MS. DIANE REHMThanks for joining us. I'm Diane Rehm. Noise used to be viewed as merely a nuisance. But recent studies show excessive noise can be a serious health risk. In addition to noise-induced hearing loss, exposure to noise can contribute to cardiovascular disease. Federal noise abatement efforts were defunded during the Reagan administration and never reinstated. As part of our ongoing Environmental Outlook series, we talk about the effects of noise pollution and what to do about it.

MS. DIANE REHMJoining me in the studio, Dr. Gordon Hughes of the National Institute on Deafness and Other Communication Disorders and Les Blomberg of the Noise Pollution Clearinghouse. Joining us from Portland, Ore., environmental public health lawyer, Monica Hammer. I do invite you to be part of the program. Give us a call at 800-433-8850. Send us an email to drshow@wamu.org. Follow us on Facebook or Twitter. And welcome to all of you.

DR. GORDON HUGHESThank you.

MR. LES BLOMBERGThank you very much.

MS. MONICA HAMMERThank you.

REHMGreat to see you all. Les Blomberg, forgive me for mispronouncing your name earlier. Talk about some of the primary causes of excessive noise.

BLOMBERGWell, if you look at the noise in the environment that we experience, the biggest one has to be transportation noise. That would be roadways -- from, you know, cars, trucks, buses, planes, trains, ships in some cases. So that would be the major source of noise in our environment. In addition to that, we have industrial noise sources, manufacturing, resource extraction. We have commercial noise sources. We might be next to a bar that has amplified music or a building with a noisy HVAC system, a air-conditioning system or something like that.

BLOMBERGWe also have a lot of recreation noise in our country. Motorized recreation -- boats, motorcycle, dirt bikes, ATVs, shooting of guns, stuff like that. And finally, we just have neighborhood noise that -- lawn equipment, stuff you hear in your neighborhoods, parties.

REHMYou know the one thing you've left out is something I experienced just the other night. I was in a relatively small restaurant and a woman's voice shouted above everything, everyone else. You could hear her throughout the restaurant. And one wonders whether the human response to the kind of noise you're talking about is to get louder itself.

BLOMBERGSure. I mean, that's our natural reaction. If we can't hear somebody, we talk louder -- we move closer together or we talk louder. And our world has become -- it's as noisy as it's ever been. Probably 2007 was probably the noisiest year in the history of the world.

REHMWhy 2007?

BLOMBERGWell, because our major noise sources are planes, trains, cars, stuff like that. In 2008 we had the Great Recession and we had an incredible spike in gas prices. We have not started flying and driving as much as before. And we have retired some of the noisiest aircraft. And so we did hit a peak then, where we're going down. We're not going down because we're trying to tone the noise down. We're going down because of economic and other considerations.

REHMAnd turning to you, Monica Hammer. The World Health Organization came out with a major report a few years ago on the health findings...

HAMMERMm-hmm.

REHM...of noise pollution. Give us a summary of the main findings.

HAMMERSure. So the health effects of noise are serious. And they're more interesting than you may think. I think everyone knows acute kind of feelings of what happens when you have decreased sleep quality and quantity or increased stress because of noise in the short term. And however, the effects of noise go beyond that. Because from a chronic point of view, you experience high blood pressure, reduced learning and productivity, endocrine disruption. And then, finally, the long-term risks include heart disease and hearing loss. Hearing loss is a disability and, I mean, that's no small thing.

HAMMERBut heart disease, of course, changes mortality figures. I mean, there's nothing more serious than that really. And in the United States, we have notices that, I mean, in terms of other environmental pollutants, noise is right up there with air pollution. And so it's, over 100 million Americans are affected by noise and are at risk of heart disease and hearing loss due to noise pollution.

REHMSo to you, Dr. Hughes. Give us a sense of what happens physiologically when people are affected by excessive noise.

