CHAPTER EIGHT
The Medical Consequences of Noise
Kenneth Einhorn, M.D.

The problem of environmental noise pollution and the health concerns it raises are not new. In fact, in ancient Rome, concern about the noise emitted from the iron clad wheels of wagons clattering against the pavement stones, causing disruption of sleep and annoyance to the Romans, led to the adoption of rules and restrictions. However, the scope and magnitude of the problem pales in comparison to present day. In response to this worldwide epidemic, the World Health Organization (WHO), after several years of work, published their guidelines on noise. This comprehensive report documented seven categories of adverse health consequences of noise pollution in humans.
This chapter will focus on four of these effects as they represent direct, adverse medical conditions that may present to the medical community. These are Noise-Induced Hearing Loss; Sleep Disturbance; Cardiovascular Effects; and Disturbances in Mental Health. Each will be explored in depth as to presenting symptoms, medical evaluation and workup, and treatment options.

Noise-induced hearing loss (NIHL) results from damage to the sensitive structures of our inner ears from exposure to sounds that are either extremely loud or loud sounds over a long duration. The resultant hearing loss may be temporary or permanent, mild to profound in degree, and is cumulative over a lifetime.

While many diseases that affect the human body occur mainly in certain age groups, NIHL crosses all age lines. The Center for Disease Control estimates that 10 million adults in the United States have NIHL, with 70 percent of them under the age of 60. Furthermore, there are 5.2 million children from ages 6 to 19 with hearing loss attributable to loud noise exposure. More than 30 million Americans are exposed to hazardous sound levels on a regular basis. While NIHL is one of the most widespread health concerns in the US, it remains one of the most preventable. . .

The predominant symptom of NIHL is the difficulty understanding speech (some words are not clear). This, in turn, is caused by hearing loss in the high frequencies. In the early stages, a person may be without symptoms. However, as noise exposure continues and the loss progresses, affected persons may begin to experience difficulty understanding certain words and conversations, especially in the presence of background noise. Distinguishing certain higher frequency consonant sounds (like /s/ or /f/) pose difficulty hearing high-pitched women’s and children’s voices. Hearing damage in the high frequencies is of particular concern for the musician as it may lead to poor performance, overcompensation, or even music distortion.