Category Archives: Articles

Leading Hazardous Hearing Occupations

Could excessively noisy conditions on the job be affecting your hearing?Noise-induced hearing loss is the single most common reason for hearing damage. If you work in one of the following high-noise occupations, you have reason to be concerned about your hearing.The Centers for Disease Control estimates that 30 million workers are subjected to dangerous noise on the job and an additional 9 million risk hearing loss from other agents such as solvents and metals.Occupational hearing safety is best addressed with facts and an open discussion between employers and workers. Staff should learn as much as they can about the risks.

The risk of hearing damage should be reduced as best as possible in any occupation. Below is a starter list of particularly noisy careers.

  • Miners – According to the Center for Disease Control, 49 percent of male miners are expected to have a hearing disability before age 50 – versus 9 % of the general public – increasing to 70% by age 60.
  • Bartenders and DJs – Absolutely everyone that works in a night club – security, wait staff, bartenders – is at risk, not just the DJs. In a managed study, sound levels of up to 108 decibels were recorded in popular nightclubs. The average noise level for a normal nightclub outing was 96 decibels which is above the level at which employers are required to provide hearing protection. The study concluded that Disc Jockeys are at substantial risk of developing noise-induced hearing loss and noise exposure in nightclubs routinely surpasses safe levels.
  • Construction Workers – Construction workers rank second highest for permanent hearing loss disabilities sustained in the workplace. Construction equipment routinely exposes workers to machinery which produces upwards of 90 decibels. A Washington State study of construction workers found that in spite of being exposed to noises exceeding 85 decibels during 70% of their shifts, construction workers only wore hearing protection 20 percent of the time (or less).
  • Orchestra & Band – Research on the noise exposures of classical musicians experienced across both rehearsals and performances found that the strings and percussion sections averaged 90 decibels while the brass section averaged 95 decibels. Top volumes were 130 decibels in the brass and percussion sections of the orchestra. A different Swedish study revealed that 59 out of 139 orchestra musicians – 42 percent – had hearing losses higher than that predicted for their ages.
  • Airport Staff – The sound of a jet engine is among the loudest occupational hazards, with sound levels at a shocking 140 decibels.
  • Firefighters and Paramedics – The many sirens squealing accumulate over time. Numerous studies have explored the prevalence of hearing impairments in firefighters and ambulance drivers with most finding that firefighters experienced increased hearing loss relative to the general public of the same age.
  • Military – Noise-induced hearing loss is the leading disability amongst US military personnel. According to the Deafness Research Foundation, in excess of 65 percent of combat troops returning from Afghanistan suffer from noise-induced hearing loss.
  • Manufacturing – The majority of permanent hearing losses sustained on the job are in manufacturing. Manufacturing positions repeatedly expose employees to machinery and equipment which generates over 90 decibels of noise.

A Look at Perforated Eardrums: Causes, Prevention, Indicators and Treatment

The eardrum performs two very important functions: clearly, it vibrates when it senses sound wavesand is thus a fundamental part of hearing, but additionally it serves as a barrier to guard the inner ear from infections. Whenever your eardrum is intact, your inner ear is basically a protected and sterile place; but once it is punctured or torn, microbes can enter and cause a serious infection generally known as otitis media.

A perforated eardrum – also called a ruptured eardrum orin medical terminology, as a tympanic membrane perforation – is a puncture or tear in this thin essential membrane. There are numerous causes of perforated eardrums. The most common is an inner ear infection. Fluid associated with the infection presses up against the eardrum membrane, increasing pressure until it ultimately tears. Some people perforate their own eardrums by inserting foreign objects into the ears, for example the use of Q-tips to clear away ear wax. Another frequent cause is barotrauma – the circumstance that happens when the barometric pressure outside the ear is different from the pressure inside the ear – which may occur in scuba diving and in airplanes. Loud noises and explosions can also cause ruptured ear drums. This is known as acoustic trauma.

Indications of ruptured eardrums include:

  • Pain in the ear
  • Hearing loss in the affected ear
  • Dizziness or vertigo
  • Fluid draining from the ear

Visit a specialist immediately if you experience these symptoms, because if your eardrum is ruptured, prompt treatment helps to prevent infection and to prevent hearing loss. Not treated, you risk serious inner and middle ear infections, middle ear cysts and the possibility of long term hearing loss.

