Tag Archive: noise induced hearing loss

Will personal music players be the next public health disaster for young people?

Photo credit: Elena Buzmakova(borisova) from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalitio

This article in The New York Times details ten years of regulatory dithering while millions of young people became addicted to nicotine through vaping. The health dangers of vaping were clear to many, but political considerations, lawsuits, and perhaps an early lack of clear evidence of harm led to inaction. And now young people, and a few older ones, are being sickened with several dying.

I see a similar situation developing with the widespread use of personal music players by young people.

The Sony Walkman was marketed in 1979, the iPod in 2001, and the now ubiquitous iPhones in 2007 and Androids in 2008. A large number of Americans use personal music players, and surveys find that users listen for several hours a day.  This report citing Nielsen figures says that Americans listen to music 32 hours a week!  That’s 4.5 hours every day. The World Health Organization recommends listening to no more than one hour daily, to prevent hearing loss. Other studies show that some users typically listen to music at high volumes, loud enough to drown out ambient noise.

There has been some media coverage about prolonged exposure to personal music players, but most people don’t seem to be aware of the problem.

I have communicated with the Federal Trade Commission’s Division of Advertising Practices, the Consumer Product Safety Commission, the National Institute on Deafness and Other Communication Disorders, and the Centers for Disease Control and Prevention about what I see as a future epidemic of noise-induced hearing loss when today’s young people reach mid-life, after 30-40 years of excessive noise exposure. The CDC has begun a research program into noise and the public and undertaken educational efforts about the dangers of noise on hearing, but as with vaping devices, it’s clear to me that regulatory action is needed and that’s not something CDC does. Education can help change health behaviors, but regulation is much more effective.

Will there be media reports in 2030 or 2040 about the lost opportunity to prevent the epidemic of noise-induced hearing loss? I wouldn’t be surprised if there were.

Unfortunately, then it will be too late to prevent the epidemic of noise-induced hearing loss. The time for action is now.

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.

Genetic susceptibility to hearing loss from noise exposure

by Daniel Fink, MD, Chair, The Quiet Coalition

This article in The Hearing Journal reviews research on genetic susceptibilities to hearing loss from noise exposure. The author notes that 34 genetic variants have been reported to show an association with increased susceptibility to hearing loss from noise exposure. She concludes that “[f]urther work on the genetic and cellular bases of NIHL could enable the characterization of individual susceptibilities and help prevent this widespread disease.

Actually, additional work isn’t needed to help prevent noise-induced hearing loss (NIHL).  Additional research is always good, but the molecular bases of NIHL are very well understood.

Even better understood is how to prevent it: Avoid exposure to loud noise, leave the noisy environment, or wear hearing protection of one can’t do either. The CDC states that NIHL is 100% preventable.

Because noise exposure causes hearing loss, and if something sounds too loud, it is too loud.

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 revised definition of noise for National Protect Your Hearing Month

Photo credit: Chris Fithall licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

October is National Protect Your Hearing Month, and I am using the occasion to propose a revised definition of noise: noise is unwanted and/or harmful sound.

For many decades, noise has been defined as “unwanted sound,” a phrase usually attributed to the late acoustics pioneer Leo Beranek. The problem with this definition is that it implies that the perception of noise is subjective. This means that those complaining about noise have no real basis for their complaints, other than a personal reaction to noise.

The new definition acknowledges that noise can be harmful to human health and can interfere with human activity. Even if a noise is merely unpleasant, that experience is stressful.  Recent research shows that stress causes vascular inflammation and cardiovascular disease.

The revised definition is supported by my article in the Fall 2019 issue of Acoustics Today, summarizing the evidence-based noise levels affecting human health and function. My article makes it clear that there can be no rational doubt that noise is harmful, and unwanted noise especially so. Sounds as quiet as 30-35 A-weighted decibels (dBA) can disrupt sleep. A good night’s sleep is important for health and function. Forty-five decibel (dB) sound can disrupt concentration and interfere with learning. At 55 dB, non-auditory health impacts of noise begin, including hypertension, cardiovascular disease, and increased mortality. These effects are best studied for transportation noise, but are seen with occupational noise exposure. At 60 dBA ambient noise, people with hearing loss have difficulty understanding speech. At 70 dBA, those with normal hearing also have difficulty understanding speech.

Seventy dB time-weighted average for 24 hours is the only evidence-based noise exposure level to prevent hearing loss, but the actual safe noise level is probably lower than that. And 85 dBA is the occupational recommended noise exposure level, not a safe noise level for the public. And as I notedin my article, the World Health Organization recommends only one hour exposure at 85 dBA daily to prevent hearing loss. Because the decibel scale is logarithmic, this is mathematically the same as 70 dB time-weighted average for a day.

