Noise Induced Hearing Loss

The Happiest Baby—With Noise-Induced Hearing Loss

By Nadine Dehgan

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Nothing in my life compared to giving birth and being able to hold my heart in my arms. As most sleep-deprived new parents will attest, there also is nothing quite like the helplessness you feel when this tiny person whom you love more than anything won’t settle and continuously cries (after being fed, changed, swaddled, and is fever-free).

Before my oldest daughter was born I thought I was well-equipped to be a parent. I had always been around children, was the second oldest of six children, became an aunt at 19, had a strict  pediatrician, took my parenting class seriously—and read “The Happiest Baby on the Block,” a best-selling book by Harvey Karp, M.D., recommended to me by other new parents.

Nine years later, it has been brought to my attention Karp’s ardently recommended action of “shh-ing” my daughters is extremely damaging to an infant, or any human. He advises the “shh-ing” sound needed to activate a crying baby’s calming reflex is a rough, rumbly whoosh noise that is as loud as your infant’s crying. This is at least 115 decibels (dB), according to Oregon pediatric audiologists Heather Durham, Au.D., and Shelby Atwill, Au.D. Alarmingly, sounds over 80 dB for an extended period of time are damaging and anything greater than 100 dB for even a few minutes can cause permanent noise-induced hearing loss (NIHL).

NIHL is an epidemic for American children—one in five are estimated to have significant hearing loss before the age of 20. I wonder how many children suffer from NIHL as a result of well-intentioned parents who relied on this harmful advice.

I remember reading I could put my daughters at ease by putting my mouth close to their ears and making a strong “shhhhhhhh” noise. The sound of someone’s forceful “shhhh” directly in your ear can actually be painful. (Please do not try it!) Babies have super hearing—the best hearing humans will have in their lives is when they are first born. I shudder to think how loudly I was “shh-ing” my daughters to sleep. The louder they cried, the louder I “shh-ed,” thinking I needed to do more to soothe them as I had learned.

A new grandparent and supporter of Hearing Health Foundation (HHF) recently alerted me to this danger, and after testing the decibels of my so-called soothing “shhh” sounds, I immediately had a pit in my stomach because indeed the noise is loud—dangerously loud. I had “shhh-ed” my daughters for countless nights and naps. White noise machines (usually in a stuffed animal) placed right near a baby’s head can be equally dangerous.

Like sun exposure, loud noise exposure has a cumulative effect; it could be that “inevitable” age-related hearing loss is merely the result of a lifetime of living in our noisy environments with unprotected hearing. Parents with newborns who are difficult to calm down need another, less risky option for inducing sleep, one without lifelong consequences.  



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A Fast Track to Hearing Damage

By Andrew J. Guralnick

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Millions of commuters using the New York City subway system know it can be noisy, but just how loud is it? As a 2018 Hearing Health Foundation (HHF) intern, I set out to measure the danger that the NYC Metropolitan Transit Authority (MTA) subway system presents to riders and employees.

I found that the system significantly breaches the threshold of what is safe for our ears. To protect hearing, both the U.S. Environmental Protection Agency and the World Health Organization recommend an average exposure limit of 70 decibels (dB) over the course of 24 hours. But what we measured exceeds that limit: Our samples show the average noise levels on all subway platforms and on all subway rides (inside subway trains) is between 72.5 and 76.5 dB and between 74.1 and 75.8 dB, respectively. And, with maximum readings actually as high as 119 dB on platforms and 120 dB on rides—based on actual recorded data within the sample—the NYC subway is likely an auditory minefield. (See hhf.org/subway for full data.)

Using our data’s sample averages, I determined ranges as to what the actual averages are on all subway platforms and rides through the MTA system. Based on the data, we are 99 confident about our results.

Collecting and Analyzing

From January to August 2018, three data collectors used Decibel Meter Pro, a smartphone app on iPhones and an iPad to collect 120 samples from platforms and rides. All 60 platform samples were equally represented at five minutes each. The 60 ride samples were assigned random recording lengths from 10 to 30 minutes. Samples on Saturday and Sunday or between 11 p.m. and 4:45 a.m. on any day were excluded. Random sampling was utilized as much as possible to help ensure generalizability on behalf of all platforms and rides.

