Tuesday, August 24, 2010
A new national health survey finds the rate of hearing loss rising in US teenagers. We'll discuss whether the use of personal music devices, like IPods, are increasing hearing problems and find out ways to decrease that risk.
MAUREEN CAVANAUGH (Host): I'm Maureen Cavanaugh, and you're listening to These Days on KPBS. Remember boom boxes? Kids from a previous generation used to carry huge stereo devices with them causing noise pollution wherever they went. Now, of course, personal stereos fit in your ear. That's much kinder to your neighbors, but it doesn't mean the excessive noise has disappeared. A new survey has found that in the past 20 years hearing loss has risen in the teenage population by a whopping 30%. To explain more about the research and what it means about the future hearing health for today's teenagers is my guest, Peter Torre, audiology professor at San Diego State University. And Professor Torre, welcome to These Days.
PETER TORRE (Professor of Hearing Science, San Diego State University): Well, thank you very much. I’m happy to be here.
CAVANAUGH: We’d like to invite our listeners to join the conversation. Are you concerned about what iPods, earbuds, cell phones may be doing to your hearing or your child’s? Are you taking precautions to protect your hearing? Give us a call with your questions or your comments. Our number is 1-888-895-5727. So, Professor Torre, where does this new information about teenage hearing loss come from?
TORRE: It’s actually a national survey that’s been done through the National Institutes of Health. It’s an ongoing health and nutritional survey that has been going on now. The data that were presented in the recent article in the Journal of American Medical Assocation was from, I believe, 1985-86 data from the NHANES III database and then the more recent 2005-2006 survey data that were collected in those years and subsequently analyzed and now presented in that article. So it’s one of the longest ongoing studies of other things, not just hearing loss, I mean, that’s the important aspect of it, but it’s – hearing loss is one of the mechanisms they’re evaluating, looking to see, like they presented in the paper, what characteristics of hearing loss have changed over time and are there reasons for that? What are the risk factors involved in that. So…
CAVANAUGH: And what exactly did the survey find out about hearing loss among the age group I think it’s 12 to 19?
TORRE: 12 to 19, right. They did a couple of things. They did survey data first so they did ask the young adults some questions about their hearing. Do you have concerns? Are you exposed to any loud noise? Actually, firearm use and things of that nature. But they also did actual hearing testing, so then they couldn’t just use the survey data like, you know, depending on how they would recall their experience with noise. So they actually put them in a sound booth and did hearing testing on these young adults and found that the hearing loss, by definition, by diagnostic definition, not just us deciding among us, for the prevalence of hearing loss in those adolescents has gone up in just since the two thous – I’m sorry, the 1985-86 data up until the 2005 data.
CAVANAUGH: And what kind of hearing has been lost?
TORRE: It’s actually what’s called sensory neural hearing loss and I guess if there’s any good news for this, and I’m not going to, you know, make a bright light of this, but it’s a slight hearing loss so it’s used more for children and adolescents where it’s what’s called a 16 decibel loss or more. So that’s the other problem is they didn’t really talk about how much more after that, so slight hearing loss means that there’s going to be a problem potentially in their communication strategies as well as maybe in their learning environments. So that’s what’s an important consideration here, is that the slight hearing loss may, whether or not the child or adolescent recognizes that they have a hearing problem, could be a factor in their communication as well as learning situations.
CAVANAUGH: Now, I’m wondering, in doing this survey, did the study find that teenagers would notice that they have any kind of hearing loss?
TORRE: In most cases probably not. This is a – like, I said, slight or even mild. I may even have a mild hearing loss, I mean, I test my hearing a fair amount…
TORRE: …just because of what I do. But it’s probably not going to be noticeable and maybe in certain situations, in a quiet environment like you and talking, they’re probably not going to notice it. When the listening environment becomes more complex, that’s when they might notice a problem. But then, again, all of us do. If we invite 20 people into the studio and we’re trying to talk, clearly there’s going to be more of a problem for us communicating one-on-one. It just – it’ll show up more in those more complex listening environments where they may think, huh? You know, the what? You know, all the jokes I tend to get when I say I’m in hearing science.
TORRE: So that seems to be when they’ll have more problems. The problem with hearing loss and the progression of the disorder is that it’s very slow barring any acoustic insult or any trauma to the auditory system, so you’re probably not going to recognize the hearing problem until later in life. That’s what makes studies in young adults more difficult is because they’re not going to recognize hearing loss. You may not see it for 20, 30 years.
