Tag Archive: noise exposure

Does noise kill thousands every year?

by Daniel Fink, MD, Chair, The Quiet Coalition

This piece by Richard Godwin in The Guardian discusses the health dangers of noise exposure, including increased mortality. The dangers of noise are well-known in Europe, where the Environmental Noise Directive requires European Union member states to develop and implement government policies to reduce noise exposure for their citizens. Writes Godwin:

Noise exposure has also been linked with cognitive impairment and behavioural issues in children, as well as the more obvious sleep disturbance and hearing damage. The European Environment Agency blames 10,000 premature deaths, 43,000 hospital admissions and 900,000 cases of hypertension a year in Europe on noise. The most pervasive source is road-traffic noise: 125 million Europeans experience levels greater than 55 decibels – thought to be harmful to health – day, evening and night.

Somehow, this body of knowledge has yet to reach this side of the Atlantic Ocean, even though the overwhelming majority of experts think that the scientific evidence is strong enough to establish causality, not merely a correlation or association of noise and health problems.

I am confident that when the public does learn about the dangers of noise for health–not just causing hearing loss, but also hypertension, diabetes, obesity, heart attack, stroke, and death–Americans will also push their elected officials for laws and regulations to achieve a quieter environment.

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’s Health Advisory Council, and he served on the board of the American Tinnitus Association from 2015-2018.

 

Four in 10 UK adults unknowingly endanger their hearing on a daily basis

Photo credit: Gary J. Wood licensed under CC BY-SA 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

This report states that 40% of adults in the United Kingdom (England, Scotland, Wales) unknowingly endanger their hearing on a daily basis.

This finding fits neatly with Dr. Gregory A. Flamme’s report that 70% of U.S. adults get total noise doses exceeding safe limits and Dr. Richard Neitzel’s similar finding in a Swedish population.

This isn’t rocket science–noise exposure for the ear is like sun exposure for the skin. If you don’t want deep wrinkles, age spots, and skin cancers when you get older, wear a hat, long sleeves, sunscreen, and avoid the sun.

If you don’t want hearing aids when you get older, avoid noise exposure.

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.

Noise discriminates–heavier burden unfairly borne by the poor and non-white

Photo credit: Alicia Nijdam licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

Noise exposure has multiple effects on humans–it causes auditory disorders, interferes with learning, and disrupts sleep, causing increased cardiovascular disease and death, among other things. A new analysis of socioeconomic, racial, and spatial variation in noise exposure in the U.S. shows that the poor and nonwhite have greater exposure to noise than wealthier and nonminority populations.

Life may not be fair, but governments have a responsibility to try to make it more fair, and to protect all citizens from harm: rich and poor, white and non-white, native-born and immigrant. Those who often refer to the U.S. Constitution often seem to forget this, but the preamble includes a mandate to “promote the general Welfare.” A quieter environment for all Americans would appear to be part of this.

This also happens to be current federal law. The Noise Control Act of 1972 is still on the books, even if the Environmental Protection Agency’s (EPA) Office of Noise Abatement and Control (ONAC) was defunded in 1982. Reasonable people understand that the EPA and ONAC will not be properly funded during this current administration, but at some future time the funding must be made available. Noise damages more than hearing, and it is simply unacceptable that poor and nonwhite Americans suffer greater noise exposure while the federal government stands by and does nothing to protect them.

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.

Noise exposure directly damages rat brains. What does it do to humans?

Daniel Fink, MD, Chair, The Quiet Coalition

The evidence keeps mounting, almost on a daily basis, that noise is a health and public health hazard. Just last month, an article by researchers in Italy found that noise exposure directly damaged rat brains, producing changes in DNA, neurotransmitters, and even morphological changes. (For those who might be skeptical of this report, there is an existing body of research on the effects of noise on the brain. I don’t understand the details of the newer scientific studies, and I’m always cautious because studies have shown that positive results get reported more frequently than negative results, but taken together with the new report, there is a large amount of research pointing to a direct effect of noise on the brain.)

The Italian study exposed rates to noise of 100 decibels for 12 hours. That level exceeds exposure levels for most humans–certainly for a half-day period–but probably not cumulatively for many who attend clubs, rock concerts, or have noisy hobbies such as woodworking or motorcycle riding.

Humans and rats are genetically very similar–experts argue about whether the rat and human genomes are 97% or 99% similar, and about how to measure this similarity–but regardless of the exact percentage, we’re not talking about applying data from a roundworm to humans. The basic similarities are there in organ and cellular biochemistry, structure, and function. So it’s very likely that noise is also a direct toxin to the human brain, with similar genetic, neurotransmitter, and morphological changes, and most likely at lower noise exposure levels, too.

So what can we do? The solution is simple: avoid loud noise exposure, and wear hearing protection if you can’t.

