Loud Noises and Children

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http://www.sfgate.com/cgi-bin/article.cgi?file=/c/a/2010/03/07/MN7E1C9CIG.DTL
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Sunday, March 7, 2010 (SF Chronicle)
Loud noises pose hearing-loss risk to kids
Joyce Cohen, New York Times

For football fans, the indelible image of last month’s Super Bowl might
have been quarterback Drew Brees’ fourth-quarter touchdown pass that put
the New Orleans Saints ahead for good. But for audiologists around the
nation, the highlight came after the game – when Brees, in a shower of
confetti, held aloft his 1-year-old son, Baylen.
The boy was wearing what looked like the headphones worn by his father’s
coaches on the sideline, but they were actually low-cost, low-tech
earmuffs meant to protect his hearing from the stadium’s roar.
Specialists say such safeguards are critical for young ears in a deafening
world. Hearing loss from exposure to loud noises is cumulative and
irreversible; if such exposure starts in infancy, children can live “half
their lives with hearing loss,” said Brian Fligor, director of diagnostic
audiology at Children’s Hospital Boston.
“This message needs to be conveyed to parents over and over again,” Fligor
said. “If a child attends only one loud sporting event, it isn’t a big
deal. But for those kids who will be going to football games throughout
their lives, as Drew Brees’ kids will, it’s a very big deal. A young,
tender ear may not be able to withstand damage.”
According to the National Institute for Occupational Safety and Health,
more than 15 minutes of exposure to 100 decibels is unsafe. The noise in a
football stadium can reach 100 to 130 decibels.
And noise that is potentially dangerous to an adult is even more dangerous
to a child, said Levi Reiter, head of the audiology program at Hofstra
University, who also has a private audiology practice in Brooklyn, N.Y.
Because a young child’s ear canal is much smaller than an older child’s or
an adult’s, Reiter said, the sound pressure entering the ear is greater.
An infant might perceive a sound as 20 decibels louder than an older child
or an adult. The shorter length of the ear canal increases dangerous noise
levels in the higher frequencies, which are crucial to language
development.
Awareness of the problem is spotty, audiologists say. Even if concertgoers
know about damage from loud music, few children are wearing protective
gear at sporting events, parades or fireworks displays, or around
high-decibel motorcycles and snowmobiles.
It’s a hard message to convey. Hearing loss, which accumulates slowly over
a lifetime, is neither painful nor disfiguring, so it goes unnoticed.
Stephen Glasser, an audiologist in Great Neck, N.Y., says the stigma
attached to hearing aids – often considered a sign of age or weakness -
seems to carry over to hearing protection.
And while adults may be able to escape from uncomfortably loud noise,
“when you are a toddler in your parents’ arms or a stroller, you can’t
walk away,” said Nancy Nadler, assistant executive director of the Center
for Hearing and Communication, formerly the League for the Hard of
Hearing. Nor are they likely to articulate it if they are feeling
aftereffects of loud noise exposure, which include sensations of fullness
or muffling, or the ringing sounds known as tinnitus.
But protecting the hearing of very young children is not easy. Earplugs
are too big for tiny ear canals and too easy to put into the mouth, where
they pose a risk of choking. They are also hard to insert – even adults do
not always insert their own earplugs correctly.
Enter protective headgear, like the earmuffs worn by Baylen Brees. Sold by
a number of companies (Baylen’s came from Peltor), they include
lightweight foam-filled ear cups, weigh less than half a pound and
typically cost $20 to $30.
Most are not meant for infants, but Baby Banz sells earmuffs for babies 6
months and older. Though they are adjustable, they may still be too loose
for younger babies, said Shari Murphy, the company’s North American
operations manager, adding that earmuff sales rose 40 percent after the
Super Bowl.
More than half of customers have special needs, like autism or sensory
disorders, Murphy said. For other children, the purchasers are typically
grandparents, who sometimes say that their grandchildren cover their ears
at fireworks or air shows, or that they themselves suffer from hearing
loss.
The use of hearing protection “can make the experience enjoyable instead
of having the baby crying and you don’t know why,” said Nadler.
Often, she added, limiting a child’s noise exposure is a matter of common
sense. It might be best to leave the baby home with a sitter.
“We need to look at noise as something that is dangerous,” Nadler said,
“like sharp tools or a hot stove.”