CAVANAUGH: Right, right.
CAVANAUGH: Now, did this study – did the people who did the research on this study speculate as to why there was this hearing loss?
TORRE: They were smart enough to probably rein it back just a little bit. They did note that in some of the survey questions that the 2005-2006 adolescents reported more noise exposure or more loud environments, I think, is what I think they reported. But what they didn’t recognize was the configuration of the hearing tests were not consistent with that type of stereotypical noise induced hearing loss that we’ll see usually in more adult populations, that we see like at the clinic, that are older. So they didn’t quite say that this is noise induced-based. They were cautious, saying we want to be careful that these adolescents report more noise exposure but it’s not showing up on the audiogram, and that goes back to the way the disorder progresses, so it – just because they report it now, it may not show up until later in life. So it’s possible and it’s part of the stuff I do in my lab, looking at this earlier onset noise induced hearing loss, it’s possible that these adolescents are just young enough not to have manifest the degree or the type of hearing loss, configuration of hearing loss, that we would put as the stereotypical noise induced type hearing loss.
CAVANAUGH: We are taking your calls at 1-888-895-5727. My guest is Dr. Peter Torre, and we are talking about a new survey that showed that in the past 20 years, hearing loss has risen in the teenage population by about 30%, and we’re speculating on the reasons why that might be. And we’re taking your calls, as I said, 1-888-895-KPBS. Let’s hear from Liz calling us from Poway. Good morning, Liz, and welcome to These Days.
LIZ (Caller, Poway): Yeah, good morning. I’m an educator myself and I was just commenting that I thought it was ironic that we need experts. It seems very much a common sense situation when you see the headphones and how loud they are and you can hear them when you walk by the kids so they’re extremely loud. And so I’m just concerned that it’s just as a nation it seems like we need to pay attention to this. And also cell phone use in young children. You know, because down the road we’re probably going to have the same thing where the studies show that those are very dangerous, too.
LIZ: And I just hope we can wake up to these things.
CAVANAUGH: Liz, thank you so much for the call. I want to jump in on Liz’s question because, Dr. Torre, we have been told for at least two or three generations that loud music is ruining teenagers’ hearing, you know. It’s the parent calling in, turn that down.
CAVANAUGH: But what’s different now?
TORRE: I just think actually, like Liz mentioned, the fact that you have sounds sources now that are in the ear canal. Cell phones, you put it to your ear. iPhones have their earbud for communication. So I think a lot of the sound sources that you mentioned in the introduction, the boomboxes, technically depending on how you rollerskated down the Strand at the beach, you may have had the boombox on your shoulder. But in most cases, your music or noise exposure was always at a distance which allows for some—and I want to be careful with it—some protection of the auditory system because of the environment will absorb some of the acoustic energy. But if you’re putting that right in your ear canal, you’re putting yourself a little more at risk for creating damage and, as Liz mentioned, there’s a couple things going. The earphone, some of the children’s earphones may not be that good so that’s where you may hear the music, you may sing along with them as you’re walking through the halls of the school. But you’re right, they’re also listening to it tend to be louder, and that’s where things become problematic. You’re introducing a very loud signal right against – into the ear canal, which is close to the ear drum which puts it directly into the inner ear causing potential damage. So what you may see—again, I want to make sure I emphasize may see—with cell phone use as well as other recreational noise exposure, we can pool that all together, is the aspect of increased noise induced hearing loss but maybe even a unilateral, in one side to the other, depending on your favorite ear. If I talk on my cell phone with my right ear, I’m exposing that ear to more auditory input. Whether or not it’s too loud or stuff like that is a different story. So my favorite ear may be more susceptible because of use, let’s just say.
CAVANAUGH: Does the quality of the music being delivered by these digital devices also play a factor in this?
TORRE: Yeah, most definitely because when I first got, you know, the tape, analog, Walkman, back in the day, the quality was okay but it wasn’t like we have now where you have digitized music so you now hear more of the frequency spectrum in the music than you did maybe in the past. And the quality’s maintained. Tapes, if you left them in your car today, you know, are going to melt, so that tape’s gone. If I leave my iPod in the sun, sure, it’s going to get damaged also.
