Tag Archive: tinnitus

My 4th Noise Activist Anniversary

by Daniel Fink, MD, Chair, The Quiet Coalition

Anniversaries are special. We celebrate wedding anniversaries. Alcoholics Anonymous celebrates the anniversaries of those who are in recovery. Wounded military veterans celebrate their Alive Day, the day on which they were wounded. And yesterday was my anniversary, the fourth anniversary of my becoming a noise activist.

I developed tinnitus and hyperacusis after a one-time exposure to loud noise in a restaurant on New Year’s Eve, 2007. As midnight approached, they kept turning up the music louder and louder. My wife could tell that the noise was bothering me and suggested that we leave, but I didn’t want to offend our friends who had arranged the dinner. As soon as it was polite to leave, maybe 12:30 a.m., we did. My ears were ringing when we left, and the ringing never stopped.

I also found that noise that didn’t bother others hurt my ears: Movie soundtracks, the grind of a food processor, loud exhausts and sirens, and especially noise in restaurants. I’m a doctor and have always done what I could to stay healthy. But I had no idea that a one-time exposure to loud noise could cause tinnitus and hyperacusis for the rest of my life. When my wife would suggest an evening out, I would ask, “Can’t we eat at home?”

On December 2, 2014, I read an article about hyperacusis in the New York Times science section, written by journalist Joyce Cohen, who has since become a friend. I circled it in red and gave it to my wife, saying, “Honey, this is why I don’t want to go to restaurants any more. They are all too noisy. The noise hurts my ears. Just like it says in this article.” My wife finally understood that while I might have been getting grumpier with age, my dislike of noisy restaurants was caused by an auditory disorder.

So I decided to do something to make the world a quieter place. I reached out via email to the four experts cited in Joyce’s article. One thing led to another, and I ended up serving on the board of the American Tinnitus Association and helping create The Quiet Coalition, where I am the board chair.

I learned that I wasn’t the only person in the world with auditory disorders. Hearing loss, tinnitus, and hyperacusis are all too common. But auditory disorders are invisible, and largely occur in older people, who themselves are largely invisible in our society. Except for congenital deafness, auditory disorders tend to be ignored.

It’s been quite an odyssey. I found that via the internet, I could communicate with experts in various areas of noise, across the country and even around the world. At the urging of one of them, I submitted abstracts to scientific meetings about noise. Those were accepted for presentation, and I spoke at national and international scientific meetings. I have had publications based on my talks appear in peer-reviewed medical and scientific journals, and I have been quoted in articles and have advised national and international health authorities about noise. And I have learned, through the nonprofit Hyperacusis Research, how truly life-limiting noise-induced hearing problems can be. All because I read an article and decided to do something to make the world quieter.

The world is still too noisy, and I still can’t find a quiet restaurant, but apps like iHEARu and SoundPrint are now available.

And as more evidence becomes available about noise as a health and public health hazard, I am confident that an informed public will push legislators and public health officials to eliminate unnecessary noise.

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.

Tinnitus and what to do about it

Photo credit: erik forsberg licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

I think the title of this report from the Harvard Medical School is misleading. I have tinnitus so part of my response is a personal one. To me, the most important sentence in the report is this: “There are no FDA approved treatments for tinnitus.” That means that none of the many proposed treatments for tinnitus–from a variety of vitamins and drugs, to various auditory training programs–has been demonstrated to be safe and effective, the FDA’s standard for approval. Cognitive behavior therapy may improve the ability to accept or deal with a constant ringing in the ears, but it doesn’t change the underlying symptoms.

It can be difficult to live with a constant ringing in the ears. I haven’t tried any of these unapproved treatments because I believe in evidence-based medicine, both for patients and for myself. Also, I am fortunate–my tinnitus is relatively low volume, and the only time it really bothers me is when I wake at night and it’s loud enough to cause difficulty in falling back to sleep–but the symptoms can be so bad that people commit suicide because of them. I suppose that if my symptoms were worse, I might be willing to try some of the treatments mentioned. And I would add that I know people who have had success using some of them.

Perhaps most significantly, the report neglects to mention three important facts:

1. The overwhelming cause of tinnitus is noise exposure, not the many other possible causes listed in the report. I haven’t been able to find a percentage, but my estimate is at least 80% and probably 90 or 95%.