The analysis examined potential harm to hearing from loud noises on subway platforms and loud noises during subway rides. For platform noise, the main variable is the number of trains that pass; for subway ride noise, the main variable is the number of local stations the train passes. We also investigated the number of seconds the subway noise level reached 75 dB or higher.

When measuring subway rides, we noted train travels between Manhattan and another borough or vice versa; whether a train runs above ground; whether the sample was collected during rush hour; and whether a local train ever becomes an express train, with fewer stops.

The statistical method of multiple regression was used to predict dangerous noise exposure on both platforms and rides. We can predict that each train that enters or leaves a platform will expose a rider’s ears to 16.53 seconds of noise at 75 dB or higher. For example, if a rider waits at a platform where two trains come and go before their train arrives, that would be a predicted exposure of 82.65 additional seconds of noise at 75 dB or higher.

We can also predict that each subway stop that is passed will expose a rider’s ears to 36.06 seconds of noise of 75 dB or higher. For example, if a rider passes 10 local train stops on their trip, the predicted exposure of noise at 75 dB or higher is 360.60 additional seconds—or 6.01 additional minutes.

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Cumulative Effect

HHF’s recommendation for commuters, MTA staff, and platform retailers such as newsstand operators is simple: Wear ear protection. MTA staff and platform retailers are at elevated risk given the hours they spend underground and on the trains. The tendency for many commuters to block noise by raising the volume of their headphones is not a helpful approach and could in fact damage hearing even more.

The subway is merely only one of many sources of daily noise. “Noise-induced hearing loss can result from a single, sudden noise event and from constant exposure to loud noises that has a cumulative effect (not unlike sun exposure) and can lead to related negative health effects when unknown and untreated,” says Lauren McGrath, HHF’s marketing manager.

The MTA appears aware of the issue of subway noise. The newly built Second Avenue subway line uses effective noise-reduction measures such as “low vibration tracks and sound absorbing panels.” We hope the MTA will continue to use these quieter, low vibration tracks when making subway and station upgrades, especially since they are more cost-effective than traditional wooden tracks.

2018 HHF intern Andrew J. Guralnick is pursuing a master’s in public administration at Baruch College in New York City.

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Meet the Researcher: A. Catalina Vélez-Ortega

By Yishane Lee

2018 Emerging Research Grants (ERG) awardee A. Catalina Vélez-Ortega received a master’s in biology from the University of Antioquia, Colombia, and a doctorate in physiology from the University of Kentucky, where she completed postdoctoral training and is now an assistant professor in the department of physiology.

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IN HER WORDS:

TRPA1 is an ion channel known for its role as an “irritant sensor” in pain-sensing neurons (nerve cells). Noise exposure leads to the production of some cellular “irritants” that activate TRPA1 channels in the inner ear. The role of TRPA1 channels has been a puzzling project, with most experiments leaving more questions to pursue. My current project seeks to uncover how TRPA1 activation modifies cochlear mechanics and hearing sensitivity, in order to find new therapeutic targets to prevent hearing loss or tinnitus.

My father, our town’s surgeon, fueled my desire to learn. When I asked him how the human heart works, he called the butcher, got a pig’s heart, and we dissected it together. I was about 5 when I learned how the heart’s chambers are connected and how valves work. He also set up an astronomy class at home with a flashlight, globe, and ball when I asked, “Why does the moon change shape?” My father’s excitement kept my curiosity from fading as I grew older. That eager-to-learn personality now drives my career in science and teaching.

My training in biomedical engineering guided my interest into hearing science. The field of inner ear research mixes physics and mechanics with molecular biology and genetics in a way I find extremely attractive. Analytics also intrigues me. People who work with me know how complex my calendar and spreadsheets can get. I absolutely love logging all kinds of data and looking for correlations. I also like to plan ahead—passport renewal 10 years from now? Already in my calendar!

I take dance lessons and participate in flash mobs and other dance performances. But I used to be extremely shy. As a child I simply could not look anyone in the eye when talking to them. I was also terrified of being onstage. It was only after college that I decided to finally correct the problem. Interestingly, taking sign language lessons was very helpful. Sign language forced me to stare at people to be able to communicate. It was terrifying at first, but it started to feel very natural after just a few months.

Vélez-Ortega’s 2018 ERG grant was generously funded by cochlear implant manufacturer Cochlear Americas.

We need your help supporting innovative hearing and balance science through our Emerging Research Grants program. Please make a contribution today.

