Photo by Alexis Kenyon via DALL·E 2
People attending loud concerts or listening to music on their earbuds this summer should be aware— about 1.1 billion young adults worldwide are at risk of hearing loss according to the World Health Organization. A quarter of adults under 70 already have impaired hearing.
KGNU’s Alexis Kenyon spoke with Nicholas Reed, an audiologist at Johns Hopkins University School of Medicine who says with every new wave of technology, new groups of people end up with hearing loss.
Protect Your Hearing: Set Your Phone Volume Below 85 Decibels Kira Z
Nicholas Reed: Pre-early 2000s. I mean, it really was like a free for all and if you remember things like the Discman and the Walkman could really get cranked up and we, you probably remember, like the late 80s, early 90s culture too was like louder is better and we really, really were playing with fire there for a while. But then we hit like the digital era, and a lot of devices did get some regulation, particularly in Europe. European countries are very aggressive with standards and then in the US were sort of like quasi-regulated, but laissez-faire like, you know, you’re saying. So, we’re not completely unregulated, but at the same time, you know, it’s possible to turn up sound in some devices.
Alexis Kenyon, KGNU: So, I actually just learned recently that you can go into your phone and set it so that it doesn’t go louder than a certain level, which is 85 decibels, that is a recommended limit that you should not surpass, why 85 decibels? And how loud is that?
Nicholas Reed: Yeah, so, 85 decibels, right? Which is pretty loud. That’s like a loud, restaurant seriously, a loud restaurant, over an eight-hour period is considered potential damage by OSHA. But like, the thing is, it’s over an eight-hour period, it’s a long period, but something like 130 decibels, you’ve got seconds before it causes damage, right? So, it’s a very, like, you know, extreme scale where, you know, you can be pretty loud and deal with it for a while, but if you’re sitting next to a jet engine at 120, 130, you just have seconds. So, to me, I would think that the goal with these phones would be more like giving you a setting that is, you know, ‘Hey, you could listen to this for two hours before potentially causing damage, or just set it below that 85, so it’s sort of always outside of the range’.
85 is plenty loud, believe me, we’ve all been in restaurants that were way too loud, and it’s like, it’s like loud enough to mask out a conversation.
Alexis Kenyon, KGNU: So someone could actually get hearing damage from working in, like a really loud restaurant? I mean, you’re probably on like, the borderline levels.
Assistant Professor Nicholas Reed: Yeah, there are restaurants that are like really loud. But remember, that’s eight hours of like, continuous exposure, restaurants don’t tend to work that way and they tend to be like, two hours of really loud, four hours of, you know, almost nothing happening. So, you know, it’s a cumulative thing, like it’s happening over a period that would have to happen to cause damage.
Alexis Kenyon, KGNU: What does time have to do with it? Why would a longer period of time with the same sound affect your ears differently?
Nicholas Reed: So without going over, apparently into, like physiology, what kind of like, I mean, this is really simplifying it but it’s like stepping on grass, right? It doesn’t necessarily destroy the grass when it happens once, the grass comes back, but you can see it’s matted down, and then slowly, little piece by piece blades come back up. But if you walk on that grass enough, in a short enough time period, that grass is going to go away. That is literally what is happening with those hair cells because they are being damaged repeatedly over a brief time period, like you know, within that eight hours or within four hours at a certain amount. That will cause irreparable damage to those hair cells and they will not come back up, if you will they will not stand up straight again.
When they’re gone, it’s one of the only areas of our body where there is no regeneration at all. Once it’s gone, it is gone.
Alexis Kenyon, KGNU: Sucks.
Assistant Professor Nicholas Reed: Does suck.
Alexis Kenyon, KGNU: So what about people who already are experiencing hearing loss? Or who were hearing aids? For example, my Dad wears a hearing aid and he listens to music on his earbuds, is he at risk of turning up the levels too high and then exposing himself to even more hearing loss?
Nicholas Reed: You know, it’s hard to say if he’s at risk or not like, just because you have hearing loss doesn’t mean what’s loud isn’t still loud.
A really important phenomenon that most people do not understand, honestly, is that hearing loss is all about the soft end of things, right? It’s about not being able to hear and access really wide information.