Specialists diagnose this condition using an otoscope, which is an instrument with an internal light which allows them to see the eardrum. If your eardrum has been perforated, generally it will heal on its own within two to three months, but during this time period you should refrain from swimming or diving, avoid certain medications, and try to avoid blowing your nose (which would place more pressure on the already-damaged eardrum). If the rupture or hole is close to the edge of the eardrum, the doctor may help the healing process by inserting a temporary patch or dam to help prevent infection, or even propose surgical treatment.

Your health care provider may also recommend over-the-counter (OTC) pain medications such as aspirin or acetaminophen to cope with any discomfort. Not every perforated eardrum can be averted, but there are things you can do to reduce your risk. Always get prompt treatment for any ear infections and don’t place any foreign objects into your ear canal (even for cleaning).

BPPV – What It Means and How to Treat It

Vertigo – the sensation of movement where the individual or the individual’s surroundings seem to whirl dizzily – is, typically an unpleasant event. Vertigo feelings can disrupt balance and result in falls that can be dangerous in the elderly; vertigo can also be coupled with sensations of spinning in space, dizziness, and more rarely, nausea, vomiting, migraine headaches, visual irregularities including nystagmus, and fainting spells.

There are many causes for vertigo, but one kind of it – benign paroxysmal positional vertigo, abbreviated BPPV – is related to hearing. It occurs from calcium crystals that form naturally called otoconia or otoliths, that generally cause no problems. In individuals who suffer from BPPV, however, these crystals become dislodged from their normal location and migrate into one of the semicircular canals which control our sense of balance. When somebody with BPPV reorients their head relative to gravity, these crystals cause an abnormal displacement of endolymph fluid and induce vertigo.

Everyday motions such as tilting your head, looking up and down or rolling over in bed can trigger the BPPV. The vertigo sensation comes on very suddenly and in very brief. The ensuing vertigo can be made worse by anxiety, sleep disorders, or changes in barometric pressure (such as, just before a snowfall or rainfall). The disorder can manifest itself at any age, but it typically appears in people over age 60. The precise reason behind benign paroxysmal positional vertigo is hard to determine for any given individual, but sometimes it is brought on by a blow to the head.

BPPV is readily distinguished from other types of vertigo because it is almost always brought on by movements of the head with symptoms receding in 60 seconds or less. Vertigo specialists may diagnose it by having the patient lie on their back and then tilt their head to one side or over the edge of the examination table. More comprehensive tests can be used in selected cases including electronystagmography (ENG), videonystagmography (VNG) and magnetic resonance imaging (MRI). ENG and VNG test for abnormal eye movements while MRI is used to eliminate other possible causes of vertigo such as tumors or brain abnormalities.

The standard therapy for BPPV is canalith repositioning, including the Epley maneuver and the Semont maneuver, both of which are a sequence of physical movements used to guide the crystals to an area of the inner ear in which they no longer cause trouble. In some cases (under 10 percent), if these treatment methods don’t provide relief, surgery may be suggested. Visit your balance disorder specialist if you have felt symptoms which seem as if they could be related to BPPV, especially if they persist for more than a week.

Precisely What do Speech Bananas, Audiograms and Phonemes Mean to Human Hearing?

“Speech bananas” are not mid-day treats for audiologists.Speech banana is a reference to the distribution of sounds in an audiogram – a graphical rendering of someone’s hearing acuity inside a range of frequencies and loudness levels. In an audiogram, you generally see the frequency level of the sound ( in Hertz) on the x axis, and the volume level ( in Decibels) on the y axis.

When the typical sounds of human speech – or phonemes – are charted on such an audiogram, they have a tendency to all cluster inside an region of the graph that is shaped like a banana. Nearly the whole alphabet and most letter combinations (such as ng, th, sh and ch) cluster into the speech banana range on an audiogram. The primary exceptions are the letters q, w, x, and y.

The speech banana is important because it includes most of the sounds of human speech which is vital for our communications with each other. Individuals with normal hearing, can hear lots of sounds outside of the speech banana such as low frequency tubas or high frequency leaves rustling. It is quite common for people to have trouble hearing or understanding specific vowels and letter combinations such as ch, sh, th and ng.