 
 
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Noise: Exposed

By Nadine Dehgan

Aboard my noisy flight to the Hearing Loss Association of America (HLAA) Convention in June, I couldn’t help but reflect upon loud sounds—and what can be done to reduce our exposure.

I’d recently learned that the word “noise” is derived from “sea sickness” or “nausea” in Latin. Noise has literally been associated with poor health outcomes for thousands of years.

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Synonyms for “loud” include “ear-splitting” and “deafening.” In fact, vibrations from loud noises travel through the eardrum to reach our inner ear, where sensory hair cells change them into electrical signals to be interpreted by the brain. Hair cells, however,  come in limited supply. Humans are typically born with 16,000—and when these cells are damaged by noise, age, ototoxic drugs, or other factors, the brain’s ability to communicate with the ears is significantly weakened, resulting in permanent hearing loss.

Concerned about my fellow plane passengers’ hair cells, I opened my phone’s decibel (dB) measuring app, which indicated the maximum noise level after takeoff was 92 dB, while the average was 83 dB. The app also pointed out that this dB level is equivalent to that of alarm clocks. While this doesn’t seem uncomfortable, it’s actually not recommended for periods over two hours. I’d come prepared with both earplugs and noise-canceling headphones—which I limit to 60 percent of maximum volume in accordance with the World Health Organization (WHO)’s recommendation. But not everyone taking flights comes prepared for the dangerous levels of noise inside the plane.

The National Institutes of Health (NIH) states noise greater than 75 dB can harm hearing, and in 1974, the Environmental Protection Agency (EPA) recommended that sound exposure should remain at or below 70 dB to prevent noise-induced hearing loss. Sudden loud noise—such as from blasts, gunfire, firecrackers, and bullhorns—also can cause hearing loss with levels reaching 165 dB! This is why so many veterans return with hearing loss and tinnitus. Tragically, they are the two most common disabilities for those who serve.

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And yet our society glorifies noise. Two confessions explain my frustration. The first is I love to listen to love songs from the ’90s and my children think these songs are current hits. My second is when my kids are not in my car I often listen to classical music, but once in awhile I listen to current hits. One station’s tagline actually is “Ear-Popping Music.” I couldn’t believe that damaging eardrums was being advertised as a good thing! My youngest daughter, Emmy, had many eardrum ruptures—from infections, not noise—and she truly suffered. My anguish as a parent watching my baby and then toddler in pain was nothing compared to the pain she endured with no understanding of why.

How can we be okay with hearing loss and ear damage advertised as a positive experience? No one would advertise skin cancer from excessive sun exposure as a perk of a beach vacation. Nor would a beverage manufacturer tout soda’s negative impact on dental health.   

It is my wish that one day we take the real risk of hearing loss seriously and recognize it for the epidemic that it is. Experts say approximately one in five American children will have permanent hearing loss (largely noise-induced) before reaching adulthood. University of Ohio scientists report that even mild hearing losses in children can cause cognitive damage that would typically not occur until at least age 50. This is horrifying.

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Still, we surround our children with damaging noise. Birthday parties, movie theaters, weddings, and family celebrations can blast noise exceeding 115 dB. Football stadiums, hockey arenas, exercise classes, and music concerts have clocked in at over 140 dB, which can cause irreversible hearing loss—whether sudden or progressive damage—in minutes.

Recently, a friend told me she complained of high noise levels (105 dB) to her daughter’s dance studio. Instead of offering to turn down the volume, management told her that she could leave the class. While her daughter can no longer attend dance class, my friend has the consolation of knowing her child is safer. My thoughts go to the employees of fitness centers, stadiums, restaurants, bars, and other commercial establishments whose ears are constantly assaulted.

Before becoming CEO of Hearing Health Foundation (HHF), I didn’t appreciate the dangers and consequences of loud sound. I now know that even a mild untreated hearing loss can lead to social issues including isolation, depression, and poor academic performance in children. In adults, the stakes are also high, with untreated hearing loss bringing the risks of mental decline, falls, and premature death.

Hearing loss can be mitigated by technology including hearing aids and cochlear implants. While these treatments are beneficial and life-saving, HHF is funding research toward permanent cures. Birds, fish, and reptiles are all able to restore their inner ear hair cells once damaged—but mammals including humans cannot. HHF funds a consortium of top hearing scientists through our Hearing Restoration Project (HRP) who study how other species are able to regenerate their hearing in order to apply this knowledge to humans through a biological cure.

