Make Listening Safe

By Sloan Blanton

Our ears are one of our most precious commodities. With our ears we are able to communicate with our peers, enjoy the beauty of music, tune into the natural world around us and become aware of safety hazards, such as sirens. Some people are born without the ability to hear, and for thousands of years those individuals lived without any legitimate hearing solutions. In the past 150 years, numerous technological advancements have emerged, providing hearing assistance through the use of hearing aids, assistive listening devices, cochlear implants, and more.

However, today's increasingly industrialized society poses a new risk. A growing number of people are prone to noise-induced hearing loss. Our smartphones and personal audio devices increase our vulnerability, especially when we are tuned in for extended periods of time. Concerts, nightclubs, and sporting events make us prone to hearing loss as well.

For all of these reasons and more, the First International Conference on Prevention and Rehabilitation of Hearing Impairment established the annual International Ear Care Day in 2007. The event is held on March 3 each year to build advocacy and promote hearing care in countries all around the world. This year's theme is: "Make Listening Safe."

The World Health Organization (WHO) works closely with this event, releasing an annual assessment of each country's status in providing quality ear care services. This year, the WHO found startling numbers to be true about the state of hearing loss in the world; over 1.1 billion young adults ages 12 to 35 are at risk for "recreational hearing loss." In this age group, 43 million people currently deal with the unfortunate effects of hearing loss, whether it is noise-induced or through birth defects or illnesses. Recreational hearing loss leads to many harmful effects. Physical and mental health can be affected, as well as employment and education opportunities. Hearing loss may also lead to attention-seeking behaviors and learning disabilities.

“As they go about their daily lives doing what they enjoy, more and more young people are placing themselves at risk of hearing loss,” says Dr. Etienne Krug, the director of the WHO’s Department for Management of Noncommunicable Diseases, Disability, Violence, and Injury Prevention. “They should be aware that once you lose your hearing, it won’t come back. Taking simple preventive actions will allow people to continue to enjoy themselves without putting their hearing at risk.”

Both intensity and duration affect safe listening levels. The safe level at 85 decibels (dB) is eight hours of continual exposure. The number drops drastically at 100 dB to just 15 minutes. Exposure to these loud sounds usually leads to temporary hearing loss and a ringing sensation in the ear (tinnitus). When the exposure is particularly loud, regular, or prolonged, it can lead to permanent hearing loss and a lack of speech comprehension, and is damaging the ear's sensory cells. High-frequency sounds are typically the first to be impacted.

To reduce the risk of noise-induced hearing loss, set the volume on your personal audio device to no greater than 60 percent of the maximum volume. Wear earplugs in bars, at sporting events, and in other loud places. Even using headphones allows sound to be customized for individual listeners. Take short breaks while in loud environments to reduce the harmful effects of noise exposure, such as avoiding loudspeakers.

By having one’s ears checked regularly, individuals are able to monitor the onset of hearing loss before it becomes a serious concern. There are also many smartphone apps that provide useful information regarding volume levels to inform users of whether they are exposing their precious ears to risky sound levels.

Hearing Health Foundation is a proud supporter and partner of International Ear Care Day. It is worth marking on your calendar in an effort to curb the trend of noise-induced hearing loss while encouraging mankind to develop lasting solutions to lifelong problems.

Source: World Health Organization

Good Acoustics for Green Buildings

By Kathi Mestayer

LEED, or Leadership in Energy and Environmental Design, is a green building certification program run by the U.S. Green Building Council. Its objective is for buildings to save money and resources and have a positive impact on the health of occupants, and promote renewable, clean energy.  

This includes good acoustics. “Our 2009 ratings systems for schools and healthcare institutions cover sound because of the overwhelming evidence that it critically affects learning and healing environments,” says Larissa Oaks, the LEED Indoor Environmental Quality Specialist with the U.S. Green Building Council (USGBC).

Surveys by the Center for the Built Environment and other groups have shown that occupants of office buildings and other work environments rated “acoustic comfort” low, even when the air quality and temperature were deemed acceptable. Acoustic comfort is defined as conducive to speech intelligibility, speech privacy, and concentration where appropriate, with few distractions and annoyances.

