Tag Archive: Jan L. Mayes

When hearing aids don’t work

Photo credit: ikesters licensed under CC BY-SA 2.0

by Jan L. Mayes, MSc, Audiologist

Many people with hearing difficulties delay getting help because they’re told hearing aids don’t work. But in my experience, properly fitted hearing aids can improve communication and quality of life for people with hearing difficulties.

Hearing aids are worn on each ear and come in different styles. Prescription hearing aids are selected so amplified sound and chosen features are best for all shapes and sizes of hearing difficulties in all ages. Retail hearing aids are meant for adults with mild to moderate high pitch hearing loss which is a common pattern across causes.

There are different reasons people think hearing aids don’t work. Some issues depend on the hearing aids, while others depend on the person wearing them. Unless there is a health reason that requires that they only wear one, it’s best to get a pair. Like ears, hearing aids should be in pairs for best sound audibility, localization, and communication.

Were the hearing aids fit by a hearing healthcare professional? If yes, then they were chosen to work based on individual testing results and the person’s reported difficult listening situations in daily life. Retail hearing aids won’t work if the wearer doesn’t have mild to moderate high pitch hearing loss.

Do the hearing aids have basic hearing and communication features? Basic or entry level prescription or retail hearing aids should include directional microphones for paired hearing benefits and a telecoil or hearing loop feature. Hearing aids without directional microphones won’t work well in daily life, and hearing aids without hearing loop compatibility won’t work in settings offering disability access.

Do the hearing aids offer modern digital technology? Current entry level features in behind the ear hearing aids, which start at around $1,000 per pair, include more than one listening program for quieter and noisier environments and wireless connectivity to other devices. Some hearing aids include sound therapy for people with tinnitus or decreased sound tolerance, i.e., hyperacusis. Many now have rechargeable batteries with an overnight recharging station which is a plus for convenience and the environment. Old technology hearing aids don’t work nearly as well as modern technology aids.

Were the hearing aids properly manufactured? Even brand new hearing aids can be lemons. While prescription hearing aid manufacturers typically meet international amplification acoustics standards, quality control is voluntary for manufacturers selling directly to the public with no Food and Drug Administration oversight in the U.S. Problems are common even among popular retail manufacturers, with defect rates of 100% for amplification under $150 and 66% defective when under $500 per hearing aid. New amplification sound quality problems include static and distortion, over-amplified or too loud, no high frequency amplification, broken volume control, malfunctioning directional microphones, and faulty telecoils. In my opinion, too many hearing aids sold directly to the public are poorly made and don’t work as advertised.

Does the wearer have hearing system distortion? Some people, especially with a history of noise exposure, have hearing loss with sound processing damage where sound becomes distorted or unclear while travelling up the hearing nerves to the brain. This happens after sound is amplified, meaning people feel their hearing aids don’t work because they still can’t hear or converse easily, especially in ambient environmental noise environments.

Are the hearing aids In-The-Drawer style? ITD style hearing aids worn only seldom or occasionally don’t help much. People with hearing loss need to practice hearing amplified sound again in their daily life. With regular use, people hear better with amplification than without, even in noisy or difficult listening situations.

The next time somebody says hearing aids don’t work, don’t forget there is often more to the story. Did the person get well manufactured hearing aids that meet their individual hearing and communication needs? Do they have realistic expectations of hearing aids? If not, a visit to a hearing healthcare professional could be helpful for problem-solving and guidance.

Jan L. Mayes is an international Eric Hoffer Award winning author in Non-Fiction Health. She is also a blogger and newly retired audiologist still specializing in noise, tinnitus-hyperacusis, and hearing health education. You can read more of Jan’s work at her site, www.janlmayes.com.


Community to vote on noise control cost

Photo credit: Andy Nystrom licensed under CC BY-NC-ND 2.0

by Jan L. Mayes, MSc, Audiologist

What happens when citizens want highway noise control but the financial cost is high? The Canadian community of Beaconsfield, Quebec is facing skyrocketing noise control estimates for a long awaited concrete sound barrier. Since the need was identified in 2010, cost estimates have risen from $25.5 million to $46 million putting the entire project at risk.

Beaconsfield’s sound energy is above World Health Organization noise limits recommended to prevent health damage in pregnant women, newborns to teens, elders, and other groups-at-risk. This doesn’t mean the noise control budget should be unlimited. But a $46 million sound barrier may not be the only solution. Modern options include different sound barrier designs, lower speed limits, quiet asphalt, and greenscaping between residences and the highway. There are new technology sound barriers designed to cut noise and chemical air pollution that are as effective as other barrier styles, and might be less expensive.

While there is no doubt this highway noise is a public health risk, authorities have decided to let community members vote on whether to pay for noise control or not. This will pit resident against resident, leaving the outcome in the control of many people who don’t live near the highway.

