Tag Archive: hyperacusis

Restaurant noise in the news

by Daniel Fink, MD, Chair, The Quiet Coalition

I became a noise activist because I have tinnitus and hyperacusis and find loud restaurants unpleasant, so it was gratifying to see these two articles about restaurant noise. One is about restaurant noise in Austin, Texas, and the other more broadly reports about a study on restaurant noise sponsored by hearing aid manufacturer Oticon.

Both articles point out that the noise levels in many restaurants are loud enough to cause hearing loss, and that restaurant patrons have difficulty conversing due to the high ambient noise levels.

What the articles don’t mention is that restaurant noise is a major problem for older Americans, half of whom have hearing loss.

As long as the restaurants are busy, I don’t think they will voluntarily bother to make themselves quieter. As with smoke-free restaurants, this is something that will require enough voters complaining often enough to their elected officials to get regulations requiring quieter restaurants. Until that happens, speak up. If you go to a restaurant that is too loud, ask the manager or wait staff to lower it. If they won’t, leave.

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.

How a YouTube-inspired prank ruined a young girl’s life

 

photo credit: Edvvc licensed under CC BY-SA 3.0

Laurie Redmond writes about how a stupid prank by YouTube “trickster” Rick Lax inspired a miscreant to copy a video the aptly named Lax posted of his “prankster pal,” Ryan Hamilton, blasting his girlfriend with an air horn to get her to put down her phone.  Redmond notes that the video “entitled ‘How to get your girlfriend to put her phone down,’ has an astounding 246m views.” Sadly, one of the viewers was her 12-year old daughter Cindy’s friend’s ex-stepfather, who decided to play the prank on Cindy.

But after this miscreant played his prank, things fell apart for Cindy who eventually was diagnosed with “hyperacusis, or noise-induced pain.” As a result of this “prank,” Cindy has a “burning pain in her ears all the time…[and] [w]ith all noise louder than ordinary conversation, she feels like she is being stabbed in the ear. Her ears ring.”

Redmond has since learned that another “YouTube prankster, an F-list celebrity named Jake Paul, was sued for wrecking someone’s ears with an air horn.”  And yet the air horn “prank” videos remain on YouTube and Facebook, even though they “recently removed Tide Pod challenge videos so as not to encourage dangerous stunts.” Redmond asks what it will take to have these dangerously stupid and vile videos off of social media.  We would suggest litigation might do the trick, while recognizing how terrible things are when the only option is litigation.

MRIs are dangerously noisy

Photo credit: liz west licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

MRI noise is in the news in two recent reports.

People magazine reported the story of a woman who suffered permanent auditory damage from an MRI, developing hyperacusis (a sensitivity to noise, which causes pain) and tinnitus. The Quiet Coalition’s Bryan Pollard, an expert on hyperacusis, is quoted in the article.

And researchers from SUNY Buffalo and China wrote about MRI noise in The Hearing Journal.

Standard MRIs produce noise in the 110-115 decibel range, and newer more powerful MRIs are even louder. Knowing this, I have several quibbles with the information in The Hearing Journal article. Namely, the article cites occupational noise exposure standards, but these use A-weighted decibels (dBA) to reflect the frequencies of human speech. MRI noise is low frequency noise, so occupational noise limits may not protect hearing adequately. And occupational standards are not safe standards for the public. At least 25% of workers exposed to sound at occupational noise exposure standards will develop hearing loss.

Most importantly, for many people the auditory damage caused by MRI noise isn’t hearing loss but tinnitus and hyperacusis, as in the People magazine article. Exactly how noise causes tinnitus and hyperacusis isn’t yet known, but the mechanisms are likely different from cochlear hair cell damage causing noise-induced hearing loss.

Finally, the authors talk about temporary auditory damage, but many researchers think that any temporary auditory changes indicate that permanent damage has been done.

I can’t find any large-scale studies of auditory problems after MRIs–the equipment manufacturers wouldn’t be excited about funding such a study, and radiologists are interested in the image, not in the patient’s hearing–but anecdotal reports from audiologists indicate that this is a problem for too many people undergoing diagnostic MRIs.

So if you need an MRI, be sure to ask for “dual protection”– ear plugs and ear muffs. NIOSH recommends dual protection for noise exposure over 100 dBA.

And if you suffer auditory damage from an MRI, be sure to file a report with the FDA. That’s the only way the government will be induced to issue appropriate patient safety regulations.

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.

The wrong answer to the restaurant noise problem

Photo credit: Jeremy Keith licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

This report from the United Kingdom discusses expensive new headphones which can help someone understand conversations in a noisy restaurant.

This is the wrong answer to the restaurant noise problem.

Why should someone have to spend £400–about $530 at current exchange rates–just to be able to understand a conversation in a restaurant in London?

