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Hearing in a Noisy World: Problems and Solutions

Tremblay, Kelly PhD

doi: 10.1097/01.HJ.0000521755.77871.f2
Journal Club

Dr. Tremblay is a professor at the University of Washington in Seattle. She has a 30-year history of serving and advocating for people with hearing loss. She studies the effects of hearing loss and hearing prosthesis on the brain, and the public health benefits of intervention for our aging society.

Excessive noise exposure is a topic to which everyone can relate. Whether it be an article in the popular press about loud restaurants or a passing reference to the inevitable hearing problems that millennials will experience because of excessive sound levels coming out of their ear buds, there is a plethora of opinions on the topic of noise-induced hearing loss (NIHL). There is also plenty of research.

In 2016 alone, over 200 manuscripts were published on the topic—more than double the number that appeared regularly in the mid-1990s. So how does the clinician condense all of this information in a way that can be digested by the public? And what do we do about it?

The Centers for Disease Control and Prevention (CDC) provides three key points (MMWR Morb Mortal Wkly Rep. 2017;66:139 http://bit.ly/2lZxpNr; Vital Signs, 2017 https://www.cdc.gov/vitalsigns/hearingloss):

* Noise exposure at home and in the community can permanently damage hearing.

* People with noise-induced auditory damage usually do not recognize it; one in four adults in the United States who reported excellent or good hearing had an audiometric notch.

* Noise exposure at younger ages needs particular attention, and early life interventions need to be developed.

As hearing loss is not often realized until it is too late, there is a need to raise awareness of the consequences of excessive noise exposure, particularly among younger people.

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SOUND LEVEL APPS

Some of the frequently cited preventive measures are not new, such as reducing listening time to music at high volumes; taking breaks from exposure; requesting lower volumes in public settings (restaurants, movie theaters); and using equipment that produce less noise (e.g., household appliances, power tools, recreational vehicles). New tools such as sound level meter (SLM) applications help increase a person's awareness of sound. For example, the National Institute for Occupational Safety and Health (NIOSH) SLM app http://bit.ly/2qK3BbL was released in 2017 to enable people to measure the sound levels in their environment using a smartphone.

Sound level apps are not new, but previous studies by scientists at the NIOSH did not find these tools sufficiently reliable and accurate (J Acoust Soc Am. 2014;135[4]: EL186 http://bit.ly/2qKbSMM; J Acoust Soc Am. 2016;140[4]:EL327 http://bit.ly/2qJZFrl). For this reason, the NIOSH SLM was built for IOS devices and can be downloaded for free. The app provides a means for accurately measuring noise levels and raising awareness of sound levels in one's everyday surroundings (J Occup Environ Hyg. 2016;13[11]:840 http://bit.ly/2qK4fpw); however, it does not replace the need for professional sound level meters or noise dosimeters when making decisions about occupational safety.

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CROWDSOURCING SOUND LEVELS

Taking sound level measurement one step further, a new app helps people measure environmental sound levels so they can better choose to go to or avoid loud places. iHEARu http://ihearu.co/ allows people to report and share sound levels in various public settings. Users also earn HEAR-O points for each report. The free app makes use of the power of crowdsourcing to help people avoid the noisiest times at restaurants and other places.

iHEARu's sound level measurement module was evaluated in collaboration with NIOSH researchers according to the methodology outlined by the NIOSH smartphone apps study (J Acoust Soc Am. 2014 http://bit.ly/2qKbSMM). Because sound levels can vary depending on the type of microphone in a phone, users can also provide their own subjective sound level rating as well as write comments and share photos. Through crowdsourcing, people can make choices to avoid the noisiest times at restaurants and other places. Users can note which places are more ear-friendly, if the business offers customers an option to be seated in a quieter area, or if the establishment is approachable about turning down the music.

iHEARu recently launched the San Diego Sound Project, and many students volunteered to record sound levels at public establishments around town, including the lively Gaslamp Quarter. These and other efforts to increase the number of user-generated reviews on the iHEARu app will help everyone make sound decisions about where to meet others so they can hear and be heard.

These tools can serve as educational and intervention tools for younger generations so they can be aware of the sound levels around them. This latter point is especially relevant in light of a recent survey commissioned by the American Speech-Language-Hearing Association (ASHA), which found that 41 percent of adults age 18 and older were concerned that past noise exposure in loud leisure settings might have harmed their hearing (ASHA, 2017 http://bit.ly/2qK98yY). Slightly more than 50 percent of the people surveyed expressed concern that future exposure could be harmful. Together, these interactive solutions can empower people to understand more about noise levels of different environments and make “sound decisions.”

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