Tag Archive: public health

Why is Cosmopolitan writing about hearing loss?

By Daniel Fink, MD, Chair, The Quiet Coalition

When The Quiet Coalition came together last year, there were few articles in the popular media about noise issues, and those that did appear often contained significant factual errors. But over the last few months, the number of articles has increased and errors within them have decreased. One example is a recent article in Cosmopolitan, an international women’s magazine covering fashion, beauty, and sex, which offers very sound advice about hearing protection, including the admonishment to abandon the use of earbuds.

Health education is one of the cornerstones of public health practice. It is believed that if people know what are healthy practices, they will do it. My observation is that this may be true for those at the higher end of the socioeconomic scale but doesn’t necessarily hold for the majority of people, who are either not interested, lack resources, or are too busy handling everyday life to worry about how what they do today might affect their health tomorrow. I think society has a responsibility to protect the health of all people whatever their socioeconomic status, and I believe that strict regulations are more effective in encouraging healthy behaviors than health education programs. If health education programs worked reliably, nobody would smoke, everyone would exercise, there would be no sexually transmitted diseases, and etc.

As with laws banning indoor smoking (and in some places, outdoor smoking at beaches and parks), comprehensive local, state, and federal indoor and outdoor quiet laws will be more effective than health education programs and articles in the popular media to protect the nation’s auditory health. But health education efforts about the danger of noise are a start, at least for those who read the information.

In the United States, the best example of disparate health habits correlated with educational status may be smoking, where only about 3.7% of adults with graduate degrees (and presumably higher income levels) smoke, compared to 25.6% of those without a high school diploma. This is a striking seven-fold variation. Another example is obesity, which is inversely correlated with educational status and annual income, but the relationship isn’t as strong. Nearly 33% of adults who did not graduate high school are obese, compared with 21.5% of those with a college or technical degree, and more than 33% of adults earning less than $15,000 are obese, compared with 24.6% of those earning at least $50,000 annually.

It’s clear that higher education and income levels are keys to better health. And this now likely applies to hearing health, including Cosmopolitan readers.

And that’s important. I’m an internist who believes in practicing what I preach. I don’t smoke. My body mass index (BMI) is 24.5. I walk an hour or more a day, eat at least 5 servings of fruits and vegetables daily, avoid red meat, eat lots of fish, wear a hat and long sleeves if I’m in the sun, and always use a seat belt. But I had no idea that a one-time exposure to loud noise could give me tinnitus and hyperacusis for the rest of my life. So if just one young woman who reads the Cosmopolitan article protects her hearing–and tells her friends and family to do so too–the staff at Cosmopolitan will have done a great public service.

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.

Scientists discover that eardrums move in sync with eyes

By Daniel Fink, MD, Chair, The Quiet Coalition

Aylin Woodward, New Scientist, reports on new research that shows that our eardrums appear to move to shift our hearing in the same direction that our eyes are looking. Jennifer Groh, the lead researcher, believes “that before actual eye movement occurs, the brain sends a signal to the ear to say ‘I have commanded the eyes to move 12 degrees to the right’.” Why? She opines that “[t]he eardrum movements that follow the change in focus may prepare our ears to hear sounds from a particular direction,” noting that one reason why the eyes and ears move together may be to help “the brain make sense of what we see and hear.”

My guess is that for our primate ancestors, and then for primitive humans, there was a survival advantage to hearing sound from something that had been seen. Friend or foe? Food or predator? It will be interesting to see where this research leads, particularly as Woodward writes that the study might help develop better hearing aids, “which must locate where sounds are coming from to work well.”

Research is always good. That’s how we learn about how the world works. But we don’t need any more research to know that noise is a health and public health hazard, and that we need to press our elected officials to make the world quieter now.

Because no matter how good the technology becomes, preserved normal hearing is far better than any hearing aid. And far cheaper, too.

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.

Who should get their hearing checked? Everyone!

By Daniel Fink, MD, Chair, The Quiet Coalition

This local television anchor recommends that everyone get his or her hearing checked.

But this isn’t what the experts at the U.S. Preventive Services Task Force recommend. They reviewed the published medical literature on screening for hearing loss and concluded that, based on the literature, there is no proven benefit to screening for hearing loss in adults. People who complain of not being able to hear should be checked, they cautioned, but they found no benefit in looking for hearing loss is those who don’t have an obvious problem.

Maybe it’s time to rethink that recommendation. A recent report from the Centers for Disease Control and Prevention (CDC), Vital Signs: Noise-Induced Hearing Loss Among Adults, found the following based on recent data from the National Health and Nutrition Survey:

Results: Nearly one in four adults (24%) had audiometric notches, suggesting a high prevalence of noise-induced hearing loss. The prevalence of notches was higher among males. Almost one in four U.S. adults who reported excellent or good hearing had audiometric notches (5.5% bilateral and 18.0% unilateral). Among participants who reported exposure to loud noise at work, almost one third had a notch.

Conclusions and Implications for Public Health Practice: Noise-induced hearing loss is a signficant, often unrecognized health problem among U.S. adults. Discussions between patients and personal health care providers about hearing loss symptoms, tests, and ways to protect hearing might help with early diagnosis of hearing loss and provide opportunities to prevent harmful noise exposures. Avoiding prolonged exposure to loud environments and using personal hearing protection devices can prevent noise-induced hearing loss.

Audiometric notch is the hallmark of noise induced hearing loss.

The CDC information that a quarter of American adults have hearing loss but don’t know it–including those who rate their hearing as good or excellent–indicates a major problem. Experts recommend checking blood pressure at every doctor visit and cholesterol at varying intervals, depending on risk factors, beginning in childhood. Screening for auditory disorders is recommended for children but not for adults. But hearing loss is like high blood pressure or high cholesterol–it is painless and asymptomatic, and unless someone checks, the patient doesn’t know that he or she has it.

