It's Reasonable to Continue Drinking Coffee

By Pallavi Bharadwaj

National Coffee Day was yesterday. A number of national fast food chains doled out free coffee to mark the day. But wait! There is more than one reason to celebrate this dark caffeinated drink.

New study findings have shown that higher caffeine intake is associated with a lower risk of tinnitus, although the underlying mechanism remains unknown. The study showed that intake of caffeine, in the form of coffee, tea, sodas, candy and chocolate, was on the contrary, associated with a lower risk of incident self-reported tinnitus.

Caffeine has long been thought to play a role in the development of tinnitus, but no pertinent clinical data are available. On the basis of data from the Nurses’ Health Study II, a team of researchers from Ontario, Canada and Massachusetts, USA, compared caffeine intake levels and the incidence of tinnitus. Study participants included 65,085 women in the survey, aged 30 to 44 years and who did not have tinnitus at baseline in 1991. Participants completed questionnaires about lifestyle and medical history every two years and food questionnaires every four years.

Information on self-reported tinnitus and date of onset was obtained from the 2009 questionnaire, with cases defined as those reporting experiencing symptoms “a few days/week” or “daily.” Multivariable adjusted hazard ratios (HRs) were calculated using Cox proportional hazards regression models.

“We can’t conclude that caffeine is a cure for tinnitus,” says the lead author, Dr. Jordan T. Glicksman. “But our results should provide some assurance to people who do drink caffeine that it’s reasonable to continue doing so.”

Sources:

• Glicksman JT, et al. A prospective study of caffeine intake and risk of incident tinnitus. The American Journal of Medicine 2014 Aug;127(8):739-43;

• New York Times August 13, 2014

• For more tinnitus resources, please visit ‘What is Tinnitus’ section on HHF’s website

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

Tips for Hearing Well in the Classroom

By Yishane Lee

It’s hard to hear well in school. Between the hard surfaces, open spaces such as gyms and cafeterias, shouting teachers, and the children themselves who can be counted on NOT to be quiet, it’s hard for hearing children as well as children with hearing loss to always hear well.

TED Talk speaker Julian Treasure says children sitting in the fourth row of a classroom lose as much of half of what is being said.

“Now that's not just deaf children. That could be any child who's got a cold, glue ear, an ear infection, even hay fever,” he says. “On a given day, one in eight children fall into that group. Then you have children for whom English is a second language, or whatever they're being taught in is a second language,” Treasure says in his TED Talk on why architects need to use their ears.

Fortunately, there are ways you can hear better in the classroom. Here are some tips.

• Sit in the front of the classroom, and make sure the classroom is well lit, particularly the teacher or whoever is doing the talking.

• Don’t sit too close to air conditioners and other appliances or machinery that can make it difficult to hear.

• Use assistive devices. As 7-year-old Samantha Brownlie recounts in the YouTube video about how she hears better in school, “Samantha’s Fun FM and Hearing Aid Book” (which you can now buy), an FM unit can help. The teacher wears a microphone around her neck that transmits wirelessly to Samantha’s hearing device.

• Schedule time with the teachers to review how to use the FM unit. As the parents of Lily, who wears bilateral cochlear implants, note in their blog post about prepping for school, “Make sure there is a management plan in place, especially for the FM unit.... There are so many moving parts.”

• Bring extra batteries and cords.

• Encourage the school to use drapes, carpets, and soundproofing material to help dim noise and reverberation.

• Consider auditory training programs that can help your child hear better in noise. A recent study in The Journal of the Acoustical Society of America found that auditory training boosted speech understanding in school children with hearing loss by 50 percent, even three months after the study. The training involved practicing the comprehension of speech in the presence of “interrupted” white noise—white noise with brief silences. Read about auditory training programs and other tips for hearing better in noise in the Spring 2012 Hearing Health magazine “Hearing Aids 101” column.

People Make Spaces Quieter

By Kathi Mestayer

I used to think that crowded spaces were noisier. But I was wrong. More people can make a space quieter, especially if it's an echoey, reverberant room. That's right—people make spaces quieter.

I noticed this the other day when I was leaving a large gathering that I attend often. The crowd was much smaller than usual, but the echoes were way worse than usual. I asked a couple of friends, who echoed (really!) my observation. Way noisier than usual.

So I got home and emailed an acoustician, Richard Peppin, of Engineers for Change. My question: "Is it possible that the space was really noisier with fewer people in it?"

His terse, but (as always) helpful, reply: "Yes. Because people absorb sound and hence reduce reflections."

Who knew?

Kathi Mestayer writes articles on a wide variety of aspects of hearing loss: office acoustics, building acoustics, ADHD and hearing loss, hyperacusis and recruitment, nonverbal communication, and language and culture.

ERG 2015 Announcement

By Pallavi Bharadwaj

We are excited to inform you of the opening of the application period for Hearing Health Foundation's 2015 Emerging Research Grants program. 