As the plane descended toward Minneapolis, my ears popped, but I know the minor discomfort can’t compete with what Emmy experiences. As the mother, sister, daughter, and granddaughter of individuals with hearing loss, I remember my two biggest wishes: for society to place a greater value on hearing protection, and for HHF to continue to support researchers on their quest to treat and cure hearing loss and related conditions.

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Hearing Better Through the Ages

By Rebecca Huzzy, Au.D.

Chances are, you visit your doctor for an annual physical, wear a seatbelt, and use sunscreen. These are just a few small efforts we regularly make to stay healthy and injury-free.

Tending to the health of our hearing is another important, simple way we can maintain our overall physical and emotional well-being. Supporting hearing health begins at birth, when we test newborns for hearing loss, and continues into our elder years, when assistive technology can vastly improve overall health and quality of life.

Diagnosing Newborns & Infants

According to the Centers for Disease Control and Prevention, hearing loss is one of the most common congenital conditions, impacting approximately 12,000 infants per year. About half of these cases are linked to certain genetic syndromes, such as Down syndrome, Treacher Collins, and Usher syndrome.

But with the advent of universal newborn hearing screening programs in the early 1990s, hearing loss can now be identified and treated very early. According to what we call the “1-3-6” EHDI (Early Hearing Detection and Intervention) national goals, infants should be screened by age 1 month; diagnosed by age 3 months; and in an early intervention program by age 6 months.

“The effects of providing acoustic stimulation to the immature neurological system, including the brain, and combining the input with a rich and meaningful environmental experience, allows children to develop sufficient auditory skills to learn spoken language at a very young age,” says Janice C. Gatty, Ed.D., the director of Child & Family Services at Clarke Schools for Hearing and Speech.

This means families should expose their infants to sound frequently and consistently—talking to them, naming objects, narrating actions, singing, and reading books. With access to sound and an early intervention program at this young age, a child with hearing loss can begin learning to listen, babble, and eventually talk.

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Common Risks for Adolescents & Teens

Since the prevailing cause of hearing loss in young people with typical hearing is noise exposure, we need to educate kids early, as many begin listening to music on personal devices, playing in bands, and attending concerts at a young age.

According to the American Speech-Language-Hearing Association, exposure to sound that is higher than 85 decibels (the volume of a blender, hair dryer, or siren) for an extended period of time can cause permanent hearing damage. And the maximum output of most MP3 players is a powerful 110 decibels!

Fortunately, there are options for volume-limiting software that can mitigate unhealthy sound levels. Many devices offer parental controls and volume-controlling apps that limit noise levels, and there are various kid-friendly, hearing-healthy headphones available.

Follow the 80/90 rule: Set the maximum headphone volume to be 80 percent (not 100 percent), and listen for up to 90 minutes daily. If you listen for longer, lower the volume even more.

How Sound Exposure Catches Up With Us in Middle Age

“Adult onset hearing loss typically progresses slowly over the course of a number of years,” says audiologist John Mazzeo, Au.D., the audiology supervisor at Nemours/Alfred I. duPont Hospital for Children in Wilmington, Delaware.

Noise-induced hearing loss (NIHL) can have a sneaky, cumulative effect, similar to the impact of years of exposure to the sun. The people at the highest risk for NIHL work in noisy professions and include musicians, farmers, dentists, airport workers, and military service members. For those who spend time in loud environments, wearing hearing protection is the best way to guard against NIHL.

Ototoxic drugs (drugs harmful to hearing) and certain conditions, such as Ménière’s disease, can also contribute to progressive hearing loss over time. Regular screenings, prior to the recommended age of 50, are especially important if hearing loss runs in the family, or if you have symptoms associated with hearing loss, such as tinnitus, dizziness, or a perceived decrease in hearing.

Caring for Seniors as Hearing Abilities Change

Hearing loss becomes much more prevalent with age, affecting more than 30 percent of people over age 65, and 80 percent of adults over 80.

Hearing loss in seniors is linked to serious health conditions, including dementia. When communication is difficult, many people will avoid social situations, and research shows that social isolation is linked to cognitive decline, a key symptom of dementia. Additionally, difficulty hearing can impact the effectiveness of our other neural processes.