2. The article implies that temporary tinnitus after noise exposure is a normal thing. No, temporary tinnitus indicates that one has been exposed to too loud noise, and that auditory damage has occurred.

3. Avoiding loud noise exposure will most likely prevent tinnitus from ever developing.

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.

Restaurant noise in the news

by Daniel Fink, MD, Chair, The Quiet Coalition

I became a noise activist because I have tinnitus and hyperacusis and find loud restaurants unpleasant, so it was gratifying to see these two articles about restaurant noise. One is about restaurant noise in Austin, Texas, and the other more broadly reports about a study on restaurant noise sponsored by hearing aid manufacturer Oticon.

Both articles point out that the noise levels in many restaurants are loud enough to cause hearing loss, and that restaurant patrons have difficulty conversing due to the high ambient noise levels.

What the articles don’t mention is that restaurant noise is a major problem for older Americans, half of whom have hearing loss.

As long as the restaurants are busy, I don’t think they will voluntarily bother to make themselves quieter. As with smoke-free restaurants, this is something that will require enough voters complaining often enough to their elected officials to get regulations requiring quieter restaurants. Until that happens, speak up. If you go to a restaurant that is too loud, ask the manager or wait staff to lower it. If they won’t, leave.

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.

How a YouTube-inspired prank ruined a young girl’s life

 

photo credit: Edvvc licensed under CC BY-SA 3.0

Laurie Redmond writes about how a stupid prank by YouTube “trickster” Rick Lax inspired a miscreant to copy a video the aptly named Lax posted of his “prankster pal,” Ryan Hamilton, blasting his girlfriend with an air horn to get her to put down her phone.  Redmond notes that the video “entitled ‘How to get your girlfriend to put her phone down,’ has an astounding 246m views.” Sadly, one of the viewers was her 12-year old daughter Cindy’s friend’s ex-stepfather, who decided to play the prank on Cindy.

But after this miscreant played his prank, things fell apart for Cindy who eventually was diagnosed with “hyperacusis, or noise-induced pain.” As a result of this “prank,” Cindy has a “burning pain in her ears all the time…[and] [w]ith all noise louder than ordinary conversation, she feels like she is being stabbed in the ear. Her ears ring.”

Redmond has since learned that another “YouTube prankster, an F-list celebrity named Jake Paul, was sued for wrecking someone’s ears with an air horn.”  And yet the air horn “prank” videos remain on YouTube and Facebook, even though they “recently removed Tide Pod challenge videos so as not to encourage dangerous stunts.” Redmond asks what it will take to have these dangerously stupid and vile videos off of social media.  We would suggest litigation might do the trick, while recognizing how terrible things are when the only option is litigation.

MRIs are dangerously noisy

Photo credit: liz west licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

MRI noise is in the news in two recent reports.

People magazine reported the story of a woman who suffered permanent auditory damage from an MRI, developing hyperacusis (a sensitivity to noise, which causes pain) and tinnitus. The Quiet Coalition’s Bryan Pollard, an expert on hyperacusis, is quoted in the article.

And researchers from SUNY Buffalo and China wrote about MRI noise in The Hearing Journal.

Standard MRIs produce noise in the 110-115 decibel range, and newer more powerful MRIs are even louder. Knowing this, I have several quibbles with the information in The Hearing Journal article. Namely, the article cites occupational noise exposure standards, but these use A-weighted decibels (dBA) to reflect the frequencies of human speech. MRI noise is low frequency noise, so occupational noise limits may not protect hearing adequately. And occupational standards are not safe standards for the public. At least 25% of workers exposed to sound at occupational noise exposure standards will develop hearing loss.

Most importantly, for many people the auditory damage caused by MRI noise isn’t hearing loss but tinnitus and hyperacusis, as in the People magazine article. Exactly how noise causes tinnitus and hyperacusis isn’t yet known, but the mechanisms are likely different from cochlear hair cell damage causing noise-induced hearing loss.

Finally, the authors talk about temporary auditory damage, but many researchers think that any temporary auditory changes indicate that permanent damage has been done.

I can’t find any large-scale studies of auditory problems after MRIs–the equipment manufacturers wouldn’t be excited about funding such a study, and radiologists are interested in the image, not in the patient’s hearing–but anecdotal reports from audiologists indicate that this is a problem for too many people undergoing diagnostic MRIs.

