HHF Co-Sponsors Hearing Health Care Economics Presentation on Capitol Hill

By Lauren McGrath

Our aging population’s lack of access to hearing loss treatment is a public health crisis. More than half of Americans 60 and older live with hearing loss. When left untreated, hearing loss can increase the risk of cognitive decline, social isolation, falls, and dementia. Unaddressed hearing loss is also connected to higher rates of unemployment, longer hospital stays, and premature mortality.

On May 29, 2019, Hearing Health Foundation (HHF) and 11 other Friends of the Congressional Hearing Health Caucus (FCHHC) member organizations co-sponsored a briefing luncheon on the economics of hearing health care for Congressional staff and other Federal employees at the Rayburn Office House Building on Capitol Hill.

As both a leader in hearing loss research and a founding member of the FCHHC, the coalition that supports the policy interests of the Congressional Hearing Health Caucus (CHHC), HHF is committed to increasing adoption of hearing loss treatment. The CHHC, a U.S. House of Representatives caucus* co-chaired by Reps. David McKinley (R-WV) and Mike Thompson (D-CA), aims to raise awareness of issues that affect Americans with hearing loss, and has previously been influential in the passage and preservation of universal newborn hearing screening legislation. Each year, the FCHHC organizes a briefing for Congressional staffers on an important topic in hearing health.

Event Flyer (Click to Enlarge)

The year’s meeting, entitled “Understanding the Cost of Not Treating Hearing Loss in Adults,” featured two expert speakers, Richard K. Gurgel, M.D., clinician and Associate Professor of Otolaryngology at University of Utah School of Medicine, and Ian Windmill, Ph.D., Clinical Director of the Division of Audiology at Cincinnati Children's Hospital Medical Center.

Gurgel and Windmill spoke about the prevalence of hearing loss and its impact, noting that by 2060, this sensory deficit — the most common among seniors — will impact more than 73 million adults, with the overwhelming majority financially unable to pursue treatment. According to the NIDCD, about 70% of adults ages 70 and older who could benefit from hearing aids have used the devices.

Cost is the largest barrier to purchasing hearing aids, the primary treatment for hearing loss, among adults in the U.S. A 2017 Hearing Health Foundation (HHF) and Hearing Loss Association of America (HLAA) survey found that the cost of hearing aids exceed the next most commonly cited limitation — uncertainty about where to get hearing tested — by 575 percent.

Both Gurgel and Windmill cited the implications of paper entitled “Cost-Benefit Analysis of Hearing Care Services: What Is It Worth to Medicare?”, published in the Journal of the American Geriatric Society in April 2019. The paper’s authors determined that the average annual spending of Medicare beneficiaries who use hearing care services is $8,196, which the spending of those who do not use hearing care services is $10,709, an annual difference of $2,513 per recipient. This difference amounts to a cost savings of more than $7 billion to Medicare annually.

Windmill also cited a report showing that worker’s compensation costs related to hearing loss for a single year in Kentucky averaged $14,500 per person and amounted to a total of $14.5 million statewide. From this report, we can estimate at least $725 million in worker’s compensation payments related to hearing loss are made each year.

While the Congressional luncheon attendees were enthusiastic, and the economic case for Medicare coverage of hearing aids is compelling, more advocacy work is needed to maximize the number of older adults treating hearing loss. HHF encourages you to take action by inviting your local representatives to join the CHHC and to garner support for relevant existing bills: Medical Hearing Aid Coverage Act of 2019 (H.R. 1518), Medicare Dental, Vision, and Hearing Benefit Act of 2019 (S. 1423 / H.R. 1393), and the Seniors Have Eyes, Ears, and Teeth Act (H.R. 576).

You can learn more about the FCHHC and review the presenters’ slides via the American Cochlear Implant Alliance.

