Infants and Children/Noise/Hearing Loss

A memorable highlight of 2010 Super Bowl XLIV between Green Bay and New Orleans occurred after the game ended, and had little to do with whom you rooted for or who won (New Orleans). During the victory celebration on the field, the winning quarterback, Drew Brees, held his infant son high in the air amid the roar of tens of thousands of screaming fans. What made this gesture memorable were the large noise-reducing earmuffs the infant was wearing. The earmuffs made Brees (the elder) a super hero for hearing health professionals, and made Brees (the infant) a poster boy. 

1. Excessive noise is especially hazardous for young children. It does to hearing what tobacco smoke does to lungs and the sun to skin: cumulative damage for life, irreversible and untreatable. Young children have more potential years of noise exposure ahead of them than older children and adults, making prevention more important. Their ear canals are smaller and sound pressure entering the ear is greater. This increases noise levels at the higher frequencies, the frequencies crucial to language development. Noise is a leading cause of hearing loss. Statistics suggest that the incidence of hearing loss is increasing and occurring at younger ages.  According to the American Academy of Otolaryngology, three million individuals under the age of 18 have some kind of hearing difficulty.

2. How loud is too loud? The loudness of a sound is measured in decibels (dB). Zero dB is the softest sound the normal human ear can hear. Generally, sound above 85 dB is considered harmful. Normal conversation is about 60 dB. The longer the exposure to loud noise, the greater the risk of damage. More than 15 minutes of exposure to 100 dB is unsafe. Genetic and other determinants make some individuals more vulnerable than others.

3. Infants cannot articulate discomfort from noise. Older children and adults have the option of covering their ears or distancing themselves from excessive noise. Warning signs are discomfort and pain or ringing in their ears. Assume that crying infants in noisy surroundings may be reacting to noise and remove them from the situation.

4. Many travel and outdoor activities produce excessive noise.  The noise in a football stadium can reach 100 to 130 dB. Amusement park rides, snowmobiles, and aircraft engines are other sources. See the table below for the decibels of various noises. 
 

5. Listen to toys before purchasing them. Some produce excessive sound. And young children’s arms are relatively short, so they hold objects closer to their heads than do adults – and some children like to hold noise-making objects up to their ears. There are rattles at noise levels of 110 dB; drums and horns, 120 dB; toy phones, 125dB; and toy guns, 150 dB. There are almost no regulations that address the loudness of toys.

6. Excessive noise affects health and behavior. Children living near airport runways are more likely to have hearing deficits than children living in quiet neighborhoods. Hearing deficits, even very mild ones, subtly interfere with language acquisition, reading and learning skills, and social interactions. Hearing deficits increase the likelihood of behavior problems in class and of problems with cognitive and emotional development.

7. Avoidance is the best way to protect young children’s hearing. But most cases of noise-induced hearing loss are caused by repeated exposure to moderate levels of noise over many years, the kind that are difficult to prevent – traffic and industrial sources, for example. Reducing exposure generally requires action by local governmental authorities.

8. Earplugs are generally ineffective in young children. It is difficult to place earplugs into infants’ small ear canals and to make them form an airtight fit. And earplugs often fall out. Moreover, many infants seem to find them uncomfortable and remove them. Earplugs are a choking hazard for small children. One available alternative is an “ear band,” which goes around the head and over the ears to keep earplugs in place.

9. Specialized earplugs are available for air travel. Makers of such earplugs claim that the plugs not only reduce noise but also minimize earaches caused by the rapid changes in atmospheric pressure as aircraft ascend and descend. These earplugs slow the movement of air into and out of the outer ear, giving the inner ear more time to adjust to the pressure changes. Models are available for children as young as one year of age. Many parents say that these earplugs suffer from the same problems as do regular earplugs (tip #8).

10. Noise-reducing earmuffs offer the best solution. Young children seem to prefer earmuffs to earplugs; many seem to actually enjoy wearing them. They are lightweight, can be adjusted, have wide, foam-filled cushions to ensure that the set doesn’t squeeze uncomfortably and that there is plenty of space for the earlobes. Sizes are available for children as young as 6 months.

Decibels of common noises

Sound above 85 dB is considered harmful