Hearing loss is very common in older people, but I’ve learned that this isn’t part of normal physiological aging. Rather, presbycusis or age-related hearing loss is largely noise-induced hearing loss.

So what can you do to protect your hearing? There are two ways to protect hearing: avoid loud noise, and if you can’t, use hearing protection devices.

We only have two ears, and unlike knees they can’t be replaced. So if a noise sounds too loud, it IS too loud. And if a noise is so loud that one can’t converse without straining to speak or to be heard, the ambient noise is above 75 dBA and your hearing is at risk.

And always remember that noise is unwanted and/or harmful sound

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.

Animal study may have implications on human hearing issues

Photo credit: Батяшев Александр licensed under CC BY-SA 3.0

by Daniel Fink, MD, Chair, The Quiet Coalitionhttps://creativecommons.org/licenses/by-sa/3.0/deed.en

I’ve only read the press release and the abstract for this paper in JNeurosci but the findings are interesting. In chinchillas–a common animal model for hearing research–scientists at the University of Rochester and Purdue University found that mild noise-induced hearing loss also caused changes in nerve processing of auditory signals.

This may have implications for humans in terms of the very common “speech in noise” problem, in which people with normal audiograms complain that they can’t understand a conversation if the ambient noise level is moderate to high.

But to me, the most important implication of this study is that it emphasizes how important it is to protect our ears.

The only evidence-based noise exposure level to prevent hearing loss is a time-weighted average of 70 decibels a day and even that low level of noise exposure may be too high.

According to the World Health Organization, only one hour at 85 A-weighted decibels is enough to cause hearing loss.

The CDC states that noise-Induced hearing loss is entirely preventable.  Avoid exposure to loud noise, or wear hearing protection if one can’t.

Because if something sounds too loud, it IS too loud.

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.

Study urges efforts to prevent noise-induced hearing loss

This image is in the public domain

by Daniel Fink, MD, Chair, The Quiet Coalition

This report from Purdue University highlights research done there with the University of Rochester that shows noise-induced hearing loss has worse effects on hearing than hearing loss caused by age-related metabolic loss. Specifically, the researchers found that “noise trauma causes substantially greater changes in neural processing of complex sounds compared with age-related metabolic loss,” which the researchers think may explain why there are “large differences in speech perception commonly seen between people with the same clinically defined degree of hearing loss based on an audiogram.”

According to the CDC, noise-induced hearing loss is 100% preventable. In public health, prevention of disease is almost always better and cheaper than treatment of a disease or condition.  For hearing, natural hearing preserved into old age is much better and much cheaper than costly hearing aids.

So remember: if it sounds too loud, it IS too loud.  Avoid excessive noise exposure and use hearing protection now, or need hearing aids later.

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.

Want a quieter town? Urge local government to “Buy Quiet”

by David M. Sykes, Vice Chair, The Quiet coalition

These two 5-minute videos from the U.S. Centers for Disease Control and Prevention spell out how business owners can reduce noise-induced hearing loss by creating “Buy Quiet” programs as a first step when purchasing or renting machinery or tools.  The Buy Quiet program “encourages companies to purchase or rent quieter machinery and tools to reduce worker noise exposure” when they first start up or when older machinery and tools are replaced. You can make your town or neighborhood quieter by getting your local government to encourage it’s own departments–as well as area businesses–to Buy Quiet.

Buy Quiet programs originated at NASA, where they were concerned about astronauts who, it turns out, were exposed to excessive and dangerous noise level when they were floating around in space.

But Buy Quiet gradually expanded to other federal agencies, for instance the National Park Service, eventually reaching the CDC, which realized that exposing the public to excessive noise levels from construction, traffic, airports, etc. was actually a dangerous public health problem. At that point, the CDC and other federal agencies began publishing the kind of public education materials linked above and much more.

It’s time for all of us to take the noise problem seriously. Remember, as our chairman Dr. Fink says, “if it sounds too loud, it IS too loud!”

In addition to serving as vice chair of the The Quiet Coalition, David Sykes chairs several professional organizations in acoustical science: The Acoustics Research Council, American National Standards Institute Committee S12, Workgroup 44, The Rothschild Foundation Task Force on Acoustics, and the FGI Acoustics Working Group—a partner of the American Hospital Association. He is the lead author of “Sound & Vibration 2.0 (2012, Springer-Verlag), a contributor to the National Academy of Engineering report “Technology for a Quieter America,” and to the US-GSA guidance “Sound Matters”, and co-founded the Laboratory for Advanced Research in Acoustics (LARA) at Rensselaer Polytechnic Institute. He recently retired from the board of directors of the American Tinnitus Association. A graduate of the University of California/Berkeley with graduate degrees from Cornell University, he is a frequent organizer of and speaker at professional conferences in the U.S., Europe, Asia, and the Middle East.

