Hearing In the Heartland

This post is a little late, but we still want to bring awareness about hearing conservation with regards to agricultural safety. Ag Safety Week was actually March 3-9, with Friday focusing on hearing safety. Being in the middle of America’s “Heartland”, we see a large number of farmers and ranchers in our clinic. Unfortunately, many of these folk spent a lifetime around farm equipment that paid little attention to engineering and design for noise abatement, and public awareness of the danger associated with accumulated noise exposure was not timely. A common lament we hear from many of these people is “I wish I knew then what I know now…”.

Well, we do now know the toll that unprotected exposure to loud noise can have on hearing, and this is especially evident among farmers and ranchers. Hearing loss and tinnitus are no longer tolerated as minor inconveniences, but rather are acknowledged as serious issues that lead not only to poor communication and other health risks, but puts these workers and managers at higher risk for accidents involving the equipment they work with.

Here are some typical noise levels on the farm:

·         Tractor 74-112 dB

·         Grain Dryer 81-102 dB

·         Combine 80 - 105 dB

·         Chainsaw 77 - 120 dB

·         Grain Grinding 93-97 dB

·         Pig Squeals 85-115 dB

·         Orchard Sprayer 85-106 dB

When you consider any exposure at 85 dB or high is potentially damaging (some research suggests even lower levels), it should be obvious that around 92% of farmers nationwide are at risk for hearing loss. Excellent treatment options for hearing loss are now available, however, we should remain focused on ways to avoid and reduce noise exposure on the front-end.

·         Avoid loud noise and reduce exposure time when possible

·         Always use ear-plugs (preferably custom made plugs) and/or ear-muffs around loud equipment (look for the NRR – noise reduction ratings)

·         When purchasing new equipment, ask about engineering designs that reduce noise levels

Call us if you have questions. We’ll look forward to discussing your particular situations and how we can help ensure you are safe in your work.

How Many Channels Are Enough?

A question that comes up frequently at our clinic, and I’m sure is asked by many people seeking treatment for their hearing loss, is - how many channels in a hearing aid are enough? Isn’t more better?

First, let’s get some terminology straight…

With respect to hearing aids, frequency regions are divided into “bands” that can be adjusted for the appropriate amount of volume ( or “gain”) depending on a person’s hearing pattern. Research studies have shown that hearing aids that have between 4 and 15 bands are adequate to fit the vast majority of hearing loss patterns. Generally, the steeper the slope of the hearing loss, the more benefit will be achieved with more bands – up to perhaps 15 or 18.  

“Channels” in a hearing aid are processing filters that can automatically adjust for compression (reduction of loud sounds), noise, acoustic feedback, microphone directionality and other functions. Theoretically, the more channels a hearing aid would have, the more precisely it would suppress feedback, differentiate speech from noise, compress unwanted loud sounds, etc. -Right?

Well, there is a point of diminishing returns when it comes to the number of channels and measurable or perceived benefit. Processing functions for all those extra channels takes time and power and can lead to spectral distortion and time delays. At a certain point, there is at best, no additional benefit, and at worst, degraded sound quality and clarity.

So there is a balance to be determined, and it is important to have certain information at hand in order to determine the proper balance. A comprehensive audiogram with hearing thresholds, loudness tolerance levels, speech-in-noise performance, a review of a patient’s listening environments and complexity demands – all of these come into play when making a decision on how many “channels” and “bands” are needed to get the job done.

An Ounce of Prevention...

We’ve discussed the impact of hearing loss, and even “hidden” hearing loss, and how to manage this once the damage is done – let’s talk about hearing protection. 

Most guidelines agree that sound levels in excess of 85 decibels (dB) can damage the sensory cells in the inner ear, and there is a dosage guideline for this: at 85 dB a safe exposure would be 8 hours. How much is 85 dB? Stand next to your dryer or garbage disposal at home – that’s about 85 dB.

If the decibel level (loudness level) increases by 3 dB - cut the exposure time in half. For example, if safe exposure time is 8 hours at 85 dB, safe exposure at 88 dB goes down to 4 hours. So by the time 100 dB is reached, we’re talking about very little exposure time, indeed.

…and this is for causing measurable hearing loss – there is strong evidence now that “hidden” hearing loss, can occur with lesser exposures. “Hidden”, here, refers to damage to the auditory system that does not show up with a conventional hearing test or screening. To be safe with our hearing, we recommend using earplugs or earmuffs with any exposure at or above 80 dB. If you have to raise your voice louder than your normal level for conversation to be heard, you are likely in noise levels louder than 80 dB.

When you consider the sound levels coming out of the barrel of a shotgun or rifle and the safe levels we just discussed, you can see – there is no safe level for firearms without hearing protection. The rule is simple: If you want to keep from damaging your hearing and experiencing the disabling effects of permanent hearing loss, use hearing protection any time you use power-tools, mowers, leaf-blowers, firearms and any noise that would cause you speak above your normal level to be heard.

Helping Loved Ones with Hearing Loss

Whether or not they’re aware of it, there is a good chance your loved one has hearing loss. Here's how you can help.

Recognize Hearing Loss is Stressful

Before you step in, it’s important to recognize how stressful living with hearing loss can be. People with hearing loss tend to feel frustrated, isolated or worn out. They may blame themselves for the trouble they have understanding others or mistake their intelligence for the problem. Even after hearing loss is identified as a problem, they may be reluctant to recognize the severity of the problem or to treat it. Addressing their hearing impairment may make them feel weak, disabled, or old. For these reasons, it's important to approach the issue respectfully and with sensitivity.