The risk of falls also becomes more likely with age, due to both decreased spatial awareness and increased cognitive load. A 2012 Johns Hopkins study found that older adults with mild hearing loss were nearly three times more likely to have a history of falling.

Staying Fit

If you’re diagnosed with a hearing loss, remember: Hearing loss is not only very common, it’s also very treatable! A licensed audiologist or hearing healthcare professional can discuss options with you, including hearing aids and assistive listening devices.

When it’s a loved one struggling to hear, or being stubborn about getting help, be patient. Gain their attention before talking, rephrase sentences instead of repeating them, and encourage trying out some kind of amplification.

Think of your hearing health as essential to your body’s complete performance. Our bodily systems are all interconnected; neglecting to protect our ears or refusing helpful interventions can have cascading health effects. When you take even small steps to protect your hearing health and that of loved ones, such as through regular hearing screenings and using earplugs in noisy environments, take heart in knowing you have bolstered your overall well-being.

Rebecca Huzzy, Au.D., CCC-A, is an educational audiologist at Clarke Schools for Hearing and Speech at its Philadelphia location and a clinical audiologist at Nemours/Alfred I. duPont Hospital for Children in Wilmington, Delaware. For more, see clarkeschools.org. This article also appeared in the Spring 2018 issue of Hearing Health magazine. For references, see hhf.org/spring2018-references.

Receive updates on life-changing hearing research and resources by subscribing to HHF's free quarterly magazine and e-newsletter.

 
 
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Researchers Fighting the Effects of Noise

By Yishane Lee

The cornerstone of Hearing Health Foundation, ever since its founding in 1958 as the Deafness Research Foundation, has been funding early-career researchers who bring innovative thinking to hearing and balance research. HHF’s Emerging Research Grants (ERG) are awarded to the most promising scientists in the field, with many going on to earn prestigious National Institutes of Health backing.

HHF is always proud to see ERG grantees thrive in their careers and research. Most recently, two ERG scientists funded in the mid-1990s have made headlines, each for treatments for noise-induced hearing loss (NIHL).

1996 and 1997 ERG scientist John Oghalai, M.D., of the University of Southern California, coauthored a study showing promise for preventing NIHL. Published May 7, 2018, in the Proceedings of the National Academy of Sciences, Oghalai and team used miniature optics to examine the mouse cochlea after exposure to extremely loud noise, and found that in addition to immediate hair cell death, a fluid buildup in the inner ear over several hours eventually led to nerve cell loss. The fluid buildup, or endolymph hydrops, contributes to synaptopathy, or damage to the auditory nerve cell synapse. In a USC News press release, Oghalai described the excess fluid as a feeling of fullness and ringing in the ear that a person may experience after attending a loud concert.

Because the extra fluid showed a high concentration of potassium, the team saw a method to re-balance the fluids that naturally occur in the inner ear by injecting a salt (sodium) and sugar solution into the middle ear three hours after exposure. Nerve cell loss was reduced by 45 to 64 percent, which may help preserve hearing. The researchers see applications for this treatment for military service members who experience blast trauma as well as for people who have Ménière’s disease, the hearing and balance condition that is associated with inner ear fluid buildup.

Images from the cochleae of guinea pigs show the presence of more hair cells in animals treated with a short interfering RNA that interrupts a gene upregulated after damage (right; control on left). Inner and outer hair cells (IHC and OHC) are labeled in green, stereocilia in yellow, and nuclei in blue. Arrowheads indicate ectopic hair cells. Credit:    The Scientist    via    Molecular Therapy   .

Images from the cochleae of guinea pigs show the presence of more hair cells in animals treated with a short interfering RNA that interrupts a gene upregulated after damage (right; control on left). Inner and outer hair cells (IHC and OHC) are labeled in green, stereocilia in yellow, and nuclei in blue. Arrowheads indicate ectopic hair cells. Credit: The Scientist via Molecular Therapy.

1996 ERG scientist Richard Kopke, M.D., FACS, of the Hough Ear Institute in Oklahoma, spent more than 20 years serving with the U.S. Army, becoming well aware of the dangers of NIHL for service members. In a paper in Molecular Therapy, published online in March 2018, Kopke and colleagues used “small interfering RNAs” (siRNAs) to block the activity of the Notch signaling pathway gene Hes1 that itself blocks hair cell differentiation in developing supporting cells and may contribute to the failure of hair cells to regenerate after injury.

