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Encyclopedia of Health and Medicine

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nose 37<br />

Most hearing experts agree that exposure to<br />

sounds louder than 85 dB begins to damage the<br />

hair cells in the COCHLEA, which activate the nerves<br />

that translate sound waves into NERVE impulses.<br />

Sounds at higher frequencies (2,000 Hz <strong>and</strong><br />

above) do more damage at the same decibel level<br />

than sounds at lower frequencies (under 800 Hz).<br />

Much <strong>of</strong> human conversation takes place between<br />

2,000 Hz <strong>and</strong> 4,000 Hz. Damage to the hair cells<br />

responsible for sound translation in this frequency<br />

range is particularly devastating.<br />

Noise Exposure<br />

Nearly everyone faces exposure to noise at levels<br />

capable <strong>of</strong> causing damage to the hair cells <strong>and</strong><br />

ultimately hearing loss. The sounds <strong>of</strong> city traffic,<br />

a noisy restaurant, <strong>and</strong> a flushing toilet all measure<br />

in at about 85 dB. The US Occupational Safety<br />

<strong>and</strong> <strong>Health</strong> Administration (OSHA) has established<br />

regulations limiting noise exposure in the<br />

workplace. These regulations stipulate the amount<br />

<strong>of</strong> time an employee may experience noise exposure<br />

at certain decibel levels, prohibit exposure<br />

without protection to sounds over 115 dB, <strong>and</strong><br />

prohibit exposure <strong>of</strong> any kind to sounds over 140<br />

dB. The OSHA Web site (www.osha.gov) publishes<br />

current noise regulations <strong>and</strong> guidelines.<br />

Musicians face the unique conundrum <strong>of</strong> needing<br />

to hear the full range <strong>of</strong> pitch while protecting<br />

their hearing from its intensity, particularly in<br />

group settings such as playing in a b<strong>and</strong> or orchestra.<br />

Yet musicians playing in a rock concert may<br />

experience bursts <strong>of</strong> exposure at 150 dB, as loud<br />

as a jet taking <strong>of</strong>f, which causes permanent damage<br />

to the inner ear after only a minute or two.<br />

The audience at a symphony concert experiences<br />

a sound level <strong>of</strong> 110 dB, equivalent to a car horn,<br />

<strong>and</strong> peaks near 140 dB. Musicians playing the violin,<br />

flute, <strong>and</strong> trombone face continued exposure<br />

to 110 dB or greater at frequencies above 2,000<br />

Hz, among the most damaging <strong>of</strong> exposures. People<br />

who work in construction, steel working, mining,<br />

air travel, manufacturing, <strong>and</strong> public safety<br />

also face increased exposure to noise that threatens<br />

hearing.<br />

Noise exposure exists in personal environments<br />

as well. Appliances such as hair dryers, blenders,<br />

c<strong>of</strong>fee grinders, <strong>and</strong> even c<strong>of</strong>fee makers can generate<br />

90 dB <strong>of</strong> sound or louder. The decibel level <strong>of</strong><br />

movies on television or in theaters can exceed 120<br />

dB. Stereos played beyond the halfway point on<br />

the volume indicator, especially when using headphones,<br />

quickly pass the 100 dB mark. Children’s<br />

noise-making toys can reach 110 dB to 140 dB.<br />

Ear Protection<br />

The most effective protection against noise exposure<br />

is to avoid it. As this is not always practical or<br />

possible, health experts recommend (<strong>and</strong> in the<br />

workplace OSHA requires) wearing hearing protection<br />

for exposure to sound at 90 dB for longer<br />

than eight hours <strong>and</strong> for any exposure that<br />

exceeds 90 dB. There are two kinds <strong>of</strong> ear protection:<br />

ear plugs <strong>and</strong> ear muffs.<br />

Ear plugs fit snugly into the auditory canal <strong>and</strong><br />

block sound waves from traveling to the middle<br />

<strong>and</strong> inner ear. They are available in various materials<br />

<strong>and</strong> in different sizes <strong>and</strong> shapes; finding ear<br />

plugs that fit properly <strong>and</strong> comfortably can take<br />

some experimentation. Custom ear plugs are also<br />

available, made specifically to fit an individual’s<br />

ears. A common complaint about ear plugs is that<br />

they block so much sound that conversation is difficult.<br />

This dampening <strong>of</strong> the sound is called attenuation.<br />

Some designs <strong>of</strong> ear plugs contain<br />

channels that allow sounds at certain frequencies<br />

to pass through. This improves the ability to hear<br />

<strong>and</strong> underst<strong>and</strong> speech. Customized ear plugs for<br />

musicians can block selected sounds so the musician<br />

can hear the tones <strong>and</strong> pitches necessary to<br />

play or sing.<br />

Ear muffs fit over the ears with a strap that holds<br />

them in place. They form a seal around the ear,<br />

which prevents sound waves from traveling into<br />

the auditory canal. As with ear plugs, there are various<br />

designs that <strong>of</strong>fer different levels <strong>of</strong> effectiveness<br />

<strong>and</strong> comfort. Ear muffs tend to muffle all<br />

sound, though ear muffs <strong>and</strong> ear plugs have comparable<br />

ability to block noise, about 30 dB. People<br />

exposed to noise louder than 100 dB to 110 dB<br />

should use both ear plugs <strong>and</strong> ear muffs, which in<br />

combination can block up to about 45 dB.<br />

See also AUDIOMETRIC ASSESSMENT; COCHLEAR<br />

IMPLANT; HEARING AID; OCCUPATIONAL HEALTH AND<br />

SAFETY.<br />

nose The facial structure that serves as the organ<br />

<strong>of</strong> smell as well as the portal through which air

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