TORRE: But in most cases, I can just reload the music back onto it. So you’re exactly right, the quality of the music, being that it’s digitized, is probably going to increase the frequency spectrum being presented to the ear causing more let’s just call it work by the inner ear to break down that musical signal.
CAVANAUGH: I’m speaking with Dr. Peter Torre. We’re talking about the possible hearing – detrimental hearing effects of iPods and other very close in and personal stereo devices. We’re taking your calls at 1-888-895-5727. Steve is calling us from San Diego. Good morning, Steve. Welcome to These Days.
STEVE (Caller, San Diego): Oh, good morning.
STEVE: Yes, I just wanted to ask a question of the doctor. I just wanted to know if the minor hearing loss can be correlated to Attention Deficit Disorder in children? I’ll take my answer off the air.
CAVANAUGH: Thanks, Steve.
TORRE: Thanks. It’s hard. I’m not sure of any research that’s actually looked at those two things specifically because hearing does have an aspect of cognitive, you know, ability because you’re asking someone to respond to a signal. But what we’re talking about and with the data that we’re presented in the most recent article, are more looking at how the sensory function changes as well as some of the neural aspects. So it’s possible but nothing that I’m aware of from a science perspective has linked those two things together. But I, you know, like I said, slight hearing loss may cause someone who doesn’t get that auditory input to kind of float away and their attention may leave them so it’s possible but, unfortunately, I’m sorry, Steve, I’m not aware of any other research that’s been done on that.
CAVANAUGH: Let’s take another call. Annie is calling us from Alpine. Good morning, Annie, and welcome to These Days.
ANNIE (Caller, Alpine): Good morning. Good morning.
TORRE: Good morning.
ANNIE: I just – There’s a relatively newly known phenomenon called soft sound sensitivity. There’s about 1300 people on the internet now who have identified but having an iPod is a blessing because the footsteps, mouth sounds, breathing sounds, sibilant esses, are getting blocked out by those. And I’m wondering if – I’m wondering how many audiologists in the study are asking the kids why are you listening to the music so loud?
TORRE: Ah, that’s a good question. I’m not sure – I don’t think – I’m trying to think of who – I know the authors that presented the paper in JAMA weren’t audiologists by training and I’m sure that they have audiologists on the NHANES group that evaluates the hearing data. But from a perspective of – I mean, there’s – I think a lot of the answers to why people listen to it so loud is they’ll give you the classic answers, well, this is my favorite song, or I didn’t want to hear the environment around me, I wanted – I love – I’ve actually done some survey work in college students and some of them say I don’t want, you know, to be distracted by people around me so I’ll just distract them with my music, I guess is what it plays out. So I’m not sure why – I mean, that’s – it’s a tough question because to use it in a survey and these NHANES database questions, they’re a closed set. In other words, they have 5 or 6 answers with maybe a ‘don’t know/cannot recall’ option. So what they try and do is, it’s called a forced choice option, allow someone to pick one of the five answers so when you have a question like that, why do you listen to it so loud, there are probably a thousand options to include on that but given that the NHANES protocol is hours long, they have to limit the number of answers they provide for certain questions. But that’s a hard one because it’s a open-ended question and you will – you could spend hours deciding on what’s the right answer, what’s the wrong answer. So…
CAVANAUGH: Let’s take another call. Nancy is calling us from San Diego. Good morning, Nancy and welcome to These Days.
NANCY (Caller, San Diego): Yeah, hi, thank you for taking my call. I’m an avid fan of National Public Radio. I’m 72 years old and I hear well. My boyfriend is 95 and because he’s a musician, he goes out of his way to use hearing aids and his hearing is still alive at 95. But he’s in a retirement home where most of the people cannot hear and they have withdrawn. They don’t communicate. So he says he just smiles and waves at them. And I think we should show our children what it’s like to get old and not having your hearing. You lose communication power, and I have been in the situation, too, where the people around me, nobody can hear so you can’t communicate.
NANCY: But it is such a big issue. The children must know that even if there’s the slightest risk, you don’t want it. Now, I myself, at 72, love the Beach Boys blasting in my car. At this age, I don’t care. I like it and it’s because it vibrates throughout and so I understand it.
CAVANAUGH: So you understand why the kids are playing at such a loud frequency.
