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.


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.


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.


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.

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

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Idaho Seniors Receive Hearing Health Resources


Idaho Senior News, the Gem State's oldest and largest publication for individuals 50+, printed hearing loss resources in its October 2017 edition. Authored by Hearing Health Foundation (HHF)'s Communications and Programs Manager Laura Friedman, the piece educates readers about hearing loss—the third most common health problem in the U.S.—noting that the condition is most common among older adults.

Left untreated in adults, hearing loss can "lead to considerable negative social, psychological, cognitive and health effects and can seriously impact professional and personal life, at times leading to isolation and depression," Laura writes. 

But there is good news. The most common form of hearing loss, noise-induced hearing loss, is preventable. "If you are in an environment where you have to shout to be heard, it is probably too loud."

Laura's full article, "Hear, Hear: All About Hearing Loss," is available in this PDF on the Idaho Senior News website on page 19

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Turning Fourth of July Into a Science Lesson

By Kelly N. Barahona

In most cities if not towns of a certain size in the U.S., a grand display of fireworks for the Fourth of July is part of the celebration of America’s birthday. But just how loud are the fireworks people have come to expect every summer? Unfortunately fireworks can measure from 140 to as high as 165 decibels, easily a hearing-damaging event if you are sitting too close.

This doesn’t mean you can’t enjoy the festivities. With the abundance of decibel-reading apps for smartphones it’s easier than ever before to learn how much noise is in the world around us. Most apps use the smartphone’s microphone to give a reading of the decibel level. As with a professional-grade meter, most apps can also show how the noise fluctuates over time, in real time, and provide numerical reference points that users can compare to their own sound levels. Some apps even let you geo-tag the decibel level to a specific location, like your local coffee shop or favorite restaurant.

Parents, camp counselors, and teachers can turn the Fourth of July into a science lesson. On the night of the fireworks show, Hearing Health Foundation recommends staying at least one block away from where the fireworks are being displayed and using a smartphone app to measure the decibel level.

If you want to be closer to the action, protect your hearing by using foam earplugs or over-the-ear earmuffs for the youngest children. A fun but loud activity like this can be a good segue for conversations about how listening to music at too loud a volume and participating in noisy recreational activities may be harmful, as well as how to incorporate better hearing health practices in your daily life.

Fourth of July should be a time of fun and enjoyment, but as with anything, it is necessary to take precautions to make the holiday safe as well. Teach your loved ones about the noises and sounds around them to hopefully encourage everyone to take active measures to protect their hearing on a regular basis. Remember, noise is the most preventable cause of hearing loss.

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Getting Married? Turn It Down

By Emilio Cortez, Ed.D


Wedding day celebrations often include music, but when music is too loud, you and your guests may experience hearing loss as a result. The problem of loud music is rampant and has contributed to the growing number of 48 million Americans who suffer from hearing loss.

Many bands and disc jockeys play music at 100 decibels (dB). If you’re not wearing earplugs, 100 dB can cause hearing loss in just 14 minutes, according to the Centers for Disease Control and Prevention. A telltale sign that music is too loud is when you need to shout to the person next to you just to be heard. If the music at a wedding is played consistently at 90 dB of loudness, hearing loss can occur after two hours of exposure.

Since we are all the targets of dangerous decibels, we need to remember, “Be decibel-wise: under 85 keeps hearing alive.”

When interviewing bands or DJs for a wedding, insist that you want the music to be no louder than 80 dB—and then be prepared for bewildered faces. Since many musicians and DJs are accustomed to playing very loud music, some of them have already lost hearing, so 80 dB won’t seem loud enough; an alternative plan would be to make earplugs available to your guests (see below).

The louder music is played, and the more guests that attend a wedding, the louder guests must talk to converse which adds to the total loudness. You may want to appoint a wedding helper to monitor the music’s loudness and to remind musicians to turn down the volume as needed. Also, by having the music alternate between loud songs and softer music, you can give your guests and their ears a healthy rest from potentially dangerous decibels.

