When It's Not Just Hearing Loss

By Morgan Leppla & Laura Friedman

This year Autism Sunday, an international day to raise awareness of autism spectrum disorder (ASD), is on Feb. 12.

Did you know that one third or more of pediatric hearing loss cases overlap with another condition? This may sometimes be ASD, making treatment and management of co-occurring conditions a challenge.

In a 2007 report in the Journal of Deaf Studies and Deaf Education, British researcher Lindsay Edwards, Ph.D., cites an estimate that 30 to 40 percent of children with hearing loss have co-occurring conditions that could prohibit them from forming language, speech, and sociocognitive skills. But despite this large percentage, there is little research on hearing loss that occurs with other disorders. What research there is has shown the benefit of cochlear implantation for children with additional needs (such as physical or learning disabilities), and the difficulties of language acquisition and development for 3-year-olds with developmentally related conditions such as ASD, cerebral palsy, or Down syndrome.

One silver lining is that the fact that 30 to 40 percent of pediatric hearing loss may occur with other conditions may prove helpful in predicting future disorders. A July 2016 Autism Research paper suggests that a noninvasive measure of otoacoustic emissions in the inner ear—a common hearing test for infants, who are preverbal—may help identify the risk of ASD at an early age, accelerating treatment. Study author Anne Luebke, Ph.D., of University of Rochester Medical School, found that children with ASD often have trouble hearing a frequency range (1–2 kHz) that is important for understanding speech. The range includes sounds for the meaning-conveying consonants S-, H-, and F-.

Scientific conclusions can help shape future research, but cannot illustrate daily life for families with children with co-occurring conditions. Dual diagnoses make unlocking any child’s learning style challenging, but reviving research and upgrading professional training are essential tools in order to advocate for and successfully educate children with co-occurring conditions.

If you’re interested in funding research related to diagnosing and treating co-occuring disorders, such as hearing loss and autism, please consider donating today: hhf.org/donate or contact us at development@hhf.org.

This blog was adapted from an article original appearing in Hearing Health magazine’s Fall 2016 issue. For references in this story, see hhf.org/fall2016_references.

Noise-Induced Hearing Loss Affects More Than 50% Not in Noisy Jobs

By Yishane Lee

The Centers for Disease Control and Prevention (CDC) made an announcement Feb. 7 on the dangers of noise-induced hearing loss (NIHL). Among the many statistics cited, the CDC says:

• 40 million U.S. adults ages 20 to 79 have NIHL

• More than half (21 million) with hearing damage do not have noisy jobs

• One in four U.S. adults who say they have good or excellent hearing actually show hearing damage

• Hearing loss is the third most common chronic health condition in the U.S.

• People report hearing loss at a rate nearly double of those reporting diabetes or cancer

The CDC says its latest Vital Signs report, using data from more than 3,500 hearing tests in the 2012 National Health and Nutrition Examination Survey (NHANES), shows “much of this [hearing] damage is from loud sounds encountered during everyday activities at home and in the community,” such as using a leaf blower or going to a loud concert without hearing protection. Nearly three-quarters of those who are exposed to loud noises never or rarely use hearing protection, the report says.

According to the press release, CDC researchers “found that 20 percent of people who reported no job-related noise exposure had hearing damage in a pattern usually caused by noise. This damage—shown by a distinctive drop in the ability to hear high-pitched sounds—appeared as early as age 20.” But it added that while a few studies have linked noise exposure among young people to the use of portable devices and entertainment venues, more research is needed to determine the relationship between this type of early noise exposure and hearing loss in older age.

Untreated hearing loss is linked with anxiety, depression, loneliness, and stress, the CDC says. In addition to causing hearing loss, chronic noise exposure can worsen heart disease and increase blood pressure, among other adverse health effects.

But don’t forget, noise is the only fully preventable cause of hearing loss.

Please see HHF’s resources on NIHL here, as well as our Summer 2015 cover story about NIHL. Taking care of your hearing should always be part of your overall health. If you suspect a hearing loss, get your hearing checked, and if you do have a hearing loss, get it treated. Avoid noisy areas, and wear protective earplugs or stronger when you need them in noisy environments. Download the CDC’s fact sheet here.

