It's Time To Do More About Preventable Hearing Loss Than Just Telling Kids To Turn Down The Volume On Their iPods

Researchers at Harvard University and Brigham and Women’s Hospital in Boston have concluded that nearly one in five American adolescents suffers from the same degree of hearing loss comparable to the age-related loss normally found in adults in their ’50s and ’60s. And people immediately are pointing the finger of blame at all the usual suspects: rock concerts, cell phones, and the ubiquitous Apple iPod and other portable music players. That’s all well and good, but it begs the question of all the other environmental noise people are subjected to from birth. The sad fact is we’re living in a much noisier world than 20 or 30 years ago, and no matter how many times we tell people to turn down the iPod, there is no substitute for a far more organized response to the epidemic of environmental noise-related hearing loss than we have seen to date.

In findings published in this month’s Journal of the American Medical Association, the researchers analyzed data from two major surveys done by the National Institutes of Health, one done in 2005-2006 and the other done from 1988 through 1994. They found the rate of significant hearing loss — such as inability to hear soft sounds such as whispers or high-frequency sounds such as high musical notes or high-pitched voices — had increased among adolescents aged 12-19 from 14.9 percent in the first survey to 19.5 percent in the second, a 30 percent increase.

The study’s authors were careful not to point to reasons for the hearing loss but emphasized the need for everyone to take more steps to protect their hearing, and to invest more energy in teaching adolescents about the dangers of hearing loss. “What makes hearing loss in adolescents even more concerning is previous research showing that teens underestimate the importance of hearing and the dangers of noise exposure, and don’t make protecting their hearing a priority,” said lead study author Josef Shargorodsky, a physician-investigator at the Channing Laboratory at BWH.

Shargorodsky, a clinical fellow in otology and laryngology at Harvard Medical School told the Boston Globe that the study points to the need for more awareness among educators about the possibility that hearing loss is affecting a significant number of students’ ability to hear in the classroom: “There are probably a couple of kids in every classroom in America who will have some level of hearing loss, and it’s important for teachers to be aware of that and parents and physicians, as well.’’

The researchers’ primary conclusion was one that you usually get with every government funded study — that it should lead to more government funded studies. For sure, more research needs to be done on the specific causes of the epidemic of adolescent hearing loss. And the admonitions to turn down your iPod should continue. But there are dozens of things the public can do today to address the problem. Starting with:

1. Investment in a public health campaign focused on hearing prevention. In Europe there have been far more public awareness campaigns on hearing loss prevention than in the U.S., where past investments by the Centers for Disease Control and other agencies to educate the public about preventive health concerns relating to cigarette smoking, AIDS, obesity and other issues have been very successful.
2. More screening by general practitioners–including pediatricians–in annual physical exams. A scandalously low number of physicians even asks their patients about their hearing when in fact good hearing, and hearing assistance if needed, are critical to maintaining good mental and physical health.
3. More efforts by the schools to help students hear their teachers. Screening of students for hearing loss in the first week of school, more sound field classroom systems and other assistive listening technologies, plus a new look at acoustics in the design of schools and classrooms, can all help students hear and learn much more effectively.
4. More and better hearing protection devices. This is one problem where technology definitely can and should come to the rescue. There is a huge market opportunity for hearing aid companies and other entrepreneurs to develop better ear plugs, including dynamic hearing devices that filter out dangerously loud noises while enabling the user to hear normal sounds including speech.
5. Focus on hearing protection in the workplace. Again, the European Union is ahead of the U.S. in raising awareness of the dangers of hearing loss in the workplace and, when necessary, doing something about it. The U.S. Occupational Health and Safety Administration (OSHA) needs to take a closer look at the societal cost of hearing loss in the workplace and begin to hold employers accountable for simple steps to protect their workers’ hearing.

Hearing loss is entirely preventable, but it will take more than gratuitous, knee-jerk bellyaching about people tuning out on their iPods to avoid what could become one of the larger public health crises we will face in coming years.

HearUSA Markets Hearing Aids To 40 Million U.S. Baby Boomers Who Belong To AARP

HearUSA may have found its key to success in retail sales of hearing aids with its exclusive contract with AARP, the 40-million member organization for Baby-Boomer Americans aged 50 and above. In its second-quarter financial report this week, HearUSA said the nationwide roll-out to AARP members that began early this year helped account for a nine percent increase in sales over the first quarter of 2010.

