Study Shows Millions of People Can't Hear Smoke Alarms

One of the scariest scenarios you can imagine if you suffer from hearing loss is not being able to wake up in case of a fire. 

That is indeed a scary thought and, unfortunately, it happens much too often. The Hearing Loss Association of America (HLAA) has long suspected that people died in fires because they were unable to hear smoke alarms. Until recently, however, no government investigations into the fire fatalities have focused on whether the victims were hearing-impaired, and no smoke alarms or strobe lights were tested to see whether they were effective for people with hearing disabilities. 

A recent study by the Fire Protection Research Foundation (FPRF), a nonprofit organization which provides practical data on fire and building safety, finally shed some light – and sounded a loud alarm – on the failure of most commonly used systems to awake millions of hard-of-hearing people.

"This study shows there is a critical need for emergency warning systems to be redesigned or supplemented as soon as technically feasible," says Terry Portis, HLAA's executive director.

Saving Lives, But Not Enough

There is no doubt that well-maintained smoke alarms, which sense the presence of smoke in a room or a building and warn occupants of the impending danger, prevent injuries and save thousands of lives each year. The National Fire Protection Association says these alarms are largely responsible for the nearly 50 percent drop in fire-related deaths in the past three decades.

Invented in the late 1960s, smoke detectors became widely available in the early 1970s. Before that date, fatalities from home fires averaged 10,000 a year, dropping by almost half by the 1990s. That may have been the reason why in 1992, readers of the R&D Magazine, which reports on the newsworthy research and development topics, selected home smoke alarms as one of the "30 Products that Changed Our Lives."

Most conventional smoke alarms feature one of two kinds of detectors. The photoelectric one, which uses light technology and sensors, quickly reacts to smoldering fires that release relatively large amounts of smoke.

The other type, used in the vast majority of American homes, has ionization detectors that work off an electrical current. 

Unfortunately, in too many cases neither of these alarms is loud enough to be heard by people with hearing loss, putting an estimated 34 million Americans at risk.

Sleeping Through Fires

According to the July 2007 FPRF study, "Waking Effectiveness of Alarms for Adults Who Are Hard of Hearing," the most effective way to awake a sleeping person suffering from mild to moderately severe hearing loss is by emitting a sound he or she can clearly hear.

That might sound like a logical conclusion, but the reality is different. The study -- which also tested various alarms that did not rely on sound emission, such as bed and pillow shakers and strobe lights -- found that the lower pitch tone was considerably more effective than higher pitches (typically 3150 Hz) commonly used in smoke detectors.

In fact, the high signal emitted by conventional smoke alarms failed to awaken up to 43 percent of tested subjects. Bed and pillow shakers woke up over 80 percent of study's participants but strobe lights had the highest failure rate, waking up only 27 percent of those tested. In contrast, a specific audible multiple frequency signal of a 520 Hz square wave -- the signal containing multiple harmonics of the fundamental 520 Hz frequency -- successfully alerted over 90 percent of participants when used at the code-minimum sound level of 75 decibels for 30 seconds. The same device awakened all the subjects when increased to 95 decibels at the pillow.

The Knowledge Gleaned

So is there a full-proof way of ensuring that people with hearing loss can wake up to the sound of a smoke detector?

Not at this time, but knowing what doesn't work is the first important step toward exploring effective solutions.

While currently there are no smoke alarms on the market that emit a low frequency, the study might nudge manufacturers of these systems – as well as other warning devices such as carbon monoxide alarms and weather radios – to produce safety appliances providing a low frequency near 500 Hz 

"Finding that an auditory signal at a low pitch is best for alerting those with mild to moderately high hearing loss will certainly prompt further investigation into this area," says FPRF executive director Kathleen Almand . "Ultimately it will lead to better protection for this high risk group."

Knowing Your Right Can Save Lives

While waiting for more efficient smoke detectors to be available, what can you do to ensure that you or a loved one with hearing loss is well protected in case of a fire?

The first thing to know is your rights. Under the Americans with Disabilities Act, hotels, motels, and other public facilities offering sleeping accommodations are required to provide effective access to the building's alarm system for hearing-impaired or disabled guests. 

If that service is lacking or inexistent you can file a complaint at www.ada.gov/

Hopefully it won't be long before fire-related fatalities among hearing-impaired people will be phased out. 

At least now the warning alarm has been sounded – and heard.

Smoking Damages Ear Health and Complicates Ear Surgery

It has long been known that active smoking exerts a negative effect on normal ear functioning and hearing by chronically irritating the Eustachian tube and the lining of the middle ear. Smokers tend to have more chronic ear disease requiring surgical correction, and have more advanced disease at presentation than their non-smoking counterparts. Their hearing commonly suffers as a result.