Tips for Having the Conversation

It’s best to have a one-on-one conversation in a quiet place where you can speak face-to-face. This will help make sure your loved one can hear and understand you easily. Here are some tips for the discussion:

• Ask if they want you to schedule and attend a hearing evaluation with them. It’s recommended that each of us gets a baseline test, so even if it reveals no loss, he or she will have taken a step toward better health.

• Remind your loved one how common hearing loss is (affecting 1 in 3 adults over age 65 and 1 in 6 people age 41-59).

• Discuss the benefits of being able to hear well again, like enjoying family dinners or going to the movies again.

• Let them know hearing aids have changed. They are now small, highly effective, and compatible with many other technologies like cell phones and computers.

Encourage them to have a hearing evaluation

Be Patient

Some people may be willing to schedule a hearing test right away. But for most folks, this will be the start of a dialog. Be patient and continue to raise awareness by gently noting instances when they do not hear something or hear it correctly to raise awareness of how much it affects your lives.

What’s So Important About Hearing?

Every day of every month our sense of hearing is an essential part of our lives. That’s right! It’s not a luxury, it is not an add-on convenience. It is one of the primary senses we use to experience our world, to interact with our environment and to engage with our fellow human beings. So, why do so many normally hearing people take it for granted, and why do so many hard of hearing people settle for the difficult and disengaged experience that hearing loss causes?

It is our hope at Quincy Audiology that people have a greater awareness of how sound shapes our lives and greater expectation for a richer, fuller experience. We are, of course,  proud of the diagnostic testing and treatment options we provide, but we are equally proud to be a resource center for education and information for people wishing to find out more about our hearing, how sound impacts us socially and psychologically, the physics of sound, hearing conservation, and so much more. We encourage everyone to learn more, to ask questions and to enjoy more fully the wonderful world of sound and our sense of hearing.  

Healthy Hearing

Healthy living is more than just exercising and eating right. It also involves taking care of another critical aspect of your health—your hearing. Visualize all the sounds that surround you on a given day: the chorus of birds singing, laughter after you have landed a joke, the rain on the roof while you are lying in bed, a golf ball dropping in the hole, or a great song on the radio. It is this symphony of sounds that bring joy, connection, and purpose to our lives.

For many of us, we do not appreciate what we have until it is gone. Occasionally, we all miss a few words here and there, but in general many people hear effortlessly while talking to one another, listening to the television, and conversing over the telephone. For people with hearing loss, the ability to communicate easily and naturally becomes a challenge.

When a person has to concentrate to hear what others are saying, he or she may feel frustrated, embarrassed, lonely, irritable, or sad. If left untreated, this may eventually lead to depression and isolation.

Hearing loss is invisible and usually painless, so many people fail to realize when it is happening. One of the first signs you may notice is that people seem to not speak as clearly as they used to. You may begin to ask for repetition and may even criticize others for mumbling. You may find that you are withdrawing from social situations. The television may become a source of dispute within the family, as they complain of the volume being too loud. Another sign may include ringing in the ears that is more noticeable in quiet places.  If you are experiencing any of these symptoms, consult with an audiologist. 

Audiologists are professionals who evaluate and treat hearing and balance related disorders. Changes in hearing can occur at any time throughout life and for many different reasons, thus hearing should be checked routinely throughout life.  Please do not suffer in silence. Hearing makes life richer and connects us with those we love!

Ototoxicants

When we’ve spoken in the past about hearing health and hearing conservation, we have focused on the effects of noise and excessively loud sounds. This is of course important and well recognized - that we watch our exposure to noise in order to protect our hearing.

It is less well known, though, that our hearing and other functions of the inner ear can be damaged, notably through ototoxicants – products that are toxic to the inner ear and auditory nerves. Some of these include:

Solvents: carbon disulfide, hexane, toluene, styrene, PVC
Metals: mercury, lead, arsenic
Asphyxiants: carbon monoxide, tobacco smoke

Ototoxicants in Industrial Environments
Industries that use potential ototoxicants include manufacturing, mining, utilities, construction, and agriculture. Manufacturing industry subsectors may include:

• Fabricated metal

• Machinery

• Leather and Allied Product

• Textile and Apparel

• Petroleum

• Paper

• Chemical (including Paint)

  • Plastics

  • Furniture and Related Product

  • Transportation Equipment (e.g. Ship and Boat Building)

  • Electrical Equipment, Appliance and Component (e.g. Batteries)

Occupational activities that often have high noise exposure and could have synergistic effects when combined with ototoxicant exposure include:

• Printing

• Painting

• Construction

• Manufacturing occupations in the subsectors listed above

  • Fueling vehicles and aircraft

  • Firefighting

  • Weapons firing

  • Pesticide spraying

Synergistic Effects
Both OSHA and NIOSH recognize the synergistic (combined) effects of these chemicals and air pollutants on hearing loss. That is to say, we might be safe for eight hours of noise exposure at 85 dB. However if we are exposed to solvents at the same time, the sensory cells and nerves in our hearing system are more susceptible to damage at lower noise levels.

Excessive noise will often cause mechanical damage to the sensory cells of the ear. Damage from ototoxicants we mentioned is typically chemical damage. One caveat to this is recent studies that indicate constant, long-term noise, often below regulatory levels, can cause chemical toxicity in the sensory hair cells.

The Take-Home
We’ve highlighted industrial environments, but obviously many of these materials can be found and are used in home settings, especially the solvents. Be aware of the short-term and long-term risks of both noise exposure and chemicals and air-borne toxins to your hearing and balance, as well as the risk of developing tinnitus. Use a respirator if these materials are going to be used and lower your exposure time.