Why you temporarily hear muffled sound after a loud noise

Photo credit: Katie Tegtmeyer licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

Noise-induced temporary threshold shift, or NITTS, describes the temporary muffling of sound after a person is exposed to loud noise. This article from the American Association for the Advancement of Science’s Eureka Alert details a report in the prestigious scientific journal Proceedings of the National Academy of Sciences, that provides an explanation for NITTS. Namely, researchers in Sweden found changes in calcium ions in the tectorial membrane of the cochlea.

While NITTS is a real and observable finding, the idea that auditory damage from noise is temporary is most likely false. Research by Liberman and Kujawa and colleagues at the Massachusetts Eye and Ear Infirmary strongly suggests that there is no such thing as temporary auditory damage. And decades of occupational noise exposure studies show that NITTS eventually becomes NIPTS, noise-induced permanent threshold shift, i.e., noise-induced hearing loss. That is, your awareness of muffled hearing following exposure to loud noise is temporary, but the damage caused by the loud noise is permanent.

Noise-induced hearing loss is 100% preventable. Avoid noise exposure and if one can’t avoid noise exposure, use hearing protection devices.

Because if it sounds too loud, it IS too loud!

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.

Another drug trial to prevent noise-induced hearing loss

by Daniel Fink, MD, Chair, The Quiet Coalition

This press release from the Washington University School of Medicine in St. Louis says that the medical school is receiving a $10 million grant from the Army to test whether an epilepsy drug can prevent noise-induced hearing loss.

The study population includes patients undergoing surgical procedures requiring use of noisy drills and police officers.

While I’m glad that people who can’t avoid loud noise may have an option that will offer them some level of protection, for most of us it’s a whole lot easier to prevent noise-induced hearing loss by just avoiding exposure to loud noise.

Remember, if it sounds too loud, it IS too loud.

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.

CDC educates public about the dangers of noise

by Daniel Fink, MD, Chair, The Quiet Coalition

Our contacts at the Centers for Disease Control and Prevention have informed The Quiet Coalition that the CDC’s National Center for Environmental Health will be educating the public about the dangers of noise exposure at sports events, via advertisements in official printed programs for NHL, NBA, and NFL games, including this year’s Super Bowl LIII. An example of the advertisement appears at the top of this post. One of the ads suggests that these efforts will even extend to NASCAR races.

Research done by the CDC showed that about 25% of American adults age 20-69 had noise-induced hearing loss, and that 53% of these people with NIHL had no major occupational exposure to loud noise. The hearing damage was occurring outside the workplace.

We applaud the CDC’s educational effort, but suspect that, as with creating the largely smoke-free environment we now enjoy, much more must be done. Namely, real change won’t happen until government regulations are promulgated that set standards for noise levels in different settings and require the use, or at least the offer, of hearing protection devices to attendees. Nothing less will protect the nation’s auditory health.

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.

How to “rock out” with headphones without damaging your hearing? You can’t!

Photo credit: bruce mars from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

In this article from the Cleveland Clinic, Sandra Sandridge, PhD, Director of Clinical Services in Audiology, offers advice on protecting hearing when using ear buds or headphones to listen to music.

She first notes that hearing loss is 100% preventable, and this might be the only statement that is accurate. Unfortunately, the advice she gives to prevent noise-induced hearing damage is not.

This piece is like an article fifty years ago advising smokers on how to smoke safely. One can’t! There is no such thing as a safe cigarette, and there is no such thing as safe headphone or ear bud use.

Dr. Sandridge notes that many headphones and ear buds can be too loud–most personal music players put out 100-110 decibel sound and some player-headphone combinations can reach 120 to 130 dB–but she implies that 85 decibels is the sound level at which auditory damage begins.

That’s not the cutoff between safe and unsafe sound levels. It’s derived from the NIOSH recommended exposure level for occupational noise, an exposure level that doesn’t prevent hearing loss.

Even in children age 9-11, who haven’t been using headphones very long, auditory damage is already present.

The only way to prevent auditory damage is not to use ear buds or headphones. Or to use Dr. Sandridge’s language:

The only way to rock out with ear buds or headphones without damaging your hearing is not to rock out with them!

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.