The right answer is making restaurants quieter, by reducing background music levels and adding sound-absorbing materials, so everyone can have a conversation without straining to speak or to be heard.

Noisy restaurants are a major disability rights issue for those with hearing loss, tinnitus, and hyperacusis. And it is an important issue for older Americans, many of whom have significant (25-40 decibel) hearing loss.

I will be speaking about the problem of restaurant noise at the December 2017 meeting of the Acoustical Society of America in New Orleans.

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.

Millions of people don’t protect their ears

Photo credit: Quinn Dombrowski licensed under CC BY-SA 2.0

By Daniel Fink, MD

Noise is a medical and public health problem, and yet people ignore it at their own peril. Most of us are exposed to too much noise every day. That may explain why the Centers for Disease Control and Prevention found that about 25% of adults age 20-69 had hearing loss, and that many people with hearing loss didn’t know they had it.

Which is why a recent article by Mark Fischetti in Scientific American,A Loud Warning: Millions of People Do Not Protect Their Ears,” is particularly disturbing. Fischetti reports that while “many people know that they should use earplugs or earmuffs when mowing the lawn or partying at the club,” they don’t protect their ears against noise at home or at work. If you click the link to the article, you’ll see a frightening infographic that very clearly shows that millions of Americans are at risk of losing their hearing or suffering other hearing damage because they fail to protect their ears.

Maybe if people knew that noise caused hearing loss, tinnitus, and hyperacusis–none of which can be cured–they might be motivated to protect their hearing and fight for quiet.

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 teens get tinnitus?

The answer, sadly, is yes. Emily Barker, writing for Redbrick, tells us about how she developed tinnitus from a one-time exposure to loud sound at a night club when she was 19-years-old. Barker says that she “never had any trouble with nights out being too loud, never had any pain or discomfort from loud music.” But after spending the evening at the club, and after she and her friends went back to the hostel they were staying at, she noticed that her ears “were ringing like crazy,” and she remembered “laughing about it with my friends because they were having the same issue and we were unintentionally shouting at each other from across the room.”

The laughter stopped the next day when Barker found that her ears were still ringing even as her friends’ ears had recovered. A couple of months later, she got confirmation that her hearing had been permanently damaged and she had tinnitus. She also was diagnosed with hyperacusis, a sensitivity to sound, so that “[a]pplause, doors or cupboards slamming, and things being dropped on hard floors are all sounds that [she] now find[s] extremely painful.”

Barker writes about the frustration of having developed tinnitus while everyone else she knew at the event did not, particularly since there was no family history of tinnitus. All she was told was that “sensitivity to noise is thought to be partly hereditary,” so her doctor theorized that she was “just an ‘at risk’ person.”

Barker concludes her piece with a warning to other teenagers and young adults, by listing myths about tinnitus, including, most importantly, the belief that you can’t get it from one night of clubbing. As she points out:

This is still the hardest thing for me to accept; it’s difficult to understand how just a few hours that caused me no distress or pain at the time can have had such a permanent impact. But the hairs in your inner ear can be destroyed by mere seconds of noise if it’s loud enough, and they cannot regrow: ergo, no cure.

Click the link to read the whole thing, and forward it to a teenager you know.  Hey, they might actually read it.

On hearing loss and the hope for a cure

In “High-Tech Hope for the Hard of Hearing,” David Owen, The New Yorker, has written an article that gives us a good look at what scientists know about hearing loss and where they are finding possibilities for treatment and, possibly, a cure. He begins his article with a series of personal anecdotes about himself, his family, and friends and the hearing problems they’ve developed due to exposure to loud noise and other factors. Owen’s interest in this story is motivated, at least in part, by his tinnitus, which is marked by a constant high-pitched ringing in his ears.

Among the advances that Owen examines, he discusses the discovery of hidden hearing loss and introduces us to Charles Liberman, who, with his colleague Sharon Kujawa, “solved a mystery that had puzzled some audiologists for years: the fact that two people with identical results on a standard hearing test, called an audiogram, could have markedly different abilities to understand speech, especially against a background of noise.” He writes that “[s]cientists had known for a long time that most hearing impairment involves damage to the synapses and nerve fibres to which hair cells are attached, but they had assumed that the nerve damage followed hair-cell loss, and was a consequence of it.” What Liberman and Kujawa discovered is that “the connections between the sensory cells and the nerve fibres that go first.” And the reason this early damage isn’t picked up by a standard hearing test is because it measures “the ability to detect pure tones along a scale of frequencies [which] requires only functioning hair cells…and is unaffected by nerve damage until more than eighty per cent of the synapses are gone.”

“A disturbing implication of [Liberman and Kujawa’s] finding is that hearing can be damaged at decibel levels and exposure times that have traditionally been considered safe,” writes Owen, but he is reassured by the researchers that the discovery of hidden hearing loss is cause for optimism. Why? “[B]ecause reconnecting nerve synapses is almost certain to be easier than regenerating functioning hair cells inside human ears.” In fact, Owen tells us that Liberman and others “have successfully restored some damaged connections in lab animals, and [Liberman] believes that far greater advances are to come.”

