Tag Archive: M.D.

Headphones marketed as safe for children aren’t!

kid-wearing-headphones

By Daniel Fink, M.D.

A new analysis on “the best kids’ headphones” by The Wirecutter, a product recommendations website owned by The New York Times, as reported in the New York Times science section, found that headphones marketed as “safe” for children’s hearing were louder than advertised. The Times’ article did not adequately reflect the extensive and thoughtful analysis by The Wirecutter’s reviewers, Lauren Dragan and Brent Butterworth. Their review deserves to be read (and reread) in its entirety, as it is without doubt the most complete and scientifically sound review about any noise topic that I have seen in the popular media.

The Wirecutter review mentions that two problems with headphones marketed as “safe for children”: (1) that the headphones are louder than they claim to be, and (2) that manufacturers are using an industrial-strength occupational noise exposure level as a safe noise level for children. The review doesn’t emphasize the latter point enough.

I discuss the origin of the 85 decibel noise exposure standard in detail in an editorial in the January 2017 issue of The American Journal of Public Health. The 85 decibel volume level at issue was developed by the National Institute for Occupational Safety and Health (NIOSH) to protect workers’ hearing. It comes with strict time limits–an 8-hour day, 240 days a year, for a 40-year work career–and even then does not protect all workers from hearing loss. NIOSH discussed the difference between an occupational noise standard and a safe noise level for the public earlier this year in a blog post titled, “Understanding Noise Exposure Limits: Occupational vs. General Environmental Noise.” The NIOSH post makes it very clear that 85 decibels is not a safe noise level for the public, and it certainly is not safe for toddlers or children who may be listening to music or watching videos for more than 7 hours a day, every day. In addition, children, and especially teens, are exposed to other loud noise sources–action movies, sports event, etc.–so their total noise dose likely approaches dangerous levels.

Children’s ears may be more sensitive to noise than adult ears. First, there is no doubt that an 85 decibel headphone speaker is closer to a child’s eardrum because the external auditory canal is shorter in children than adults. (Noise follows the inverse square law, so the closer a noise source is to the ear the louder it is.) Second, it’s unlikely that children will limit their listening to just 240 days a year, on average they will live for almost 80 years, and in the course of their lifetimes they will undoubtedly be exposed to more noise, in gyms, parties, rock concerts, sports events, and the like. A child’s delicate ears have to last her a whole lifetime.

Studies of auditory acuity in so-called primitive populations show that significant hearing loss in old age is not inevitable. These studies are not available online, so I can’t provide links, but the classic studies were done in the 1960’s by Rosen and colleagues in the Mabaan population in the Sudan, and by Dickson and colleagues in the Kalahari Bushmen. Rosen found that the Mabaan could carry on a conversation at normal speech volumes while facing away from each other at a distance of 100 yards. Dickson wrote that the Bushmen could hear an airplane 70 miles away. As noted in The Wirecutter review, acute hearing was a matter of life or death for our primitive ancestors, either to find food or to avoid being a predator’s meal. The Rosen and Dickson studies suggest that hearing loss so commonly seen in the U.S. is likely not part of normal part of normal physiological aging, but rather is noise-induced hearing loss–i.e., the result of a lifetime’s exposure to excessive noise. If one starts listening to 85 decibel sound at age 3, hearing loss and hearing aids may be inevitable–and at an earlier age than in the past.

What can be done to protect children’s hearing from dangerous consumer products marketed to them? The federal agencies charged with protecting the public should do their jobs. The Federal Trade Commission should take enforcement action on the grounds of false advertising against vendors claiming that headphones with the 85 decibel volume limit are safe for children. They may be safer than headphones without a volume limit, but they are by no means safe, especially without recommendations for time limits on use. The Consumer Product Safety Commission should require warning labels on headphones, earbuds, and personal music players, stating “LOUD MUSIC CAUSES DEAFNESS!” The pediatric community should do more to educate parents about the dangers of noise for children. And parents must step up and demand truly safe products for their children or deny their children access to products that will destroy their hearing.

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.

