Tag Archive: hyperacusis

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.

 

New Umbrella Organization Takes Aim at Noise

On October 1, 2016, members of nine scientific, medical, and legal organizations launched a national umbrella anti-noise group, The Quiet Coalition (TQC), hosted by the nonprofit organization Quiet Communities, to advocate for a quieter world. TQC brings together a diverse group of organizations and individuals, each with a unique focus or interest, in the fight against noise. It brings medical, scientific, legal, and other specialized knowledge to the public policy process to advocate for all Americans to make our world quieter, more sustainable, and livable. On December 7th, TQC’s website went live.

TQC recognizes that noise is like secondhand smoke, in that it is both a nuisance and a health hazard. Both environmental noise and secondhand smoke involuntarily expose large segments of the public to harmful conditions, increasing their risk of disease.  And decades of research show conclusively that excessive environmental noise adversely affects health, learning, productivity, and the environment.

Why have decision makers been so slow to regulate noise? According to a newly published editorial in the American Journal of Public Health by Daniel Fink, MD, Founding Chair of the TQC, the answer lies in public policy.  “Although noise was known to be a health hazard, it was treated as an environmental pollutant…with federal noise control activities assigned to the EPA.” These noise control activities were never adequately funded or supported, and federal and local health agencies were left with no meaningful responsibility. As a result, the issue has remained under the radar. TQC intends to change this now.

“The scientific evidence is incontrovertible: noise causes hearing loss and other health problems. We have a responsibility to speak up just as experts did when the dangers of smoking became known,” says Fink. Fink adds that “through recent discoveries, the mechanisms by which noise damages auditory cells, the nervous system, and the cardiovascular system are becoming clear.”  TQC Program Director Jamie Banks, PhD, notes that “[p]ublic health policy to protect the nation’s health from environmental noise is long overdue,” and declares that, “[TQC] will provide decision makers with the scientific evidence needed to make informed policy decisions.”

To learn more about TQC and it’s mission to protect the public from noise, visit the TQC website.

 

Why is Big Pharm focusing on new treatments for hearing loss and other auditory disorders?

Because they smell money, of course.  And because they sniff a potentially big money-making opportunity, the pharmaceutical industry is racing to find treatments for a host of auditory disorders.  It’s a shame there’s no money in prevention, because noise-induced hearing loss and most cases of tinnitus and hyperacusis are 100% preventable.  So if you don’t have hearing loss, tinnitus, or hyperacusis yet, save yourself some cash and limit your exposure to noise now.  Or try your luck and hope that at least one pharmaceutical company finds a cure before you experience symptoms.

 

 

What is America’s most common workplace injury?

Hearing loss.  Zhai Yun Tan, Kaiser Health News, writing for PBS News Hour, examines hearing loss, which the Centers for Disease Control and Prevention has identified as “the most common work-related injury with approximately 22 million workers exposed annually to hazardous levels of occupational noise.”  ‘[I]n an effort to reduce these numbers,” she writes, “the Labor Department launched a challenge earlier this summer called ‘Hear and Now,’ in which it is soliciting pitches for innovative ideas and technology to better alert workers of hazardous noise levels.”

Critics have countered that technology to address the problem already exists.  The real problem, they claim, is that the maximum noise exposure level and Occupational Safety and Health Administration (OSHA) regulations are outdated.  Among other things, the OSHA regulations “use sound level limits that don’t factor in the noise exposures that occur beyond the workplace — at restaurants, concerts and sporting venues, for instance — that can add to workers’ cumulative risks of harm.”  OSHA officials offered that “the agency will issue a request for information later this year about current regulations at construction sites to figure out if more stringent protections are needed and how companies are complying,” but Tan notes that “[a] similar call for information was issued in 2002, but no changes resulted from the action.”

Tan suggests that employers will have to assume more responsibility in educating workers, as some workers do not use hearing protection at work because they are not aware of the risk.  Click the link above to learn more, including Tan’s report about Jeff Ammon, a former construction worker who can no longer work due to hearing loss and hyperacusis, a condition marked by sensitivity to environmental noise.