HUGHESWell, sound travels down the ear canal and strikes the eardrum. Vibrations are carried across three small bones of hearing we often call the hammer, anvil and stirrup. And these vibrations are transmitted into the hearing organ we call the cochlea. At that point, it's a traveling fluid wave. And delicate sensory hair cells, because of structures on top of them, are stimulated by this traveling wave and transmit sounds to the hearing nerve out to the brain. So it is a problem if the hair cells are lost, because they're the link between the mechanical wave and the electrical nerve. And in fact, it's the hair cells and their supporting structures which can be irreversibly damaged from excessive noise.

REHMSo how do you determine excessive noise as far as the human ear is concerned? Is it a matter of decibels? What is it?

HUGHESYes, sound intensity is measured in decibels. And it's on a logarithmic scale. Pristine hearing might be called zero decibel sound-threshold detection. We communicate, normal conversation, about 60 decibels.

REHMSixty.

HUGHESA hair blow-dryer might be, say, 80, 85. And at that point, roughly 85 decibels of sound intensity, we have the potential for noise damage, depending on the duration of exposure. It's a combination of intensity and duration. So every five-decibel increase above 85 of exposure, we should cut the duration in half. There are guidelines from Occupational Safety Health Administration and the National Institute for Occupational Safety and Health, which tell us how to cut in half the time exposure. But basically both permit an eight-hour workday exposure of 85 decibels without protection, but have to cut the time in half or wear ear protection, depending on the increase in noise.

REHMBut now you heard Monica Hammer speak about cardiovascular disease. To what extent or at what decibel would damage begin to the cardiovascular system?

HUGHESI don't believe I have seen a report which is specific for an intensity. And it will vary with one individual to another. Frankly, I don't like noise at all. So with me, it might start at 90. Whereas another person might tolerate 100.

REHMThat's interesting. Monica Hammer.

HAMMERWell, my understanding is that recent research that takes place in the EU shows that basically there's a direct correlation between noise and exposure and the incidence of heart disease. And so for every 10-decibel change in noise, you get a 12 percent increased risk in myocardial infarction, which is heart attacks. And that begins -- that risk begins at 45 decibels, which is extremely low-threshold if you think about it, and really points to the fact that as human beings and as, you know, other animals and species get exposed to more noise, our health is going to be suffering.

REHMSo what happens to you, Monica Hammer, if you're in a restaurant and the level of noise starts going up? How does that affect not only your cardiovascular system but your digestive system?

HAMMERYeah. I think you're speaking to a great thing, that some -- and I think all of you are kind of naming this idea that some people care a lot about noise and they're more bothered than others, right? And I think that when it comes to our health, you can assume that everyone kind of reacts the same at a baseline level. But those -- let's just -- so, for example, someone who's really annoyed at noise versus someone really who is not annoyed at noise, they both have this baseline-level health effect. Even if someone just doesn't care, their body is still affected. Someone who's annoyed is going to have additional health effects, if that makes sense.

REHMSo what about generational differences? Because I know I am particularly sensitive to noise.

HAMMERWell, it's funny you should say that, because sometimes, and I mean I know that the NIH specialist can speak more to this, but some -- one indicator of hearing damage is noise sensitivity. And so as we grow older and there is hearing damage there, it's going to be harder for people to hear if they do have hearing damage in a place like a restaurant. And so it's going to be more irritating and frustrating to be in that situation if you have hearing damage.

HAMMEROther people, you know, who don't have hearing damage, but just are particularly sensitive, obviously are going to react a little bit differently. So yeah, there are variances. But also, you know, from a epidemiological level, through population trends, you can identify significant health effects and we can speak with certainty to those.

REHMDr. Hughes, I know that what happens with young kids, for example, is that they do listen to music rather loudly. Is that going to immunize them from concern about noise later on? Or is it going to damage their eardrums?

HUGHESNoise damage is really the most preventable form of nerve hearing loss that there is. And the earlier we can start to educate families, parents and their young children, the better. We have an active program through our institute called the Noisy Planet.

REHMDr. Gordon Hughes, he's director for clinical trials at NIH's National Institute on Deafness and Other Communication Disorders. Short break. Right back.