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

Want to Be Happier in 2017? Try a Hearing Test.

By the Better Hearing Institute

When you’re making your list of New Year’s resolutions and to-dos for 2017, be sure to put this one near the top: a hearing test.

That’s right. Research shows that when people address hearing loss it improves their quality of life in many ways.

And it’s no wonder. Ignoring a hearing loss and leaving it unaddressed can be exhausting, lead to isolation, and has been tied to an assortment of health conditions, including depression, diminished cognitive function, and an increased risk of falling.

But when people get a hearing test and use professionally fitted and individually programmed hearing aids—when recommended by a hearing care professional—most say they’re happy with the improvements they see in multiple areas of their lives.

Here are just a few potential perks of treating hearing loss that may surprise you:

1. Your spirits may brighten. People with hearing loss who use hearing aids are less likely to feel down, depressed or hopeless, BHI research shows.
   

2. Your relationships may benefit. Most people with hearing loss who use hearing aids say it has a positive effect on their relationships, according to a BHI survey. Research also finds that they’re more likely to have a strong social network.
   

3. You may start to see life’s sunny side a little more. People with hearing loss who use hearing aids are more likely to be optimistic, feel engaged in life, and even get more pleasure in doing things, BHI research finds.
   

4. Taking the reins on life might become easier. BHI research shows that people with hearing loss who use hearing aids are more likely to tackle problems actively. Not a bad New Year’s resolution in and of itself.
   

5. It may lighten your cognitive load. Experts say that effortful listening due to unaddressed hearing loss is associated with increased stress and poorer performance on memory tests. If you don’t have to put so much effort into listening due to untreated hearing loss, more cognitive resources may be available for other things—like remembering what was said, or enjoying the conversation with friends.

So, go ahead. Make a hearing test one of the New Year’s resolutions you keep in 2017. 

So do it for your health. Do it for your happiness. Get a hearing test.

To take a free, quick, and confidential online hearing check to help determine if you need a comprehensive hearing test by a hearing health care professional, visit www.BetterHearing.org

The content for this blog post originated in a press release issued by The Better Hearing Institute.

Veterans Day

By Morgan Leppla

Can you guess the number one and two war wounds among veterans? Tinnitus and hearing loss, respectively.

Sixty percent of vets return from war with hearing loss and tinnitus. Enlisted for 11 years, Sergeant Nathan Heltzel has a 40 percent hearing loss in his left ear, a 30 percent hearing loss in his right ear, and tinnitus that is a direct result of gunfire and loud jet engines on flight line duty.

He recalls that during his time in the military from 1995 to 2009 there technically was a requirement to wear ear protection, but hearing the radio, team, and anything else that could be advantageous was prioritized over protection, so it was not enforced.

He left service because of hearing loss and has learned to manage tinnitus on his own, using a white-noise machine to mask ringing sounds while he sleeps.

Another serviceman, Major Richard Uzuanis, says it is not in military culture to address things that could impact one’s ability to perform duties and missions, so many people ignore their hearing loss or tinnitus. Uzuanis adds that it contributes to the overall safety of troops if people are hearing clearly.

Hearing Health Foundation wants to thank service members and veterans and remind them that they are disproportionately at risk for sustaining hearing loss and tinnitus. Hearing loss affects how one conducts missions and follows instructions. Take precautions and protect your ears from the dangers of noise, to ensure your safety, and the safety of those around you.

Lastly, check out our veterans’ resources page today!

Greatness Always Has a Price

By Morgan Leppla and Laura Friedman

Signed in 1990, the Americans with Disabilities Act (ADA) is the most contemporary federal legislation related to disabilities, outlining important workers’ rights and their employers’ obligations to provide reasonable accommodations. However, it does raise questions in regards to union contracts under the National Labor Relations Act (NLRA), which was passed in 1935 and protects workers’ rights to unionize, collectively bargain, and take action (e.g. strikes). Thus, portions of the NLRA and ADA conflict with each other, putting strain on union workers who need reasonable accommodations.