*Current members of the CHHC, as of June 2019:

Gus Bilirakis (R-FL)
Andre Carson (D-IN)
Kevin Cramer (R-ND)
Rosa DeLauro (D-CT)
Eliot Engel (D-NY)
Bob Goodlatte (R-VA)
Peter King (R-NY)
Dave Loebsack (D-IA)
Betty McCollum (D-MN)
Richard Neal (D-MA)
Frank Pallone (D-NJ)
David Roe (R-TN)
Adam Schiff (D-CA)
Adam Smith (D-WA)

Tuning In Montreal

By Neyeah Watson

Hearing loss is the third most common chronic health problem affecting people in Canada ages 20-79, and affects 10 percent of the population. Like in the U.S., hearing loss is undertreated in Canada. Fewer than 20 percent and one percent wear hearing aids and cochlear implants (CIs), respectively, for their hearing loss.

A new policy championed by William Steinberg, mayor of Hampstead, Quebec—a suburb of Montreal—aims to make CIs more accessible to Canadians. In January, Quebec Premier François Legault authorized CI surgeries to expand to Montreal. Though CI surgery has been performed in Canada since 1982, Montreal was deprived a center for financial reasons. Following advocacy from Steinberg and others, government officials were able to make budgetary adjustments to allow for funding.

Steinberg, a bilateral CI recipient, has been at the forefront of the Montreal CI campaign. Steinberg was born with a severe to moderate bilateral sensorineural hearing loss, but was not diagnosed until second grade. “I got a hearing aid built into my glasses at that time,” Steinberg explains. “However, in those days they did not have the sophisticated hearing aids that we have today so it was basically an amplifier.”

Steinberg received CIs in 2004, at which time hearing loss in both ears had diminished to profound. Despite his powerful hearing aids, he could no longer carry out a reasonable conversation on the phone. “Today I can talk for hours and miss not much more than someone with normal hearing,” explains Steinberg, who also serves as president of the Cochlear Implant Recipients Association in Canada.

The Mayor’s personal experience with hearing loss inspired his ambition for  greater CI surgery accessibility by making the procedure available in Montreal. In Canada, the CI locations are limited geographically. Cities such as Toronto, Ontario, Ottawa, Ontario, Vancouver, British Columbia, and Saskatchatoon, Saskatchewan currently have centers for CI surgery. However, the cities are geographically scattered, requiring some residents with hearing loss to travel hundreds of miles for surgery. A center in Montreal will expand access and will hopefully encourage other cities to follow suit.

The new cochlear implant program is expected to be especially helpful to children, who make up about 40 percent of cochlear implant recipients in Canada today. Children who reside in Montreal have to travel for check-ups and configuration, causing great inconvenience to families. Many individuals from Montreal expressed their frustration about the travel and inconvenience online.The approval of the new program in Montreal has lifted a burden.

Hearing loss affects all ages. There is no limit or expiration date on the possibility of restoring access to sound. As Vincent Lin, M.D., of Sunnybrook Health Science Centre in Toronto remarks, "Age is a number, as long as patients are in good health, there's no reason why they can't have this surgery done."

Ready to Take On the World

By Neyeah Watson

Beginning at age 4, I had ear pain that caused recurrent infections. My mother, worried, took me to multiple ear specialists, the fourth of whom warned these infections could result in a conductive hearing loss. At 7, I underwent a successful corrective ear surgery that eliminated my infections almost entirely. Though my hearing has been salvaged, I still endure frequent sinus infections and ear pain that require monitoring.

My personal experience makes me grateful Hearing Health Foundation (HHF) has long been a vocal advocate for early intervention for babies and children with hearing loss. HHF’s primary focus is on advancing hearing loss research to find new treatments, and I look forward to what will one day be medically possible for my aunt and grandmother who live with bilateral moderate sensorineural hearing loss. 

Because affordable direct patient services are needed to put HHF’s research findings into practice, I’m also greatly appreciative of organizations like The Sound Start Babies Foundation for Deaf and Hard of Hearing Children, a New Jersey nonprofit that exists to support families of babies with hearing loss during the most critical years of brain development. Public funding in the state covers only about one third of the costs needed for early intervention, and The Sound Start Babies Foundation goal is for all families to have access to this quality of care, regardless of their ability to pay.

Fun in speech! One of Sound Start’s little learners is excited to see how many jungle animals she can stack, while working on the concepts "above" and "below." Credit: Kim Reis.