But what’s loud is still loud and so with full hearing, you can sit in a thunderstorm and the thunder is really loud, but you also hear that pitter-patter of raindrops on grass or on your roof or something like that, or the trees and the wind blowing. With hearing loss, you start to lose that wind blowing. You don’t hear it anymore. You start to lose the pitter-patter of rain, but that thunder is still the exact same loudness, right, you still have access to it. So, loud noise is still potentially damaging. Now, the phenomenon of the earbud versus hearing aid is sort of fascinating. Essentially, hearing aids do a lot more than just make things loud. You tend to lose high-pitch sounds, but not low-pitch sounds. Most hearing loss looks like that and so the hearing aid is actually only helping usually with high-pitched sounds where we need the help. They’re also trying to give you back dynamic range because you can imagine, if what’s loud is still loud, and we just make everything louder, then you would hate hearing aids, right? They would be terrible. So instead, we take the sound and we compress it. We literally like, shrink it all down, and then play it back to you and your hearing aids, sort of in a compressed scheme. So you’re still getting the full breadth and dynamics of sound, but for you with your specific hearing loss.
Alexis Kenyon, KGNU: I know that a lot of people who experience hearing loss, for them it can be isolating and frustrating. Tell us about some of the emotional and cognitive effects of hearing loss.
Nicholas Reed: Absolutely. So, a lot of complex things going on, you know, at a high level, right? There’s this population-level research, right, so we look across, and we see that hearing loss is actually associated with a higher risk of cognitive decline, it’s also associated with a higher risk of dementia. You know, at a social level, we believe that hearing makes it hard to keep up with the conversation, right? We start to lose bits and phrases, it sounds like others are mumbling, and maybe we start to tune out, the only thing to remember is, when trying to keep up, you know, your brain is very powerful, and it can sort of fill in the blanks, but that extra power to fill in those blanks?
Well, that comes at the expense of something else, right? So you’re working overtime, just to keep up with the conversation. And that affects short-term and working memory. It actually fatigues people faster. And so there’s actually a Nobel Prize winner who came up with this whole theory of cognitive load.
You know, like, at a very simplistic level, you hear people say things like you only use 10% of your brain. No, no, no, malarkey. You use every part of your brain that you can use all the time and if you take energy from one area and use it on something else, like trying to keep up with conversation with hearing loss, that energy comes to the expense of something else.
So the idea with hearing loss for an individual is it causes some social withdrawal and social isolation, which may contribute to cognitive decline itself, but it also contributes to fatigue, you know, and hard to keep up with information and this cognitive load, where you’re just not encoding things in working memory, because you’re using all your energy to just keep up with the conversation. These contribute to cognition over time.
Alexis Kenyon, KGNU: What advice would you have for those who are just learning that they’re experiencing hearing, hearing loss and for the people around them who are trying to communicate?
Nicholas Reed: I actually think it’s important that we start to think more about getting baseline hearing tests early in life, to see how much we’re changing, because the truth is, the earlier that you start doing something, the better it is, right?
The earlier you do something, the more your brain can adapt to it before you’ve sort of waited too long, right? And the wait too long thing is real. I often compare it to a phantom, or your limb, like your arm falls asleep or your hand falls asleep. And when you move it, it’s kind of painful for a second to get it back, right? You get the tingles, it’s the same thing for your brain, that area is not being activated and then when you give it that sound back, it’s painful, like, like, there’s a very strange reaction people have to not having heard their toilet flush, or hearing like a different version of their toilet flush to all of a sudden getting all that sound back and being like, ‘oh my gosh, I miss that’ it’s not pleasant. So, I’m sort of a believer and, you know, even early on basic amplification, basic conversations about you know, I’m struggling a little bit and
Things that help are when others remember that with hearing loss, talking fast, shouting at people, not just like repeating the same word over and over again that they can’t hear do not help. Instead, we need to go low, we need to go slow. We need to rephrase rather than repeat, and add context to the conversation, these are free ways to help overcome some hearing problems.
Alexis Kenyon: How do you know if you have hearing loss?
Nicholas Reed: truth is, most people do not realize that we have hearing loss, right? It’s sort of a clarity issue, not a volume issue. So, it actually does sound like other people are mumbling, but if you think others are mumbling, this is a key indicator that maybe we should do something about it.
Alexis Kenyon, KGNU: Nicholas Reed is an assistant professor at the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health and an audiologist at the Johns Hopkins University School of Medicine. Nicholas Reid, thank you so much for talking with me.
Produced by Alexis Kenyon
Protect Your Hearing: Set Your Phone Volume Below 85 Decibels Kira Z