These siRNAs were delivered using nanoparticles directly injected to the cochleae of live, adult guinea pigs. Kopke’s team had previously shown using siRNAs to block Hes1 to be effective in regenerating hair cells in cultured mouse cochlea. In the current study, the 24-hour, sustained-release of siRNAs through nanoparticles three days after deafening resulted in the recovery of some hearing ability, measured using auditory brainstem responses, at three weeks and continuing to nine weeks, when the study ended. Compared with the control mice, the RNA-injected mice showed less overall hair cell loss and early signs of immature hair cell development, which the authors say may signal hair cell regeneration. Hearing loss caused by noise, chemotherapy drugs, or aging that damages or kills hair cells are all targets for this potential treatment.

In an article in The Scientist, HHF’s Hearing Restoration Project consortium member Jennifer Stone, Ph.D., who was not involved in the paper, echoed the study authors in saying further research should work to determine which cells are turning into hair cells, and whether the observed hair cell development is truly new hair cells and not the repair of damaged hair cells. Kopke and team plan to test the treatment using longer periods between deafening and injection, while also modifying dose and delivery.

We need your help supporting innovative hearing and balance science through our Emerging Research Grants program. Please make a contribution today.

 
 
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Let’s Make Noise Safer

By Vicky Chan

April 25 is International Noise Awareness Day, an annual, vital reminder to take a stand against noise exposure and to spread awareness about the underestimated threat of noise-induced hearing loss (NIHL). Seemingly harmless rhythms, roars, and blasts heard daily from music, trains, and machinery are, in fact, among the top offenders of NIHL.

Noise-induced hearing loss (NIHL) progressively occurs after chronic exposure to loud sounds. The frequency and intensity of the sound level, measured in decibels (dB), increases the risk of NIHL. Gradual hearing loss can result from prolonged contact with noise levels of 85 dB or greater, such as heavy city traffic. Noises of 110 dB or more, like construction (110 dB), an ambulance (120dB), or the pop of firecrackers (140-165 dB) can damage one’s hearing in a minute’s time.

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NIHL is the only type of hearing loss that is completely preventable, yet billions of individuals endanger themselves daily. Over 1.1 billion young adults ages 12 to 35—an age group that frequently uses headphones to listen to music—are at risk. Already, an estimated 12.5% of young people ages of 6 to 19 have hearing loss as a result of using earbuds or headphones at a high volume. A device playing at maximum volume (105 dB) is dangerous, so exposure to sounds at 100 dB for more than 15 minutes is highly discouraged.

Most major cities around the world have transit systems that put commuters in contact with sounds at 110 dB. BBC News found that London’s transit systems can get as loud as 110 dB, which is louder than a nearby helicopter taking off. The sound levels of some stations exceed the threshold for which occupational hearing protection is legally required. New York City has one of the largest and oldest subway systems in the world where 91% of commuters exceed the recommended levels of noise exposure annually. In a study on Toronto’s subway system, 20% of intermittent bursts of impulse noises were greater than 114 dB.

People who work in certain fields are more vulnerable to NIHL than others. Professional musicians, for instance, are almost four times as likely to develop NIHL than the general public. Military personnel, who are in extremely close proximity to gunfire and blasts, are more likely to return home from combat with hearing loss and/or tinnitus than any other type of injury. And airport ground staff are surrounded by high-frequency aircraft noises at 140 dB. In all of these professions, the hazard of NIHL can be significantly mitigated with hearing protection.

NIHL is permanent. Increased exposure to excess noise destroys the sensory cells in the inner ears (hair cells), which decreases hearing capacity and leads to hearing loss. Once damaged, the sensory cells cannot be restored. To find a solution, Hearing Health Foundation’s (HHF) Hearing Restoration Project (HRP) conducts groundbreaking research on inner ear hair cell regeneration in hopes of discovering a life-changing cure.

Nearly three-quarters of those who are exposed to loud noises rarely or never use hearing protection. It is our dream that someday, NIHL will be reversible as a result of the HRP. Until then, to make noise safer, HHF advises protection by remembering to Block, Walk, and Turn. Block out noises by wearing earplugs or protective earmuffs. Walk away or limit exposure to high-levels of noises. Turn down the volume of electronic devices.