The Sound Start Babies Foundation was founded as Lake Drive Foundation in 1997 by community volunteers and parents of children with hearing loss in Mountain Lakes, New Jersey. Inspired by the foundation’s history and mission, I was eager to interview a few representatives from the organization, Jessica Griffin and Kayley Mayer, who make this work possible.

Griffin, who is President, discovered Sound Start Babies™️ when her son, Ian, was born profoundly deaf. Sound Start Babies™️ was Ian’s early intervention provider and greatly helped her family through his hearing loss journey, which included his cochlear implantation at 10 months. In gratitude, Griffin joined the volunteer Board of Trustees in 2014 and was appointed President after two years of service.

Kayley Mayer is a Teacher of the Deaf and Program Coordinator. She began working for the Sound Start Babies™️ program in 2010, the first year the full-day, inclusive nursery program opened up. For her first eight years, she taught in a nursery classroom and provided home-based services for children with hearing loss and their families. Now, she is teaching in the classroom, providing family training to families, and  working on programming development. Although Mayer, unlike Griffin, does not have a personal connection to hearing loss, she finds fulfillment in the progress that families gain in their short time with program.

Griffin attributes members of the Sound Start Babies™️ staff, like Mayer, with her son’s preparedness for mainstream kindergarten this fall at age 6. Her goal as President is to make sure that every child who has a hearing loss has the same wonderful experience as her son. As Mayer notes, each impactful experience is unique. “Every family is at a different point when we meet them, but by the time the child and family graduate from our program, they are truly ready to take on the world,” Mayer says.

We are all fortunate for resources like Sound Start Babies™️ that help children who need hearing loss intervention succeed developmentally. Hearing is a precious gift, and I learned at age 7 that your hearing can be stripped from you without notice. I am grateful my doctors and parents acted promptly to ensure my hearing was preserved, making sure I, too, could be ready to take on the world.

HHF marketing and communications intern Neyeah Watson studies communications at Brooklyn College. For more information about Sound Start Babies™️ and The Sound Start Babies Foundation for Deaf and Hard of Hearing Children, see www.soundstartbabies.com.

Veterans Sue Over Defective Hearing Protection

By Joseph Oot

Veterans nationwide are filing lawsuits against the military equipment manufacturer 3M, after a July 2018 verdict concluded the company’s dual-ended Combat Arms Earplugs Version 2 (CAEv2) were defective. The verdict in this whistleblower lawsuit, filed by Moldex-Metric on behalf of the U.S. government, paved the way for service members seeking legal restitution.  

This case began three years ago in May 2016 when Moldex-Metric, a California-based company in the military equipment industry, brought charges against their competitor, 3M. The plaintiff claimed that the original manufacturer of the CAEv2 devices, Aearo Technologies which was purchased by 3M in 2008, colluded to manipulate product tests and falsify data in order to achieve government standards and sales. Moldex-Metric was able to present evidence that both Aearo and 3M continued to sell the defective devices for more than 10 years, even though the devices were found to be too short, a defect that made the equipment difficult to properly insert in the ear. As a result, the devices were loose fitting, prone to fall out, and inadequately provided the level of protection claimed by the manufacturer.

After years of litigation, 3M agreed to settle the allegations in July 2018. 3M was ordered to pay the U.S. government $9.1 million in damages—but none of these damages compensated CAEv2 users, and 3M said this settlement was not an admission of liability. However, the verdict against 3M likely sparked the flood of class-action lawsuits filed since then.

More than 300 lawsuits have been filed by service members seeking restitution. Retired U.S. Marine Capt. Matt Morrison of New Jersey is one such service member who in February 2019 filed his case against 3M. He says the CAEv2 devices were the direct cause of the complete hearing loss he has sustained in his right ear. While deployed between 2007 and 2013, including two tours of Iraq and one of Afghanistan, he was frequently exposed to loud equipment, machinery, gunfire, and explosions.

Along with thousands of other service members, Morrison says he came to rely on the standard-issue hearing protection as much as a bulletproof vest. "The gear you're issued is everything from a helmet to a flak jacket, eye and ear protection. I never thought that, after the fact, the gear would be faulty or defective and cause this kind of injury," Morrison told a local news reporter.