If this was a contaminated water supply, there would be no vote on whether to pay what is needed to protect public health. Unfortunately, noise isn’t treated with the same seriousness even though exposure is linked to communication breakdowns, reading delays, and increased risk of impaired health like anxiety, depression, heart disease, Type 2 diabetes, obesity, hearing loss, and dementia.

One of the root causes of this Canadian noise control problem is lack of community planning. Highways and infrastructure were built and expanded too close to homes, schools, playgrounds, and parks. Now there is a $46 million price tag to fix the problem.

In the U.S., the Quiet Community Act of 2019 would include limiting vehicle source noise emissions and better infrastructure planning to prevent community noise. This Act needs senate funding at a cost of $21 million a year. Experts estimate for every $1 spent on noise control, there will be an estimated $1.29 in future savings by eliminating preventable diseases and other adverse social effects of noise.

When it comes time to vote, one hopes the community in Quebec will vote so everyone has equal health protection from harmful noise no matter where they live. When it comes time to vote in the U.S., one hopes citizens will vote for senators who support funding the Quiet Community Act. Prevention will improve public health equality and cost less than noise control after the fact.

Jan L. Mayes is an international Eric Hoffer Award winning author in Non-Fiction Health. She is also a blogger and newly retired audiologist still specializing in noise, tinnitus-hyperacusis, and hearing health education. You can read more of Jan’s work at her site, www.janlmayes.com.


Fake crowd noise poses real health threat

by Jan L. Mayes, MSc, Audiologist

With coronavirus pandemic restrictions on fan attendance, NFL football teams have lost the stadium crowd noise once called a home field secret weapon by the Seattle Seahawks.

As a solution, the NFL has developed club and stadium specific crowd-noise audio to use during TV broadcasts. While the TV crowd-noise audio will have dynamic volumes reactive to game situations, a separate field-level crowd-noise audio played during games has been described as “human torture” by 49ers coach Kyle Shanahan.

The steady volume continuous field-level noise is being played in the 70 to 75 decibel (dB) range which is much lower than typical levels in stadiums full of fans. This new NFL audio soundscape is a good example of the subjective nature of sound perception with teams preferring real or realistic crowd noise reactions over the lower volume drone of pre-recorded field-level audio.

Objectively, sound energy above 70 dB is a hearing health risk. Some teams use special earplugs to screen out harmful noise. Stadiums could also turn down the volume of the new ambient crowd-noise.

One day it will be safe again for fans to return to stadiums. But until then, the NFL’s new field-level crowd-noise won’t give a home field advantage to any team.

Jan L. Mayes is an international Eric Hoffer Award winning author in Non-Fiction Health. She is also a blogger and newly retired audiologist still specializing in noise, tinnitus-hyperacusis, and hearing health education. You can read more of Jan’s work at her site, www.janlmayes.com.


Canadians find quiet ways to connect during the pandemic

This photo is in the public domain

by Daniel Fink, MD, Chair, The Quiet Coalition

Our Canadian colleague Jan L. Mayes reports that in Vancouver people are working together to help amuse children who can’t play with each other due to the social isolation recommendations during the COVID-19 epidemic. One of these is a “bear hunt.” Residents place teddy bears in the windows of their homes or apartments, for the children to spot and count. There are plans for similar Easter egg hunts, with pictures of Easter eggs to be placed in the windows.

These quiet activities contrast sharply with reports of people banging pans to show support for hospital workers as they go to their workplaces, or community singing from windows or balconies in Italy. Or TV host Jimmy Fallon’s cowbell challenge in the United States.

We have reported that the air has become both quieter (Jimmy Fallon excepted) and cleaner in many parts of the world as people shelter in place and avoid social contact.

This may be a small silver lining in the coronavirus cloud enveloping us all.

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 noise control cure for noise-induced tinnitus and hyperacusis

Photo credit: Owen Barker from Pexels

by Jan L. Mayes, MSc, Audiologist

In a 2019 article titled “Why is there no cure for tinnitus?” the authors looked at whether studies had dentified if participants have a history of significant noise exposure that could cause decreased sound tolerance, like hyperacusis or tinnitus. A cure for noise-induced tinnitus and hyperacusis, the authors noted, could be very different from a cure for tinnitus or hyperacusis from other causes, like aging or head injury.

The article shows that it’s important for research to identify noise sub-types when evaluating potential cures. The underlying hearing health damage for sudden high level noise like acoustic trauma is different than damage from chronic moderate level noise over time. That is, the cure for noise-induced tinnitus and hyperacusis from bomb blasts or firearms is likely different than the cure for noise-induced tinnitus and hyperacusis from being exposed to unhealthy noise at school, on public transit systems, or at noisy workplaces.

High level public noise pollution in daily life can impact hearing health of all ages from babies to elders. Fortunately, the solution for tinnitus and hyperacusis caused by public noise pollution is not a cure–it’s better than a cure, as the solution is preventing the noise from happening in the first place.

How? There must be noise control for human manufactured unhealthy noise sources like personal listening devices, aircraft, road vehicles, railways, consumer products, and even MRI machines. There is no need for a cure if the source noise is never manufactured to be loud enough to cause decreased sound tolerance in the first place.