The ADA outlaws discrimination against qualified individuals with disabilities, stating that individuals must negotiate with employers for “reasonable accommodations.” On the other hand, the NLRA prohibits union members from negotiating individually. Once the ADA was passed in 1990, it outlawed any part of previously entered collective bargaining contracts that included discriminatory clauses. Additionally, an employer cannot use a collective bargaining agreement as a means to engage in discriminatory practices that are otherwise prohibited by the ADA.

The challenge for employers is balancing their dual obligations to comply with established collective bargaining arrangements while accommodating individual workplace needs.

Many union contacts contain seniority clauses, providing benefits based on how long union employees have been in their position. For example, an employee who is at a company for 10 years may choose their hours before the newest hire. However, if the newest hire has a disability, it may be necessary for them to pick their hours before the more senior worker as a reasonable accommodation. This violates the union contract and NLRA for two reasons: 1) it can be considered direct dealing with an employee, and 2) it overlooks the terms of the contract. Even so, this accommodation does not otherwise pose “undue hardship,” and therefore should be granted under the ADA.

NOT SO FAST: Firstly, the NLRA does not contain language that protects people with disabilities. Secondly, the ADA was meant to expand upon, not replace, the Rehabilitation Act of 1973, which prohibits discrimination against people with disabilities in federal hiring practices and requires affirmative action in hiring for federal agencies, programs that receive federal funding, federal contractors, and subcontractors. However, the ADA does not have an affirmative action requirement, so employers are no longer obligated to give applicants with disabilities preferential treatment throughout the recruitment or hiring process. Furthermore, ignoring the seniority clauses in collective bargaining agreements would be using affirmative action in the hiring of persons with disabilities, and therefore illegal, adding the web of confusion as to which legislation must employers comply with.

Other issues are related to privacy of medical records. In one instance, a union needed workers’ medical histories in order to meaningfully negotiate their contract, which is permitted by the NLRA but prohibited by the ADA. Due to lack of evidence, guidance, and clarity, the court had the parties settle. While in this particular instance the issue was put to bed, the inability to make a decision failed to set a precedent which could address future disputes.

This amounts to a murky legal landscape. While some of the language has been interpreted by courts, there is a lot employers and individuals need to navigate on their own. Such uncertainty and lack of clarity further hurts the disabled individual because they have to take extra strides to ensure that they receive reasonable accommodations and are not subjected to discrimination based on disability by either the terms of a collective bargaining agreement or the actual employer.

Have a personal experience with discrimination in the workplace or with negotiating reasonable accommodations with an employer? 

Please share it with HHF by emailing info@hhf.org today!

FOOTNOTES:

• http://digitalcommons.ilr.cornell.edu/cgi/viewcontent.cgi?article=1300&context=edicollect

• https://www.eeoc.gov/laws/regulations/backqround_and_summary.cfm

• http://www.americanbar.org/content/dam/aba/events/labor_law/basics_papers/nlra/collective_bargaining.authcheckdam.pdf

Labor Day: A Reflection of Disability in America's Workplace

By Morgan Leppla

Did you know that the first Labor Day in the U.S. was celebrated on September 5, 1892, to commemorate the achievements of the labor movement? More than a century later, we still celebrate our workforce for their contributions and successes. Mandatory safety regulations in the workplace, anti-discrimination policies, and establishing minimum wage are some of the noteworthy milestones accomplished.

Labor Day exudes an inclusive spirit. 

But what about individuals who have a disability?

The Americans with Disabilities Act of 1990 (ADA) mandates that employers must make reasonable accommodations for qualified candidates with disabilities in the workplace. However, many people do not speak up or are ashamed to disclose their disability and needs to their employer, including those with hearing loss.

The employment rate for people who are deaf or hard of hearing in the U.S. is 50 percent, compared with 70 percent among workers who do not have disabilities. There is also a stark disparity between annual income for those who have a substantial hearing loss or are deaf, compared with their typical hearing peers: $38,000 per year vs. $50,000 annually in 2011.