Like Morrison, active duty military members are exposed to machinery, aircraft, and sudden weaponry blasts leaving their ears susceptible to noises as loud as 184 decibels (dBA). Sounds at or above 110 dBA can cause permanent hearing loss and tinnitus instantaneously without hearing protection. The U.S. Department of Veterans Affairs reports tinnitus and hearing loss are the most common disabilities among veteran service members, with 60 percent of those who served in Iraq and Afghanistan living with one or both of the conditions today.

Both the military and hearing loss communities take seriously all reports of defective hearing protection, especially given the prevalence and permanence of hearing loss and tinnitus among veterans. Without a commitment to strict product performance, user testing, and data verification standards, service members will remain at risk.

Joseph Oot is a writer with ConsumerSafety.org, an organization connecting individuals with information on developing lawsuits, court cases, and recent news affecting consumers. As a consumer advocate, Oot works with both individuals and industry professionals to share helpful information surrounding potentially harmful products.

Hair Cell Eulogy

By Dawn Doig

People don’t seem to understand the damage they’ll incur
The way that birds’ songs, music, voices, all become a blur -
When the ears are not protected from loud music, shotgun blasts;
The birdsong they heard yesterday may have been their last...

The problem is maybe ignorance, lack of info about the ear
And how its “innards” function when it’s enabling us to hear.
The inner ear is lined with hair cells that when healthy will respond
To incoming sound energy from the ear canal and beyond.

Some hair cells dance to drum beats, some dance to jingling bells,
But regardless of the dance they do, they know their dances well.
The mighty “Endo” (Endolymph) taught them all from the very start
To learn the dance for hearing’s sake; to learn it all by heart.

Endolymph is a fluid that courses through the inner ear
And when Endo starts to move too fast, the hair cells cringe with fear -
Fear of death impending if Endo moves too fast
For hair cells fall like blades of grass as Endo rages past.

What causes Endo’s rages? - for a warning’s never there
And the hair cells least expecting are the ones who never fare.
Amidst a dance of merriment, the rage takes them by surprise
And one by one the hair cells die before the others’ eyes.

One day a shotgun blast went off and downed a startled moose
Another day another blast downed an unsuspecting goose.
Both moments enraged Endo, who pounded in his fury
And lunged upon some hair cells who would otherwise be merry.

The dance to birds’ songs dwindled first as yet another hair cell died;
The remainder knew their fate too well and curled up and cried -
They wept for all their comrades who had lost their lives in vain,
If only muffs or earplugs were worn, they would not have such pain.

They had to strain for spoken words, some still tried to dance,
But numbers now as they were, the hair cells didn’t have a chance.
How hard they tried to make new sounds as loud and clear as before,
But with their numbers now so low, they couldn’t do it anymore.

Farm machinery, music blaring at volumes much too high,
Snowmobiling, off-roading - they all make hair cells die.
Why risk the chance of losing a hair cell dance or two?
Wear ear protection and smother Endo’s rage -

THE DECISION’S UP TO YOU!!

Dawn Diog is a clinical audiologist. Originally from Victoria, British Columbia, Canada,, she resides in Cameroon, West Africa where she is the English Language Learners (ELL) coordinator for the American School of Yaounde.

Prevent the Preventable

By Neyeah Watson

International Noise Awareness Day (INAD) is observed annually on April 24 to redirect our focus to the invisible: hearing loss caused by noise, or noise-induced hearing loss (NIHL). More than 48 million Americans live with a form of hearing loss, and one third of all hearing loss cases can be attributed to noise exposure. In honor of INAD, sponsored by the Center for Hearing and Communication, Hearing Health Foundation (HHF) urges the public to zealously protect the hearing of adults and children from the dangers of loud noise.

Loud noise can harm from exposure to one sudden, disturbing, blast-like sound (an impulse noise) or a series of loud sounds over time. Impulse noises include fireworks, explosions, car horns, gunfire, and thunder. These noises reach the outer ears unexpectedly before conversion to sound, sometimes causing immediate trauma and NIHL.