When hearing loss impacts the frequencies and volumes inside the speech banana it disrupts interpersonal communications. For this reason hearing specialists and audiologist will normally focus on that area. If an audiogram reveals that an individual has hearing loss inside the speech banana region, it is practically certain that they’re having oral communication problems.

That is one of the reasons why hearing tests using audiograms are required in the schools of several states – to detect possible hearing difficulties at an early age, when they can be easily solved. The importance of this special region of sounds is also why – if you use hearing aids – you should have them properly programmed and adjusted by a qualified audiologist or hearing specialist, to make sure you can hear the sounds of speech clearly.Whether you currently wear hearing aids or not, contact us if you have concerns about your ability to hear in the speech banana frequency and volume range.

Music Therapy Offers an Alternative to Patients with Hearing Loss

As with most matters in life, the sounds we hear influence us depending on the quality and quantity of them. Most people, for example, take pleasure in listening to music. However, if we are at a noisy concert or are listening to the music on headphones turned up to a literally ear-splitting volume, the exact same music can cause anxiety and stress.

Everyone has a different taste in music, therefore the quality of a piece of music is always subjective. On the other hand, the quantity as measured by decibel level and duration is very objective and readily quantified. Being exposed to loud sounds, particularly for prolonged time periods, can permanently damage the sensitive hair cells off the inner ear, and lead to noise-induced hearing loss. Noise exposure is a huge problem in America. Some estimates are that one in every five persons has some degree of tinnitus or hearing damage as a direct result of noise. The truth is, even quiet sounds can be disquieting; for example, sounds at a volume under 10 decibels – quieter than a whisper, such as the sound of a ticking clock – have been proven to cause anxiety, stress, and insomnia.

Yet although sound can be a cause of stress and hearing damage, it can also become a tool to treat the effects of hearing damage. Like many people, you have probably experienced the soothing effects of some sounds, such as surf on the ocean, the falling water, or the meditative sounds of chanting. Increasingly, these sorts of sounds are being used by psychologists to treat anxiety rather than create it, and by audiologists to treat hearing problems like tinnitus rather than cause them. Music therapy is hitting the mainstream in clinics and hospitals to accelerate healing after surgery, in stroke rehabilitation, and to slow the progress of Alzheimer’s. People have successfully used white noise generators (which create a mixture of frequencies similar to the sound of ocean surf) to help people conquer insomnia and sleep disorders, and to lower their perceived awareness of background sounds in noisy environments.

More directly related to hearing loss, sound and music therapy is being used increasingly more to treat tinnitus by creating what therapists call a threshold shift, which allows tinnitus patients to psychologically mask the continuous buzzing or ringing sounds they hear. By using specialized tones or carefully selected music tracks, audiologists have been able to teach tinnitus patients to retrain their brains to prefer the sounds they want to hear over the buzzing sounds produced by the tinnitus. While the tinnitus ringing doesn’t disappear, the anxiety and stress that it otherwise produces are diminished. The patients learn to focus attention on appealing sounds in favor of undesirable ones.

For tinnitus sufferers looking for new treatment options, music therapy is worth looking at. Contact us to discuss your specific situation.

Addressing the Fundamental Safety Requirements of Individuals with Hearing Loss

One topic which is rarely discussed with regards to hearing loss is how to keep those who have it safe inside their homes. For example, suppose that a fire breaks out in your home; if you are like most people you have smoke alarms to sound an alert so that you and your family can evacuate the home before the fire becomes widespread, and thus deadly. But this time imagine that this fire breaks out at night, when you’re asleep, and you have taken off your hearing aid.

The smoke alarms standard in almost all houses and those mandated by city and local governments emit a very loud warning sound at a frequency between 3,000 and 4,000 Hz. This approach is acceptable for most people, but unfortunately these frequencies are among those most vulnerable to age-related hearing loss, so older adults or people who have suffered other forms of hearing loss can’t hear them. So even if you had been awake, if you are among the more than eleven million people in America with hearing loss, there’s a chance that you would not hear the alarm.