A hearing loss may affect one’s ability to remain communicative and productive in the workplace, as the majority of today’s jobs require some form of verbal correspondence. Whether that is listening to instructions on a construction site, providing medical expertise, or receiving feedback from a supervisor, the words people say tend to be important. Gaps in understanding lead to gaps in accuracy, productivity, and performance.

This is not just an individual worker’s problem either. When people stop working at optimal capacity, bottom lines shrink. And considering that 67 to 86 percent of the 48 million Americans who have hearing loss do not have hearing aids, more dollars than you’d expect could be lost.

Workers’ general wellness includes knowing about, managing, and treating hearing loss, as well as feeling comfortable asking for reasonable accommodations without fear of discrimination. Eradicating the stigma surrounding hearing loss is key to addressing it as an epidemic medically, economically, and socially—and we at HHF are working hard to eliminate that stigma through building education and awareness.

Labor Day is about honoring the workforce. Please join Hearing Health Foundation in celebrating the progress made for American workers, as well as acknowledging the obligation to improve the livelihood, both in and out of the workplace, of our fellow citizens. 

Enjoy Summer Concert Season Right

By the Better Hearing Institute

With at least another month-and-a-half left of summer concert season, we thought it would be a good time to remind music lovers to pack the earplugs. It’s an easy and smart way to make sure you can enjoy those tunes for years to come.

Bringing earplugs to that next concert is more than a good idea, it should be a must, says the Better Hearing Institute (BHI). Millennials and teens especially should think twice about music volume because data show that hearing loss is on the rise in these age groups, which means they’re permanently losing some of their hearing at younger ages.

But take heart. Earplugs really can help. One study, carried out in conjunction with an outdoor music festival in Amsterdam last fall, found that festival-goers who wore earplugs were roughly five times less likely to have some temporary hearing loss than those who didn’t wear them. The earplug-users also were less likely to suffer from tinnitus afterwards.

Any sounds at or above 85 dBA for a prolonged period of time can be unsafe. The sounds at that Dutch music festival were at 100 decibels, pretty consistently, for 4-and-a-half hours. At that sound level, hearing damage can occur in just 15 minutes.

Luckily, earplugs are pretty easy to come by. Disposable earplugs, made of foam or silicone, usually can be found at local pharmacies. They’re practical because you can still hear music and conversation when they’re in your ears. But when they fit snuggly, they’re effective in adequately blocking out dangerously loud sounds.

The impact of noise on our ears

We hear sound when delicate hair cells in our inner ear vibrate, creating nerve signals that the brain understands as sound. But just as we can overload an electrical circuit, we also can overload these vibrating hair cells. Loud noise damages these delicate hair cells, resulting in sensorineural hearing loss and often tinnitus (ringing in the ears). The cells that are the first to be damaged or die are those that vibrate most quickly—those that allow us to hear higher-frequency sounds clearly.

Warning signs of too much noise

If you have to shout over the noise to be heard by someone within arm’s length, the noise is probably in the dangerous range. Here are the warning signs:

• You have pain in your ears after leaving a noisy area.

• You hear ringing or buzzing (tinnitus) in your ears immediately after exposure to noise.

• You suddenly have difficulty understanding speech after exposure to noise; you can hear people talking but can’t understand them.

Repeated exposure to loud noise, over an extended period of time, presents serious risks to hearing health.

The content for this blog post originated in a press release issued by The Better Hearing Institute on July 19, 2016.

Summer Is a Time for Play (and Protection)

By Morgan Leppla

“The best offense is one that does not trigger any defense,” says Daniel Gilbert, Ph.D., a psychology professor at Harvard University.

Gilbert says humans are not hardwired to think long term. When people don’t see a threat as immediate, they are not inclined to take action to mitigate it. This psychological phenomenon is why it’s easy to forego protective measures that’ll make a difference in the long run, especially during one of the most fun-filled times of the year: SUMMER!