Gradual NIHL, on the other hand, occurs over time. Sources include loud music and occupational sounds from construction sites or airport runways. Gradual NIHL can also result from hobbies, like playing in a band, attending group fitness classes, and snowmobile riding.

The irreversible damage of NIHL physically takes place when hair cells within the cochlea of the inner ear are damaged. This results in what’s called sensorineural (permanent) hearing loss.

Fortunately, NIHL is 100% preventable. For adults, protecting your ears doesn’t require a lot of effort. When going about your busy lifestyle, keep these simple techniques in mind.

• Always keep a pair of earplugs with you. Whether you ride public transportation as a passenger or employee, loud noises accompany you on your commute.

• Purchase noise-cancelling headphones, which are safer for your ears because they prevent the user from needing to raise the volume to block out external sounds.

• Listen to music and television at medium volumes.

• Most importantly—give your ears time to recover. Quiet time is one of the best healing experience you can give to your ears.

Protecting your children’s hearing is easy, and begins in the home. Here’s what you can do:

• Practice the 60/60 rule: Only listen to music at 60% of the volume for 60 minutes.

• Inspire their preference for quiet toys such as puzzles, dolls, coloring books, and building blocks. When considering electronic toys, look for for products with volume control settings.

• Set the TV or game consoles to reasonable volumes.

• Make sure your child does not sit too close to the television or other noisy electronics.

• Use plush furnishings such as curtains, carpeting, and pillows to allow for sound to be absorbed.

• Always set an example for your children. Your use of earplugs and low volumes will allow your children to learn a behavior that will become part of their hearing lifestyle.

Life’s enjoyments don’t necessarily need to be limited by diminished hearing. We all have the power to protect our ears.

HHF Endorses California Pediatric Hearing Aids Bill

A young girl speaks at the podium during Assemblyman Bloom’s press conference to introduce his bill to require insurance companies to cover pediatric hearing aids. Credit: Richard Bloom

Hearing Health Foundation (HHF) has formally endorsed AB 598, a bill in California calling for the expansion of hearing aid insurance coverage for children.

California resident Elizabeth Keithley, Ph.D., Chair of HHF’s Board of Directors, recently wrote a letter of support to Assemblywoman Lorena Sanchez, who has stopped earlier versions of the bill. You can read her letter below.

If you live in California and would like to identify and contact your representative about AB 598, you may do so here.

Letter of Support from Elizabeth Keithley, Ph.D.

Dear Assemblywoman Lorena Gonzalez,

Thank you for the leadership you provide to San Diego. I write to you as the Chair of the Board of Hearing Health Foundation (HHF) and Professor Emerita of Surgery/Otolaryngology Head and Neck Surgery at the University of California, San Diego, School of Medicine. I am requesting your support for AB 598, introduced by Assemblyman Richard Bloom, which will require insurance coverage for children’s hearing aids in our state.

HHF is the nation’s largest nonprofit funder of hearing and balance research. Our scientists’ work has led to development of cochlear implants, innovative ear treatments, and progress toward biological cures for hearing loss. We work tirelessly to better the lives of the 50 million Americans with hearing loss.

Beyond research, HHF has been a longtime advocate for Universal Newborn Hearing Screenings, federally mandated in the 1990s. Identifying hearing loss at birth enables parents to promptly pursue intervention for their child. The first six months of a child’s life are the most critical in forming auditory pathways in the brain to hear.

The majority of individuals with sensorineural (permanent) hearing loss, including children, can benefit from hearing aids as treatment to communicate, learn, and develop healthily. A pair of pediatric hearing aids can burden a family by as much as $6000 per pair, which generally must be replaced every three to five years. This is an out-of-pocket expense of over $40,000 before a child reaches 21.

This immense financial barrier to treatment result in absence of treatment that then inhibits children’s social, speech and language development, and academic performance. For an individual child who does not receive intervention, the estimated cost of special education and loss of productivity is $1M.

Right now, California urgently needs the help of leaders like you to relieve families from the stress of choosing between hearing aids for their children and other health necessities. The strength of the future CA workforce depends on it.