This program is designed only for the first year applicants, who are dedicated to explore new avenues for hearing and balance science. Please note that the current Hearing Health Foundation awardees, applying for a second year of funding, are no longer eligible. 

We encourage you to review our announcement and Policy on Emerging Research Grants, as several eligibility changes have gone into effect for this funding cycle. If you are eligible to apply for this program, please make note of the deadlines given below. 

For 1st year Applicants:

LOI deadline: October 25, 2014 by 5pm ET

Full Application opens: Early November, 2014

Full Application deadline: December 6, 2014 by 5pm ET
Then please review the instructions for submitting a LOI.

With any questions about this opportunity, please feel free to reach out to us at grants@hearinghealthfoundation.org . 

Thank you for your interest in this program and please do share this information with your interested colleagues as well. 

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.

Emerging Research Grants for 2014 Announced

By Tara Guastella

HHF is proud to announce that 10 leading hearing scientists have been an awarded an Emerging Research Grant. It was an incredibly competitive funding cycle and it is a true honor for these investigators to have risen to the top and received this award.

Six grantees are first-year grant recipients and are studying areas such as noise-induced hearing loss, tinnitus, ototoxicity (hearing loss caused by certain drugs and medications), age-related hearing loss, and hearing aids.

Four previous grantees are receiving a second year of funding for their work. This group is researching such areas as central auditory processing disorder (CAPD), auditory physiology, cochlear implants, genetic hearing loss, and Usher syndrome.

One first-year grant recipient, whose work is funded by the continuing support of the General Grand Chapter Royal Arch Masons International, is aimed at developing better ways to assess auditory processing disorders. Here is an excerpt on his work:

Srikanta Mishra, Ph.D.

New Mexico State University

Medial Efferent Mechanisms in Auditory Processing Disorders

Many individuals experience listening difficulty in background noise despite clinically normal hearing and no obvious auditory pathology. This condition has often received a clinical label called auditory processing disorder (APD). However, the mechanisms and pathophysiology of APD are poorly understood. One mechanism thought to aid in listening-in-noise is the medial olivocochlear (MOC) inhibition— a part of the descending auditory system. The purpose of this translational project is to evaluate whether the functioning of the MOC system is altered in individuals with APD. The benefits of measuring MOC inhibition in individuals with APD are twofold: 1) it could be useful to better define APD and identify its potential mechanisms, and 2) it may elucidate the functional significance of MOC efferents in listening in complex environments. The potential role of the MOC system in APD pathophysiology, should it be confirmed, would be of significant clinical interest because current APD clinical test batteries lack mechanism-based physiologic tools.

Read more about the research all of the 2014 grant recipients are conducting.

A Musician Tunes Into Positive Thoughts

By Tara Guastella

Lynn Crisci and her boyfriend, Doug Julian, attended the Boston Marathon on April 15, 2013, sitting on the edge of a sidewalk café, about 30 feet from the first bombing that occurred that fateful day.

When the explosions occurred, Lynn watched the smoke, debris, and shrapnel travel upward. But what she later learned is that pressure cooker bombs are designed to explode horizontally, rather than vertically. This fact appears to be part of the reason why Lynn incurred a frontal lobe brain injury, hearing loss in her right ear (which was facing the explosion), and constant tinnitus. Other people she knew who were closer to the explosion—but standing up instead of sitting down—did not suffer the same type of injuries.

Though Lynn had her hearing tested after the explosion, and has documented hearing loss, the doctors did not recommend a hearing aid. This makes it very challenging for Lynn in situations where background noise is present, such as in a busy restaurant or bar.  The hearing loss plus her brain injury makes it often impossible for Lynn to hear, and then mentally process, what someone in a noisy setting is saying to her. Lynn feels her hearing problems put a strain on her relationships, embarrassing herself and others and drawing negative attention.

Tinnitus impacts Lynn to the point where she has much difficulty falling asleep and usually gets three hours of sleep nightly. Her tinnitus is further aggravated by stress and loud noises, which makes the tinnitus worse.

Lynn also suffers from severe post-traumatic stress disorder (PTSD), putting another strain on her long-term relationship with Doug. “I feel that he often ends up taking care of me, more like a dependent than an equal partner,” says Lynn. “I feel like a burden to him which leaves us both frustrated, stressed, and unable to focus on my strengths.”

One positive is that Lynn knows she has survived a traumatic event before. A professional musician who started performing at age 5, Lynn had a workplace accident in 2006 that left her in a wheelchair for several years and needing a cane to walk for several years after that.

Not only is Lynn walking today, but she also completed the 2014 Boston Marathon. “I did it to take back my neighborhood,” she says. Living blocks from the marathon finish line, she was sick and tired of feeling afraid every time she went outside. With the goal of facing her fears in mind, she trained for five months—often daily and often in pain—in order to finish the Boston Marathon. She had never been a runner before, much less race a marathon.