NANCY: It’s joyful. It’s vibration, it’s good.
NANCY: And I think a lot of the people, the older people especially, they’re so jealous of these young kids and their iPods and iPhones and they’re so unhappy that they’re isolated. The young don’t care about them, they like their music.
CAVANAUGH: Well, I…
NANCY: I think they’re jealous.
CAVANAUGH: Nancy, thank you. You’ve given us a lot to think about.
TORRE: Yes, Nancy.
CAVANAUGH: Thank you for your call. And, you know, Nancy brings up the point that, you know, if kids are losing hearing that they don’t even know that they’ve lost and they are loving their music, they’re loving their iPods and their cell phones, how do you get that message across that this is like a slow thing eating away at a very, very important sense that may cause you trouble down the line.
TORRE: Yeah, that’s the biggest hurdle, is trying to bring enough awareness for the risk factors because what I try and do in my classes is basically just talk about – I mean, the easy one is vision. Right now, with hearing loss, when you have a hearing loss, that’s not coming back. There is some hair cell regeneration, resurge, but that is far down the road and it’s probably not likely to be – nobody knows how that’s going to play out with humans. So what I try and tell them is I have audio examples of this is what a slight hearing loss is, this is what a mild/moderate/severe hearing loss is. Then I even have examples that include tinnitus or ringing in the ear and the kids’ll go, oh, of course I remember that. After the so-and-so concert, my ears rang for two days.
TORRE: Okay, well, that’s great because two days and it was gone but in some situations with hearing loss, you’ll have that tinnitus can – like concurrent with the hearing loss and it makes things twice as bad because you can’t hear, plus you have a background ringing going on. So they also get – So I use the vision example as an ex – saying, look, I know some of you are probably wearing contact lenses right now as I talk, okay, your vision’s fine. You have corrected vision that’s probably at least 20/20. When you get a hearing aid, it’s going to help but it’s not going to give you the hearing you had when you were 20, 25 years old. So that’s one of the examples I try and present to them. It’s like this is – when this sensory loss occurs, it can’t come back at least today.
TORRE: Probably not for the next few years. So I try and explain, just like other risk factors in life, you’ve got to be aware of what the consequences are for loud music, constant bombarding of the auditory system, that one day, you know, it may not be there for you. So, and again, the problem, like we talked about, is that they may, ah, I don’t have a hearing problem. Yet we find that, you know, 12, 15% of adolescents have a slight hearing loss.
CAVANAUGH: Well, one of our callers who couldn’t stay on the line asked the question, are there any supplements like Gingko that can mitigate hearing loss?
TORRE: I’ve seen a couple. None have been really reviewed by both the FDA or any science. So the problem is those are systemic issues like talking about better health overall so it’s probably there may be a secondary component. I just saw a commercial about something that gets rid of ringing in your ear and I was like – half of me laughed, half of me goes, well, let’s figure out why.
TORRE: But for the most part, it’s because it’s such a very small system, and it’s a very sensitive system, although resilient but sensitive, it’s hard to know what insults, you know, small insults, will cause problems. Or, on the other hand, what small things like supplements can benefit that small system. So just like anything else, it’s a general health issue that can probably be maintained within the auditory system also.
CAVANAUGH: Bruce is calling us from Del Mar. Good morning, Bruce, and welcome to These Days.
BRUCE (Caller, Del Mar): Good morning. I just wanted to make a comment about that tinnitus. I’m retired military and, you know, a concert-goer when I was a teenager, was around weapons and heavy construction equipment and stuff, and I have that tinnitus and, trust me, you don’t want anybody to have that. It’s horrible. It’s so loud. When I’m listening to the San Diego Symphony in the Symphony Hall, I hear the ringing in my ears over the symphony.
BRUCE: And there’s nothing I can do to get rid of it. The only time I don’t hear it is when I go down to the beach and I go out on my boogie board and I’m in the waves with the noise around the boogie board.
BRUCE: But other than that, it rings constantly. I sleep with a pillow speaker under my pillow so I can listen to old radio shows or…
BRUCE: …a CD and there’s nothing you can do to get rid of it. I’ve been to a great specialist in Poway and he’s tried all kinds of stuff and there’s just nothing I can do. And it’s not fun. And those vitamins and – that were advertised, I think I know the same ones you saw, the only thing they alleviate is the money out of your wallet.
