Hearing Protection and Listening Safety

If you are an Audiophile, save your ears

If you are an Audiophile, then you are probably familiar with the years of hard work and stress your ears go through. Continual music and sound effects and many other diegetic sounds (voices of characters, sounds made by objects in the story, music represented as coming from instruments in the story space) or actual real-life sounds eventually take a toll on our ears. Researchers found that 18 to 33 percent French horn players under the age of 40 had noise-related hearing loss. Only 20 percent of musicians surveyed used any sort of ear protection, and very few used it 100 percent of the time. Within our own group of non-musician audiophiles who enjoy their home theater or attending concerts, the percentage is the same or worse.

Checkout our recent Youtube video were we discuss safe daily listening doses to preserve your hearing.

When Is it Too Loud YouTube Video Discussion

What Happens with Hearing Loss?

It all begins with a few doses of temporary hearing dullness when your ear is exposed to extremely loud sounds. This is called concert cacophony and it’s controlled by the cochlea to protect your hearing. The cochlea produces the hormone ATP, which is directly related to the hearing loss caused by exposure to this type of loud sound. There are people with mutation to this gene that controls this ATP production in the cochlea and sadly they have a higher risk of hearing loss in their later years.  Of course, if someone is repeatedly exposed to extremely loud sounds then it’s another story since it will eventually lead to high frequency hearing loss and worse, speech intelligibility issues. The same goes for chronic use of louder than needed headphone and many other personal hearing entertainment devices. Our bodies have safeguards that turn on during acute trauma. However, over time the body is not able to understand or compensate for the constant hammering of increased high levels of sound, resulting in hearing loss. There are always exceptions to the rules since some people are more sensitive to sound than others or genetically predisposed to familial hearing loss.

There are also cases in which either hearing loss or hearing trauma occurs. Both can be a result of chronic high frequency sound exposures, brain trauma, or disease pathways that affect your hearing. Some of these are: head trauma in accidents (called post-traumatic hearing loss), noise-induced hearing loss, ear and sinus infections, diseases of the heart and blood vessels, thyroid issues, brain tumors, brain surgery, medications, thyroid abnormalities and more. The most common issue from all these causatives is tinnitus. For those not familiar with tinnitus, according to the NIDCD (National Institute of Deafness and Other Communication Disorders), tinnitus is commonly described as a ringing in the ears, but it also can sound like roaring, clicking, hissing, or buzzing. It may be soft or loud, high-pitched or low-pitched. It may occur in either one or both ears. Roughly 10 percent of the adult population of the United States has experienced tinnitus lasting at least five minutes in the past year, amounting to nearly 30 million Americans.

Starkey Hearing Foundation is an association that promotes both the resolution of hearing problems and hearing protection. Their Listen Carefully campaign is designed to raise awareness about noise-induced hearing loss and prevents a hearing loss epidemic. They focus on the fact that currently, one in six American teens has hearing loss from loud sounds. “It is irreversible, but it’s also preventable,” is the main thrust of its campaign. Audibel is a Starkey Hearing Technologies brand. Recognized across the globe as a premier provider of hearing healthcare, Starkey Hearing Technologies is the only privately-held American-owned company in its industry. Audibel focuses both on hearing loss prevention and resolving issues due to hearing loss. Hearing loss not only affects the ability to “hear” your surroundings, but it affects the brain’s ability to recognize words, which in turn affects mental sharpness, communications and safety around your environment. 

There are a few ways that Audiophiles and the general public can start preventing this devastating noise-induced hearing loss. The most obvious would be general-use earplugs and musician earplugs, which can be customized for a tighter fit. Most of these earplugs, especially Audibel’s Custom Hock Noise Brakers (HNB) focus on filtering high frequency noise that can give you 9, 12 or 25 dB of attenuation. They allow low and mid frequency sound to get through, so the ability to decipher speech is preserved. However, since they don't attenuate all frequencies equally, they are NOT true musician earplugs.

Check out the following frequency attenuation chart for details.

Testing was performed in accordance with The American National Standards Institute (ANSI). A copy of the full report is available upon request. All numbers (unless otherwise noted) are in decibels (dB).

Note:  Research from "Study of Noise and Hearing in Jute Weaving" (Taylor,Pearson and Mair, JASA 1964) revealed workers from 14 different jute mills who have been exposed to relatively constant machine noise for up to 25 years all exhibited hearing loss most prominent in the 4kHz range where our ears are most sensitive.  It's very important when choosing hearing protection for such situations that your devices provide maximum attenuation in this region.  As you can see in the above ANSI attenuation table, the Audibel devices do just that with a mean attenuation of 41.1 dB at 4kHz.

Editorial Note about Musician Earplugs

If true musician earplugs are desired, one should look for a product that reduces the sound level without altering the frequency spectrum.  Etymotic is a USA based company that invented musicians' earplugs.