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Copyright 2010 SF Chronicle

March 11, 2010 · Posted in Hearing Loss

Diabetes Risk Test

American Diabetes Association
Alert Day

March 7, 2010

none We’re doing our part to stop diabetes! This year, for the first time ever, BHI is participating in the American Diabetes Association Alert Day—a one-day, “wake-up” call asking the American public – “What will you do to Stop DiabetesSM? Know your risk.” Held on the fourth Tuesday of every March, the 22nd annual Diabetes Alert Day is scheduled for Tuesday, March 23, 2010.

BHI is urging hearing health professionals across the country to join us in the Stop Diabetes movement. By encouraging hearing health patients to take the Diabetes Risk Test, the hearing health community can help save lives. The Diabetes Risk Test, created by the American Diabetes Association, asks users to answer simple questions about weight, age, family history, and other potential risks for pre-diabetes or type 2 diabetes. The test shows users whether they are at low, moderate, or high risk for type 2 diabetes. If they are at high risk, they are encouraged to talk with their health care provider.

Hearing loss is about twice as common in adults with diabetes compared to those who do not have the disease, according to a study funded by the National Institutes of Health (NIH). Yet hearing screenings typically are not part of the regular regimen of care that people with diabetes are routinely recommended to receive. Nor do the vast majority of doctors in today’s health care system include hearing health as a routine part of annual exams, leaving people with diabetes all the more vulnerable to the negative impact that unaddressed hearing loss has on an individual’s life.

Diabetes is a serious disease that threatens the lives of far too many Americans. While diabetes already strikes nearly 24 million children and adults in the United States, an additional 57 million, or one in five Americans, have pre-diabetes and are at high risk for developing type 2 diabetes.

BHI believes strongly that it is important that the hearing healthcare community become increasingly involved in diabetes outreach efforts. Until the day that we can stop diabetes altogether, let’s do what we can to make a meaningful difference in the lives of people with this disease by educating them on how they can identify and address diabetes-related hearing loss and take action to better preserve both their health and quality of life.

There are several ways you can participate in American Diabetes Alert Day. Here are just some ideas:

Organize a hearing screening in your community on March 23, Diabetes Alert Day, encouraging visitors to take the Diabetes Risk Test as well as to get their hearing tested.

Host a health fair and team up with other healthcare professionals.

Host a walk or run in your community.

Disseminate Diabetes Alert Day and hearing health information, including English and Spanish versions of the Diabetes Risk Test and the Diabetes Alert Day Backgrounder.

Issue a customized press release and share our BHI diabetes and hearing loss backgrounder facts – http://www.betterhearing.org/professionals/tools.cfm (Under the title ADA Stop Diabetes Campaign).

Send information through listservs.

Hang posters in prominent locations such as your office, library, local mall, or church.

Include a Diabetes Alert Day banner on your web site.

Include an article on Diabetes Alert Day in your newsletter, on your web site, or as a handout in your office.

Include a BHI article on diabetes and hearing health in your newsletter, on your web site, or as a handout in your office—or send it to your local newspaper for publication.

To download materials on American Diabetes Association Alert Day, visit http://www.diabetes.org/community-events/programs/alert-day/

To download BHI press information on the American Diabetes Association Alert day, visit http://www.betterhearing.org/professionals/tools.cfm (Under ADA Stop Diabetes Campaign)

March 9, 2010 · Posted in Hearing Loss

Ear Candles Bad?

I personally have seen ear candles in action and they do not work! I have seen 3 cerumen(wax) impacted ears on the video otoscope and then candles were used on all 3 people. The end result, all 3 ears were still impacted, and to top it off they now had burnt candle ash on top of their impaction. This is a pretty good article, but nothing compares from seeing this up close and personal. Be afraid, very afraid!

Don’t Get Burned: Stay Away From Ear Candles

A lit “candle” that can drip hot wax into your ear, usually as you lie on your side.