Optimizing green design and good acoustics can be a balancing act. "The imperatives of green design—such as lower-energy consumption mechanical equipment and designs, harder-surfaced materials, reduction in use of full-height partitions, and more glass—resulted in spaces that achieved high marks for efficiency, and high LEED certification levels, while simultaneously not meeting the needs of the occupants acoustically," says Ethan Salter, a principal at Charles M. Salter Associates in San Francisco and a lead technical adviser for the LEED acoustics credits.

These credits specify measures to create (and ways to measure) sound isolation and speech privacy, and reduce background noise and external noise. For example, for school acoustics, limits apply for noise from HVAC (heating and cooling) systems and noise from adjacent spaces.  

Limits are also set to minimize the effect of reverberation from hard surfaces, which makes speech harder to understand. Reverberant environments can degrade speech intelligibility and increase the “noisiness” of a space, with greater potential for distraction. To mitigate reverberation, designers can incorporate absorptive materials where possible; there are a number of new, sustainable material options that fit within the “green” framework.

As of this writing, LEED credits are in place for acoustical performance for healthcare facilities, classrooms, offices, and other workplaces. There is also a pilot credit for exterior noise control.

Take a closer look at an example of LEED acoustical credits here.

I’ve written about the dangers of workplace noise; the perils of an open office plan, especially for anyone with a hearing loss; and one company’s efforts to protect their employees’ hearing.

Marion Downs Appreciation

By Amy Gross

I had no idea how influential Marion Downs had been—and at the time, still was—regarding newborn infant screening, but it didn't take much research to discover that this woman was a big, big deal. I don't know why, but her passing on November 13, 2014, caught me by surprise. It didn't matter that she had reached her 100th birthday; I, like many of her fans, found it difficult to accept that the force known as Marion Downs had moved on, peacefully, in her sleep.

Marion (she wouldn't let me call her "Ms. Downs") was 92 when we spoke. She was still skiing and swimming and playing tennis competitively, and one of the photos in “Shut Up and Live!” showed her gleefully skydiving with a handsome young instructor (she made sure to point out the "handsome" part several times). I had read every word of her book, in which she provided candid advice for anyone dealing with the aging process: the importance of weight training, why hearing aids are critical in the health of a marriage, and how to maintain a healthy sex life into one's senior years. I loved that she was able to make me blush more than a few more times; the woman minced no words.

What had put Marion Downs on the map, audiologically speaking, were her pioneering efforts, beginning in the early 1960s, in the essentially unheard-of area of infant hearing testing. An audiologist herself, Marion and a research partner started hearing testing for newborns before those infants had even left the hospital, fitting even the tiniest babies with hearing aids. Today, thanks to Early Hearing and Detection Intervention programs, 97 percent of newborns have their hearing screened. Knowing what we know today about the importance of hearing with respect to language and even cognitive development in extremely young children, there's no telling how many infants with hearing loss were identified as such in a timely manner, and their developmental skills saved, because of Marion Downs's work.  

The Marion Downs Center in Denver, Colorado, a nonprofit organization that espouses, as Marion did herself, a cradle to grave approach in dealing with hearing loss, will continue her efforts in advocating for those with hearing loss. Marion was a visionary in the world of hearing health. Her legacy lives on, quite visibly, in the children whose lives she touched.

Show our Veterans that You Are Hear For A Cure

By Pallavi Bharadwaj

Can you imagine returning home after serving in the military for your country without your hearing and with constant ringing in your ears?

Credit: @srz/Unsplash

Tinnitus and noise-induced hearing loss (NIHL) are the number one and two war wounds among veterans returning home. In the past decade, over one million service members have been impacted by tinnitus, hearing loss, and/or other auditory disorders.

To provide support to the community of veterans with hearing problems, Hearing Health Foundation (HHF) launched a veterans’ resource center on our website. This section is designed to help veterans cope with hearing loss and tinnitus. Resources such as research updates on new treatment options, stories from veterans who have been affected, and topical features from Hearing Health magazine can be accessed here.