With its blaring tunes and crackling fireworks, it makes sense that summer excitement distracts us from remembering the permanent effect of noise on our ears. Loud sounds are more insidious than one might expect. This is in spite of the fact that noise-induced hearing loss (NIHL) can happen at any age, to any race, gender, etc. Hearing loss from all causes is a growing epidemic, affecting nearly 50 million Americans.

Sound volume, length of time listening, and repeated exposure to loudness all can lead to NIHL. One extremely loud sound can cause it, but so can exposure to softer (but still dangerous) sounds over an extended period. To put that into tangible terms, a single loud sound may be a shotgun going off right next to you, while sounds that may damage hearing more slowly are repeated exposure to heavy city traffic, music listened to at a high volume using earbuds, or even regular use of a hairdryer!

So, with all of these potential threats to hearing, what is there to do?

Here is the trinity of protection: WALK away from loud sounds, BLOCK loud sounds with ear protection, and TURN the volume down (when you can control it). These simple actions can have a major impact on your long-term hearing health.

Walk, Block, and Turn!

By Maggie Niu

April 27 is International Noise Awareness Day (INAD), a day dedicated to encouraging people to “do something about bothersome noise where they work, live, and play.”

Every day in our environment we experience sound, whether it’s pleasant, like music, or bothersome, like sirens. Unpleasant or unwanted noisy environments can be dreadful; not only can noise increase our stress level and inhibit us from carrying out daily tasks, but also in the long run overexposure to noise can damage our hearing. This is known as noise-induced hearing loss (NIHL). All too often, we become immune to the constant hum of traffic (about 85 decibels, or dB) and noisy subway stations (95 dB). The Safe and Sound safe listening levels chart, on the left, details the effects of various decibel levels on our ears.

There are two causes of NIHL. One is impulse noise, a one-time exposure to a loud sound such as an explosion. This can cause temporary and/or permanent hearing loss. The other cause of NIHL is continuous exposure to loud noise. This type of hearing loss happens gradually over time.

NIHL affects our inner-ear hair cells (the cells that help us hear) as well as the auditory or hearing nerve. Not only can this type of hearing loss be permanent, it can also lead to tinnitus. Tinnitus is hearing a constant ringing, buzzing, or roaring without an external sound source. It can be in one or both ears and often occurs with hearing loss.

Now the question is: How do we protect ourselves from NIHL? It can be as easy as remembering to Walk, Block, and Turn! Walk away from loud sounds. Block noise by wearing earplugs or other hearing protective devices. Turn the volume down on stereos and personal music devices. If you work in a noisy environment, take proper measures to protect your ears by wearing ear plugs or ear muffs. Being able to hear is important for daily interactions and often taken for granted until it's too late.

To learn more about Hearing Health Foundation's Safe and Sound program, please email development@hhf.org.

7-Day Challenge for Better Hearing Health

By Maggie Niu

In honor of National Public Health Week kicking off April 4, Hearing Health Foundation has seven challenges for you to complete over the course of next week, all related to hearing loss and hearing prevention. Help us celebrate by completing our list of challenges below and sharing your experiences in with us in the comments.

On your mark… get set…GO!

Day 1: Make an appointment to get your hearing tested!

It is important to have your ears tested at least once a year, especially if you are experiencing any buzzing or ringing in your ears or unable to hear clearly. Don’t hesitate to make an appointment: Early intervention is key for preventing further damage.

Here is a directory for audiologists from the Academy of Doctors of Audiology. It is super-easy and quick to find an audiologist close to you. Simply type in your zip code and the radius you are willing to travel and bing, you have your list of audiologists.

Day 2: Reduce the volume on personal music devices to under 70% of the maximum.

We all know that unwanted noise is a nuisance so we try everything in our power to drown it out—either by turning up the volume of the music we're listening to, or talking louder. In the long run, does it benefit our hearing health? The answer is no.

Noise-induced hearing loss can occur gradually over time by listening to loud music or being exposed to loud environmental noises. We can’t always control ambient noise, but we can control personal earphone volume. Next time you are using your earphones on a high volume, remember that you are damaging your ears!

