Noise as a Public Health Hazard; The Hearing Journal, May 6, 2022
An editorial by Jamie Banks, PhD, MSc and Daniel Fink, MD, MBA
In January, the American Public Health Association (APHA) published its updated policy statement on noise, Noise as a Public Health Hazard. 1 Hearing health professionals need to learn more about the dangers of noise to advise and protect their patients from its harms and because the public depends on them as trusted sources of auditory health information. In addition to providing a concise summary of the adverse impacts of noise on auditory and non-auditory health, the policy statement offers recommendations to address noise as a public health problem. This includes recommending that health professionals become knowledgeable in order to educate the public about the dangers of noise and advocate to make the world a quieter, healthier place for all.
The APHA policy uses the new definition of noise, “unwanted and/or harmful sound,” 2 rather than the outdated older definition, “unwanted or undesired sound.” That’s because the older definition did not reflect the serious health impacts of noise and placed the onus on those who complained about noise rather than on the source of the noise.
In our modern world, everyday noise exposure—from sources including air, road, and rail transportation, construction and outdoor power equipment, and industry, as well as hobbies, entertainment, and personal audio system use 3 —is great enough to cause hearing loss in the public, not only in those exposed to occupational noise. 4 Those everyday noise exposure levels also raise the risks of non-auditory health problems. 5 The health of more than 100 million Americans is at risk from noise, with children being amongst the most vulnerable. 6
As audiologists know, hearing is the social sense, important for communication with others. Hearing loss—much of it noise-induced hearing loss— 7 is the third most common chronic physical condition in the United States. Hearing loss is not a benign condition. Untreated hearing loss is associated with learning difficulties, lower rates of employment, and lower lifetime earnings. 8 Hearing loss is also strongly correlated with higher risk of hospitalization, death, falls, and frailty, and with social isolation, dementia, and depression. 9
The extensive scientific evidence about the effects of noise on non-auditory health, especially cardiovascular health, is not well known among hearing health professionals. Noise causes annoyance and stress and disrupts sleep and daily activities. These responses set off a cascade of physiological events involving increased production of stress hormones and neurotransmitters that raise blood pressure, heart rate, and other factors which, in turn, raise the risks of stroke, hypertension, heart attack, metabolic disturbances, and death. 10 These effects are especially well studied for road traffic and aircraft noise. 11 Noise also contributes to anxiety and depression and adversely affects concentration, communication, learning, productivity, and overall quality of life. Furthermore, the policy statement notes that the greatest burden of noise is borne by poor and minority communities least able to deal with it. Those communities tend to be located closer to airports, railways, highways, and industrial sites, 12 putting them at risk for poorer health and learning outcomes. 13
What can audiologists, otolaryngologists, and other hearing health professionals do? They can support efforts to make America quieter. At the federal level, they can ask Congress to re-fund the Environmental Protection Agency’s Office of Noise Abatement and Control and/or its mandated activities as required by law, recognize the disparate impacts of noise on environmental justice communities, and ensure that noise is included in environmental and health initiatives. They can ask the U.S. Environmental Protection Agency to carry out its mandatory responsibilities on noise, described in the Noise Control Act of 1972 and the Quiet Communities Act of 1978.
They can ask that the Federal Aviation Administration work with health agencies to systematically address the harmful impacts of aircraft and airport noise and act to mitigate impacts on low income and minority communities. At the state level, they can advocate for measures like quiet restaurant laws and programs that accelerate a transition away from noisy, polluting construction and land care equipment. At the local level, professionals can support reasonable noise ordinances on the use of outdoor power equipment and insist on enforcement of existing vehicle exhaust noise laws. They can also communicate with the public about the dangers of noise.