Sound dangerous? The Food and Drug Administration (FDA) thinks so, and is warning consumers to steer clear of products being sold as ear candles.

These “candles”—hollow cones that are about 10 inches long and made from a fabric tube soaked in beeswax, paraffin, or a mixture of the two—are being marketed as treatments for a variety of conditions. These conditions include ear wax buildup, sinus infections, hearing loss, headaches, colds, flu, and sore throats.

Marketers of ear candles claim that warmth created by the lit device produces suction that draws wax and other impurities out of the ear canal.

“Some ear candles are offered as products that purify the blood, strengthen the brain, or even ‘cure’ cancer,” says Eric Mann, M.D., Ph.D., clinical deputy director of FDA’s Division of Ophthalmic, Neurological, and Ear, Nose, and Throat Devices.

He adds that some firms claim the candles are appropriate for use on children.

But FDA warns that ear candles can cause serious injuries, even when used in accordance to manufacturers’ directions. “Also,” says Mann, “FDA believes that there is no valid scientific evidence for any medical benefit from their use.”

Burns and Other Risks

Mann says that ear candling—the procedure is also called “ear coning” and “thermal auricular therapy”—exposes the recipient to risks such as

starting a fire
burns to the face, ear canal, eardrum, and middle ear
injury to the ear from dripping wax
ears plugged by candle wax
bleeding
puncture of the eardrum
delay in seeking needed medical care for underlying conditions such as sinus and ear infections, hearing loss, cancer, and temporomandibular joint (TMJ) disorders. (TMJ disorders often cause headache and painful sensations in the area of the ear, jaw, and face).

Even many promoters of ear candles warn potential users to have the procedure done by an experienced “candler,” and to not use the candles on themselves.

Ear candling involves placing the candle in the outer ear, usually while the recipient lies on his or her side. It is also done with the recipient sitting upright.

Often, before being lit, the candle is placed through a hole located in the center of a plate. The plate is supposed to protect against hot wax or ash coming down the side of the device and onto the recipient.

Enforcement

FDA and the Canadian health regulatory agency Health Canada have acted against manufacturers of ear candles. These actions have included import alerts, seizures, injunctions, and warning letters. FDA import alerts identify products that are suspected of violating the law so that agency field personnel and U.S. Customs and Border Protection staff can stop these entries at the border prior to distribution in the United States.

In February 2010, FDA issued warning letters to three large manufacturers of ear candles. These firms were informed that FDA had determined that there was no agency approval or clearance, no manufacturing facility registration or device listing, and no adverse-event reporting systems in place in regard to their ear candles.

FDA will continue to take enforcement action when appropriate.

Concern for Children

Claims that ear candling is appropriate for kids have caused great concern at FDA. “Children of any age, including babies, are at increased risk for injuries and complications if they are exposed to ear candles,” says Mann.

He adds that small children and infants may move while the device is being used, increasing the likelihood of wax burns and ear candle wax plugging the ear canal. “Also, their smaller ear canal size may make children more susceptible than adults to injuries from ear candles,” he says.

Since FDA views ear candles as medical devices, manufacturers seeking approval to sell them must submit evidence to FDA that the products are safe and effective.

Reports of Injuries

FDA believes that injuries associated with ear candles are likely underreported, and encourages consumers and health care professionals to report such injuries to FDA’s MedWatch Adverse Event Reporting program⁴.

Over the past decade, FDA has received reports of burns, punctured eardrums, and blockage of the ear canal which required outpatient surgery from the use of ear candles.

In its testing, Health Canada found that ear candles produce no measurable effect in the ear and have no therapeutic value.

And in a survey published in 1996, the medical journal Laryngoscope reported 13 cases of burns of the ear, seven cases of ear canal blockage due to wax, and one case of a punctured eardrum.

That study also reported that ear candles produced no measurable vacuum pressure or suction on a model of the ear, and that burning ear candles dripped candle wax onto the eardrum of test subjects and of the ear model.

This article appears on FDA’s Consumer Updates page⁵, which features the latest on all FDA-regulated products.

Date Posted: February 18, 2010

For More Information

March 2, 2010 · Posted in Hearing Loss