A new study presented at the 2007 AAO-HNSF Annual Meeting & OTO EXPO has shown for the first time that once surgery is performed to rid smokers of their ear disease, their postoperative hearing acuity is significantly worse than non-smokers who undergo similar surgery. They are also prone to more complications and need more revision surgery on average than non-smokers. The large retrospective study examined 1,531 procedures in 1,183 patients for ear disease from 1990-2004. Patients included 846 smokers, 291 nonsmokers, and 74 former smokers. Most importantly, patients who smoked had worse preoperative and postoperative hearing. However, those who had been smoke-free for more than five years attained recovery rates similar to nonsmokers.

These study results provide for millions of smokers who suffer from chronically infected ears and some forms of hearing loss, scientific evidence that renewed efforts to quit will positively impact their treatment course and perhaps protect their ability to hear.

About the AAO-HNS

The American Academy of Otolaryngology – Head and Neck Surgery (www.entnet.org), one of the oldest medical associations in the nation, represents more than 12,000 physicians and allied health professionals who specialize in the diagnosis and treatment of disorders of the ears, nose, throat, and related structures of the head and neck. The Academy serves its members by facilitating the advancement of the science and art of medicine related to otolaryngology and by representing the specialty in governmental and socioeconomic issues. The organization's mission: "Working for the Best Ear, Nose, and Throat Care."

Is it Really a Hearing Aid? What You Need to Know Before Purchasing

The advertisements usually run late at night or real early in the morning because they're targeted at the senior crowd – those of us who have trouble sleeping. Or you see them in weekly coupon books and magazines. The commercials and ads push various hearing devices that enable "You to hear the TV without disturbing your partner for less!"

Well, maybe it's true but there's plenty of research to demonstrate that these ear amplifiers are not true hearing aids. And worse, yet, these low-ball, $19.95 plus shipping and handling personal sound amplification devices can actually be dangerous.

A study published by Michigan State University (MSU) in 2008 found low-cost amplifying devices not only do not meet the fitting requirements to help a person with hearing loss, but could actually potentially damage a person's hearing.

As reported in an article on Healthy Hearing, "Can You Put a Price on Good Hearing?": "The MSU research is important to consumers, Callaway said. Aside from being of extremely poor quality, very low-cost hearing aids - those under $100 - have the potential to damage your hearing because they send very loud sounds into the ear. The study's mid-range hearing aids ($100-500) were of higher quality and were not considered a safety hazard."

Regulation Hearing Aids Versus Personal Sound Amplification Products (PSAPs)

The strictest definition of a hearing aid covers a broad range of hearing "support" and conditions. Here's the definition, plain and simple.

Hearing aid means any wearable instrument or device for, offered for the purpose of, or, represented as aiding persons with or compensating for, impaired hearing.

So, a tiki shell necklace sold by a voodoo man who claims the necklace, when worn for eight full moons, will clear up that lost hearing qualifies as a hearing aid under this definition. After all, the salesperson "represented" the voodoo magic as a cure for hearing loss. Hey, what more do you need?

Ok so perhaps that is an extreme and silly example. And of course we all know a shell necklace is not a hearing aid; however, you may think you know what a hearing aid really is and does. But when it comes to PSAPs versus hearing aids, looks can often be deceiving. In all reality, many PSAPs look like an actual hearing aid and many consumers, persuaded by a cheap price, purchase them thinking they are getting a hearing aid for their hearing loss.

Consumer must look beyond appearance to know if a device is an actual hearing aid. Hearing aids are compact devices comprised of digital circuitry that can be adjusted to the wearer based on professionally administered hearing evaluations.

So, a true hearing aid:

• is programmed by the hearing professional (such as an audiologist or licensed hearing aid dispenser) in order to precisely amplify for a diagnosed hearing loss
• may or may not be manually adjusted by the consumer, depends on model chosen
• are intended to compensate for hearing loss and are labeled with this intention
• are regulated by the Food and Drug Administration (FDA)

Now, how is a hearing aid different from a personal sound amplification device or PSAP?