Many free decibel meter apps are available for both Apple and Android smartphones. You can check it for accuracy by talking into it in a normal speaking voice. You should be getting a reading somewhere between 60 and 70 dB, which is a normal reading for conversational speech. The National Institute for Occupational Safety and Health has blogged about the accuracy of decibel meter apps.

If you choose to use earplugs that conform to your ear canal size, refer to the YouTube video, “Fitting Foam Earplugs.” In essence you want to roll the earplug down to toothpick size and then insert it into your ear, allowing it to expand in order to provide the most effective hearing protection.

My daughter is getting married this August, and I had her share this information with the prospective DJ so he knows exactly what I will be expecting as the father of the bride! Noise is the most preventable cause of hearing loss. Don’t squander it on your wedding day.

Emilio Cortez, Ed.D., is a member of the Hearing Loss Association of America of Pennsylvania and a co-chair of its Turn Down the Volume Committee.

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Hearing Loss: The Costs, The Effect on Society and How to Prevent It

Hearing Health Foundation's Communications and Programs Manager, Laura Friedman, was featured in the Mediaplanet UK's Ear, Nose, and Throat Campaign. Read her article on Hearing Loss: the costs, the effect on society and how to prevent it, here

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Make a Sound Investment

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By Frankie Huang

In honor of World Hearing Day, which takes place on March 3 every year, Hearing Health Foundation is joining forces with the World Health Organization (WHO) to draw attention to the economic impact of hearing loss and the importance of treating hearing loss.

Did you know the economic cost for unaddressed hearing loss is estimated to be $750 billion globally? In the U.S. individuals with untreated severe to profound hearing loss are expected to cost society $270,000 each over the course of their lifetimes. Most of these costs are due to reduced productivity in the workplace, although the use of special education resources among children and other social services are also factors.

Lifetime earnings for those with untreated hearing loss average 50 to 70% less than their typical-hearing peers in the U.S., and has been shown to negatively impact household income up to $12,000 per year, on average, depending on the degree of hearing loss, according to the Better Hearing Institute. This is largely due to having fewer opportunities for promotions, reduced job performance, and decreased earning power.

Beyond economic losses, untreated hearing loss can significantly impact a person’s quality of life. Researchers have found that individuals with untreated hearing loss are more likely to develop depression, anxiety, and feelings of inadequacy. They may also avoid or withdraw from social situations. Left undetected in children, hearing loss can negatively impact speech and language acquisition, academic achievement, and social and emotional development.

Prevention, screening for early identification, early intervention, and rehabilitation through hearing devices are among the strategies that mitigate hearing loss and its consequences. Those who treat their hearing loss with hearing aids and/or cochlear implants show improvement in social, emotional, and psychological well-being. Interventions can significantly decrease isolation, increase self-esteem, and lead to better employment opportunities and earnings—all of which will benefit society as a whole.

For World Hearing Day 2017, the WHO has joined forces with Mimi Hearing Technologies. To raise awareness of hearing loss, Mimi hopes to have 1 million people test their hearing. To do this, they are offering the Hearing Test app on iOS free for everyone. If you suspect you or a loved one may have hearing loss, this is a great opportunity to test your hearing with Mimi’s Hearing Test, which is an initial online assessment. The results may require a follow-up appointment with a hearing health professional. However, by detecting signs of hearing loss early on the benefits of treating hearing loss far outweigh the consequences if left untreated.

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A Fight Against Cancer Is a Fight Against Hearing Loss

By Frankie Huang

In honor of World Cancer Day on February 4, Hearing Health Foundation (HHF) wants to raise awareness of the connection between cancer and hearing loss. Every year, 8.2 million people worldwide die from cancer, a disease that is responsible for 13% of all deaths globally.

Depending on the type of cancer, patients that undergo chemotherapy are sometimes required to take certain drugs that could cause many side effects, including hearing loss. Cisplatin is a chemotherapy drug that is often used to treat testicular, bladder, ovarian and lung cancers. However, an excessive dose of cisplatin can be ototoxic (toxic to the ear), which could lead to temporary or permanent hearing loss.