REHMAnd welcome back for this month's environmental outlook. We're talking about noise pollution and noise, of course, in many forms. Here's just one example from Lisa in Silver Spring, Md. who says, "My teenagers are constantly plugged into their iPods. Even if the volume is not excessive, which it probably is, does this constitute a danger? Does having NPR on the radio all day long constitute a danger? Can this research possibly convince my neighborhood supermarket to stop the terrible '70s Muzak?" What do you think, Monica Hammer?

HAMMERWell, those are a lot of questions there. You know, getting to the point of children and protecting children from hearing loss, I think that's absolutely important. And I'm a mother and I take precautionary measures through headphones when we're in loud spaces. I make my daughter wear headphones, and in terms of earmuffs, if that makes sense, because I know that we're in a number of places that have dangerous acoustical environments. And so if I'm taking her to a concert, you know, that's what she's wearing.

HAMMERBut I think also, I mean, I absolutely also agree that, and again as a mother, if your children are listening to ear buds, those can be very dangerous and cause hearing loss after prolonged use. And so it's definitely something to keep an eye on. If you can hear the music or the television through the ear buds then that's a warning sign that they're too loud.

REHMThat's a warning sign, Les.

BLOMBERGYes. I hope to have another warning sign soon. The Noise Pollution Clearing House is developing an app to allow parents and young people alike to determine if they've been listening to their iPod at too loud of a level. And hopefully early next year that'll be available.

REHMSo what will that do? It will send a signal?

BLOMBERGYeah, what we'll do is we'll have people count the number of tones that they can hear before and after exposure. And if after listening to your iPod for several hours you can't hear as many tones – quiet tones as you could earlier, we know that you've suffered a temporary threshold shift, a short term loss of hearing. And that's a good indication that you've probably been listening a little too loud.

REHMAnd Dr. Hughes, what do those short term hearing losses indicate for the long term?

HUGHESThe community is divided on the possible safety of short term loss, even if it's 100 percent recoverable. Some damage may have occurred that we don't perceive. We know this from animal studies. And some human studies are coming up. So frankly I think a temporary threshold shift, which is what Les is describing, is potentially worse than you would think, even if there's perfect recovery.

REHMSo have you ever been in a situation the likes of which I described in a restaurant where somebody is talking so loudly. And I wonder what you might have done.

HUGHESWell, I think it's rude for one person to commandeer the environment but basically that can happen. A restaurant has a closed space where in order for a person to hear, he or she may want to raise his voice in order to hear himself talk. And if there's a lot of background noise, he or she will raise his voice above the ambient sound. Unfortunately this dampens out at a certain peak of noise intensity because nobody can hear anybody else. But there could be one person, like the women you described, who's capable of producing a lot more sound intensity.

REHMI wonder, Monica Hammer, what you think my options might have been in a situation like that.

HAMMERYeah, absolutely. I think there's short-term options and long-term options. So let's talk about long-term options first because they're more, I think, interesting. So the long-term options, you know, working with your city, working with your elected officials to increase disclosures on what people are being exposed to real time and also what the dangers are. So some restaurants are dangerously noisy. And – you know, and again we were talking previously about preferences. Some people love that hustle and bustle of, like, an exciting restaurant. It means that, you know, you can feel more important or something, I don't know.

HAMMERBut that being said, you know, it can be dangerous. And so if people are aware, you know, through city or ideally, you know, federal and state educational efforts, then they can maybe make informed decisions about, you know what, this restaurant just disclosed in real time that I'm being exposed to 84 decibels. That's too loud. I'm going to leave. And then the restaurant has every incentive to produce an acoustical environment that's safe for their customers because people aren't going to eat there if they know that they're in danger.

HAMMEROn the short-term level, which I think, you know, obviously, you know, matters to you, I think that as a consumer you are an incredibly powerful woman. I mean, not only just because you're Diane Rehm, but also because as a consumer, you know, in D.C. you can let your wait staff know. You can – that, you know, noise matters to you and that you're going to make decisions with your dollars.

REHMI think that's a good point. And I thought afterwards perhaps I should have simply said something to the manager who then might have politely said something to the young woman involved. Here's an – go ahead.

