contact tracing with isolation of infected individuals. Thanks to these efforts, according to WorldOMeter South Korea has had only 667 cases of COVID-19 per million population and only 10 deaths per million population.

In contrast, in the U.S., the lack of an effective national response has led to 41,444 cases per million and 823 deaths per million.

To use absolute numbers, which may be easier for some to understand, the population of South Korea is approximately 51 million and that of the United States 330 million. Using an adjustment factor of 7, which actually overstates the adjustment for the respective population sizes, South Korea has had 34,652 cases of COVID-19 and 526 deaths. If South Korea had as many people as the United States, it would have had 242,564 cases of COVID-19, and 3682 deaths. The U.S. has unfortunately had almost 14 million cases and almost 275,000 deaths. The difference in case and death numbers is due to almost universal mask wearing in South Korea.

But universal mask wearing in South Korea made it hard for those with hearing loss to understand what others were saying, because they were deprived of the visual cues associated with speech.

And according to Prof. Moon Il-jung in the Otorhinolaryngology Department at Samsung Medical Center, more patients are coming to the hospital to receive hearing tests, with hearing aids prescribed for those who have hearing loss.

And that may be a rare silver lining to the COVID-19 cloud.

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 wearing a mask protect your hearing?

Photo credit: Anna Shvets from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

COVID-19 (technically SARS-CoV-2) is a novel coronavirus first detected less than a year ago. Because it is new, no one has immunity to it, leading to a worldwide pandemic. And also because it is new, physicians, public health experts, virologists, and many others have much to learn about it.

Two recent articles add to this knowledge.

One, in JAMA Otolaryngology-Head and Neck Surgery, reports that COVID-19 was isolated from mastoid bone and middle ear tissue. The other, in BMJ Case Reports, described a case of sudden irreversible hearing loss ascribed to COVID-19 infection.

It is well known that respiratory viruses can affect the middle and inner ear. Now we know this is also true for COVID-19.

Could wearing a mask to protect yourself and others from COVID-19 also protect your hearing?

Based on these two articles, I think the answer is, “Yes.”

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 study shows association of hearing loss with cognitive decline

Photo credit: Xiaofan Luo licensed under  CC BY-NC-SA 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

We have reported previously on associations between hearing loss and dementia in the U.S., and studies finding brain changes associated with decreases in auditory input due to hearing loss. Hearing loss is also associated with depression.

This study from China, published in JAMA Network Open, confirms these associations in a different population. The China Health and Retirement Longitudinal Study is following a nationally representative survey of adults age 45 and older, and their spouses. The current study looked at data from 18,038 participants with an average age of 59.9. Hearing impairment was associated with worse performance in episodic memory, mental intactness, and global cognition and a greater risk of depression.

Correlation is not causation, but this report from another country with a different language and culture confirms studies in the U.S. and Europe. It’s another piece of the puzzle in trying to understand why some people develop certain problems as they age. Research is ongoing to elucidate how hearing loss contributes to or causes cognitive decline, and whether providing hearing aids can prevent or slow cognitive decline.

In the meantime, we urge people to protect their hearing as assiduously as they protect their vision. We don’t stare at the sun. We wear sunglasses when outdoors. And we should view hearing loud noise just like staring at the sun. Loud noise is as dangerous for the ears as the sun is for the eyes.

Because if something sounds loud, it’s too loud, and auditory health is in danger.

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.

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.