In the 23 years HearUSA has been selling hearing aids through company-owned retail outlets throughout the U.S., the company has struggled along with the rest of the hearing industry to effectively reach the 30-plus million Americans with hearing loss, including an estimated 10 million or more who have never tried hearing aids. Since signing a deal with AARP to provide its members with hearing-aid discounts and other services in 2009, HearUSA has aggressively marketed Siemens hearing aids to the 50-and-over set of hearing-impaired consumers through a hearing care network of nearly 2,000 independently practicing audiologists and hearing care professionals and its more than 180 company owned hearing centers throughout the U.S.

“We have seen appointments grow at an accelerating pace since we launched our AARP national advertising campaign, and AARP included the HearUSA program in its publications and web sites in the latter half of the second quarter,” said HearUSA CEO Stephen Hansbrough in a news release reporting second-quarter sales of $21.4 million. Although the revenue total is an increase over the first quarter of 2010, on a year-to-year basis it is still less than the second quarter of 2009, a decline HearUSA attributed to managed care insurance programs cutting back hearing-health benefits to their members in the past year.

HearUSA’s AARP distribution program is not an insurance plan but does provide AARP members with benefits including:

• 20% savings on a range of digital hearing aids
• 90-day money-back guarantee
• 3-year manufacturer warranty
• Free 3-year supply of hearing-aid batteries (a $100 value)
• Free directional microphones (a $150 value per hearing aid) for models that use them
• 1-year extended follow-up care program at no charge to AARP members
• Exclusive 15% discount on hearing healthcare products including hearing aid accessories, batteries and assistive listening products from HearUSA’s online store

Since scoring the exclusive AARP distribution contract in 2009, HearUSA has invested heavily in a nationwide roll-out of the program. HearUSA reported a net loss of $1.9 million in the second quarter, attributing much of it to more than a million dollars spent so far this year advertising the AARP program to drive the increase in sales through its hearing centers. “We expect this momentum to continue and believe that center revenues will grow between 9% and 15% in the second half of 2010 when compared to the first half, and our target is to grow center revenues 15% to 20% in 2011 when compared to 2010,” Hansbrough said.

It’s probably too soon to say that HearUSA and AARP have cracked the code on getting hearing aids into all the ears of the millions of Baby Boomers who need them, as market penetration rates continue to be lower than one would expect given the need. But it’s a good sign they are demonstrating that the right mix of incentives and awareness can at least start the ball rolling.

Amplicom's New PowerTel 500 Cordless Phone Features Multiple Frequency Settings

Amplicom, the German supplier of amplified telephones and other assistive listening devices (ALDs) for hard-of-hearing consumers, has entered the North American market with first shipments of its family of PowerTel corded and cordless amplified phones. Amplicom USA, based in New York, said the new phones meet the Telecommunications Industry Association’s TIA-1083 hearing-aid compatibility standard and are among the few amplified phones to offer DECT 6.0 technology, the interference-free frequency that is standard in Europe but only recently being widely adopted in North America.

The initial entry in the product line, the PowerTel 500, is a cordless handset with hands-free speakerphone, caller ID, and a large two-line illuminated display. It provides amplified volume of up to 50 dB and offers five frequency settings. Featuring Amplicom’s yourSOUND technology, the PowerTel unit has settings on the PowerTel unit that can be adjusted and set for multiple hearing profiles, enabling each member of the household can switch to his or her own preferred volume and frequency.

Suggested retail for the PowerTel 500 is $139.95. Amplicom also said it will soon start shipping the PowerTel 501, an expandable handset that works with all cordless base PowerTel phones, for $89.95, as well as a series of combination telephone and answering machines. It enters a competitive but by no means crowded market for amplified phones, including other vendors such as Clarity Products and ClearSounds.

GN ReSound Reported Flat Sales For Q2 But Predicts An Increase In Hearing Aid Market Share This Year

More evidence of a turnaround in worldwide sales of hearing aids came with GN ReSound’s announcement of improved financial results today, but overall growth in the industry remains anemic. GN ReSound, one of the six largest global hearing aid makers, announced flat organic growth in the second quarter of 2010 over the same period in 2009, after sales declines in the previous five quarters. And the Denmark company made an optimistic forecast for the remainder of the year, predicting that it will increase its share of the global hearing aid market in the second half of 2010.