If you look at the Etymotic info, you will see several different designs. The 15 dB units are a good model to look into because they just turn the volume down leaving the sound quality pretty much alone - that is what musician's need. More aggressive attention is offered for those exposed to extreme sound levels (> 100dB) such as loud amplified concert venues.

Audioholics had the opportunity to test these earplugs from Audibel giving us the chance to help out one of our female audiophiles, yours truly. I am currently suffering from a meningioma and post-craniotomy-induced hyperacusis (sensitivity to sounds) and tinnitus. During this process, the audiology department ran a conventional as well as sensitivity tonality tests to determine my hearing sensitivity level and then which sounds I was the most sensitive to. Take a look at the test results below:

Hearing Test Results for Berta - Notice the extreme sensitivity in the 3kHz and 8kHz regions.

The frequency response tests above show Berta's extreme sensitivity most prominent in the left ear (blue trace) near where her trauma occurred as a result of the Craniotomy. 

From this test it was concluded that there were two different products needed. For the hypersensitivity, the first one was the custom fit earplugs which provide 22.05 dB of attenuation. These are best used during “loud” circumstances such as movies, concerts or extremely loud environmental noise, like constant heavy traffic, construction, close proximity to loud machinery/fans/ventilation, etc. The second set of custom fit earplugs with a high frequency filter, which works best for loud high-pitched sounds (like babies crying) and loud conversation of many people at once. These earplugs are made of hypoallergenic silicone and are customized to the person’s ear canal. The process is painless and once the filler is inserted in the ear canal, it takes about 10-15 minutes for it to dry, then it’s pulled out and sent to the lab for manufacturing. See picture below.

Once the earplugs are back at the office, they are fit-tested once again to make sure they are comfortable and giving the appropriate coverage. They are easy to use, they are color-coded (blue for left ear and red for right ear), easy to clean with either alcohol or soap and water (let dry overnight). Special plant oils are provided for a comfortable fit as well as a better seal in the ear canal. We recommend its use. Audioholics performed a short case study to evaluate the immediate effect of these custom fit earplugs.

Berta and Gene getting fitted for custom ear plugs - courtesy of Audibel

The earplugs with the 22.05dB attenuation have been used for the past 1.2 years, in different settings such as restaurants, family gatherings and even at the movies (the new “Star Wars” Episode VII). The earplugs’ attenuation did in fact help relieve the mind and body from the negative effects of hypersensitivity, such as nausea, headache, nervousness and fear and anxiety. It was much easier to tolerate crowds of people talking, as well as reducing the annoyance of surrounding noises such as intrusive background music in a restaurant or nearby traffic. Speech remained easily recognizable, as long as you were not eating or drinking while wearing the device, otherwise your own chewing and sipping sounds became prominent.

As you know if you’ve worn any type of hearing protection devices in the past, you might feel that you are speaking more softly than everyone else, so your own tone and volume can be hard to discern while wearing the earplugs. But overall, it’s well worth it, since the sound of crying infants, crowded rooms full of conversation, high background noise levels, etc. all become much more manageable. Attending loud public events is much easier and more comfortable. Plus, these earplugs are small and don’t bulky in the ear canal.

Custom Fitted Audibel Earplugs

Pricewise, they fall into the $150 to the $300 dollar range, depending on what is needed. Both earplugs are pretty easy to use and not a bother while using, especially the smaller ones. If you want to make a real statement, then customization of colors can be done for an extra charge. The best part of all, a small pull out mechanism is attached to the earpieces for easy removal. Just one quick pull and out they come.  

Dealing with Hyperacusis

Hyperacusis was only one of my side effects from my brain trauma. Tinnitus was its counterpart. As explained before, tinnitus can have different ranges and sounds, and it affects either one or both sides of the brain. As explained by the neuro-otologist (Neuro Ear-Nose and Throat specialist) trauma to the brain, can cause fibrosis in the brain undetected sometimes by an MRI. In this case, the brain tissue had scarring on left side around the remaining tumor that couldn’t be removed. This scar tissue causes irritation and consequent inflammation of the brain, causing misfiring and signal degradation. The solution is not so simple and tinnitus is still a topic of much studying and research. No true answers exist as to why or how to actually fix the problem. The only thing to do is to deal with the consequences and treat them as well as we can.

In many cases of severe, constant and chronic tinnitus, biofeedback (relaxation, counseling and hypnotism), sleeping and calming medication are used to help the brain heal and decrease the inflammation and irritation. With this, many patients feel that they are able decrease the effects and deal with the tinnitus. For some people, more immediate action is required. For them, the answer can be sound therapy. The American Tinnitus Association recommends that tinnitus sufferers seek the expert care of a Neruo-ENT specializing in this field. 