Controlling the source of noise would have other positive effects. Moderate levels of public noise pollution can significantly affect the quality of life for people with tinnitus and hyperacusis by causing poor sleep and making it significantly harder to understand speech in the presence of background noise. This, in turn, can increase stress levels, making it harder to cope and potentially interferring with available treatment.

Noise control is not impossible. Protecting the general public from unhealthy noise must cost less than the combined healthcare costs of diagnosing and treating tinnitus, hyperacusis, and other hearing health damage. And new noise prevention materials are constantly being invented. Examples include an acoustic material invented by Boston University that silences or cancels out 94% of sound waves without blocking light or airflow. A Canadian company is making noise barriers that absorb noise and air pollution. Quiet electric passenger planes could be in regional operation by 2021.

But nothing will change about public noise pollution until authorities and decision makers make health and hearing health a priority. This includes real time city and transportation noise mapping and reporting to identify locations with unhealthy noise. Noise prevention and control is necessary to protect public health and it should be mandatory.

Dr. Daniel Fink describes implications for acoustic engineering and design considerations for structures and enforced noise emission regulations and restrictions. Examples could include muffling school and public hand dryers, hour restrictions or night curfews at airports, quieter leaf blowers, quiet defaults on consumer products like microwaves with an option to turn on audible alerts, quiet solutions to replace vehicle back-up beeps, or preventing new imposed noise from delivery drones or noisy audible vehicle alert systems on electric cars. New technology needs to be quietly accessible for everyone.

Preventing public noise pollution won’t stop all cases of tinnitus and hyperacusis, but it could stop millions of cases around the world. Safe soundscapes without unhealthy noise are best for everyone from newborns to elders. And prevention is always better than trying to treat the problem or find a cure for noise-induced hearing damage after it occurs.

Jan L. Mayes is an international Eric Hoffer Award winning author in Non-Fiction Health. She is also a blogger and newly retired audiologist still specializing in noise, tinnitus-hyperacusis, and hearing health education. You can read more of Jan’s work at her site, www.janlmayes.com.



The health impact of environmental noise

by Jan L. Mayes, MSc, Aud(C), RAud, Audiologist

Environmental noise is damaging and inflicts unwanted sounds into everyday life. In 1984, Gordon Hempton, The Sound Tracker, found 20 natural locations in Washington State with noise-free intervals lasting over 15 minutes. No manmade noise at all. No planes, trains, or traffic. By 1995, only three locations were noise-free. When I employed current sound tracking in my suburban neighbourhood in the Pacific Northwest, I never had noise-free intervals last more than 4 minutes.  And I tried tracking at different times of the day, every day of the week for months.

Sociocusis is high distortion hearing loss caused by loud personal environmental noise (i.e., 75 dB average or higher). The louder the noise, the faster the damage. Noise-induced hidden hearing loss starts first. It begins with permanent rips in hearing nerves for which there are no symptoms, but damage is progressive for months after noise ends. More unprotected noise exposures causes yet more nerve damage leading to temporary or permanent inner ear hearing loss and what I call “hyper ears” (tinnitus and hyperacusis). Presbycusis, or age-related hearing loss, comes from gradual inner ear changes over time. Sociocusis, wrongly called early presbycusis, has a much greater impact on communication and music enjoyment than presbycusis alone.

There are also physical and mental health hazards from chronic environmental noise (i.e., 55 dB – 75 dB average). Health effects include stress, insomnia, learning problems in children, obesity, diabetes, high blood pressure, heart attacks, strokes, dementia, and shorter life. Blood pressure goes up with every 10 dB increase in environmental noise.

Ear protection prevents sociocusis from loud activities like nightclubs, concerts, and stadium events. Imagine if these venues were designated “Noise Hazard Zones”: no ear protection, no entry. Imagine Noise Free Zones like at Comic-Con 2017 in New York City. Imagine architects designing public spaces with quiet acoustics in the first place. Imagine if it was standard for manufacturers to make quiet products, dropping the noise hazard of everything from blenders, lawnmowers, planes, trains, and traffic.

The UK estimates noise pollution related healthcare costs at £1.09 billion annually. The EU is using urban planning and government polices to prevent environmental noise. Noise mitigation strategies include quiet asphalt, low-noise tires, traffic curfews, quieter airplanes, noise-optimized airport take-off and approach procedures, and better infrastructure planning.

But in the U.S., the FAA denies the crippling public health burden of noise pollution, and Congress hasn’t passed the Quiet Communities Act of 2016 or 2017.

Nobel Prize Winner Robert Koch predicted in 1910 that “[o]ne day man will have to fight noise as fiercely as cholera and pest.” I think the day is here.

Jan L. Mayes is an international Eric Hoffer Award winning author in Non-Fiction Health. She is also a blogger and audiologist specializing in noise, tinnitus-hyperacusis, and hearing health education. You can read more of Jan’s work at her site, www.janlmayes.com.