Thank you for your consideration. I truly hope you will act to support California’s children through AB 598.

Sincerely,

Elizabeth M. Keithley, Ph.D.

Sharper Than They Expected: A Tribute to Nansie Sharpless, Ph.D.

By Neyeah Watson

Women and people with disabilities have been historically underrepresented in science. In 2014, individuals with hearing loss compromised only 1.2% of Scientific & Engineering degree recipients. Women represented only 29% of the science, technology, engineering, and mathematics (STEM) workforce as of the same year.

While these statistics remain low, women and people with disabilities have seen overwhelming growth in opportunity in the past 50 years, which we can attribute changes in policy, personal attitudes, and the success of some exceptional individuals. One such pioneering individual was Nansie Sharpless, Ph.D., a biochemist who lived with bilateral hearing loss. HHF has chosen to highlight her victories this Women’s History Month. Her motivation to push barriers strengthened the confidence society has in women in science today.

Sharpless was born in Pennsylvania in 1932. Though this year saw breakthroughs for women, such as the election of the first female Senator, Hattie Wyatt Caraway, and Amelia Earhart becoming the first woman to fly solo across the Atlantic Ocean, limitations remained. Women’s suffrage had just become a law 12 years prior, and the Equal Rights Amendment, which mandated gender equality and prohibits discrimination on the basis of sex, did not yet exist. During childhood, Sharpless gravitated toward science, mathematics, and education. Tragically, at 14 Sharpless contracted meningitis, a disease that was still considered fatal at this time. Sharpless recovered but was left with a profound hearing loss in both ears.

Credit: American Association for the Advancement of Science

Sharpless’ hearing loss did not halt her academic goals despite the lack of accommodations for students with disabilities at this time. The Education of All Handicapped Children's Act—which mandated schools to provide students with learning, mental and/or physical disabilities equal access to education and to protect them from harassment and discrimination—was not passed until 1975.

Still, Sharpless defeated the odds. In 1960, only 35% of the total bachelor’s degrees achieved were women. In comparison to today, over 57.34% of total bachelor’s degrees are women. In 1954 Sharpless earned a bachelor’s degree in zoology from Oberlin College. Although Sharpless thrived in school academically, she struggled to listen in the classroom. She was fortunate to have classmates who assisted with her notetaking.

Sharpless faced similar communicative challenges in her pursuit of a master’s degree in medical technology at Wayne State University. She attended meetings, learned innovative techniques, and developed strategies to alleviate her learning obstacles.

At Wayne, Sharpless’ strong educational performance was unprecedented—and unsupported. Administrators were discouraging; in fact, the director of admissions for Wayne State University warned Sharpless she’d face unusual scrutiny in which she would be expected to achieve a perfect grade point average in order to prove that she could handle the work. Sharpless was undeterred and went on to receive her doctorate from Wayne as well.

After graduation, Sharpless was hired to conduct biochemistry research at Mayo Clinic, where she focused on the correlations between chemicals and mental disorders. Some of her most notable work includes the studying of the L-dopa metabolism in spinal fluid and its relationship with Parkinson’s Disease. Her research showcased the patterns of dystonia, a movement disorder, in response to L-dopa therapy for Parkinson's disease.

Sharpless was also fortunate to defy expectations by joining the Albert Einstein Medical College faculty as an associate professor. She was later promoted to the position of Chief of the Albert Einstein Medical College’s Neuropsychopharmacological laboratory.

Sharpless passed at the age of 55 while still serving in the Chief position at the Albert Einstein Medical College. In her career, Sharpless published over 50 papers and penned 11 books. Through her triumphs, Sharpless illustrated that hearing loss did not limit her. She was able to utilize her passion for science to become a dominant voice within research and advancement for women and for individuals with disabilities.

March celebrates the journeys of resilient women around the world. Gender and disabilities have presented challenges to individuals, especially before protective laws were in place. Sharpless fought to be outside of the statistic, seeking her purpose within what she loved most—science.

HHF intern Neyeah Watson studies communications at Brooklyn College.