One study suggested that cisplatin-induced hearing loss is generally bilateral (both ears) and irreversible. The study also found that cisplatin accumulates in cochlear tissue, preventing the cochlea from flushing out toxins. The same researchers found that patients receiving doses of cisplatin between 150-225 mg/m2 showed some degree of hearing loss. For testicular cancer patients, more than 50% of the patients that took cisplatin in doses greater than 400 mg/m2 had permanent hearing loss. Hearing loss may occur within hours or days after the treatment, or hearing may gradually decline after completion of therapy. After following up more than two years later, the study authors found that 44% of patients who took cisplatin had significant hearing loss.

In another recent study, researchers found that the WFS1 gene is associated with cisplatin-related ototoxicity; the heavier the dose, the more severe the hearing loss. Also, a mutation of the WFS1 gene results in Wolfram syndrome, a disorder with deafness as a major symptom.

As of now, there are no safe and protective agents against cisplatin, but scientists are hard at work to find a protective agent that would eliminate the negative side effects of cisplatin. Currently there’s a solution for children that are receiving cisplatin-based chemotherapy: The use of sodium thiosulfate may minimize or protect children and adolescents against cisplatin-induced hearing loss. HHF hopes more preventative therapies and cures for hearing loss can be discovered for all cisplatin-treated patients.

Interested in funding research in this area? Email us at

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Music-Induced Hearing Loss: What Do College Students Know?

By Frankie Huang

Music-induced hearing loss (MIHL) is a result from listening to music that exceeds 85 decibels for prolonged periods of time. A decibel, or dB, is a unit to measure sound intensity, and 85 dB is roughly equivalent to the sound of heavy city traffic. Our listening devices and preferred listening levels are the leading cause for MIHL. For example, when you’re working out at the gym and you up the volume of your music to 100% to drown out the music the gym is broadcasting, you are putting yourself at risk for permanent hearing loss.

The frequent use of these devices to listen to music and watch videos typically requires the use of headphones, increasing the risk of MIHL. Portnuff, Figor, and Arehart (2011) found that a person should only use their listening devices for no more than 4 hours per day at 70% volume, or 90 minutes per day at 80% volume.

In a recent study, researchers measured college students’ knowledge on the proper use of listening devices and the effects of listening to music at high volumes. It was found that prolonged use of these devices coupled with loud preferred listening levels is higher in males than in females, with males being less aware of safe listening habits and were more likely to exceed the recommended daily limit. The study also found that female students were more conscious of these limits and more knowledgeable about the maximum listening levels per day, compared with their male counterparts. Furthermore, younger students (freshmen) were less aware of safe listening levels compared with older students who were sophomores.

The use of certain headphones can also increase the risk of MIHL. Among college students, in-ear headphones (e.g., earbuds) are more commonly used than over-the-ear, noise-canceling headphones, and in-ear headphones are associated with a higher risk of MIHL. The biggest difference between in-ear and over-the-ear headphone users was the individual’s listening levels: The study found that in-ear headphone users preferred to listen at a higher volume, while over-the-ear headphone users favored a lower volume because the noise-canceling features meant ambient noise was less of an issue.

Headphone users tend to increase the volume if they can’t block out environmental noises. New York City, for example, is usually noisy so individuals are more likely to listen to their music at a higher volume, which is putting individuals at a greater risk of MIHL. There’s also a greater preference for in-ear headphones between males and females. According to the studies, 52.8% of males believed that in-ear headphones delivered better sound than over-the-ear headphones, compared with 46.4% of females.

Overall, the study suggested that individuals should refrain from listening to music and watching videos at the maximum volume for an extensive amount of time. However, if there’s too much background noise, and it's a distraction, the individual should only increase the volume to 80% of the maximum for no more than 90 minutes daily. In addition, education about the risks of hearing loss and how to prevent it is important, including how noise-canceling headphones drown out environmental noises so the wearer can enjoy music on their personal devices at safer levels.

Hearing loss is irreversible, so investing in a quality headphone that can reduce the risk of MIHL is priceless.


Berg, Abbey L. et al. Music-Induced Hearing Loss:What Do College Students Know?. 43rd ed. 2016. Web. 12 Dec. 2016.