And one last thing–encourage legislators, regulators, and public health authorities to do more to protect us from exposure to unnecessary noise.

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.

Are loud concerts bad for Beyoncé’s unborn twins?

Tom Avril, Phillynews.com, writes about the impact of loud music on the unborn. Avril notes that “[r]esearchers cannot perform a controlled laboratory study, because it would be unethical to expose pregnant women to anything that might damage a fetus,” but he adds that there are “a few observational studies of pregnant women who work in noisy environments.”  Sadly, the conclusion of those studies is mixed. Avril cites a 2016 study on prenatal noise exposure in Sweden that revealed that for “women in a workplace with sound levels above 85 decibels, children exposed in utero were slightly more likely to suffer impaired hearing than children born to mothers whose workplaces measured below 75 decibels.”  But other studies, he states, did not find noise to be a problem.

Avril speaks to Lindsay Bondurant, a pediatric audiologist at Salus University in Elkins Park, who offers that while a one time exposure to a concert should be fine, chronic exposure could be a problem. Rock concerts can reach much higher decibel levels than one would typically be exposed to–up to 120 decibels. Catherine Palmer, director of audiology at the University of Pittsburgh Medical Center, explains that exposure is different for the fetus than its mother, because “the sound travels through the mother’s abdomen.”  She cautions, however, that “timing of the exposure may matter, as well, depending on the developmental stage of the auditory pathway.”

So, what should one do?  With conflicting and incomplete information, we would err on the side of caution. As Pediatric audiologist Bondurnat opined, exposure to the sound at one concert should be fine. So unless you are Beyonce, keep your exposure to loud sound to one concert during a pregnancy.  And don’t forget to bring ear plugs to the one concert you attend. Developing a practice of using ear protection in loud spaces will come in handy once your child is old enough to attend noisy events with you.  After all, it will be easier to get your child to wear ear plugs if she sees her parents doing it.

Update: Before this post was published, the NY Times reported that Beyonce pulled out of Coachella ‘Following the Advice of Her Doctors’.  Apparently her doctors advised her to keep a less rigorous schedule.  We like to think that they suggested some quiet time too.

 

The CDC issues report on noise-induced hearing loss

and the facts are frightening. The Centers for Disease Prevention and Control’s (CDC) current issue of Vital Signs focuses on the dangers of noise on hearing health.  Among other things, the report states that:

  • 40 million Americans aged 20-69 years old have noise-induced hearing loss (NIHL). Hearing loss is the third most common chronic health condition in the US, and almost twice as many people report hearing loss as report diabetes or cancer.
  • 1 in 2 American adults with hearing damage from noise did not get it exposure to noise at work. Noise outside of work can be as damaging as workplace noise.
  • Too much loud noise, whatever the source, causes permanent hearing loss.
  • 1 in 4 Americans who report excellent hearing have hearing damage.  You can have hearing loss without knowing it.
  • The louder the sound, and the longer you are exposed to it, the more likely it will damage your hearing permanently.
  • Continual exposure to noise can cause stress, anxiety, depression, high blood pressure, heart disease, and many other health problems.

This fascinating if distressing report comes with easy to understand graphs and charts that clearly explain the dangers of noise exposure, who is most at risk, the high cost of hearing loss, how hearing loss occurs, and, most importantly, what can be done to prevent NIHL.  Because, in the end, one point is crystal clear: noise-induced hearing loss is 100% preventable.

Declining prevalence of hearing loss in U.S.? What do the data really show?

by Daniel Fink, MD

On December 16, 2016, an article appeared in the New York Times, Americans’ Hearing Loss Decreases Even With Ubiquitous Headphones, which focused on a study by Howard J. Hoffman, MA, et al. (Hoffman) that appeared in the respected medical journal JAMA Otolaryngology–Head & Neck Surgery. The study found that there was a declining prevalence of hearing loss in U.S. adults. The results were considered surprising, as the study showed that the rate of hearing loss in adults age 20-69 had decreased from 15.9% to 14.1%. The researchers, epidemiologists, and statisticians at the National Institute for Deafness and Other Communication Disorders, who conducted the study, are among the best in the world, and the data came from the Centers for Disease Control and Prevention’s well-respected National Health and Nutrition Surgery.

The results were considered surprising because two other recent federal reports, one in October 2015 from the President’s Council of Advisors on Science and Technology (PCAST) and the other in June 2016 from the National Academy of Science’s Institute of Medicine (IOM) (since renamed the Health and Medicine Division), emphasized that hearing loss, especially in older Americans, was a major national problem. Both of these reports cited an analysis by Frank Lin, MD PhD, Johns Hopkins University, that showed that 48 million Americans suffered significant hearing loss, with the prevalence increasing sharply with age.