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A Tribute to Our Nation’s Veterans

By Laura Friedman

Each year on Veterans Day, November 11, we proudly honor the men and women who have bravely served our country and fought to protect our freedoms.

Veterans Day is important because it honors our soldiers and it is a time to raise awareness about their experiences on and off the battlefield. Noise-induced hearing loss (NIHL) and tinnitus (ringing in the ears) are the top two health conditions among military veterans, according to the U.S. Department of Veterans Affairs (VA). By the end of fiscal year 2016 over 1 million veterans received disability compensation as a result of hearing loss, and about 1.6 million received compensation for tinnitus.

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In addition to being disproportionately affected by hearing loss and tinnitus, our soldiers and veterans are also more susceptible to developing central auditory processing disorders (CAPD). CAPD occurs when one can hear sounds but is unable to understand the words. It is sometimes caused by intense exposure to sudden and loud noises from improvised explosive devices (IEDs), ammunition and engine noise.

"Both post-blast trauma and CAPD are difficult, diffuse disorders where more work is needed, particularly on people working in extreme conditions, acoustic and otherwise, such as veterans." —Edward Bartlett, Ph.D., Associate Professor, Biological Sciences and Biomedical Engineering Purdue University

Blasts can result in temporary hearing loss and put military personnel at risk. However, the word “temporary” should be approached with caution: Repeated short-term hearing loss can damage the sensitive hair cells in the inner ear, leading to permanent hearing loss.

Hearing loss and tinnitus as a result of noise is largely preventable. There’s a misconception that not using hearing protection would inhibit vital communication and mission readiness. With today’s increasingly sophisticated technology, soldiers no longer need to choose between protecting their ears or their lives. Wearing hearing protection such as noise-attenuating helmets, which use ear cups to protect against hazardous sound, or Tactical Communication and Protective Systems, which protect against loud noises while amplifying soft ones, can go a long way to reduce overall exposure, while ensuring vital communications.

Any form of hearing loss can be detrimental to soldiers on duty, as the ability to hear signs of danger and to communicate with fellow soldiers is crucial for mission success and survival. Off-duty, hearing loss and tinnitus can also impact one’s well-being.

Regardless of age, type of hearing loss, or cause, if left untreated or undetected hearing loss can lead to considerable, negative social, psychological, cognitive, and health effects. As a result, it can seriously impact professional and personal life, potentially leading to isolation and depression. Treating hearing loss can also decrease one’s risk of acquiring other serious medical conditions, such as cardiovascular disease, dementia, and diabetes.

Veterans who have acquired hearing loss and tinnitus, either as a result of war or through other causes, can seek treatment at their local Department of Veterans Affairs (VA) medical center. Through partnerships with local community providers, the VA offers comprehensive hearing health services including screening, evaluation, treatment, and/or management of hearing, tinnitus, and balance disorders.

While it may be daunting to take the initial step of having a hearing test, it is important to know there are many different treatment options available. Some forms of hearing loss, such as those that affect the middle ear, are treatable through surgery. Damage to the inner ear and auditory nerve can cause permanent hearing loss; however technologies such as hearing aids, assistive/alerting devices, TV and telephone amplifiers, and cochlear and other auditory implants can optimize residual hearing by amplifying sounds.

As for tinnitus treatments, many patients have seen improvements with counseling and sound therapy, cognitive behavioral therapy (CBT), and the use of white-noise machines. Be sure to discuss the cause of your hearing loss and tinnitus and various treatment options with your audiologist or ear, nose, and throat specialist (ENT).

“On this and every Veterans Day, HHF sincerely thanks our military and our veterans for their brave service and sacrifice. I would also encourage all members, past and present, to have their hearing tested and monitored by a hearing health professional on a regular basis.” —Nadine Dehgan, CEO, Hearing Health Foundation.

Please visit va.gov/directory/guide to find your local VA medical facility. Please also see our Fall 2017 issue of Hearing Health magazine, whose theme is Veterans & Seniors, available at hhf.org/magazine.

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A Tool to Discover Quieter Restaurants and Voice Concern for Loud Noise

By Gregory Scott

Restaurants and bars are simply too loud. In New York City, restaurants, on average, have decibel levels (77 dBA) that make conversation very difficult.  And bars are even worse with sound levels (81 dBA) that put people in danger of noise-induced hearing loss.  