Your Support Is Needed!

Hair cell regeneration is a plausible goal for eventual treatment of hearing and balance disorders.

The question is not if we will regenerate hair cells in humans, but when.  

However, we need your support to continue this vital research and find a cure!

Please make your gift today.

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Your Cell Phone Can Save Your Hearing

By Murray Grossan, M.D.

As a ear, nose, and throat specialist I treat patients with hearing loss and tinnitus. Did you know that by simply by using your smartphone, you can help prevent these hearing conditions?

Loud noises damage the ear. But how loud is too loud? When a guest attends a wedding and sees children seated in front of eight-foot speakers, are the speakers too loud? Your phone knows.

When a parent yells to his teenagers to lower the volume of their music, is it truly too loud? Your phone knows.

There are many smartphone apps available to Apple and Android operating systems. A simple search for the terms “sound meters” or “decibel meters” will bring up  different apps, including many of which are free!

Hearing sounds at 115 decibels for more than 15 minutes can cause permanent hearing loss. With hearing loss you may also develop tinnitus. Chronic tinnitus can be so distracting that it can disrupt daily life, including the loss of sleep.

It is not essential to know all the ins and outs of sound measurement in order to protect your hearing. (For technical details, see the Occupational Safety and Health Administration’s report.) A sound meter is all you need.

Why? It may be hard to realize how loud a sound really is, how close you are to it, and how long you are exposed to it. One person says the sound is too loud; another says it seems fine. A smartphone sound meter can measure the volume level. Recent research by National Institute for Occupational Safety and Health scientists shows the apps’ accuracy is approaching that of professional sound meters. And once you know the danger, you can limit your exposure: Block, walk, and turn.

We know that many older people have hearing loss. But science is not sure if age causes the loss or if it is an accumulation of years of hearing loud noises, just as the cumulative effects of sun exposure are evident decades later. I have an 88-year-old patient with perfect hearing. She never used a noisy lawnmower.

If sound meter use becomes common, and we are all fully aware of the danger of noise exposure, you won’t see children seated in front of giant speakers at a wedding. And I sincerely hope that I will see fewer people at my office because they can’t hear and have tinnitus.

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'Tis the Season to Protect Your Hearing from Noisy Toys

By It's A Noisy Planet

The winter holidays are the time of year for giving and sharing! The holidays provide many opportunities to spend time with family and friends and enjoy some festive cheer. Perhaps you’ll see a local holiday musical or performance or participate in a holiday gift exchange. As you prepare to wrap (or unwrap) those gifts, it’s important to consider if that noisy toy could actually be a hazard. Ever thought about how those concerts and new toys and gadgets might affect your hearing?

The U.S. Public Interest Research Group (PIRG) has found toys on store shelves that produce sounds loud enough to contribute to hearing damage over time, including music players and toys that are intended to be held close to the ear. Read the full U.S. PIRG report. During the holidays, make sure to consider the noise levels of toys for children and follow these simple tips to help keep the noise down:

  • Pack hearing protectors, such as earplugs or ear muffs, if you’re attending a local seasonal concert or other festivities. Musical events can register at or above 120 decibels—that’s roughly as loud as an ambulance siren.

  • Did one of your children get a new noisy toy? If the racket is driving you crazy, it may be too loud. Consider putting masking or packing tape over the toy’s speaker. This should muffle the sound enough to make it safe for everyone. Some toys have volume controls to lower the volume or turn off the sound completely.

  • Buy quiet gifts. Look for toys or gadgets with low-volume settings or ones that make no noise at all, such as books or puzzles.

  • Test out toys in the store before buying them to check sound levels. Ask yourself, “Is this too loud?” If so, find another toy with a softer sound. Also ask, “Can I control the volume on the toy and maintain a lower level of noise output?”

  • Limit “screen time” to cut back on noise. Televisions, tablet computers, and video games contribute to high sound levels in the home.

  • Turn on only one toy at a time. Avoid competing noises in the same area.

From everyone at Hearing Health Foundation and It’s a Noisy Planet. Protect Their Hearing® we wish you a happy holidays and a healthy New Year! 

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