Hyped Up Now, Hurting Later

By Yishane Lee and Lauren McGrath

In an interview, longtime healthcare professional Bob Kambic warns about the health risks of the over-amplification that is becoming increasingly common at recreational events.

What got you interested in the topic of the dangers of loud entertainment?
I am 75 and a grandfather. Recently I was in Detroit for an event in which my grandchildren participated. The finale of the event was held in Ford Stadium, a football venue. The electronically amplified sound was deafening even wearing my noise-canceling headphones.

The 30,000 or so people in the stadium were subject to what in other places would be called torture. I wondered, is there a way to tell the organizers they are harming our young citizens, the future of our country?

As a retired healthcare professional, I have a half century of experience in the healthcare field and more than 50 publications in peer-reviewed journals. This got me thinking about noise levels in entertainment venues. Raising awareness of this public health problem needs to be done.

Why is the music so loud?
Consider a musician playing an electric guitar in front of a crowd. She will hear her music from an amplifier. But she then finds that she likes it loud and turns the small knob up. After weeks or months that level is not satisfactory and she makes another turn up.

Over time, as the louder sounds gradually diminish hearing, it becomes necessary to turn the knob up more and more. For music professionals, this is called increasing the gain, which is one way to increase the volume of sound from the speakers. The other way to increase volume is to turn up the signal coming out of the speakers themselves.

When musicians play to big crowds they now have amplifiers and systems that produce thousands of watts of power and can project over 100 decibels (dB). This technology is also used for recorded music. It “entertains” but it also may harm the listeners’ ears. Musicians and their producers know that “loudness does not equal quality”—but that caution can get lost in the need to entertain.

By 2022, live music industry revenue is projected to be worth $31 billion worldwide, according to PricewaterhouseCoopers. Like other industries, the money is the driver. To me this means the live music industry will continue to use larger and louder electronic amplification.

The electronically amplified sound is now also ubiquitous at rallies and sporting events, both professional and collegiate—or even younger—to hype up the crowd.

What can we do to protect our hearing, and especially the hearing of children?
Earplugs. I was happy to see an article in a music industry publication saying that the purchase of custom musician’s earplugs is one of the best investments a music industry worker can make. They didn’t recommend earphones, mixers, digital equipment, or music instruments—just earplugs. Frequent concert-goers should also invest in custom musician’s earplugs.

For children, this is a tough question because kids don’t want to be told what to listen to and how loud the sound should be. But there are a variety of products for hearing protection. The first are simple foam earplugs, widely available at hardware stores, pharmacies, and online. The disadvantage is that they must be pushed into the ear canal and may not fit all size ears. (See “8 Pairs of Earplugs in 4 Noisy Settings,” next page.)

The next step up is over-the-ear earmuffs that cover the ear entirely. They are long-lasting and work well but they are also big and bulky.

Finally there are noise-canceling headphones made by audio or electronic equipment manufacturers. I use battery-powered noise-canceling headphones on airplanes and trains, and was wearing them at the event at the Ford Stadium. You may want to explore the varying prices and technology. Many can also play personal music through wireless and/or wired connections.

Besides using hearing protection, what else can you do?
Take action against unnecessary noise. Groups of parents can petition their schools and sports teams to reduce amplification at indoor and outdoor events. Decibel meters are inexpensive or free as smartphone apps and can be used to show managers and administrators the sound level at events, and when the volume reaches dangerous levels at over 85 dB.

The music and electronic sound industry is in control of this problem because of the amount of money in the industry, but also because well-known musicians such as Huey Lewis and Eric Clapton, who are open about their hearing loss, are helping to raise awareness. Media coverage and local action can bring attention to bear, and over time the industry may become aware of amplification as a health problem for everyone, including the audience, not just for those in the industry.

Bob (Robert T.) Kambic, MSH, is a retired health professional who worked at the U.S. Department of Health and Human Services and the Johns Hopkins University (JHU) Bloomberg School of Public Health. He is a current visiting scientist with the JHU Medical School Division of Health Sciences Informatics and plays and sings American traditional music using acoustic instruments.