So if you need an MRI, be sure to ask for “dual protection”– ear plugs and ear muffs. NIOSH recommends dual protection for noise exposure over 100 dBA.

And if you suffer auditory damage from an MRI, be sure to file a report with the FDA. That’s the only way the government will be induced to issue appropriate patient safety regulations.

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.

Turn that down! We can prevent hearing loss

Photo credit: Anthony from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

Dr. Vic Snyder, a former congressman from Arkansas who is now a medical director at the Blue Cross/Blue Shield affiliate there, has it exactly right: hearing loss (and tinnitus) can be prevented by turning down the volume, walking away from noise sources, and using hearing protection.

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.

How likely are you to get tinnitus from clubbing?

by Daniel Fink, MD, Chair, The Quiet Coalition

This article from the UK asks the question: How likely are you to get tinnitus from clubbing?

The article points out that there really isn’t any way to predict who will develop tinnitus, i.e., ringing in the ears, after noise exposure, and that’s the most important thing to know.

I didn’t know that a one-time exposure to loud noise could cause tinnitus the rest of one’s life. I developed tinnitus (and hyperacusis, a sensitivity to noise that doesn’t bother others, with noise causing pain in the ear) after a one-time exposure to loud music in a restaurant on New Year’s Eve ten years ago.

Fortunately, there is one simple rule to protect your ears: if it sounds too loud, it IS too loud.

If you can’t carry on a conversation without straining to speak or to hear, the ambient noise is above the auditory injury threshold of 75 A-weighted decibels, and your hearing is being damaged.

Research done over the last decade strongly suggests that there is no temporary auditory damage. In animal models, loud noise damages the synapses (nerve junctions) in the ear before it damages the hair cells. This damage isn’t detected by standard hearing tests (pure tone audiometry) but likely is the major reason why adults have difficulty following one conversation among many in a noisy environment.

Remember, your ears are like your eyes or your knees–God only gave you two of them! Take care of them, and they will last you your whole life.

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.

New treatment for tinnitus gives hope

by Daniel Fink, MD, Chair, The Quiet Coalition

This report from the University of Michigan about Susan Shore PhD’s research gives hope to tinnitus sufferers that finally an effective treatment may be on the way.

Tinnitus, ringing in the ears, is most commonly caused by noise exposure, either chronic noise exposure or a one-time exposure to loud noise.

Given the causal relationship between noise exposure and both tinnitus and hyperacusis, a collapsed tolerance to usual environmental sound, many people have both. About half of those with tinnitus have significant hearing loss.

My own tinnitus developed after a one-time exposure to loud noise, so my hearing remains good. But I wish I had known that a one-time exposure to loud noise could cause symptoms the rest of my life. That’s part of the message I’m trying to get out to the world.

The other message is that both hearing loss and tinnitus are largely preventable. And certainly noise-induced hearing loss is 100% preventable.

Dr. Shore’s treatment is still in its experimental phase and no one can predict how much it will cost if and when it is approved by the FDA. Or, for that matter, if Medicare and private insurance programs will pay for it.

The most basic public health principle is that it’s far better, and far cheaper, to prevent illness or injury than to treat it. So while we wish Dr. Shore well, we hope those who do not yet have tinnitus, hyperacusis, or hearing loss take this sage–and free–advice:

Protect your ears! Avoid loud noise. Put in ear plugs if you can’t leave the noisy environment.

Remember, your ears are like your eyes or your knees: God only gave you two of 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.

Eric Clapton has tinnitus and is losing his hearing

 

Photo credit: Majvdl licensed under CC BY-SA 3.0

And so he told BBC Radio while promoting his new documentary, “Eric Clapton: Life in 12 Bars.” Every pop culture site has reported some version of this story, but not one asks why or how he has tinnitus and hearing loss, even as the Variety piece linked above notes:

Clapton isn’t the only musician who’s dealt with tinnitus. The Who’s Pete Townshend has also discussed his own problems with the condition and hearing loss.

Townshend did more than that–he pointed his finger squarely at earphones used in studio as the cause of his hearing loss and expresses concern about earbud exposure among the youth.

Perhaps music and entertainment magazine should look into how and why music icons are suffering hearing loss and educate their audience on how to avoid the same fate.

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.