Afew months ago I helped chaperone a middle school dance. I arrived early and watched as the DJ set up his equipment and began playing music. It was far too loud. After a few songs, a faculty member asked that the music be turned down. Good for him, but what impressed me was seeing a lot of the kids staying at the other end of the large room. For whatever reasons, they had retreated from the potentially harmful decibels.
In those few minutes, I saw in practice two of the three strategies for preventing hearing loss from excessive noise exposure: (1) "Turn It Down" and (2) "Move Away." The third one is (3) "Protect Your Ears," which means using well-fitting ear protectors, a strategy good for occupation-related noise exposure and firearms use, but a strategy which shouldn't be necessary at a school dance.
Recently the Centers for Disease Control and Prevention, in an article titled "Promoting Hearing Health Across the Life Span," reviewed the information available on how to prevent hearing loss from noise exposure. We have work to do. Millions of us, almost 28 million between 20 and 69 years old, already have hearing loss. Many of us have measurable signs on audiograms of damage even though we may not perceive any decrease in hearing. Sadly, there are significant numbers of young people, including teens, with such signs.
Here's the problem: Chronic exposure to excessive noise or a one-time exposure to a loud noise can permanently damage tiny hair cells inside the cochlea. When I was a kid in grade school, we were good at drawing pictures of the hammer, anvil, and stirrup in the ear, but the cochlea was a mystery. Scientific advance now allows us to see detailed photos of the tiny hairs in the cochlea before and after they are damaged. When my 180 pounds tread on a lawn, the tiny blades of grass pop back up. But as my two dogs have proven, repeated excessive footsteps eventually beat down the blades, and they are permanently damaged. Just like blades of grass, repeated damage from loud noise can permanently damage these hairs, and hearing loss occurs.
Work-related hearing loss risk has decreased, but many workers are still vulnerable. Work sites have less noise than in the past, and many workers are using hearing protection; but there are still many job sites with too much noise, and some occupations in which it is difficult to eliminate the risk. Workers may neglect to wear protection or, when they do, wear protection that is not well-fitted.
The degree of damage is determined by both the level of the noise and the length of exposure. The National Institute for Occupational Safety and Health (NIOSH) recommends a limit of 85-dB (decibels) for an eight-hour day. Because the decibel scale is logarithmic, small increases in the number reflects substantial increase in noise. For example, if the decibel level exposure is 88-dB, then only four hours of exposure is recommended.
Outside the workplace, some of the common causes of noise-induced hearing loss are firearms sports, electronic music players, home devices such as power tools, and music at concerts and clubs.
About 20 years ago, I heard some live music here in Little Rock. I should have known better when the bouncer at the door was wearing ear plugs and made some comment to me about how loud it was. Or when the person I was with had to shout at me to be heard. If a conversation cannot be heard with the other person an arm's length away, the noise is too loud.
When we left, I had that muffled sound that can occur from noise exposure. Two mornings later I spent an hour going room to room trying to locate the source of a buzzing sound before I realized it was in my ear. The ringing was tinnitus, and it has never gone away.
I could blame rock 'n' roll or artillery rounds from years before in my youth. But in fact the cause was my failure to Turn It Down, Move Away, or Protect My Ears. I should have left.
Some months later I was at another music event, this one also a bit too loud, and I was using wadded-up cocktail napkins as ear plugs, obviously not approved hearing protection. A friend in jest teased me about acting like an old man. There is nothing tough or youthful about letting noise damage hearing. We should not let loud music hurt our ability to enjoy music for years to come. I left.
As adults, we need to instruct children at an early age the importance of protecting their hearing. Turn it Down. Move Away. Protect Your Ears. Good advice for any age.
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Vic Snyder is corporate medical director for external affairs at Arkansas Blue Cross Blue Shield.
Editorial on 03/16/2018