“We expect to grow above the market in the second half of 2010,” said Lars Viksmoen, CEO of GN ReSound, pointing to the successful introductions of new high-end hearing aid families in late 2009 and the first half of 2010. “This expectation is building on the successful introduction of the Surround Sound by ReSound-featured products–ReSound Live and dot2 by ReSound in late 2009–combined with the global launch of ReSound Alera.”

In ordinary times, predicting an increase in market share when your sales are flat would be a bold claim. But like all global businesses, hearing-aid manufacturers have been hurt by the recession over the past two years and will be happy to eke out single-digit sales increases in 2010. Moreover, GN ReSound’s recent successful launch of its new flagship Alera family of hearing aids, which feature new wireless technology including streaming of TV audio signals into the hearing aids without requiring a device around the neck to relay the signal, gives the company reason to hope for faster growth than the rest of the industry the rest of this year.

GN ReSound is part of the GN Store Nord group, which also includes GN Netcom, maker of the popular Jabra Bluetooth headsets and a leading supplier of contact center and office (CC&O) headsets, a market expected to triple to nearly $2 billion in global sales by 2014. Like Sonova, which leverages its research and development in hearing aids to provide a broad line of other audio products, through GN Netcom the parent company is investing heavily in high-end hearing assistance products, above and beyond hearing aids.

Classroom amplification systems have been around a long time, as have FM-based systems transmitting the teacher’s voice into headsets or hearing aids worn by individual hard-of-hearing students. But the experience of users varies tremendously depending on the placement and quality of speakers, the quality of the microphones and amplifiers, and the acoustics of the classroom itself. The drawbacks of earlier systems were so pronounced that the Acoustical Society of America found that “improperly maintained microphones and loudspeakers or poor user skills can cause even poorer speech communication than no amplification system.” In other words, amplifying unintelligible noise only makes voices that much more unintelligible.

But long-term studies have indicated that amplification and other forms of assistance in the classroom can dramatically improve learning The Mainstream Amplification Resource Room Study (MARRS), which found that “significant educational instruction effects can be achieved by sound field amplification” and that “these gains can be cost effectively realized within the regular classroom without the need for stigmatizing labeling and segregation as well as expensive and scheduling complications of special class placement.”

Phonak’s Dynamic Soundfield system addresses the reverberation and echoing that makes comprehension more difficult with amplification by its array of directional speakers that automatically adjust frequency and volume settings to the acoustics of the room to reduce rather than increase reverberation. Years of research into how directional microphones in hearing aids can achieve a higher signal-to-noise ratio to make voices easier to understand in difficult listening environments have been applied to the acoustical problems amplifying a teacher’s voice in a noisy classroom.

The new Phonak Soundfield system is also the first to operate simultaneously in multiple modes, permitting the teacher to broadcast directly through a Phonak inspiro FM transmitter to individual students wearing headsets or hearing aids while broadcasting to the rest of the class over the amplified system. The new system also is “future proof,” providing flexible integration with standard computer and audio systems, and eliminates interference issues through automatic frequency hopping, allowing the Dynamic Soundfield to co-exist alongside a school’s WiFi and Bluetooth networks.

Buy a Hearing Aid.com Provides Information On Hearing Aids And Referrals To Local Audiologists

There is a new web site devoted to helping hearing-aid buyers sort through what products on the market will best meet their needs and find a reputable audiologist nearby who can help them. Buy a Hearing Aid provides detailed information about the major hearing aid brands and makes it easy to compare and contrast features and benefits. And if you provide them with your zip code and email address, they will refer you to an audiologist in your neighborhood who can fit you with a new pair of hearing aids.

Buyers need to beware of the growing number of sites on the web that purport to offer information on hearing-aid choices, but which have actually been set up just to generate search traffic and advertising revenue, without offering substantive or even helpful information. That’s why it’s nice to see an addition to the few reputable sites (such as Hearing Planet which I’ve written about before) that are staffed by professionals who know what advice consumers need and who can provide appropriate referrals to the right kind of hearing-health professionals.

