In 1962, Rachel Carson’s “Silent Spring” described the harmful effects of insecticides and herbicides on birds, beneficial insects, animals, and humans.  Her book helped start the environmental movement. For too many people, this will be another silent spring, caused not by a dearth of birds but because people can’t hear birds sing. They have hearing loss from another environmental pollutant, noise.

Carson described how nature’s balance controlled pest species naturally, and how these species became problems only when humans changed the environment. She noted the difference between apparent short-term safety of agrichemicals and longer-term danger. People could get sprayed with pesticides or even ingest them without apparent immediate harm, with cancer and birth defects coming later.

If Carson were alive today, she might write about noise pollution, which interferes with animal feeding, communication, mating behaviors, and navigation in forests, fields, and oceans, and causes hearing loss and other medical problems in humans.  In nature’s quiet, animals developed exquisite hearing to find food or avoid being eaten. An owl can find a mouse under a foot of snow, and zebras can hear lions approaching in the veldt.

Humans are also born with excellent hearing.  Brief exposure to loud noise usually doesn’t cause obvious auditory damage in humans, but longer or repeated exposure does. The relationship between noise and hearing loss was first noted in medieval times in bell ringers and miners, then in boilermakers during the industrial revolution.  Noise wasn’t a widespread problem, and except in large cities life was usually quiet.

Industrialization, mechanization, and urbanization made life noisier.  Noise was recognized as a public health hazard in the early days of interstate highways and jet travel, but was also considered an environmental pollutant. In 1972 Congress passed the Noise Pollution and Abatement Act, empowering the Environmental Protection Agency (EPA) to establish noise standards and require noise labeling for consumer and industrial products.

During the Reagan administration, however, Congress defunded EPA noise control activities. Little has been done since to control noise, and our country has gotten noticeably louder. Sound levels of 90-100 decibels or louder are reported in restaurants, clubs, retail stores, movie theaters, gyms, sports events, concerts, and parties, from sirens, vehicles, landscape maintenance equipment, and construction, and for those using personal music players.

The National Institutes of Health states that prolonged exposure to noise at or above 85 decibels can cause hearing loss. This is misleading, because no exposure time is given and hearing damage occurs at much lower levels. The 85-decibel standard is an occupational noise exposure standard, not a safe noise level for the public.. The EPA adjusted the occupational standard for additional noise exposure outside the workplace to calculate the noise level for preventing hearing loss to be a daily time-weighted average of only 70 decibels.

Hearing is the social sense, required for spoken communication. About 40 million American adults age 20-69 have noise induced hearing loss, half of them without noisy jobs. Why is this happening? They are exposed to loud everyday noise.  Cumulative noise exposure eventually causes hearing loss, affecting 25% of those in their 60s, half in their 70s, and 80% in their 80s, and is correlated with social isolation, depression, dementia, falls, and mortality. Due to denial, stigma, and cost only 20% of older Americans with hearing loss acquire hearing aids, after an average seven year delay, and 40% of people with hearing aids don’t use them much, largely because hearing aids don’t help users understand speech well in noisy environments.

Preventing noise-induced hearing loss is simple: avoid loud noise. If it sounds too loud, it is too loud. Free or inexpensive smart phone sound meter apps make it easy to measure sound levels, but if one can’t converse without straining to speak or to be heard, ambient noise is above the auditory injury threshold of 75-78 decibels and auditory damage is occurring.

A quieter world is easily attainable. Whisper-quiet dishwashers, cars with quiet interiors and exhausts, the Airbus A380, and a few quiet restaurants and stores prove this.   Effective noise control technologies have long existed, including noise reduction via design and material specifications and sound insulating, isolating, reflecting, diffusing, or absorbing techniques.  Indoors, all that may be necessary is turning down the background music volume, which costs nothing.

In the 1950s and 1960s, half of all American men smoked and public spaces and workplaces were filled with tobacco smoke. When research showed that tobacco smoke caused cancer and heart disease, governments restricted smoking, leading eventually to today’s largely smoke-free society. Smokers can still smoke, but can’t expose others involuntarily to their smoke.

Noise causes hearing loss. Governments should set and enforce indoor and outdoor noise standards, to reduce each person’s daily noise dose. Adults have the right to make and listen to all the noise they want, but not where others can hear them. If we can breathe smoke-free air, we can make a quieter world, so future generations won’t have to endure another silent spring.

By Daniel Fink, MD, Chair, The Quiet Coalition

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