HAMMEROh, I apologize. Just that some cities do have noise disclosure ratings that the local newspapers will provide so that consumers can make a choice before they go into the restaurant. And also, I mean, we all – you know, it's an absolutely natural biological response to try to raise your voice. I mean, birds do it too. If the birds are trying to get heard above the freeway noise, they're going to be louder. And we do the same thing. And so we just need to reduce the ambient levels. And that's absolutely feasible. It can be done. It's just that we have to make that conscious effort.

REHMHow many restaurants around the country are engaging in this, Les?

BLOMBERGI think you're – I think Monica's referring to more like the people who are viewing the restaurants, you know, the restaurant reviewers in the food section of newspapers.

REHMI see. I see. I see. Rather than the restaurants themselves. All right. Here's an email from Rosemary in West Lafayette, Ind. "Many of us," she says, "use white noise to mitigate the effect of environmental noise. Is that harmful," Dr. Hughes?

HUGHESIt's a principle we call masking, which is covering up one sound by the exposure of another. In this case white sound, if it's not too intense, can successfully block out some environmental sounds. I think earplugs are much more effective myself.

REHMEarplugs.

HUGHESWell, removing yourself from the noise environment. Even if it's a restaurant that you'd like to go to, you can always leave. And wearing earplugs, if you can't remove yourself from a noisy environment, sometimes traffic on the streets can be bad.

REHMAnd Kevin in San Francisco has written. He says, "I live here in San Francisco. I'm constantly amazed at noise from motorcycles. These machines are acquired by many owners to specifically shock and awe with noise. This seems to be completely ignored by law enforcement and truly has an impact on my qualify of life, Les."

BLOMBERGYeah, you know, if there was one noise in our environment that would have the biggest impact removed -- most easily removed quickly, it would be motorcycle noise. I've done some observations myself and found that about 70, or even more than that, percent of motorcycles are run with illegal mufflers. They're required by law to have a stamp from the EPA on the muffler itself. It's supposed to be visible. You can kind of do this check yourself as you walk down a street with parked motorcycles, looking to see if it's easily accessible and seeable, this stamp.

BLOMBERGMost of them -- most motorcyclists who have loud motorcycles remove the motorcycle's mufflers and replace it with straight pipes or mufflers that are less effective, and that's illegal. And it's illegal in every state and we're not enforcing it. I think it's kind of a complicated issue because often police officers tend to have a high percentage of motorcycle riders and that those two groups overlap each other. And I think there's a little reluctance to enforce laws against motorcycles by police departments.

REHMAnd what about the motorcycles that the police themselves use? I presume the mufflers are on there.

BLOMBERGYeah, those are going to meet the regulations most likely.

REHMYeah, that's really interesting that motorcycles...

BLOMBERGIt's intentional noise. It's noise from a person who is trying to make it. You know, a lot of the noise we're experiencing is just kind of second-hand. It's not really intended for anybody. It's just a byproduct of an internal combustion engine, for example. But motorcycle noise is intentional. The operator is trying to make that noise.

REHMWhat about the effects of noise on animals? Monica referred to it briefly. Tell us about that.

BLOMBERGSure. Well, you know, we share much of the same biological architecture as animals. And we have many of the same effects, hearing loss, sleep loss, activity interference, whether it's nesting or hearing your prey or escaping your predator. So we have many of the same effects. Probably the most interesting study of animals conducted in the last 50 years I bet regarding noise was a phantom roadway. It was done by a grad student out in Idaho.

BLOMBERGHe took a forest that had no roads and put speakers in the trees and created a phantom roadway. And he put this in a migration path of birds and he could turn the roadway on and off. And when he turned the roadway on and left it on for a couple days, he found basically a 25 percent reduction in the bird species in that area -- or in all species -- all birds in that area. And some species left the area entirely.

BLOMBERGThat's important to note that we have 2 million miles -- or, excuse me, 4 million miles of roads in this country. And there's only about 2 percent of our land that you can't hear a roadway from in this country.

REHMTwo percent that you cannot hear a roadway.

BLOMBERGIt's pretty remarkable how many roads we've built in this country and what we have left.

REHMSurely that must effect our sense of hearing, Dr. Hughes.