When you go out, do you strain to hear a friend, family member, date or business partner?  Do you wish venues were quieter to carry a conversation? Looking for a polite way to ask managers to reduce their noise levels? Do you seek a way to find out where the quieter spots are in your city?

These questions have been on my mind the past few years. As someone with hearing loss, I am sensitive to loud venues and have often struggled to hear companions in noisy bars and restaurants.

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I recall many times sitting at a restaurant table feeling completely lost in the conversation while others conversed and connected with each other. I would often nod my head in unison with the conversation, pretending to hear my companions when I could not, and then idly pass the time by entertaining myself with whatever fiction entered my head. At home, I would google “quiet spots,” which was often a fruitless endeavor. A place listed as quiet would often be blasting with music when I arrived with my date. This type of setting was not a great environment to talk in and get to know someone.

To overcome these issues, a free iPhone decibel meter app called SoundPrint has been created primarily for the hearing-impaired community, but even those with typical hearing can benefit. SoundPrint is also helpful for the blind, those with autism, or those who simply prefer quiet environments.

SoundPrint allows you to discover the quieter venues in your city. Using the app’s internal decibel meter, you can measure the actual noise level of any venue, which is then submitted to a SoundPrint database that anyone can access to find out if a certain venue is quiet or loud. A database for your city is created and, with each submission, is enriched and becomes more valuable. In addition, submitting SoundPrint measurements is an effective way to tell venue managers that you and others care about noise levels and that they should mitigate the increasing din.

An initial trial in New York City has begun and to date, 3,000+ venues have been measured, many of which have been measured three times or more. This has resulted in an invaluable curated list of 30 local quiet spots where one can actually hear others! No longer am I just sitting at a restaurant table unable to participate; rather I am engaged in the conversation and able to connect with companions.

The goal is to generate a similar list for other cities and let venue managers know that we care about noise. Join the SoundPrint community by measuring a venue when you are out. By doing so, you are helping each other discover which venues are quiet and noisy.

Gregory Scott is the founder of the SoundPrint app and is involved in the New York City hearing-impaired community. For more information, and to join the newsletter, visit SoundPrint's website and download the app. SoundPrint is only available for the iPhone, but venues are searchable on the app’s website. Greg is looking for SoundPrint ambassadors for other cities outside of New York (greg@soundprint.co).

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Paying Tribute on Armed Forces Day

By Siera Whitaker

May 20 is Armed Forces Day and Hearing Health Foundation is paying tribute to the men and women who serve in our armed forces.

The number one and two war wounds for active service members and veterans are hearing loss and tinnitus, directly impacting their ability to conduct missions and follow instructions. According to the U.S. Department of Veterans Affairs, by the end of 2014 over 933,000 veterans received disability compensation as a result of hearing loss, and about 1.3 million received compensation for tinnitus.

Extended, unprotected exposure to noise that reaches 85 decibels (the sound of a lawnmower) or higher can cause permanent inner ear damage. The Centers for Disease Control and Prevention (CDC) states difficulty with hearing is the third most commonly reported chronic health condition in the U.S.; approximately 40 million Americans ages 20 to 69 have hearing loss in one or both ears, and one main cause is excessive, loud noise.

When it comes to hearing loss and tinnitus, soldiers are at an increased risk. They are susceptible to noise-induced hearing loss (NIHL) because they are exposed to loud machinery and explosions on a constant basis. In combat, soldiers are often exposed to sudden noises, such as from an improvised explosive device (IED) or other similar weapon, which are difficult to predict and be protected against. These sudden noises can result in temporary hearing loss and put military personnel at risk. However, the word “temporary” should be approached with caution. Repeated short-term hearing loss can damage the sensitive hair cells in the inner ear, leading to hearing loss that becomes permanent.

Hearing loss as a result of noise is 100 percent preventable. Wearing hearing protection such as noise attenuating helmets, which use ear cups to protect against hazardous sound, or Tactical Communication and Protective Systems (TCAPS), can go a long way to reduce overall exposure.

Since these brave men and women are disproportionately impacted by hearing loss and tinnitus that likely affects many other aspects of their lives, Hearing Health Foundation is proud to pay tribute to them on Armed Forces Day. If you are a veteran, current service member, or have family or friends who have bravely served our country, please check out our veterans' resources and share your story about hearing loss or tinnitus with us.

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