How does this sound therapy work? The aim is to help mask or make the tinnitus less noticeable. This therapy does not in any way affect one’s hearing abilities nor is it an impediment to the enjoyment of music.  During our short-term study, the relaxation that this device brings actually helps the subject to focus and enjoy the music, movies and everyday activities better.

They way sound therapy is accomplished is via a hearing aid device—but it is not a regular hearing aid. It is comprised of built-in technology for tinnitus relief using the idea of white noise. You probably used these types of sounds to help you go to sleep at night. Many Apps or devices are now available to the general public using white noise, rain or humming sounds to help you unwind and activate the sleep centers.  Regular hearing aids with sound amplification can help some cases of tinnitus, but often, that alone is not enough. The device we are testing is a Combined Multiflex Tinnitus Technology, the Audibel A2 hearing aids. This device plays white noise at a frequency that is measured during the hearing and tinnitus testing. The device is then calibrated to the frequency needs of the specific user and its setting can be adjusted throughout the process to better accommodate and help mask the tinnitus. The audiologist or technician can adjust the sound frequency and modulation to match the subject’s unique tinnitus. These are programmed into the SoundPoint tool and programmed into the device during the final fitting. Once the device is calibrated and adjusted, you can access all four levels with the touch of a finger. The hearing device is set up to adjust multimemory and tinnitus stimulus. You can adjust the four included multi-memory program by accessing the multi-function touch sensitive switch in the back of the device by pressing until the desired level is reached. The tinnitus stimulus is similarly reached, but you press and hold until the device cycles through the level, find the desired one and then release.

Audibel A2 Hearing Aid

Using the Audibel A2, it takes a few days to get used to having an external object inside your ear drum for prolonged times. However, this device is so small that it’s easy to hide the cord and cable behind the ear.  The battery compartment is tamper-resistant but easy to open and close. The battery easily pops out, but also stays tightly in place once closed. The apparatus is color-coded (red and blue as mentioned before), and it plays a beeping sound so you can find the tinnitus stimulus you need. The Instant Fit ear bud easily access the ear canal and snugs into place while the retention lock (on the outside of the ear bud) makes sue it stays put and away from “prying eyes.” Once inside, it plays a ring and the white noise fun starts.

A New Sense of Hope

Over the course of a year, the capabilities of this piece are still being tested. When the ear device was first used, there was immediate relief of my tinnitus and also a sense of relaxation.  The ease of accessing without looking the four different customized levels with the touch of the finger and hearing the levels was very convenient. This model is configured to the point that one level has absolutely no amplification and the other three levels of amplifications are appropriately modest ,since without any amplification the surrounding sounds and the person’s own speech level would be too high and create an issue with the hypersensitivity and muffled sounding speech.  Once this was fixed, the right fit was found. This device is extremely helpful in everyday tasks, especially one very important one: Sleeping!  Without this device, I found sleep to be very difficult task and fatigue would set in, exacerbating the tinnitus. This particular device’s white noise makes it sound much like a low wave in the ocean with the same pattern of high and low. Think of yourself at the beach listening to just the waves coming and going into the sand. Once you get used to enjoying that, then you can pay close attention to your other surroundings. That’s the easiest way to explain it.

The best part is that this device is also really easy to pull out by using the retention lock and dislodging the earbud from the ear canal. Maintaining it is also easy, since when it’s not being used during the day, you can open up the battery compartment and let it “air out,” as well as regularly cleaning it with the included mini brush or a soft cloth, around the switches, microphone, and battery compartment. Inspecting and maintaining the device as instructed definitely increases the longevity of this device.  The benefits this hearing device brings to tinnitus sufferers, especially if they have hearing damage as well, is unique and a plus in their lives. Not having to deal with ringing, noise or weird sounds in your head that only you can hear is a miracle of technology. Audibel really went above and beyond to provide this product for my specific needs. They continue to monitor its effectiveness, proper functioning and any issues that the device might have in the long run.  They also have provided me with complimentary ear buds and the hearing device itself, since their mantra is to bring hearing aids to the needy especially if their insurance does not cover them. Audibel is from the Starkey Hearing Foundation and they have provided more than one million hearing aids to people in need worldwide and is committed to providing one million more this decade. The tinnitus relief device itself has a cost in the $5,000 range, but most insurance only cover a percentage of the cost.

Audioholics strives to help educate its loyal readership and whenever possible through our research, give our consumers valuable information, so everyone can achieve their goal of enjoying the best audio. Just remember, you can’t enjoy great audio if you don’t take care of your hearing.

Bibliography

http://filmsound.org/terminology/diegetic.htm

http://optimalhearing.com/blog/hearing-loss-music-connection/

http://www.eurekalert.org/pub_releases/2013-04/uons-ccs041213.php

http://www.nidcd.nih.gov/health/hearing/pages/tinnitus.aspx

http://www.audibel.com/hearing-aids

http://www.audibel.com/hearing-aids/technologies/a2-tinnitus