HUGHESWe do have too much noise and frankly I think it's going to be easier for us to protect ourselves than expect motorcyclists and other vehicles to turn down the volume. What I do, just by choice, is to carry with me some custom-fitted ear molds that drop the sound down by 25 decibels, which is more than a 10 percent -- excuse me, tenfold reduction in the noise level. It takes the edge off, then I don't have to worry about an ambulance going up the street with a siren or a truck just hitting their esteem pressure brakes, which is particularly bad, or other routine street noise. And I have them with me in case I want to use them.

REHMYou have them with you all the time?

HUGHESI have them in my pocket now.

REHMYou have earphones on as well. Dr. Gordon Hughes of NIH, Les Blomberg. He's director of the Noise Pollution Clearing House. That's a Vermont-based noise abatement advocacy group, and Monica Hammer. She's an environmental public health lawyer and consultant based in Portland, Ore. And you're listening to "The Diane Rehm Show." Monica, you say that noise is affecting children's ability to learn.

HAMMERAbsolutely. I think that we already have some acoustical standards in classrooms in some situations. But at the end of the day they're an incredibly vulnerable population. And hearing loss in our children is present and, some say, growing.

HAMMERSo I think headphones are a huge source of noise, but also just to the extent that we can protect a vulnerable population, we need to remember that children don't have control over their acoustical environments. They have even less control than we do. And so with that in mind, the best way to control noise is through source control. And by that I mean instead of kind of targeting the child, which, you know, granted I do, right, by putting earmuffs on mine.

HAMMERBut that being said, you know, the most cost effective way is to really reduce noise at its source. The EPA and other federal agencies have authority to do so. And then all of us can benefit from a quieter acoustical environment if really we just have stronger enforcement at the federal level.

REHMDr. Hughes.

HUGHESThere was a question a little bit ago on MP3 and similar audio players and ear buds. And this is an example where a child may not have the judgment to recognize the potential for harm. Some of these maximum volumes can go to about 105 decibels.

REHMWhoa.

HUGHESAnd if you use the conversion table about intensity and duration and pretend it's a work environment with the same application, you can only expose about 30 minutes to 105 decibels without the risk of possible damage. So the instruction to the children should be to keep them down below the full volume and be alert to any trouble after they listen to it. The instruction to the manufacturers would be to put in some kind of governor that limits the amount of output. And some of them are already doing that. But this is an important thing for kids to learn.

REHMIs there any indication that indeed people are losing their hearing earlier because of so much exposure to high decibels?

HUGHESWell, there is an indication that adolescents are not hearing as well now as they did before but noise is only one possible ingredient. It turns out the average adult compared with 50 years ago hear somewhat better. And this may be because of education programs, noise abatement and industry recreation and so forth.

REHMGive us some of the history of noise abatement efforts in this country, and as you have now established this advocacy group.

BLOMBERGSure. Yeah, when you think of what we've done in this country to abate noise or to address it, we've really had two primary ways of doing this. One was to move to the suburbs. That only worked for people who had enough money to do that. And it only worked for awhile because what we did is we brought all the noise with us to the suburbs. We now have larger lawns, then we got riding lawnmowers, we have weed whackers, leaf blowers, string trimmers, air conditioners. And we've also got the highway nearby that takes us to our place of work, which is probably another suburb.

BLOMBERGAnd then the second method that we tried, which was back in 1972, the United States passed the Noise Control Act. And we tried the regulatory approach. That also failed and it failed for a different reason. It failed for politics. Basically it was closed in 1980 by Ronald Reagan and it was closed, you know, because of the conservative philosophy that disliked environmental regulation.

REHMBut did it cost money? Was that part of the problem?

BLOMBERGSure. I mean, it does cost money to regulate noise. It doesn't cost that much. When you think about it, we've built billions of dollars of highway, road barriers, much less than the EPA ever spent on trying to control noise. It's much more effective, like Monica said, to control the noise at the source.

REHMLes Blomberg and Dr. Gordon Hughes and Monica Hammer. They're all here to answer your questions. We'll take a short break first, talk more, take your calls. Stay with us.