While cause for optimism is welcome, Owen notes something early in his article that is particularly frustrating to those advocating for regulation of noise:

There are also increasingly effective methods of preventing damage in the first place, and of compensating for it once it’s occurred. The natural human tendency, though, is to do nothing and hope for the best, usually while pretending that nothing is wrong.

Click the link above to read this interesting and hopeful article in full.

 

 

A sobering article on a severe form of hyperacusis:

Photo credit: Epic Fireworks

When even soft noises feel like a knife to the eardrums. Joyce Cohen, writing for Statnews.com, introduces us to Tom Maholchic, who suffers from a severe form of hyperacusis where noise is felt as physical pain. Most people who have hyperacusis find ordinary environmental sounds to be uncomfortably loud, but a more severe form, like that which Maholchic has, is far more debilitating. For Maholchic “routine sounds — the sizzle of bacon, the ring of a phone, the rush of running water,” feels “like a knife stabbing his eardrums.”

Cohen explains that while researchers have known about hyperacusis for years, very little was know about the more severe form, until very recently:

Using new lab tools and techniques, pioneering scientists have identified what appear to be pain fibers in the inner ear, or cochlea. They are coining new terms, including “noxacusis” and “auditory nociception,” for this newly recognized sensation of noise-induced ear pain.

Cohen gives us an overview of the difficulties researchers confronted in attempting to learn more about nerve fibers within the cochlea, “a tiny sensory organ buried within a skull bone [that is] tough to reach and impossible to biopsy.”  But, nonetheless, advances have been made.  And for sufferers like Maholchic these new findings will help them get some understanding about a condition that “[f]ew doctors or audiologists are even aware of.”

Most importantly, as the research continues and hyperacusis becomes more generally known within the medical community, one hopes that general practitioners and other medical professionals will advise their patients to avoid exposure to loud sound. As Cohen writes, noise loud enough to cause immediate pain is rare, “[b]ut exposure over time to more modest noise — from music, movies, sirens, lawnmowers, and a thousand other everyday things — can damage hearing and set off the pain fibers.”  Maholchic didn’t think his noise exposure was unusual–he said he listened to his ipod while vacuuming, played in a garage band, and worked at a lively restaurant–but one day his ears started ringing and shortly thereafter the pain began.  Even if the research advances quickly and a treatment or cure is found in Maholchic’s lifetime, no doubt he would agree that preventing the condition would have been the better option.

 

Despite complaints, restaurant noise continues unabated

by Daniel Fink, MD

Ever since I developed tinnitus and hyperacusis from a one-time exposure to loud restaurant noise, I have been looking for a quiet restaurant (see the Acknowledgements section at the end of my editorial in the January 2017 American Journal of Public Health, “What Is a Safe Noise Level for the Public?“).

It turns out I’m not the only one complaining about restaurant noise.

Restaurant noise is the number one complaint of diners in New York, San Francisco, Portland OR, and Boston.  In fact, the Boston Globe just recently wrote about diners’ dislike of restaurant noise in a piece titled, “Listen up: Restaurants are too loud!

Restaurant owners may think that noise increases food and beverage sales, and decreases time spent at the table, and they are right.  But what they cannot measure is how many meals are lost because people like me don’t go to noisy restaurants with family or friends, choosing to dine at home, instead, where we can converse as we enjoy our meal. Perhaps restauranteurs should consider that we middle-aged folks are more likely to spend money in restaurants than other demographic groups.  After all, for many of us our kids are done with college, our mortgages are paid off, we’ve been saving for retirement, and we have the disposable income to enjoy a nice meal out more frequently than in our youth.  If there were quieter restaurants, we might dine out more often instead of avoiding them because we would rather not have a side of hearing loss with our steak frites.

I guess that as long as the restaurants are busy, they will stay noisy. But if enough of us speak up–in the restaurants and to our elected representatives, asking them to pass laws requiring some limits on indoor noise–restaurants will eventually get quieter.

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.

Age doesn’t matter,

you could have hidden hearing loss (and not know it). WMAR Baltimore reports on hidden hearing loss, a relatively recently discovered hearing breakthrough that explains how people who pass hearing tests have problems hearing in noisy environments.  WMAR interviewed audiologists about this breakthrough, who said that “why patients can’t decipher speech in noisy situations has been unexplained, but a new breakthrough is changing that.”  The researchers who made the hidden hearing loss breakthrough studied young adults who were regularly overexposed to loud sounds, and found that “hidden hearing loss is associated with a deep disorder in the auditory system.”

It’s never too late to protect the hearing you have.  Exposure to loud sounds damages hearing.  Period.