TORRE: Yeah, that’s…
CAVANAUGH: Bruce, thank you so much.
TORRE: Thanks, Bruce.
CAVANAUGH: And thanks for sharing your story. I appreciate it.
BRUCE: Thank you.
CAVANAUGH: Let’s hear from Sue calling from Santee. Good morning, Sue, and welcome to These Days.
SUE (Caller, Santee): …morning. I wanted to comment or ask Dr. Torre about a website I came across years ago.
SUE: I’m a nurse and I do hearing testing locally in San Diego.
SUE: And there was a website that was put on by retired rock ‘n rollers and they were touting the benefits of turn the volume down.
SUE: It’s damaged our hearing. Do you know what that website is? I’d love to use it at work.
TORRE: You know what, I actually had one of my doctoral students do a survey and he referenced it. It was – I don’t know if it was Rockers for Hearing or something. I can’t remember. Pete Townsend actually started that, guitar player for the Who, and he’s gotten a lot of support. I know the American Academy of Audiology uses him as a spokesperson occasionally. I – I’m sorry, I’m trying to – I’m actually, in my head I’m looking through my students project and I can’t see the writing. I thought it was Rockers for Hearing but I may be wrong so…
CAVANAUGH: Well, we can add it to our website later if you can just tell us…
CAVANAUGH: And that brings me to, I think, the point that probably we should wrap – we should end on, and that is the answer to this is really pretty simple. I mean, what you say basically is turn down the volume.
TORRE: Yeah. I mean, it’s anything. It’s – There’s recreational noise exposure throughout our day, okay? When – Out front, there’s construction, so those guys are mandated by OSHA to wear hearing protection. Whether they do it or not is up to them. But there’s so many different recreational noise exposures. Now, I think that may have been the issue compared to the ’85-’86 data compared to the ones in 2005-2006. There’s so many more recreational noise exposure opportunities—and I got that in light pencil—that you just need to be aware that louder environments, more of them, are going to cause problems earlier. Just you got to moderate. Keep the volume down in all your situations. If you go to a concert, you can still hear the concert wearing earplugs. If you can just reduce some of that input, it’s going to benefit you in the long run. If you don’t need to have your iPod up at maximum volume, keep it at 20, 30%. That’s probably going to benefit you in the long run. All of those things – I mean, cell phone use, you can turn it down, depending on where you’re at. But all of those things are important with respect to just being aware that moderation in these auditory inputs will benefit you in the long run just like any other risk factors for other sensory impairments.
CAVANAUGH: You know, just anecdotally, one of our producers, Megan Burke, said that she went to the gym here on the SDSU campus, and just plugging in the earphones, you know, from the…
TORRE: Yeah, to watch TV.
CAVANAUGH: And the earphones are just – I mean, you have to turn them down. They’re just blasting at about 80.
CAVANAUGH: I mean, what is that? What – 80.
TORRE: Well, I think that’s – I mean, I work out at the ARC also and…
TORRE: …most people are wearing, you know, earphones just to get their mind off their workout, I guess.
TORRE: I don’t know. But in most cases when they’re plugging into the TVs, they’re probably avoiding, I’ll be honest with you, the radio, the background radio. I go early enough in the morning they don’t have it blasting…
TORRE: …but when you have, you know, 150, 200, 300 students in there, the music tends to get up higher so you’re battling with, you know, trying to watch the television set among the students that are working out among the music that’s coming over the loudspeakers. So it’s not surprising that when you go to plug into the auditory function to get to the TVs, it’s on its maximum volume because somebody who wants to hear it has got to fight through that complex listening environment, like we talked about earlier, that’s drowning them out. So…
CAVANAUGH: And that’s that audio overload you were just…
CAVANAUGH: …talking about.
CAVANAUGH: So we got to get our earplugs.
TORRE: Yep. Earplugs to go work out. It doesn’t seem to make sense but…
CAVANAUGH: Thank you so much. I appreciate it.
TORRE: Right. Thank you for having me.
CAVANAUGH: I’ve been speaking with Peter Torre, audiology professor at San Diego State University. We didn’t get to all the callers who wanted to join the conversation so, please, go online and place your comment at KPBS.org/thesedays. Coming up, what you don’t know about San Diego’s urban river. That’s as These Days continues here on KPBS.