REHMAnd as you can imagine we've had lots of emails and comments about motorcycles. This one from Lauren, in Kalamazoo, Mich., summarized the concerns. She says, "I'm listening. I'm bothered by the discussion regarding motorcyclists' intention to make noise. As your guest stated, some bikes have illegal mufflers, however, it's important for bikes to have a minimum sound level as well. Motorcycles are more difficult for motorists to spot than other vehicles. And without the audible cues there would be more accidents." How do you respond, Les?

BLOMBERGWell, there's so many things wrong with that statement it's hard to begin. First of all, there's absolutely no research that shows that -- the slogan is "Loud Pipes Save Lives." And there's absolutely no research that shows that. Second of all, we have very quiet motorcycles out there right now and they do not have higher accident rates then the nosier ones.

BLOMBERGThe other thing is if you really wanted your motorcycle to warn people, you would reverse your exhaust system to point it forward. People behind you don't need to hear that you're coming. It's people in front of you, but these don't, you know, the people that do this do not do that. They're not doing it for safety.

REHMMonica, do you want to comment?

HAMMERYeah, I think just from an American perspective we have to remember that people want to be free to make noise. They want to, you know, if this is how they choose to erroneously believe that they're going to safe, not by staying off their motorcycle, but by actually just being louder, I mean, we, you know, it's a difficult balance to respect people's decision to be free to do something and also help the public be free from noise that they don't want to hear.

HAMMERAnd so it's a very tricky balancing act. And I think that really, I mean, I keep on thinking about the little birds that are trying to be, you know, chirp a little louder because their next to a highway. That motorcyclist is going to try to be the loudest thing around. And if we can lower our ambient levels to the extent such that a motorcyclist is like, you know what? I am okay applying with the EPA, complying with the EPA regulations because that's adequate for me to be heard. That is, you know, that's something to aim towards, in my opinion.

REHMDr. Hughes, is there any indication that those who ride motorcycles have more hearing problems than those who ride in enclosed cars or trucks?

HUGHESI suspect the answer is yes. I haven't read anything myself. I did own a motorcycle for seven years.

REHMReally?

HUGHESIt was incredibly noisy. And you probably get some protection from the helmet and the fact that the sound is pushed behind you, as Les said. But I do think they're just simply too noisy and you probably sustain some damage over a period of months or years.

REHMAll right. Let's go to Trish, in Fort Worth, Texas. You're on the air.

TRISHHello, everyone. Hi, Diane, I love your show.

REHMThanks.

TRISHI was curious to know if anyone has done research within the autistic community, in terms of sensory sensitivities and noise. I know from experience with variance family members, and reading blogs and such, that they hear things at different levels than a typical person would hear.

REHMAll right. Les, do you want to comment?

BLOMBERGYeah, I don't have a lot to add to that, but I know that it has been studied and that there is a link between a number of conditions and noise sensitivity.

REHMConditions, including…

BLOMBERGIncluding autism.

REHMYeah. Okay. Let's see if I can get to Doug, in Boone, N.C. Hi, you're on the air.

DOUGGood morning, guys. I'll give you a couple of quick statements here. One, my dad is retired from the military, 22 years naval aviation, prop jets at Grosse Ile Naval Air Base down below Detroit. Back then they didn't really have much ear protection and it was pathetic what they did have. When he reached about 70 to 72 years of age, his quality of life became real pathetic. The man was very intelligent. He was a missile designer. He was an aviator.

DOUGHe was very -- he read two papers, three magazines a day. But when it came to conversation around the dinner table or anything else, he just didn't get into it because he couldn't hear. So eventually I took him to the veteran's. And I said, "Look, you guys have got to help him out here." Because he'd been to the V.A. Hospital I don't know how many times, a thousand times in his lifetime. They never addressed his problem with his hearing. So we got with the Veteran's Affairs, got him registered as a disabled veteran because of his hearing.

DOUGHe got a little bit of money. It wasn't much. But they definitely stayed on top of his hearing for the rest of his life to the time he hit 85 and passed away. What I'm saying is you've got all these guys coming back from Iraq and Afghanistan and who knows where, they're coming back with horrible hearing loss.