September 8th is the Kickoff for a Public Health Crisis

By, Daniel Fink, M.D.

Some public health crises–the spread of Zika or an outbreak of Ebola, for example–are surprises.  But on September 8th, with the start of the National Football League season in Denver, a public health crisis can be predicted with stunning accuracy.  Weaponized stadium noise levels, used by professional football teams to interfere with visiting teams’ play calling, will cause mass auditory damage to tens of thousands of football fans.

Stadium noise is a danger at college games, too.   But I am going to focus on the professional game because the football players, team staff, and stadium employees are protected by regulations promulgated by the Occupational Safety and Health Administration (OSHA), which establishes permissible exposure levels for workplace noise.  The public and student athletes in college sports have no such protection.  For some strange reason–most likely because the Environmental Protection Agency’s Office of Noise Abatement and Control (ONAC) was defunded in 1981–there are no federal safe noise levels for the public. (For background on the defunding of ONAC, see Lessons from a Public Policy Failure: EPA and Noise Abatement).

The world record stadium noise level of 142.2 decibels was set in 2014, in a game between the Kansas City Chiefs and the visiting Seattle Seahawks.  That record exceeds the OSHA maximum permissible noise level of 140 decibels!  The crowd in Kansas City’s Arrowhead Stadium broke Seattle’s previous record of 137.6 decibels.  At 136 decibels, the maximum legal time for workplace exposure is less than one second.  So one could say that both stadium noise records likely set another world record: the largest number of people sustaining auditory damage at one event.  At Arrowhead Stadium, that world record number was 76,613.

Football games were always noisy, but not this noisy.  From 1989 until 2007, an NFL rule allowed officials to penalize a team if fans made noise loud enough to interfere with play calling.  Abolition of that rule allowed home teams to turn up the volume, both of crowd noise and of amplified sound.

So how loud is 140 decibels? That’s about as loud as a jet engine at full throttle getting ready for takeoff.  That’s loud enough to cause permanent hearing loss, tinnitus (ringing in the ears), or hyperacusis (a sensitivity to noise) with only one brief exposure.  Brief repeated noise exposure is called intermittent exposure.  While the noise exposure may not meet the continuous exposure thresholds used by OSHA, the total effect of enough intermittent loud noise exposure may be sufficient to cause auditory damage.

If thousands of football fans suffered diarrhea after eating tainted food or drinking contaminated water at a football game, public health authorities would sweep in, investigate, and take action.  But because it’s “only” hearing loss (and tinnitus and hyperacusis), nothing is done.  Keep in mind that an average of 68,000 fans attend each NFL game, which is the highest attendance per game of any professional sports league in the world.  That means that more than 17 million fans are potentially at risk of auditory damage in any given year.*

This risk is not hypothetical.  Research first reported in 2009 indicates that there is no such thing as temporary auditory damage.  If someone exposed to loud noise has temporary tinnitus or diminished hearing after exposure, permanent auditory damage has been sustained.

Some football teams have started to respond to the dangerous noise levels by offering earplugs to fans.  Is this enough?  In a word, no.  Without efforts to control noise levels, without warning fans that their hearing is being endangered, and without public health authorities taking steps to protect the public’s auditory health, more needs to be done.  If not, perhaps trial attorneys will step in where the government refuses to tread.  I can see the lawyers’ advertisements on television: “Were you at Arrowhead Stadium on September 29, 2014?  Do you have problems with your hearing now?  Call us to learn what you can do to get compensated for your permanent hearing injury.”

In the meantime, if it sounds too loud, it IS too loud!  Fans should bring their own earplugs or earmuff hearing protection to both professional and college football games. And if the noise level is above 100 decibels, follow the National Institute for Occupational Safety and Health’s recommendation and bring both!