I am personally involved in the question of what the facts are, since in an editorial in the January 2017 issue of the American Journal of Public Health I write about the inappropriate use of the 85 decibel occupational noise exposure standard, which should not be applied to the general public, citing Lin’s research and other studies that show increased hearing loss in young people age 12-19.

So, what do the data really show?

I am not an epidemiology expert like Mr. Hoffman and his distinguished co-authors. Their methods appear sound, their data sources as good as one can find in the epidemiology of hearing loss. The first caveat is that this study, as with all studies of the epidemiology of hearing loss in the pubic, is based on survey methodology. A group of 3831 participants are the study population, from which conclusions about the entire U.S. population were drawn. It would be too costly to test hearing in millions of people.

The second caveat is that there are newer techniques, currently only used in research and not yet in clinical use, demonstrating that before hearing loss can be detected by standard hearing tests (called pure tone audiometry), a phenomenon dubbed “hidden hearing loss” may have taken place. Hidden hearing loss has been found in young people and older adults. So while Hoffman’s study is encouraging, it may not be able to completely report what is really happening with Americans’ hearing.

The third point–not a caveat–is that Hoffman et al. studied adults age 20-69 and did not include young people under age 20. Those under age 20 may be the group most at risk of hearing loss due to ubiquitous use of personal music players at loud volumes. Two studies, using lower thresholds for measuring hearing loss than Hoffman et al. or Lin et al. used, found high levels of subclinical hearing loss (hearing loss greater than 15 decibels but less than 25 decibels) in young Americans. One from 1998 found that 15% of young people had measurable hearing loss, and the other from 2010 showed an increase in the prevalence of hearing loss to almost 20%. This is worrisome because studies of auditory acuity in young people traditionally found excellent hearing.

The fourth point also isn’t a caveat, but a quote from the last line of Hoffman’s abstract: “Despite the benefit of delayed onset of HI (hearing impairment), hearing health care needs will increase as the US population grows and ages.”

It’s great news that the percentage of Americans age 20-69 with hearing loss (the epidemiology term for this is “prevalence”) has decreased from 15.9% to 14.1%. But that still means that there are millions of Americans with hearing loss–and that’s too many! Further, subclinical hearing loss appears to be increasing in young Americans, and, as the Hoffman study notes, hearing loss in older Americans is a significant health problem.

Finally, a point of contention: noise exposure is a major cause of hearing loss, and not aging as is implied in the study. Why would men have nearly twice as much hearing impairment (18.6%) as women (9.6%)? Is it an effect of testosterone levels on the auditory system, in which case one might actually expect hearing to improve as men get older, or is it the result of more noise exposure from work and recreational activities in men than women? Noise and hearing loss are still major problems in the U.S. and in the world, and the non-auditory effects of noise on health, which are coming into greater focus, continue unabated. 

So yes, the prevalence of hearing loss in American adults may be declining, but when Lin’s analysis showed that approximately 25% of adults in their 60s, 33% of adults in their 70s, and half of those over age 80 have significant hearing loss–data cited in the PCAST and IOM Committee reports–it is obvious that there is still a major problem and still much to be done to prevent noise-induced hearing loss here and abroad.

And I and others have said before, but it bears repeating: noise-induced hearing loss is 100% preventable. If people avoid noise exposure and protect their ears from noise, they should be able to preserve natural hearing well into old age, rather than needing to rely on assistive hearing devices. The only evidence-based safe noise level remains a 70-decibel time-weighted average for a 24-hour period.

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.

Important information for parents

Catherine Caruso, reporting for Scientific American, writes about “Detecting Hidden Hearing Loss in Young People.”  Caruso looks at hidden hearing loss, a phenomenon discovered in 2009, which the researchers who discovered it consider a “likely contributor to the cumulative loss typically associated with aging.”  Now, those researchers have developed tools for detecting hidden hearing loss and have discovered evidence of hidden hearing loss in young people.

While Caruso notes that there is hope that hidden hearing loss could be reversed in the future, she also points out steps one can take now to protect hearing: namely, by limiting noise exposure and using ear protection.  And parents, talk to your kids about their earbud and headphone use.  No one knows if and when researchers will be able to reverse hidden hearing loss, so avoiding hidden hearing loss in the first instance is the best tact.

Members of the military are at higher risk of hearing injury, so this is welcome news:

U.S. Air Force to study effects of noise exposure on health.

The initial study is for a two-week period during which the Air Force “will measure all forms of noise that the soldiers are exposed to throughout their day, including sources outside of work,” but study results “will pave the way for further research to prevent hearing loss in soldiers.”

How to limit noise in hospitals

Dr. Brian Goldman discusses the significant health problems caused by noise in hospitals, which has increased since 1960–200% for daytime noise, and an astounding 400% for nighttime noise.  He also addresses the inventive ways hospitals have tried to limit noise exposure, including design changes, instituting quiet hours for napping, and making all rooms private rooms.  Click the link for more.