Most importantly, we would like to share with our service members the exciting prospect of a cure for hearing loss and tinnitus through our Hearing Restoration Project (HRP). The HRP is working to translate the ability in chickens to restore hearing for humans in order to deliver a cure for veterans and for all those suffering from hearing loss and tinnitus.

If you are a veteran, current service member, or have family or friends who have bravely served our country, review these resources about hearing loss and tinnitus.

Communication Is Critical to Care

By Kathi Mestayer

I recently visited my father, who wears a cochlear implant, in a rehab facility, where he was recovering from surgery.

His room, right next to the nurses’ station, was pretty noisy. There was a constant array of beeps, rings, clanging equipment, and talk. I measured the noise level with my decibel meter smartphone app (AudioTools) and got a reading of around 65 dBA inside the room, about 10 feet from the door. That’s equivalent to normal conversation, but it could make it very difficult for a person with a cochlear implant to correctly understand a medical question.

The rehab center staff was well-meaning, attentive, and caring. But the level of awareness of communication problems for those with hearing loss was spotty.  

• No captioning phones (and no idea of whether they would work in the facility).  

• No idea of what a cochlear implant looked like.

• No way to communicate in writing.

To be fair, that’s not unusual. Earlier this year, I visited my uncle in the hospital. He had had a hearing loss for years. Due to his Parkinson’s disease, he also had a hard time speaking. They were having difficulty getting him to agree to the doctor’s recommendation of a colonoscopy. He was under the mistaken impression that they were talking about a colostomy, and hesitant to agree. Fortunately, I had brought in a whiteboard and marker the day before. I wrote the words “Colonoscopy” and “Colostomy” in big letters on the board, and crossed out “Colostomy” with a big X. He took the write board and wrote “U Sure?” on it. “YES,” I said, nodded, and wrote on the board. He agreed to the procedure on the spot.

I recently became aware of a two-year-old Department of Justice (DoJ) program called the Barrier-Free Healthcare Initiative. The Department of Justice, which also oversees the Americans with Disabilities Act (ADA), has committed resources and attention to the important work of providing, among other things, effective communication for patients with hearing loss in hospitals, pharmacies, rehab facilities, and doctors’ offices.

Useful resources:

Click here to get the full scope of the Barrier-Free Healthcare Initiative.

The ADA’s primer on how to communicate effectively with people who have hearing loss.

And if you’re wondering whether the DoJ is making headway, read updates here including about the success the DoJ has had working with healthcare facilities to help them meet the ADA requirements.  

Kathi Mestayer writes about workplace noise issues. Read her articles here:

• This Is Your Workplace on Noise

• Undercover Noise Cop

• Closed Captioning: Keeping the Pace

• Restaurant Conversation: Not Just for the "Early Birds" Any More

The Harm from Noise

By Pallavi Bharadwaj

Workplace noise-induced hearing loss (NIHL) is among the most common type of NIHL in the United States, among other countries. In the U.S., 30 million workers are estimated to be at risk for NIHL, according to the Centers for Disease Control and Prevention.

Austrian researchers recently presented a study titled “Early prognosis of noise-induced hearing loss”  recently in the journal Occupational & Environmental Medicine. 

It has long been assumed that some individuals are more vulnerable to occupational NIHL than others because of the wide variation in hearing loss after equivalent exposures. Earlier attempts to define predictors of workplace NIHL susceptibility have been inconclusive. Recently in the journal Occupational & Environmental Medicine, Austrian researchers presented a study titled “Early prognosis of noise-induced hearing loss” that evaluated the potential of temporary threshold shift (TTS) to predict future NIHL.

Between 1982 and 1989, 311 participants (welders and fitters) were included in a prospective study during their initial health screening visit. At this occasion, a standardized noise exposure was applied: 20 minutes at frequencies of 200 to 500 hertz (Hz) and at a volume of 100 dBA. The TTS at 4 kilohertz (kHz) was determined during at least 10 minutes after exposure. Hearing loss was monitored at follow-up visits every three to five years, averaging 13 years in total.