REHMAll right. Thanks for calling. Monica?

HAMMERYeah, I hear you on the hearing loss and the military weapons and the aviation. I agree. And I have to think both in military situations -- for what it's worth, if we want to highlight a beacon of noise work that is happening at the federal level, it would actually be places that basically, through the veteran's administration, they are trying to prevent hearing loss because it's such an expensive and debilitating disability that can provide so much disservice to the people that we really need to be taking care of.

HAMMERAnd then at the civilian level, Workers' Comp laws at the state level are sometimes really pathetic in terms of just we need to prevent hearing loss because compensating them through really base monetary payments isn't going to be adequate to, you know, basically compensate them for the loss in quality of life. And, you know, workplace limits on noise, again, you know, aren't as stringent as they should be. Not at all.

BLOMBERGYou know, your caller highlights why we really ought to be taking care of our hearing. That when you get older people think, oh, well, I just won't be able to hear my wife or something. But when you think of how isolating that is, when you won't be able to hear your grandchildren and talk with them, when there's a family gathering and you're gathered around the table and you just sit there because it's just a buzz of confusion that you can't make out any of the speech from. It's really isolating and it's really depressing. It's really lonely.

REHMBut, you know, the other thing I worry about is the hearing aid industry because I think there are some people who have such difficult problems with using hearing aids effectively. You have to keep trying, Dr. Hughes.

HUGHESWe've been talking about a nerve kind of hearing loss and ignoring the other types. The two most common causes of nerve loss are aging and noise. Now aging, we haven't yet discovered the fountain of youth. Maybe, some day. But noise we can prevent. Unfortunately, noise and aging conspire as we get older to create the same kind of hearing loss, first in the high tones and then invade the speech communication range. So we have a lot of difficulty as we get older, like the one gentleman in Detroit was describing.

HUGHESHearing aids can help, but if the ability to recognize words, even if they're delivered loudly enough, is compromised by a lot of damage over many years, that's when the hearing aid ability to help is also compromised.

REHMIndeed. All right. Let's go to Steve, in Indianapolis. Hi, you're on the air.

STEVEGood morning. Thank you for taking my call.

REHMSure.

STEVEI am involved in a group called Institute of Noise Control Engineering. And I wanted to point that out as an example of where people are doing some practical work in the field, just ranging from voluntary product noise labeling efforts to studies of occupational noise exposure and noise in classrooms and hospital settings, and in the practical things of like how do you make this thing quieter, for example, whether it's a truck or an air pump or something like that.

STEVEI'm also involved in organizing their yearly conference, which is coming up next week in Ft. Lauderdale. There is a public outreach workshop for anyone who is interesting in attending on Tuesday, the 9th. And I encourage people to look on the INCEUSA.org website for more details on that. And one other thing regarding the motorcycle noise, there's also a link on that website to a report called, "Noisy Motorcycle: The Quality of Life Issue," which I believe was a National Academy of Engineering report.

REHMGood. Thank you. Monica, do you want comment?

HAMMERYes. Yeah, I love the Institute of Noise Control Engineering. I think you guys do great work. And specifically want to celebrate their work because it's so cost effective. It's so much smarter. It's so much cheaper. And we save -- we literally, you know, save our health through engineering design insulation and enclosures that reduce noise exposure.

REHMAll right. Let's go to Doug in McLean, Va. Hi there.

DOUGHi, good morning. A year and a half ago, I moved from a very quiet area to a high-rise apartment overlooking downtown McLean, which really just means overlooking lots of parking lots. And I am appalled at the noise from weed-whackers, leaf blowers, car alarms -- there's several of those every day, including a woman who -- in our building -- who was using her car alarm in the morning to locate her car. Fortunately now she has a space in the basement. The truck back-up alarms. You can hear that awful beeping for a couple hundred yards.