Why does this matter? Most Americans, including most doctors and audiologists, don’t know that the only safe noise exposure level to prevent hearing loss is only 70 decibels time weighted average for 24 hours with the real safe noise exposure level probably even lower than that. Most Americans don’t know that we are exposed to dangerous levels of noise every day, which probably explains the recent CDC findings. If people know that they have hearing loss, perhaps they will do more to protect their ears.

Significant hearing loss with age is probably not part of normal physiological aging, but represents noise-induced hearing loss. (I will be presenting a paper on that topic at the 12th Congress of the International Commission on the Biological Effects of Noise.)  Regular hearing testing could prevent current and future generations from losing their hearing.  Why? Because noise-induced hearing loss is 100% preventable, and regular tests would let people know whether and to what degree their hearing is compromised, allowing–and encouraging–them to take action today to avoid significant hearing loss tomorrow.¹

Take the initiative with regard to your hearing health, and have your hearing tested regularly as part of a preventive health plan.

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.

¹ For those who are concerned about establishing the diagnosis of hearing loss as a pre-existing condition which might increase their insurance rates or exclude coverage for future hearing health care, they should not be worried for two reasons: (1) Medicare and Medicaid don’t have a pre-existing condition exclusion, and (2) federal and commercial insurance plans do not cover audiology services and hearing aids. Which is more important? Not establishing a pre-existing condition for something not covered by insurance, or finding out that your hearing is already being damaged and having the chance to take steps to protect your ears?

CDC research on non-occupational noise-induced hearing loss

The Hearing Journal addresses the Centers for Disease Control and Prevention’s (CDC) February 2017 Vital Signs issue on noise-induced hearing loss (NIHL), focusing on the CDC’s findings with regard to non-occupational NIHL. CDC scientists Yulia Carroll, MD, PhD, and John Eichwald, MA, write about the medical community inquiries the CDC received on the topic of hearing loss related to noise in non-occupational settings, and discuss the research relied on in producing the Vital Signs’ NIHL issue.

Carroll and Eichwald write that “[m]any people may not recognize that loud noise from common activities, such as mowing the lawn or attending sporting events, can be as loud as the noise found in the workplace and is enough to damage hearing.”  They note that “it is important to raise public awareness that the louder the noise and the longer the exposure, the more likely hearing damage will occur.” After all, prevention of disease is an important CDC goal, and, as the authors write, “[n]oise-induced hearing loss is a preventable health condition that can be avoided by using relatively easy measures.”

Unfortunately, “[t]here are no federal guidelines on safe noise exposures” for the public, but Carroll and Eichwald suggest that that could change:

Because noise-induced hearing damage accumulates over time, there is a need for future research about noise exposure and prevention at younger ages. CDC is working with various organizations and continues to analyze national data to prioritize public health needs.

Hearing loss may double in the U.S. by 2060

Photo credit: Thomas Widmann

CBS News reports on a new study that concludes that millions of Americans face the prospect of losing their hearing as they age. The study by researchers at Johns Hopkins University estimates that “[a]mong American adults 20 and older, hearing loss is expected to increase from 44 million in 2020 (15 percent of adults) to 73.5 million by 2060 (23 percent of adults),” with the greater increase among older Americans. As a result, “there will be an increased need for affordable interventions and access to hearing health care services.”  Says lead study author Adele Goman, “[h]earing loss is a major public health issue that will affect many more adults,” and “to address this issue, novel and cost-effective approaches to hearing health care are needed.”

Or perhaps prevention would be a better tactic?

Dr. Debara Tucci, a spokesperson for the American Academy of Otolaryngology, Head and Neck Surgery, would agree. She tells CBS News that “people aren’t doomed to lose their hearing as they age.” “The most common cause of hearing loss is prolonged exposure to loud noise,” adds Dr. Tucci, “which includes loud music and a noisy workplace.”  Prevention, then, should be a rallying call among the medical profession, particularly public health officials.  This is especially important since the litany of horribles that befalls older adults who suffer hearing loss goes well beyond difficulty hearing.  The list includes: higher incidences of depression and anxiety, higher rates of hospitalization and of falls, and even “evidence of an association between hearing loss and mental decline.”

Coupled with the recently released and updated information concerning hearing loss from the Centers for Disease Control and Prevention, this study is a wake-up call to the medical and audiology professions and the public. Simply put, there is a low-cost and 100% effective way to tackle noise-induced hearing loss–preventing it from occurring in the first instance.

 

 

 

A little self-help can’t hurt

In light of the recent study linking traffic noise to an increased risk of acquiring dementia, this article is a must read: How To Reduce Noise Pollution At Home.

Of course, one would hope that governments would think about how best to limit noise after reading that frightening study.  The medical costs alone should be enough to motivate even the most dispassionate bean counter.  But until they do, we really must take matters into our own hands and try to make our homes as peaceful and noise free as possible.

Link via @QuietMark.

 

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.

 

The deleterious effects of noise are so obvious that even the Daily Mail recognizes it (in their own special way):

stress

How noise can make you FAT, stressed and more likely to have a stroke.  Headline aside, the article is fairly straight forward and thoughtful.  Among other things, the article notes that:

According to the World Health Organisation, noise pollution is one of the most pressing threats to public health, second only to air pollution, and responsible for a range of conditions from stress and sleep problems to heart disease and strokes — it can even make us fat.

The piece highlights the known health risks of noise and suggests ways in which readers can bring peace into their daily lives.  It’s worth the read, really.