Day 3: Plan a fundraiser to help us find a cure for hearing loss and tinnitus.

Need some ideas? See examples of past events and ideas for creating your own event. Individuals, companies, organizations, sororities, and fraternities of all sizes have joined in our efforts, and we hope you will too!

Day 4: Keep a journal of the foods you eat and note the loudness of the environment you’re in. You may be surprised at what you find.

Noise can affect many things. It can cause stress and affect our mood, but would you believe that noise can affect your palate? A Cornell University study found, "…that in an environment of loud noise, our sense of taste is compromised. Interestingly, this was specific to sweet and umami tastes, with sweet taste inhibited and umami taste significantly enhanced," said Robin Dando, an assistant professor of food science. "The multisensory properties of the environment where we consume our food can alter our perception of the foods we eat."

Day 5: Eat this! Incorporate certain nutrients into your diet for optimal hearing health.

Now we know that noise can affect the taste of food we eat, but are there foods that can help our ears? Check out these five nutrients that can prevent or delay hearing loss. 

• Omega-3 fatty acids and vitamin D: Usually found in fish, both can have positive effects on hearing loss. Studies have shown that adults who ate fish twice a week had a 42% lower chance of facing age-related hearing loss than non-fish eaters.

  • Recipe idea: Grilled Salmon and Zucchini with Red Pepper Sauce
    

• Antioxidants and folic acid: You can find this in spinach, beans, broccoli, asparagus, eggs, nuts and liver. They can reduce the number of free radicals in your body, which can damage the nerve tissue in your ears.

  • Recipe idea: Skinny Taco Stuffed Peppers.
    

• Magnesium and potassium: Bananas, potatoes, artichokes, and broccoli are rich in magnesium and potassium. Magnesium can protect you from noise-induced hearing loss. Potassium is responsible for regulating the amount of fluid in your body.

  • Recipe idea: Creamy Garlic Pasta with Shrimp and Vegetables.
    

• Zinc: Zinc can be found in dark chocolate and oysters. It is important to include zinc because it boosts the body’s immune system and is responsible for warding off germs that cause the common cold and ear infections.

  • Recipe idea: Baked Oysters with Wild Mushroom Ragout.
    

• Vitamins C and E and glutathione: Vitamin C and E can increase your overall health by reducing the chance of getting an ear infection. Vitamins C and E can be found in vegetables and in fruit. Glutathione is made naturally by the liver and is found in fruits, vegetables, and meat.

  • Recipe idea: Pomodoro Pasta with White Beans and Olives.

Day 6: Use everyday technology to enhance your hearing health. 

Take control of your hearing health with the technology you use daily: download a sound level meter on your smartphone or tablet to measure the decibel levels. In our Winter 2015 Hearing Health magazine, we listed apps that were vetted by the National Institute for Occupational Safety and Health, and they include: NoiSee by Noise Lab ($1), Noise Hunter by Inter•net2day ($6), and SoundMeter by Faber Acoustical ($20). These apps were cited as providing the most accurate A-weighted sound level measurements.

Other apps include: The Jacoti ListenApp, where you can test your hearing via earphones, and the LesserSound App, which allows the user to take sound readings and record the location from where the noise was recorded. 

Day 7: Share your story!

Share your story about living with hearing loss, tinnitus, or other hearing conditions and how it has affected you via our online scrapbook, blog, or magazine. Inspire others who are touched by similar conditions so that we can help raise awareness about the prevalence of hearing loss and other hearing disorders as well as our research to find better treatments, therapies, and ultimately a cure.

You can share your story by emailing us at info@hhf.org. It can be on ANYTHING related to hearing loss, tinnitus, or other hearing related conditions, such as funny stories, personal experiences, tips for our readers, or hearing health. If you would like to contribute but find that you're having writer's block, email us anyway! We're HEAR to get you through it! (Pun intended.) 

These are just some tips and advice that can help your hearing and the broader hearing health community. For any additional questions please contact your audiologist, email us at info@hhf.org, or visit our website.