To remedy this, there are a number of home safety products that have been re-engineered with the requirements of the hearing impaired in mind. For instance, there are smoke detectors that emit a low-frequency (520 Hertz) square wave sound that most hearing-impaired individuals can hear. For people who are completely deaf, or who are unable to hear at all when they remove their hearing aids or turn off their cochlear implants (CIs) during the night, there are alarm systems that blend extremely loud noises, flashing lights, and vibrators that shake your mattress. For comprehensive home safety, a number of these more modern devices have been developed to be easily incorporated into more thorough home protection systems to warn you in case of intruders, or if neighbors are pounding on your doors.

To hear other sounds which might signal danger, many hearing-impaired people have installed induction loops in their houses for boosting the performance of their hearing aids or cochlear implants. An induction loop is merely a lengthy strand of wire that encircles your family room, bedroom, or children’s rooms, which activates the telecoils inside your hearing assistance devices to increase the volume of sounds, and thus can help you not to miss any important or emergency notifications.

We should not forget the basic telephone, which is vital during an emergency of any kind. The majority of modern phones now can be found in models that are hearing aid and CI-compatible, which allow their use during emergencies. Other phone models incorporate speakerphone systems with high volumes that can be used by the hearing impaired, and more importantly, can be voice-activated. So if you fell and hurt yourself out of reach of the phone, you could still voice-dial for help. Other manufacturers produce vibrating wristbands that interact with your cell phone to wake you up or inform you if you get a phone call.

Other safety suggestions are less technical and more practical, like always keeping the phone numbers of fire departments, ambulance providers, doctors, and emergency services handy. We are as serious about your basic safety as we are about your hearing, so if we can be of assistance with any further tips or suggestions, feel free to give us a call.

What Chickens and Zebra Fish are Revealing to Us about Curing Hearing LossInner Ear Hair Cell Regeneration

Among the sometimes bothersome things about being a hearing professional is that many of the situations we deal with which have caused our patients to lose their hearing can’t be reversed. For example, one of the most common reasons for hearing loss is damage to the very small, sensitive hair cells that line the inner ear and vibrate in response to sound. What we think of as hearing are the translations of these vibrations into electrical impulses which are sent to the brain.

The fact is that, the same sensitivity of these hair cells that allows them to respond to sound waves and translate them into electrical impulses that our brains perceive as hearing also makes them fragile, and susceptible to damage. The hair cells of the inner ear can sustain damage from exposure to loud sounds (causing noise-induced hearing loss), by certain medications, by infections, and by aging. In humans, once these hair cells are damaged or destroyed, they cannot be regenerated or “fixed.” Since we can’t reverse the damage, hearing specialists and audiologists look to technology instead. We compensate for hearing loss due to inner ear hair cell damage with hearing aids and cochlear implants.

If humans were more like fish or chickens, we’d have other options. In contrast to humans, some bird species and fish actually have the ability to regenerate their damaged inner ear hair cells and regain their lost hearing. Odd, but true. For reasons that are not fully understood, zebra fish and chickens have the ability to spontaneously duplicate and replace damaged hair cells, and thus attain full functional recovery from hearing loss.

While it is important to point out at the outset that the following research is in its beginning stages and that no practical benefits for humans have yet been achieved, considerable advancements in the treatment of hearing loss may come in the future as the result of the innovative Hearing Restoration Project (HRP). Funded by a nonprofit organization called the Hearing Health Foundation, this research is currently being conducted in 14 different labs in the United States and Canada.Researchers included in the HRP are trying to isolate the compounds that allow the hair cells in some animals to replicate themselves, with the ultimate goal of discovering some way to enable human hair cells to do the same.

The research is painstaking and challenging, because so many distinct molecules either contribute to replication or hinder inner ear hair cells from replicating. By pinpointing which of the molecules regulate this process in fish or avian cochlea, the researchers are hoping to pinpoint which compounds promote hair cell growth. A few of the HRP scientists are pursuing gene therapies as a way to stimulate such regrowth, while others are working on using stem cells to accomplish the same goal.

Although this work is still in it’s preliminary stages, our team wishes them quick success so that their results can be extended to humans. Almost nothing would be more satisfying than to be able to provide our hearing loss patients a true cure.