The Austrian researchers say the temporary threshold shift (TTS) model can be successfully applied as a method to detect individuals at greater risk of workplace NIHL. It is recommended to routinely include such a procedure into initial workers’ examinations for suitability to work under occupational noise conditions and for counseling on the use of hearing protection.

Read the abstract here.

To learn more about workplace noises see:       

• Protection for All

• This Is Your Workplace on Noise

• Office Space

The Danger From Noise When It Is Actually Music

By Yishane Lee

Les Paul Ambassador

John Colianni

Noise-induced hearing loss affects anyone exposed to very loud or chronic noise. It doesn’t matter if the “noise” is actually music. It has been estimated that up to half of classical orchestral musicians have hearing loss because of their work in music, practicing or performing up to eight hours a day. Sound levels onstage, no matter the music genre, can reach up to 110 decibels (dB), although it is not usually continuous. That is equivalent to a jackhammer—even if there’s a melody behind it.

Researchers at the Nofer Institute of Occupational Medicine in Poland measured the exposure for classical musicians as 81 to 90 dBA (A-weighted decibels, a unit of measure for how humans perceive sound) for 20 to 45 hours a week. In their study published in the International Journal of Occupational Safety and Ergonomics, they estimated that this exposure over the course of a career increases the risk of a hearing loss of 35 dB by 26 percent. At the greatest risk for hearing loss are those in the brass section—horn, trumpet, tuba—as well as those playing percussion, the study found.

Prolonged exposure at 85 dB (the sound of heavy traffic) will permanently damage the delicate hair cells of the inner ear, leading to hearing loss. Tinnitus, or ringing in the ears, is another potential problem. Roughly 90 percent of tinnitus cases occur with an underlying hearing loss.

Not surprisingly, rock and jazz musicians are not immune. Indeed, there are a number of well-known rock and pop musicians who have publicly discussed their hearing loss and/or tinnitus, among them Sting, Eric Clapton, Neil Young, Phil Collins, and Will.i.am.

But hearing loss due to noise (or music) is completely preventable. A related study by the Polish scientists determined that brass players benefitted the most from the use of custom-molded, silicone earplugs with acoustic filters that reduced sound levels. Woodwind, percussion, and string players also benefited.

In 2013, the Les Paul Foundation and HHF teamed up to launch the Les Paul Ambassadors program. Guitar great Les Paul was determined to find a cure for hearing loss and tinnitus, and through his foundation’s support of HHF’s Hearing Restoration Project, an international research consortium of top hearing scientists, we have the opportunity to find a cure. Learn about the program and the first Ambassador, Lou Pallo, as well as our other Ambassadors saxophonist Chris Potter and jazz pianist John Colianni.

Learn more about NIHL and its risk factors, treatment, and prevention in our new Summer issue of Hearing Health magazine.

Protect Your Ears This July 4!

By Tara Guastella

The Fourth of July is a great time for barbecues, trips to the beach, and spending time with friends and family. But fireworks and firecrackers, ubiquitous to many Independence Day celebrations, not only are a potential fire hazard, they also can do permanent damage to one's ears.

These beautiful spectacles measure between 140 and 165 decibels. This means that even one minute of exposure to them can cause immediate, permanent hearing loss.  

When exposed to sounds that are too loud or loud sounds that last a long time, such as a fireworks display, delicate cells in our inner ear can be damaged, causing noise-induced hearing loss (NIHL). These sensory hair cells in the inner ear convert sound energy into electrical signals that travel to the brain. Once damaged, our hair cells cannot grow back.

While you're enjoying summertime get-togethers, remember to pack ear protection, such as earplugs or earmuffs, and don't forget a pair for the kids! Also remember to Walk, Block, and Turn:

Walk away from loud sounds.

Block loud sounds with ear protection.

Turn the volume down (when you can control it).

Learn more about how loud is too loud today.

We wish you and your family a happy, healthy, and safe Fourth of July holiday!

Stay tuned for more about NIHL—its symptoms, prevention, treatment, and related conditions such as tinnitus—in the upcoming Summer issue of Hearing Health magazine. Get a free subscription by signing up here. We also wish to salute and thank our military service members, who are disproportionately affected by hearing loss and tinnitus as a result of their service, on this American holiday.

