noise

I Would Love to Hear the Conversation

By Joe Mussomeli

Music is another language that calls to my brother, Alex. Though he was born with hearing loss, he experiences music as more than just sounds, as something more beautiful. He sets his daily activities—painting, doing homework, or reading—to the melodies of either classical or popular music. 

Music for Alex, and for many others with hearing loss, is both a blessing and a curse. Sometimes loud music volumes, especially in crowded spaces, can be a distraction for him. This recently became apparent at dinner in a restaurant with our parents. At first, he appreciated everything about the restaurant: the delicious smells, the cheerful faces, and the lively music.  We talked amongst ourselves until problems arose for Alex. Alex struggles to hear what others say under ordinary circumstances, but in a loud restaurant, conversation is virtually impossible for him. 

Restaurants serve and are staffed by so many people in close quarters, all of whom are immersed in their own simultaneous conversations. Music creates another layer of sound on top of these many voices. In this environment, Alex is only able to hear a tornado of noises, all scrambled together, that do not make any sense to him. 

That evening at the restaurant, Alex desperately tried to make sense of what we were saying, but couldn’t. The noise was too loud and too much to bear. We tried to accommodate Alex by repeating our words or speaking closer to him. Unfortunately, as the evening went on, the restaurant got more crowded and the noises, including the music, grew louder.

Eventually, Alex couldn’t manage the noise anymore, so we left. When we got home, Alex sat in his room for hours before I eventually entered to ask if he was okay. He was unhappily replaying the experience in his head. He told me, “I was lost in a storm of noise, unable to find my way out.” 

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I just sat there for a moment, unsure of how to respond, but I knew I had to say something. So, I asked Alex what he was going to do about his problem. Would he find a solution or simply refuse to go to another restaurant ever again? The choice was up to him. With that, Alex reflected, and eventually, an idea came to him: The Mini-Mic. 

The Mini-Mic is an assistive device Alex had previously used at school whenever he needed to hear others more clearly in crowded, noisy spaces. When someone speaks directly into the mic, the audio feeds into Alex’s hearing aid and cochlear implant. The mic had worked well in the classroom, so Alex figured that it could work successfully in a restaurant, too. After this realization, Alex was determined to give the restaurant another try.  

Nothing had changed at the restaurant, but Alex had. The crowded restaurant buzzed with loud chatter and music. Alex was not discouraged. As soon as we were seated, my mom placed the Mini-Mic on the table. Alex connected his implant and hearing aid to it, and then, he could hear everything. Just like everyone else, Alex was able to enjoy a meal and conversation at the same time. He was able to dine with us, talk with us, and laugh with us. And he was able to enjoy the music, playing vibrantly in the background.

Joe Mussomeli is an 11th-grade student who lives in Westport, CT. His younger brother, Alex, has been featured in Hearing Health magazine and is a participant in HHF’s “Faces of Hearing Loss” campaign.

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Hair Cell Eulogy

By Dawn Doig

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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.

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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.

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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!!

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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.

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Making Friends and Influencing People

By Kathi Mestayer

Lorrie Moore, the author of “Who Will Run the Frog Hospital?” was in town in Williamsburg, Virginia, giving a reading at Tucker Hall at the College of William and Mary. My friend Susan had invited me, and I actually remembered the author’s name and knew that book was somewhere on my shelf, so I said yes.

My husband Mac had read the book, and was sure I would like it. I managed to find it on our jumbled bookshelves, which are kind of in alphabetical order (for fiction, at least). And it was short, only 147 pages! Before long, I realized that I had already read it, too. Not because I remembered anything, mind you, but because my marks and scars were present pencil lines in the margins, and a few dog-eared pages. Mac never marks up a book, or dog-ears the pages, and it drives him crazy when I do. So, it’s usually easy to tell whether I’ve read a book. In this case, I was probably walking that fine line with my fine lines.

I got 33 pages into the book, and it was lively stuff. One passage I had circled (in ink!) was, “She inhaled and held the smoke deep inside, like the worst secret in the world, and then let it burst from her in a cry.” I love revisiting a book, like a stone skipping over water, hitting the high spots thanks to my notes.

So when the day of the reading arrived, I went to listen to Lorrie Moore read her favorite passages in her own voice.

Wishful Thinking

When I got to the lecture hall, I sat by Susan, who was fortunately in the second row, near the aisle. Someone introduced Lorrie Moore. I couldn’t hear most of that, but it didn’t really matter. Then she got up to read, holding a big, thick book (her latest), with a microphone clipped to her lapel.

I couldn’t hear a word of it. It seemed as though she was muttering softly, but I’m not a good judge of that. I leaned over and whispered to Susan that I was having trouble hearing and was going to sit in the front row. Well, Susan outed me immediately, and informed the guy who had introduced Lorrie that she wasn’t audible. While I tried to surreptitiously move to the very center of the front row, he asked Lorrie to hold the lapel mic in her hand, so it could be closer to her mouth.

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She did that for a few minutes, but it got awkward when she needed to hold the book, too. And when she held the mic in her hand, it was so close to her mouth that her speech was distorted, with the P’s and T’s sounding like balloons popping. Tiny balloons, but enough to muddy her speech. For me.

So, at the suggestion of a young man on my right, she put the mic back on her lapel, but closer to her face. She asked, “Can everyone hear me now?” I didn’t turn around to see the response behind me, but it was clear that she got some no’s because she started playing around with the mic and saying, “How about now?” And, “Now?”

That was when one of the professors leapt over the front two rows, got on the stage, took the big, regular-mic holder (which was empty), bent it around to the front of the lectern, and clipped the tiny lapel mic to it. Okay. It was closer to her mouth, and she could use her hands for other things.

Let the reading begin. Again.

This time, she read for about 20 minutes, and I still couldn’t hear clearly enough to know what she was mumbling into the mic, with the P’s and T’s popping again due to its proximity to her mouth. I sat there patiently, not wanting to be disruptive again, and thought about other things, in between the audience’s intermittent chuckling. To my credit, I did not get my phone out to check my email.

After she was done, and the Q&A period started, I slunk out of the room, as quietly as possible. Others were doing the same, so I felt a little less rude. The next day, I got an apologetic email from Susan.

Not Just Me

A couple of days later, I was in a gift shop downtown, and a young woman behind the counter asked if I had been at the reading the other night in Tucker Hall. I said yes. Turns out, she was sitting right behind me. When I mentioned that I had a really hard time hearing in that space, she replied, “Oh, I HATE that room!  It’s the worst one on campus! I can never hear in there.”

The good news is that, the next time Susan invited me to a reading, she made a point of saying they had gotten the good mic back up and running. And, in fairness, making an entire campus of classrooms and other spaces hearing-friendly will take time, money… and attention. In fact, I’ve already managed to get an FM system installed in two auditoriums in another building on campus. So, slowly, the system is getting better, one complaint at a time.

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I think of that passage I ink-circled, about inhaling smoke like a big secret and letting it burst forth. Advocating to hear can put you in the spotlight, uncomfortably, especially in a group situation, but we should let our needs burst forth to help others who are no doubt in the same situation.

Kathi Mestayer is a staff writer for Hearing Health magazine.

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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.

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 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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