Lynn’s hearing loss affects her everyday life as well as her career. Music does not sound the same to her anymore. She’s far from giving up, however. “You don’t know what you can do until you want it badly enough,” she says. Lynn is hopeful that our Hearing Restoration Project (HRP) will restore her hearing one day so she can reclaim her artistic calling.

"Hearing Loss Is a Non-Healing Injury"

By Tara Guastella

Shannon Silvestri and her two teenage children attended the 2013 Boston Marathon to cheer on dad Kevin. It was the third time they’d be watching him run the marathon.

The family was invited to watch the race by Ashworth Awards, the company that creates the marathon medals and which is based in the same town where the family lives. They were at the Lenox Hotel, located at Exeter and Boylston streets in Boston. After Kevin ran by (finishing what would be his personal best race time), and Shannon received an automated text message that he had finished the race, they gathered their things, snapped a few photos, and began exiting out a side door of the Lenox on Exeter Street. Shannon was walking between her son in front of her, her daughter with a friend behind her, and two of her husband’s friends behind them.

As they were passing through the barricades set up to keep the thousands of spectators organized, the first explosion occurred. It was the first of two homemade pressure cooker bombs that exploded that day. The blast occurred to the left side of Shannon and her family, but the sound bounced off the building and hit Shannon in her right ear. “I could feel the air and the sound waves hit me,” she says. “I could really feel it.”

She immediately covered her ears, fell to the ground, and then looked front and back to check on her children. "Everything seemed like it was in slow motion," she says. Her daughter immediately let out a big scream, knowing her father was out there. Her son ran and Shannon finally found him a couple of streets away. Shannon says, "This was his fight-or-flight response."

Seconds later, the second blast occurred and again it hit Shannon in her right ear as she was turned to comfort her daughter. “It was such a strong feeling of pressure, or a blockage, in both my ears. It felt like I really needed to pop them,” she says. “All I could hear was a muffled chaotic mess and when I looked back all I saw was smoke, debris, and metal barricades flying through the air as people were trying to escape the horror that just occurred.”

Shannon thought terrorists were attacking the city by plane. Her cousin’s husband was killed in the 9/11 attacks so this was the first thing that came to mind. Needing to find Kevin, they headed toward the family meeting area even though law enforcement was trying to keep people from entering this area. Shannon remembers thinking, “I don’t care how many pieces he is in, I am taking him home.” She felt selfish, hurt, empty, alone, and every other emotion she could think of. She didn’t care what scenario she was bringing her kids into, she had to bring the four of them home together.

What the family didn’t realize at the time was that they were closer to the blasts than Kevin was. At the time of the explosions, Kevin was farther down the road, past the finish line, picking up his finisher medal.

Since cell phone service wasn’t working properly, one of Kevin’s friends who was with the family ran ahead to find him. "He was like my superman, whipping off his jacket and saying, ‘I will find him,’” Shannon says. Suddenly, she saw Kevin emerge with the friend. Kevin was uninjured.

Shannon hugged him and remembers saying, “These are the times I appreciate your stubbornness.” Kevin had earlier said he wanted to beat his first marathon time.

Next the family attempted to get out of Boston but everything was on lockdown, including Shannon’s car. They decided to walk the nearly three miles to the Boston Athletic Club. Her son was very upset that Shannon had scraped her knee and wanted to get her something for it. The family stayed there for almost four hours. It was very emotional with people hugging, crying, and reuniting with family and friends.

Shannon went into a restroom because she felt like she needed a good cry but didn’t want to do so in front of her kids. Inside, she met a young teenage girl who worked at the club. The girl couldn’t get in touch with her mother and was frightened by the stories she was hearing. “I told her that I’m a mother and asked if she wanted a hug,” Shannon says. The girl hugged her tightly and the two cried together for a few minutes and then felt better.

Later that week after the bombings, Shannon’s left ear “popped” as did her son’s ears. As for Shannon's right ear, that never popped. Luckily, her daughter’s ears were unaffected.

To help survivors cope with the events of last year’s bombing, Shannon started a website called Boston Strong: Strength, Courage, & Healing and she began making Boston Strong pins/charms. All of the proceeds go to help survivors.

Over a year later, Shannon’s hearing in her right ear has worsened, as has her tinnitus, and her left ear also has a degree of hearing loss. Certain noises and sensations cause pain, a condition known as hyperacusis, so she decided not to get hearing aids. Her audiologist told her that at some point she may lose most if not all hearing in her right ear.

Recently, Shannon accepted a position at the Massachusetts Office of Victim Assistance, which has been instrumental in helping marathon survivors. She will be leading a peer-to-peer support network for people who sustained hearing loss as a result of the blasts. Shannon says she wants to help others cope. “People don’t recognize hearing loss as something that is life-changing. It’s a non-healing injury,” she says.