This Memorial Day, We Honor Our Veterans Who Disproportionately Suffer from Hearing Loss & Tinnitus

By Tara Guastella

In early May, I attended the Classy awards collaborative weekend in San Diego, where hundreds of people making a difference in the nonprofit sector came together to find ways to innovate and collaborate. During one of the sessions, I learned of a startling statistic: 22 veterans commit suicide each day.

When I heard this, the first thing that popped into my mind was the fact that 60 percent of veterans returning from Iraq and Afghanistan have hearing loss or tinnitus. These conditions have consistently been the top two health complaints at Veteran Affairs Medical Centers. Hearing loss is also linked to higher rates of depression.

Since hearing problems are so prevalent among military service members, as are such mental health concerns as depression and post-traumatic stress disorder, I began to wonder what services are provided to veterans to help them adjust. I soon learned that organizations like the Easter Seals Dixon Center (whom I met at the Classy awards weekend) are building collaborative networks in local communities to provide a holistic approach to veteran care.

The Dixon Center has built a network of more than 20,000 organizations and like-minded individuals, serving over 560 communities. They help communities identify and mobilize direct services to support educational and employment opportunities alongside services for healthcare, legal and financial advice, and housing. I was happy to learn that they are actively working to meet the everyday needs of veterans and their families while also anticipating their future needs.

To help veterans cope with hearing issues, we launched a veterans resource center earlier this year. We highlight various treatments for tinnitus that are being clinically tested as well as the promise of a cure for everyone with hearing loss and tinnitus, including veterans, through our Hearing Restoration Project consortium. You’ll find profiles of several veterans impacted by hearing loss and tinnitus while serving overseas, and you too can share your experience with us. We also have a page dedicated to resources where veterans can find additional hearing and health-related support. The upcoming summer issue of Hearing Health magazine will focus specifically on noise-induced hearing loss and tinnitus, highlighting these health issues in the military.

With providing continued support to our veteran community, I hope to learn that the suicide rates decrease in years to come.

Since these brave men and women are disproportionately impacted by hearing problems, which likely impacts many other aspects of their lives, the team at HHF wishes to honor all of our veterans this Memorial Day.

Help Mom Hear Better This Mother's Day

By Yishane Lee

Give the gift of hearing this Mother’s Day by taking your mom to get a hearing screening, and getting one yourself. One in five adults has a hearing loss—including adolescents—and the rate increases with age, with one in three seniors experiencing a hearing loss. But the average time between being diagnosed with a hearing loss and getting a hearing aid is seven years. That’s a long time to miss parts of conversations, misunderstand television dialogue, or be unable to fully enjoy a family gathering.

Now a new study puts more urgency into the need to check hearing. Researchers from the National Institute of Deafness and Other Communication Disorders (NIDCD) found a link between hearing loss and an increased risk of depression and published the results in the journal JAMA Otolaryngology–Head & Neck Surgery. The scientists examined data for 18,000 people and found that a decline in hearing more than doubled the risk for depression when compared with those who said they had excellent hearing.

Women ages 70 and older were particularly susceptible to depression with even a moderate hearing loss of 35 to 50 decibels. And when every level of hearing loss was considered, 14.7 percent of women of all ages were more likely to feel sad and depressed, compared with 9 percent of men with any degree hearing loss. The link between depression and hearing loss remained even when the researchers controlled for factors such as vision problems.

The NIDCD study underscores the importance of getting your hearing checked and treated, and of getting treated for depression as well in the event of a diagnosed hearing loss. However, and unfortunately, the researchers also found that depression was higher among those using hearing aids.

Don’t leave your mom out of the conversation. Book a hearing screening for both of you in honor of Mother’s Day. She’ll thank you, we promise!

Learn more about finding the right hearing health professional and taking care of your ears from the Spring issue of Hearing Health magazine:

• How to Find the Right Hearing Healthcare Professional for You

• All in Stride: Getting a Hearing Aid Was a Straightforward Shift for This Mother of Two

• How to Get the Most Out of Your Hearing Aids

• Hearing Loss and Brain Size