Listen Up! Childhood Noise Exposure and Hearing Loss

Exposure to loud noise is a common cause of hearing loss. When we think of noise-induced hearing loss (NIHL) we often think of very loud noises with long term exposures in adults; like a near-deaf ex-rocker who played way too many concerts in front of the amplifier, or the construction worker who regularly operates a jackhammer on the job. But there is increasing evidence that childhood noise exposures may be associated with early hearing loss. This should get parents to prick up their ears and pay attention!

What exactly is noise-induced hearing loss?
NIHL is a well-documented phenomenon that results from damage to the delicate “hair cells” in the cochlea that convert sounds from the outside world into signals to the brain. When that signal reaches the brain, it registers as noise. With repeated loud noise exposure over time, damage to the hair cells becomes irreversible. This is how noise-induced hearing loss works.

Can kids get NIHL?
Studies from 1988-2004 found that as many as 15% of kids in the U.S. ages 6-19 have some level of hearing loss. In 2006, this number was reported to have risen to 20%. That means almost 1 in 5 kids in America has a measurable amount of hearing loss. Kids and parents alike may not always notice these changes immediately, but these studies provide evidence that measurable levels of hearing loss are occurring in a large number of children at a very early age.

What are the implications of hearing loss in childhood?
Normal hearing during childhood is incredibly important, and reduced hearing at an early age can have a profound impact on your child. Even mild hearing loss in young children can impair speech and language development significantly. This can often lead to decreased educational achievement and even contribute to impaired social and emotional development.

How can I tell if my child is having hearing loss?
If you are worried that your child may have hearing loss, you should speak with your child’s doctor about your concerns. The doctor may want to perform a hearing exam in the office or may order testing with a hearing specialist with audiometry.

How can I reduce the risk of noise-induced hearing loss in my child?
Unfortunately, loud noises are all around us. While it is important to be vigilant about how much noise your children are being exposed to, there is no way to completely eliminate loud noise exposures. However, one commonly identified source of repeated loud noise exposure that is likely contributing to the rise in noise-induced hearing loss among kids is personal media devices such as I-Pods and cellular phones. Children have increasing access to these devices and often use earphones to listen to music or play games. Cutting back on the amount of “earphone time” and having your child take earphone breaks every 15-20 minutes may reduce their risk. Also, pay attention to the volume level. You may be able to significantly reduce your child’s loud noise exposure by having them turn down the volume.

How loud is too loud?
The exact level of noise that can cause hearing damage is variable. Noise-induced hearing loss often results from loud noise exposure over a period of time. Therefore, long exposures at lower noise levels may wreak as much havoc as shorter exposures to louder noises. Kids should not be exposed to noise levels above 85 decibels for prolonged periods. The higher the decibel range, the louder the noise, and the more likely it is to cause damage to the cochlear hair cells resulting in hearing loss.

References:
1. RV Harrison. Noise-induced hearing loss in children: A ‘less than silent’ environmental danger. Paediatr Child Health 2008;13(5):377-382.
2. Niskar AS, Kieszak SM, Holmes AE, Esteban E, Rubin C, Brody DJ. Estimated prevalence of noise induced threshold shifts among children 6 to 19 years of age: The third National Health and Nutrition Examination Survey, 1998-1994, United States. Pediatrics 2001;108:40-3.
3. Blair J, Peterson ME, Viehweg SH. The effects of mild sensorineural hearing loss on academic performance of young school-age children. Volta Review.
1985;87:87-93.

May 2015. This post was authored by Zachary Crees, University of Illinois medical student and Susan Buchanan, MD, MPH, Director of the Great Lakes Center for Children’s Environmental Health – Region 5 Pediatric Environmental Health Specialty Unit (PEHSU).

Read this post: CO kills

What is carbon monoxide?
Carbon monoxide (CO) is a gas made from the inefficient burning of carbon-based fuels like coal, wood, oil, propane, and natural gas. Your risk of exposure increases if these fuels are burned in small spaces with improper ventilation such as in garages or basement rooms.

How do I know if I’m exposed?
It’s difficult to tell if you’re being exposed to CO because it has no color or scent and is not irritating to your nose, mouth, or throat. So, it’s impossible to tell that you’re breathing it. CO poisoning is more common in winter months because it’s produced by heaters and can accumulate indoors. CO poisoning is responsible for 40,000 Emergency Department visits and 5,000-6,000 deaths each year, making it one of the most common poisons.

How does CO work?
Hemoglobin is a protein in your blood which is responsible for shuttling oxygen to all the cells in your body. Unfortunately, CO is very easily absorbed through the lungs and binds hemoglobin more readily than oxygen, so the blood carries CO instead of oxygen to the tissues. This results in a state of oxygen deprivation at the cellular level. Mild-to-moderate CO poisoning can cause general symptoms such as headache, nausea, and dizziness. Infants and toddlers, who are unable to vocalize their complaints, may only have fussiness or difficulty feeding. CO poisoning can also occasionally cause a “cherry red” discoloration of the lips and skin. More severe poisoning can cause confusion, heart rhythm problems, fluid buildup in the lungs, or loss of consciousness, followed by death.

How do I prevent CO poisoning?
The best way to avoid CO poisoning is to minimize the chance of it entering your environment in the first place. It is essential to not run fuel-burning heaters, equipment in enclosed spaces such as garages or poorly ventilated rooms.

Some appliances which produce CO are used inside homes routinely, like gas fireplaces and boilers. It’s important to make sure they are installed and operated according to manufacturer instructions or installed and maintained by professionals. It is also essential to never cover the safety mechanisms used to vent fumes. Make sure vents and chimneys are not blocked and that the bottom of natural gas or propane ovens remain uncovered.

To prevent exposure from CO leaks it is very important to install functional CO alarms throughout your living space, including in hallways and near bedrooms. CO alarms should always be compliant with the requirements set forth by the UL 2034 safety standard.

Lastly, if you feel you are being exposed to CO you should leave the area immediately, make sure everyone else has left, and seek fresh air. Call the fire department to report the leak. And if you are experiencing symptoms, call 911.

Additional resources:

http://www.cpsc.gov/en/Safety-Education/Safety-Education-Centers/Carbon-Monoxide-Information-Center/Carbon-Monoxide-Questions-and-Answers-/

http://www.safekids.org/safetytips/field_risks/carbon-monoxide

April 2015. This post was authored by Saad Arain, University of Illinois at Chicago medical student and Susan Buchanan, MD, MPH, Director of the Great Lakes Center for Children’s Environmental Health – Region 5 Pediatric Environmental Health Specialty Unit (PEHSU).

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