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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Eight Pairs of Earplugs in Four Noisy Settings: My Hearing Protection Experiment

By Kayleen Ring

Before my 2018 summer internship at Hearing Health Foundation (HHF) in New York City, I underestimated the importance of protecting my ears, often leaving myself at risk for damage from noise at concerts, sporting events, and other loud places. I took my typical hearing for granted until learning that hearing loss is largely caused by noise exposure and can negatively impact the brain function of young adults, even in its mildest forms. But I was also encouraged to discover noise-induced hearing loss (NIHL) is preventable. Earplugs in particular are a convenient, low-cost tool for hearing preservation.

To improve my own hearing health and to create awareness about NIHL, I experimented with different types of earplugs in various loud settings. Expecting no more than a handful of foam options, I was excited to learn what an assortment of earplugs is available—each with different shapes, sizes, and features. Previously, my earplug experience had been limited to basic foam pairs to drown out my college roommates’ snoring!

I evaluated each personal earplug use experience with a 1 to 10 rating—10 being highest—for effectiveness, comfort, and ease of use. The Noise Reduction Rating (NRR) metric indicates how much noise is blocked out by the pair of earplugs.

Setting: Concerts

Just one loud concert (decibel levels up to 120 dB) can cause permanent damage to your ears. I tested earplugs at two musical events.

1. Eargasm High Fidelity Ear Plugs

• NRR: 16 dB

• Effectiveness: 10

• Comfort: 10

• Ease of Use: 10

At first, I worried wearing earplugs at a performance by one of my favorite artists would negatively affect my concert experience, but this pair allowed me to hear and enjoy the music perfectly at a reduced volume. They were so comfortable I forgot they were in my ears! They were easy to remove using the pull tab and I  also liked the carrying case they come in, because it fits in my small bag and keeps the earplugs hygienic for reuse.

2. Moldex Pocket Pak Squeeze

• NRR: 27 dB

• Effectiveness: 8

• Comfort: 9

• Ease of Use: 9

The triple-flange design, neck cord, and carrying case provided a secure earplug experience at an even louder concert where sound levels spiked to 120 dB. Unprotected exposure to noise at this level, which is equivalent to that of ambulance sirens or thunderclaps, can damage hearing in seconds. Fortunately, the ridged edges on the earplugs I used made inserting them far easier and faster than foam earplugs that need to be shaped prior to use.

Setting: Group Fitness

At a popular group fitness class, I recorded sound decibel levels and the results showed extremely loud and dangerous levels of noise. The average was 91 dB and the max was 119 dB over the one-hour class period. For a healthier workout, I wore earplugs.

3. Mack’s Blackout Foam Earplugs

• NRR: 32 dB

• Effectiveness: 9

• Comfort: 10

• Ease of Use: 9

These were excellent because I was able to hear the music and the trainers’ instructions, just at a lower volume. Less distracted by the loud music than usual, I was able to focus more carefully on my workout and form. They fit snugly and stayed in place over the course of the 60-minute, high-intensity session.

4. EarPeace “HD” High Fidelity Earplugs

• NRR: 19 dB

• Effectiveness: 10

• Comfort: 10

• Ease of Use: 8

I was particularly impressed that this pair included three set of filters offering different levels of protection. I used the highest decibel filter, 19 dB, and found the class music was still clear and enjoyable. My only challenge was properly inserting the very small filters.

Setting: Restaurants

When I didn’t intern at HHF this summer, I worked at a restaurant on Long Island, New York, that was always busy, sometimes bursting with chatty customers waiting three hours for service. Beyond the crowds, the restaurant had live musical performances that amplified an already loud environment. This is dangerous for workers and patrons alike. Here, the earplugs I wore still allowed me to hear clearly and hold a conversation.

5. Etymotic ER20XS High-Fidelity Earplugs (NRR: 13 dB)

• NRR: 13 dB

• Effectiveness: 8

• Comfort: 8

• Ease of Use: 9

The Etymotic earplugs had the positive qualities of the typical high-fidelity earplugs and included three interchangeable eartips, a hygenic carrying case, and a neck cord, providing a secure and effective earplug experience.

6. EarPeace “S”High Fidelity Earplugs

• NRR: 19 dB

• Overall Effectiveness: 10

• Comfort: 10

• Ease of Use: 10

This pair was great. They reduced the noise perfectly so it was at a comfortable yet still audible volume. The dual-flange design and soft silicone material made the earplugs fit well, were comfortable and easy to use.

Setting: New York City Subway

Decibel levels on the subway platforms trains are extremely high and can cause hearing damage, especially for frequent riders and employees. For my tests, I sat inside the 34th St-Penn Station 1/2/3 subway station across the street from the HHF office, where I was greeted by screeching trains, talkative tourists, and a steel drums player.

7. Moldex Sparkplugs

• NRR: 33 dB

• Overall Effectiveness: 9

• Comfort: 10

• Ease of Use: 9

The Sparkplugs blocked out noise while allowing me to hear conversations and train announcements. They were easy to mold into my ears, allowing for optimal noise reduction. The pattern on the earplugs is colorful and fun, making them appealing for children, and easily locatable in your bag.

8. Alpine Plug & Go

• NRR: 30 dB

• Overall Effectiveness: 8

• Comfort: 8

• Ease of Use: 8

These foam earplugs reduced volume but the noise was muffled. Consequently, these would be a great option for more sedentary activities, like sleeping and flying, where you are aiming to block out all noise. The foam was comfortable and fit snugly in my ears, but was challenging to mold.

The reviews and ratings here are based on my individual experiences and are not intended to encourage or discourage anyone’s use of specific earplugs. High ratings are not product endorsements. As someone newly informed about the dangers of noise, it is my hope my summer intern experiment for HHF will raise awareness and inspire others to investigate hearing protection that best meets their needs.

Kayleen Ring is a former marketing and communications intern at HHF. She studies marketing in the honors program at Providence College in Rhode Island.