*The actual number of people at risk of auditory damage from NFL games annually is fewer than 17 million as many people attend more than one professional football game each season, but it has to be a large number.  The noise exposure issue is a complex one beyond a full discussion in a brief blog post.  Key issues include the Time Weighted Average (TWA) noise exposure (i.e., the total noise dose at an event and over a day, a year, and a lifetime that causes auditory damage) and the fact that if one experiences only two hours of noise above 85 decibels it is mathematically impossible to reach the CDC’s recommendation of an average noise dose of only 70 decibels for 24 hours to avoid hearing loss.  A discussion of sound measurement and A and C weighting and the difference between an occupational noise exposure and a safe noise exposure level for the public is also beyond the scope of this brief blog post.

Daniel Fink, M.D., is a leading noise activist based in the Los Angeles area.  Dr. Fink serves on the board of the American Tinnitus Association, is the interim chair of Quiet Communities’ 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.  Opinions expressed in this article are his own and not necessarily those of the American Tinnitus Association, Quiet Communities, or The Quiet Coalition.

 

 

A common lament:

Dyckman’s deafening daily drumbeat: A local resident is sick of the noise.

Ann Votaw writes about New Yorker’s number one complaint: noise.   Trying to understand out how to stop the noise in her neighborhood, she contacted Arline Bronzaft, a leading environmental psychologist who advised five mayors on the consequences of noise pollution, who stated that “[n]o other city in the United States is more aware of intrusive sound than New York.”  Ms. Bronzaft lauded the city’s 311 system, the Department of Environmental Protection, and the police department “for their dedication to the New York City Noise Code,” she acknowledged that 311 was effective at collecting metrics but was unsure of “how the system executes solutions leading to relief.”

New York City’s Noise Code and 311 system are good steps in combating noise pollution, but the focus must shift to enforcing the code and punishing offenders.  Until noise polluters understand that there are consequences for their actions, they will continue to make life hellish for those around them.

Thanks to Daniel Fink, M.D., a noise pollution activist in the Los Angeles area, for the link.  Dr. Fink serves on the board of the American Tinnitus Association and is the interim chair of Quiet Communities’ Health Advisory Council.

Quiet fireworks? Must be an oxymoron, no? No:

Oh, Say, Can You See (but Not Hear) Those Fireworks?

Why would someone want quiet fireworks, you may ask?  Pet owners know that cats and particularly dogs can be adversely affected by fireworks, but humans are at risk as well:

For people, loud fireworks can lead to hearing loss. The World Health Organization lists 120 decibels as the pain threshold for sound, including sharp sounds such as thunderclaps. Fireworks are louder than that.

“They’re typically above 150 decibels, and can even reach up to 170 decibels or more,” said Nathan Williams, an audiologist at Boys Town National Research Hospital in Nebraska.

Dr. Williams also sees higher traffic to his clinic after Independence Day. “We usually see a handful of people every year,” he said. “In these cases, hearing loss is more likely to be permanent.”

And Dr. Williams added that children are more vulnerable to hearing loss from fireworks because they have more sensitive hearing.  So if you are going to a fireworks display this weekend, enjoy it safely and bring ear plugs for the whole family.

Thanks to Daniel Fink, M.D., a noise pollution activist in the Los Angeles area, for the link.  Dr. Fink serves on the board of the American Tinnitus Association and the Health Advisory Council of Quiet Communities.

The Institute of Medicine to issue report on accessible and affordable hearing health care today

Dr. Daniel Fink, a leading noise pollution activist, writes about why the IOM Report Should Consider Prevention of Hearing Loss and not just treatment after injury.

Wonderful if true:

The Future Will Be Quiet.  Click through to read Alana Semuels’ piece on “how the cities and suburbs of the future could become quieter, more peaceful places.”  Ms. Semuels’ cause for optimism rests, in large part, on advances in technology.  While technological advances are welcome, and could, one hopes, be part of the solution, the media should focus more attention on hearing health and the dangers of noise so that Americans are moved to protect themselves instead of waiting for a technological panacea.

Thanks to Daniel Fink, M.D., a noise pollution activist in the Los Angeles area, for the link.  Dr. Fink serves on the board of the American Tinnitus Association.

 

 

Going to the Superbowl?

