Sound Medicine®

Audio innovation by Bongiovi Medical

DPS HEAR & Hearing Loss Prevention
Patricia Rush, MCD, CCC-A/S; Joseph Butera III, Acoustic Engineer; Glenn Yeaw
Bongiovi Medical & Health Technologies
Port Saint Lucie, Florida

Introduction

Hearing Loss is a major medical problem in the United States and the rest of the industrialized world. Historically environmental noise induced hearing loss has tended to be a problem for middle-aged to older adults. Most of these individuals hearing loss was the result of occupational issues. Over the years, awareness and better occupational safety rules has helped. Unfortunately, the number of Americans with substantial hearing loss is growing, not decreasing. Disturbingly, more and more young Americans are being diagnosed with hearing loss.

The Hearing Loss “Epidemic”

Hearing Loss is a major medical problem in the United States and the rest of the industrialized world. It is recognized that continuous exposure to sound over 85dB will cause hearing damage. Historically environmental noise induced hearing loss has tended to be a problem for middle-aged to older adults. Most of these individuals hearing loss was the result of occupational issues. Over the years, awareness and better occupational safety rules has helped. Unfortunately, the number of Americans with substantial hearing loss is growing, not decreasing. Disturbingly, more and more young Americans are being diagnosed with hearing loss.
In recent years, the number of Americans with hearing loss has been estimated in the range of 25 Million.1 Unfortunately, the estimates varied greatly. A recent review of the most current data suggests the problem is even worse; with over 30 Million Americans with hearing loss in both ears and 40 Million Americans with hearing loss in one ear. A speech-frequency pure-tone average (average of hearing thresholds at 0.5, 1, 2, and 4 kHz) of 25 dB HL(hearing level) or greater was defined as hearing loss, and this is the level at which hearing loss begins to impair communication in daily life.2 There has been a steady growth in hearing loss. In 1989 there were less than 24 Million Americans with hearing loss and it is estimated to grow to over 52 Million by 2050.3

Hearing Loss and the Youth

With the growth of occupational safety regulations, work related noise issues have improved, yet hearing loss is increasing, especially in the youth. This is supported by anecdotal evidence from audiologist like Patricia Rush, and by the National Health and Nutritional Examination
Surveys (NHANES).The NHANES Surveys show that hearing loss has increased for 14.9% of American youths (age 12-19) to 19.5% from 1994 to 2006.4
While the NHANES survey was looking at hearing loss of 25dB in the speech frequencies, it has been noted that even slight hearing loss (>15-24dB can cause learning problems in school-aged children.5 As stated in a recent article in the Journal of the American Medical Association (JAMA), “Mild hearing loss in young children can impair speech and language development and lead to decreased educational achievement and impaired social-emotional development.”6

Why the Rise in Youth Hearing Loss?

As Dr. Shargiridsky noted in JAMA, “…greater awareness of music-induced hearing loss, may have led to the expectation of no change of a reduction in the prevalence of hearing loss, but this was not observed.”6 A small study by the House Research Institute showed that 72% of teens complained of reduced hearing after a rock concert. In this study, 29 teens were given free tickets to a rock concert. They were told about the dangers of load noise and were offered hearing protection in the form of foam ear plugs. Only three used the protection. Using a calibrated sound pressure meter, researchers seated with the teens found that sound decibel levels averaged 98.5 dB. The average was greater than 100 dB for 10 of the 26 songs played.7
While almost all of the studies cited call for more research into the cause of youth hearing loss, some initial conclusions can be drawn. Loud noise, especially music, seems to be a major culprit. The advent of ear-buds may be part of this problem. And finally, awareness campaigns are not effectively curbing the growth of youth hearing loss. A technological solution is needed.

Typical Hearing

When we want to listen to a song we naturally turn it up to a level where the elements we want to hear are loud enough. This may mean some parts of the song are too loud or uncomfortable. For example: you might be having a hard time hearing the singer’s soft and emotional reflection in a pivotal moment of the song. A typical response is to turn up the volume to hear this more clearly. Harsh sound effects or hard hitting drums might also be in that section and are now sitting in an uncomfortable listening range. Ouch! We tolerate this because the emotional impact of the singer is more important.
When we listen through headphones or ear-buds, these louder sounds can cause the acoustic reflex to occur. The acoustic reflex is how our ears protect themselves from loud sounds. This effect, in turn, dulls the sound. So we turn the volume up to compensate. It’s a vicious circle! Bongiovi DPS offers a digital solution to this problem by achieving clarity without the damaging high volume levels.

Digital Power Station HEAR

DPS HEAR is an application of the Bongiovi Digital Power Station technology that allows for clear, satisfying sound at healthier volume levels. Because of the unique way DPS processes loudness and frequency information, headphones or earbuds do not need to be turned up as loud for an enjoyable listening experience.

NY NY Soundwaves Unprocessed by DPS

Audio Waveform of the song, “New York, New York” featuring Tony Bennett and Frank Sinatra.

Notice the lighter blue core of the waveform surrounded by darker blue peaks. The light blue represents the average power of the audio and includes much of the information we perceive as loudness. The darker blue peaks can be much greater than the average power at any given moment.

Digital Power Station Processing

The Bongiovi DPS Real Time Audio Re-Mastering™ process reacts instantly to the incoming audio signal. This patented algorithm understands that human ears pay the most attention to sounds to which they are most sensitive. No matter what the original content of the audio is, Bongiovi DPS will optimize the signal so that important sounds stay at a consistent volume without losing their emotional impact. Here is an example:

NY NY Soundwave Processed by DPS

Audio Waveform of “New York, New York” processed by Bongiovi DPS.

Conclusions

DPS HEAR provides a satisfying sound at safe volumes. The parent lock feature allows parents to have some control of the listening habits of their children. DPS HEAR, combined with education, has the potential of helping to curb the alarming rise of youth hearing loss.

Acknowledgements

The authors would like to acknowledge the research assistance of Donna Strickland, BSN, RN in helping with the background research for this poster.

References

1Pleis JR, Lethbridge-Cejku M. Summary health statistics for US adults: National Health Interview Survey,2006. Vital Health Stat 10.2007;(235):1-153.
2Frank R. Lin F, Niparko J, Ferrucci L, Hearing Loss Prevalence in the United States, Archives of Internal Medicine, 2011;171(20): 1851-1852
3Kochkin S, MarkeTrak VIII: 25-Year Trends in the Hearing Health Market, Oct 2009 Hearing Review, 12-31
4National Center for Health Statistics. National Health and Nutrition Examination Survey III& 2005-2006: Audiometry and Tympanometry. Rockville, MD:
5Northern JL, Downs MP. Hearing in Children. 5thed. Baltimore, MD: Williams & Wilkins; 2002.
6Shargiridsky J, et.al., Change in Prevalence of Hearing Loss in US Adolescents, JAMA. 2010;304(7): 772-778.
7Derebery M, et.al., Rock Concerts and Hearing Loss, Presentation given at American Otologic Society Meeting, TBP in Otology & Neurology, http://www.betterhearing.org/press/news/Rock_concerts_put_youth_at_risk_for_hearing_loss_pr05312012.cfm
World Health Organization Prevention of Blindness and Deafness (PBD) Program. Prevention of deafness and hearing impaired grades of hearing
impairment. http://www.who.int/pbd/deafness/hearing_impairment_grades/en/index.html.