DOUGThen there are the trash trucks, who pick -- picking up the dumpsters at 6:30 a.m. and slamming them on their trucks to make sure that everything is dumped out. But the worst story is last year, starting at 1:00 a.m., I was awoken by the beeping of something backing up. I went out on the balcony. I could tell there was construction out somewhere -- it looked like it was on the street. And I thought oh, my gosh, did a water main break. I went out and they were paving the parking lot of the office building across the street. So I thought this can't be legal.

DOUGSo I called the police. Officer came out right away, went to talk to them, came back to me and he said, "Well, yeah, what they're doing is illegal, but I can't ticket or stop them." And I have confirmed this with other officers. The only thing that could be done would be if I or the group of us in the building who were really upset by this, had a civil suit against the company. Ridiculous, isn't it.

BLOMBERGYou know, the world…

REHMHe move to the wrong place.

BLOMBERGHe did.

REHMHe really did.

BLOMBERGBut it's not his fault.

REHMIt’s not his fault. Of course not.

BLOMBERGWhat we've done to the soundscape -- noise is really trash. It's audible litter. And if you could envision noise as McDonalds' wrappers floating in the air, what you would be looking at, if you step out, is what he stepped out on his balcony, is just a landfill. It's just trash everywhere. It's kind of -- it says something about how we value our hearing, I think, in that we've been able to ignore this. Because, you know, in terms of sight, we haven't been able to ignore litter. We've cleaned it up. We are just beginning to start to clean up noise, I think.

REHMThere about to start ticketing people here in Washington for litter. And maybe they ought to do the same for sound. And you're listening to "The Diane Rehm Show." Tiny anecdote, years and years ago for our 25th wedding anniversary, my husband and I first went to Florence. Stayed in a very quiet hotel. Beautiful. And went from there to Venice. And we were right on the bay. And the Vaporetti were there. And the noise in the morning and all through the day was just a shock to my system.

REHMAnd I went to the doorman and said, "I don't think I can stay here." And he said, "Madam, I promise you, just give it 24 hours." He was right. I got used to it. So are we all simply getting used to it?

BLOMBERGYou know, sometimes we get used to it. We do habituate somewhat. But there's an extent to which we don't habituate. One is the physiological effects, the cardiovascular effects, they happen no matter what. Also, for some people they don't get used to it. They don't habituate. They become more sensitive with more exposure. And so it's not always that you'll get used to it.

REHMWhat do you think, Monica?

HAMMERYeah, I absolutely agree with Les, that, you know, maybe on a conscious level we will get used it, but certainly our bodies will never get used to those unnatural sounds that are really pollution. And we have to think about it as a source of pollution, just as Les was indicating.

REHMSo in general, I gather cities are not doing a great job about trying to keep noise levels at a low point, Monica.

HAMMERYou know, cities are trying to use a salad fork to slay a dragon. And it's just because that's the tool they have available to them. And it's not their fault. They just basically have limited means through noise ordinances to really reduce pollution at its source. And we really have to look for federal leadership at this level. I mean, I can talk more about what cities can do to increase the level of noise awareness and educate individuals and disclosure and that kind of thing. But at the end of the day we really need a national effort here.

REHMDo you agree with that, Les?

BLOMBERGYes. There is almost no national effort right now. The cities are where the activity is just because they have to be. Cities have had a resurgent in the last 10, 20 years. They've become more popular places to live, more attractive places to live. And mayors of those cities have taken efforts to improve the quality of life by reducing noise. They've done it in Boston, in New York, in major cities there's been efforts to do that. And that is where the action is right now. It's in cities because there isn't any action on the federal level and very little on the state level.

REHMI would think that there would be cooperation, Dr. Hughes, between the medical community and the civic community trying to achieve some of this.

HUGHESI think the medical community -- such as our institute, which is devoted to improving public health -- should educate people that noise is preventable, noise damage. And to put out campaigns for target groups, like adolescents.

REHMAll right. We'll have to leave it at that. Dr. Gordon Hughes, Les Blomberg, Monica Hammer, thank you all so much.

BLOMBERGThank you very much.

HUGHESThank you.

HAMMERThank you.

REHMAnd thanks for listening all. I hope we haven't damaged your eardrums today. See you tomorrow.