Don’t forget your ear plugs! Why?  Because stadium noise is deafening and, unbelievably, encouraged.  The Kansas City Chiefs, for example, actively encourages stadium noise at Arrowhead Stadium, which the franchise boasts is the “loudest in the league.”  In 2013, a “record-setting attempt was planned by Chiefs fans but had support of the organization, which paid $7,500 to fly an adjudicator from Guinness to Kansas City to document the effort.”  They “won” with a record-breaking 137.5 decibels.  And then they did it again in 2014, this time reaching a punishing 142.2 decibels.  On purpose.  Because a lot was at stake: Kansas City Chiefs had to best the Seahawks’ loudest stadium record.  Yes, team fans compete for the glory of having the world’s loudest stadium.

While the various franchises brag about whose fans are the loudest, at least some people recognize that being the ‘world’s loudest stadium’ is a bad idea.  NBC News, reporting on the record attempt, reached out to experts to address the obvious–for some–concern about the effects of extreme noise on hearing:

What [the record-breaking attempt] is most certainly doing is damaging the hearing of every person in attendance. People don’t recognize how much damage they can do to their hearing, says Alison Grimes, an assistant clinical professor of head/neck surgery at the David Geffen School of Medicine at the University of California, Los Angeles, and director of audiology at the Ronald Reagan UCLA Medical Center.

“People will say, ‘Oh, it was just for 10 minutes,’” Grimes says. “And what I tell my patients is that noise is cumulative over the lifetime. Each time you use a chain saw or ride a motorcycle or go to a stadium to make the sound meter reach the top, it accumulates.”

While the NBC News piece sensibly suggested that fans attending the game purchase over-the-counter ear plugs, it’s likely that most of the fans who were present for this misguided attempt at glory were not protected.  Does that matter?  Will there be long-term consequences for this lapse in judgment?  Sadly, yes.  As Dr. Grimes noted:

“If you’re literally talking about 130 decibels – nobody should ever be exposed to that,” Grimes said. “There isn’t a safe amount of time for 130 decibels. It’s physically painful as well as acoustically damaging.”

Remember, “hair cells in your ear don’t grow back. There is no Rogaine for your inner ear,” warns Grimes. “While hearing aids work really well, there is no substitute for natural hearing.”

Daniel Fink, M.D., a noise pollution activist in the Los Angeles area, believes that the Kansas City organizers missed a golden opportunity to obtain recognition of another world record.  Noting that the record 142.2 dB roar exceeded the Occupational Safety & Health Administration’s (OSHA) maximum Permissible Noise Exposure of 140 dB, he suggested that the organizers should have submitted the event for a second world record: the most people whose hearing was permanently damaged at one time (about 80,000 in attendance).*

So skip the stadium and watch the Super Bowl at home.  Your ears will thank you for it.

*Dr. Fink adds that while there is no law protecting the public from the dangers of loud noise, workers have legal protection provided by OSHA.  On the day of the world record event, stadium employees and players and staff of two NFL teams were exposed to noise exceeding the maximum allowable workplace noise exposure level.  Dr. Fink filed a complaint with OSHA but was informed that the statutory limit for reporting a workplace safety violation had passed.

New York City reconsiders taxi tv screens

The New York Times reports that after almost a decade of being bombarded by unnecessary noise, taxi passengers may be given a reprieve.  Namely, it appears common sense may reign as the City’s Taxi and Limousine Commission may adopt a pilot program to remove the ubiquitous and annoying “Taxi TV from some cabs and replace it with more modern — and less intrusive — technology.”  This is welcome news for those of us who spend the first minutes in a cab struggling to find the right button to shut the tvs off.  One hopes that the pilot program will be successful and one less layer of noise and distraction will litter the city.

And no surprise, the cabbies are happy with the news too.  The New York Times reports that, “Bhairavi Desai, the executive director of the New York Taxi Workers Alliance, said the mood among drivers over the change was ‘utter elation.’  ‘The T.L.C. is eight years late in reversing a horrible decision,’ she said, ‘but we’re glad the time has finally come.’”

Thanks to Daniel Fink, M.D., a noise pollution activist in the Los Angeles area, for the link.  Dr. Fink serves on the board of the American Tinnitus Association.