• PSAPs are intended to amplify environmental sounds for non-hearing impaired consumers
• Amplification is preset and is further controlled by the wearer by volume control changes
• They are not programmed based on a hearing loss
• They are low cost, which translates in to low quality sound quality
• The PSAP is not fit by a hearing professional
• A PSAP is NOT recognized as a medical instrument, which means (1) it doesn't have to meet the same FDA standards as hearing aids do and (2) it doesn't have to fulfill the promise on the box of "Easy, natural sound." (no labeling restrictions)

The Food and Drug Administration

The FDA requires hearing aid manufacturers to adhere to a strict set of regulations and standards in the design, development and use of their hearing aids. These stringent standards fall into the Category of Class I (General Controls) under FDA regs and these, in no uncertain terms, set the bar for even minimum quality standards for hearing aids.

The FDA defines a hearing aid as "any wearable instrument or device designed for, offered for the purpose of, or represented as aiding persons with or compensating for, impaired hearing." This definition encompasses both air and bone conduction devices in a variety of styles.

PSAPs are regulated under something called the Radiation Control for Health and Safety Act of 1968 that simply states that PSAP makers must provide "Notification of defects or failure of compliance of manufacturers" and "repurchase, repair of replace the electronic product."

The FDA states: "PSAPs are intended to amplify environmental sound for non-hearing impaired consumers. They are not intended to compensate for hearing impairment. Examples of situations in which PSAPs typically are used include hunting (listening for prey), bird watching, listening to lectures with a distant speaker, and listening to soft sounds that would be difficult for normal hearing individuals to hear (e.g., distant conversations, performances). Because PSAPs are not intended to diagnose, treat, cure or mitigate disease and do not alter the structure or function of the body, they are not devices as defined in the Food, Drug and Cosmetic Act. As such, there is no regulatory classification, product code, or definition for these products. Furthermore, there are no requirements for registration of manufacturers and listing of these products with FDA."

That's it. Basically unregulated devices are available to persons to purchase just as long as they do not claim to compensate for hearing loss on their labeling.

So what's the Big Deal?

Several big deals, actually, all involving your ability to hear and keeping what natural hearing you have left. So, that makes it pretty important.

The problem comes from the widespread use of PSAPs by a lot of people who don't need them. In addition, these devices can be cranked to max volume, no sweat. No hearing, either, but no sweat.

PSAPs, which are currently under study by the FDA, are growing in popularity and actually replacing the use of certified, quality hearing aids for a number of reasons:

• easily accessible (just watch TV for half an hour)
• much lower cost and,
• ease of use

However, the use of these listening devices creates some problems that users might not have even considered:

• the delayed diagnosis of a treatable hearing loss problem
• the inappropriate use of the o-t-c devices
• less-than ideal fit – in fact, PSAPs are usually a one-size fits all gizmo
• less-than ideal fits due to the poor quality of PSAPs can lead to negative opinions toward amplification devices in general and prevent persons with hearing loss from pursuing hearing aids when they actually truly need them

And while all of these are serious, potentially dangerous aspects of PSAP use, the worst is yet to come.

Hearing aids – even basic, plain vanilla hearing aids – come standard with sound limiters and filters that prevent further damage to the already-damaged hearing mechanism. These hearing aids are further tuned by your hearing professional to ensure that you get the boost you need at certain frequencies, but limits the loudness the device produces.

This protects the inner ear from further damage caused by exposure to loud noise over a long time period. Not so with PSAPs.

PSAP maximum volume comes preset and is determined by the wearer who, naturally, amps up the volume to a comfortable hearing level. Unfortunately, it may also be a dangerous hearing level due to existing hearing loss – the reason the consumer purchases the PSAP in the first place, in many cases.

To hear the TV better, to hear on the telephone (watch that feedback), or to hear the deer before it hears you – some people who purchase PSAPs don't even have hearing loss. The just want to hear better in certain situations. Unfortunately, PSAPs don't come with limiters or filters so the danger of further hearing loss is always a possibility.

And though the FDA is in the process of defining regulations for PSAPs, in the end it's your responsibility to get pro-active when it comes to hearing health. What does that mean?

If you're considering the purchase of a PSAP, you already suspect hearing loss, right? So, have a hearing evaluation and consider purchasing actual, legit hearing aids and enjoy the sounds that surround you. (If you truly are looking at a PSAP for recreational use and do not have hearing loss, great - wear with caution.)

Your hearing aid – even the entry-level variety – will deliver a healthier and more natural listening experience – one worth the investment. In fact, you'll wonder why you waited this long. Treating hearing loss with hearing aids has been shown time and time again in studies to improve overall quality of life. When it comes to your quality of life, is it worth going cheap?

See a hearing professional today and take the first step toward a better quality of listening, a better quality of life. And stay clear of any device that let's YOU decide what's loud enough. Chances are, it's too loud.

Think "healthy" hearing, your ears will thank you.