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Celebrating the 10th Anniversary of Grace’s Law

By Jeanine and Grace Gleba

In December 2008, a small (Christmas) miracle happened in the state of New Jersey and personally for our family. It’s hard for us to believe that it has been a decade since Governor Richard Codey said these words:

Grace Gleba (red sweater on right) looks on as HAIL is signed into law.

“I want to personally thank Grace and the entire Gleba family for their years of advocacy on behalf of children with hearing loss. Grace’s tenacity, and her own example of what children can achieve with the proper treatment for hearing loss, are a major reason why kids in New Jersey will be able to receive the gift of hearing for years and years to come. Grace and her family have taken personal adversity and turned it into something positive for the people of New Jersey. We all owe her a debt of gratitude.”  

The governor spoke as we witnessed the passage of Grace’s Law S467/A1571. These bill numbers are emblazoned forever in my mind.

Grace’s Law is known as Hearing Aid Insurance Legislation (HAIL) and mandates hearing aid coverage for New Jersey children ages 15 years and younger. For our family and all of the families who advocated in the state capital of Trenton with us, it was a monumental accomplishment. In fact, it took nine years to raise awareness and fight for this law to become a reality. The statistics validate this being quite a feat as only 3 percent of all bills introduced ever become a law!

On the law’s 10th anniversary, here are 10 ways you can celebrate this landmark legislation:

1) Take a few minutes to learn the history of the bill here and here. You can read the original legislation and the most recent pamphlet that the NJ Department of Human Services’ Division of the Deaf and Hard of Hearing has produced explaining Grace's Law. Take note that as a result of the Affordable Care Act, the state has made this an essential health benefit and since 2014 there is no longer a maximum benefit limit of $1,000 per hearing aid (after deductibles, copays etc.). Now that’s something to celebrate—that children now can have even better coverage!

2) Support research toward a biological cure for hearing loss with a contribution to Hearing Health Foundation (HHF)’s Hearing Restoration Project (HRP). The HRP is a scientific consortium studying how fish, birds, and mice regenerate their hearing to replicate this phenomenon in humans.

3) Do you know a child who has benefitted from Grace’s Law and is a shining example that with their hearing aids they have overcome obstacles and achieved great things? Help them join HHF’s Faces of Hearing Loss awareness project. Their participation will show that hearing loss and related conditions can affect anyone.

4) Make a difference in someone else’s life and give the gift of sound by donating old hearing aids to Hearing Charities of America.

5) Wear earplugs for a day to gain a better understanding of living with hearing loss on a daily basis and why getting fitted for proper hearing aids can improve lives.

6) Participate in Walk4Hearing events held nationwide by the Hearing Loss Association of America.

7) Tweet a message showing your gratitude for HAIL. Tag @graceslaw and @hearinghealthfn include a link to this blog post. Here are sample tweets to get you started:

• For 10 years #GracesLaw #HAIL has helped children in NJ hear. Help spread the word by doing something from the 10 Ways to Celebrate!

• Millions of Americans experience some sort of hearing loss. #HAIL is needed in every state. #listenupamerica

• #HAIL Yeah!

• I’m celebrating #GracesLaw #anniversary by _____________.

• #GracesLaw improved my/my child’s quality of life by ____________.

• This year I am thankful for #HAIL #GracesLaw and hearing technology #gratitude

8) Advocate like we did 10 years ago! Last year, President Donald Trump signed into law the Food and Drug Administration Reauthorization Act of 2017, which includes the Over the Counter Hearing Aid Act. Next, we hope Congress will pass federal HAIL for all ages. Hearing loss doesn’t discriminate, so why does insurance coverage? Write your legislators to let them know that this is important to you.

9) Schedule a hearing exam for you or a loved one.

10) Protect your hearing or lose it. People of all ages can be affected by noise-induced hearing loss. Turn down the volume on your electronic devices. Find more ways to protect your hearing.

This article was repurposed with permission from Jeanine and Grace Gleba. Jeanine Gleba serves as a public member on the NJ State Audiology and Speech-Language Pathology Advisory Committee. Grace Gleba is a student in the Schreyer Honors College at Pennsylvania State University, where she is majoring in communications sciences and disorders with a minor in health administration and policy.

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