The Buy a Hearing Aid site is the brainchild of Mark Brumback of Hearing Aid Express, one of the largest independently owned and operated hearing-aid sellers in the U.S. with primary locations in Houston and Dallas, Texas. (It is also among the first North American hearing-aid companies to sell the new Panasonic line of hearing aids). Hearing Aid Express fits multiple brands of hearing aids, and the company’s breadth and depth of knowledge of the various hearing-aid brands  is now presented on the Buy a Hearing Aid site for three classes of consumers: those who have never owned hearing aids, those who currently own hearing aids, and those who are interested in buying hearing aids.

Petar Dimov, a web developer and search optimization expert, built the site and is developing a comprehensive database of all hearing aid brands and models. Audiologists can pay a small annual fee to have details of their practice presented on the site including any sales offers to attract local customers.

Passage was expected after the U.S. House of Representatives overwhelmingly approved its version of the same bill, H.R. 3101, last week, and now all that is required is reconciliation of the two bills, a final vote in the House and President Obama’s signature. In what House sponsor Rep. Edward Markey has called “online ramps to the Internet” for people with disabilities, the new law will, among many other things:

• Require captioned television programs to be captioned when delivered over the Internet.
• Authorize the FCC to require 7 hours per week of TV video description for vision-impaired people on the top 4 network channels and top 5 cable channels nationwide.
• Allocate up to $10 million per year for communications equipment used by individuals who are deaf-blind.
• Require devices of any size to be capable of displaying closed captioning, delivering available video description, and making emergency information accessible.
• Require accessible user controls for televisions and set-top boxes, and easy access to closed captioning and video description.

The new law is a huge step forward for people with disabilities in an age when equal access to Internet services is an absolute must for anyone to successfully earn a living and enjoy the quality of life that other accommodations have enabled ever since passage of the Americans With Disabilities Act (ADA) 20 years ago.

The slowdown from the much faster sales ramp in 2009 is bad news for an industry hoping for a quick recovery from the 2008-2009 recession. It may also indicate that even the raft of new products and capabilities introduced by hearing aid manufacturers in the past two years may not be enough to spark the long-awaited takeoff in hearing aid sales to a generation of Baby Boom consumers steadily losing their hearing at predictable rates.

The surge in government-funded purchases by the VA can be attributed to loosened restrictions on reimbursement for veterans needing hearing aids over the past several years, as well as to the age wave of Korean War and Vietnam War veterans now requiring hearing assistance and the many younger veterans returning from Iraq and Afghanistan with hearing damaged by overexposure to environmental noise in the war zones.

While the government-supported VA market is a welcome shot in the arm to the industry, it’s still an open question why sales to ordinary consumers have yet to take off. With up to a third of the 35 million Americans in need of hearing assistance doing without hearing aids, the question to answer is “when,” not “if.” However, the poor sales improvement in 2010 so far makes it clear the hearing aid industry has yet to crack the code to realizing the expected surge in sales to a market that needs hearing assistance more and more all the time.

The GN ReSound Alera Hearing Aid Family Sets The Bar High For Next-Generation Wireless Features

The wireless features in the new GN ReSound Alera family of hearing aids, which start shipping this week, are very similar to those found in several other high-end hearing aids already announced by other manufacturers. But, taken together, they help set the bar higher for premium hearing aids and assistive listening devices in general. The only question is how much better the new wireless features will make the new hearing aids from GN ReSound and other manufacturers when users start trying them out in the field.

One of the first things you learn in Marketing 101 is that  ”first,” “best” and “only” are some of the strongest words in the English language. So it’s no surprise that in the increasingly competitive hearing-aid industry, manufacturers are starting to use those words more often. GN ReSound’s news release announcing first shipments of the Alera hearing aids is a good example, claiming the company has come up with “the first truly wireless hearing aid with no strings attached.” The news release goes on to announce “a new approach to the way a hearing aid receives sound from devices such as TVs, stereos, cell phones and computers,” claiming that, “for the first time the patient can receive sound directly from the device without cables, wires or the need to wear uncomfortable accessories.”

That’s an exciting claim, except for the fact that, at least two other leading manufacturers that I know of have already announced products delivering very similar benefits by streaming wireless audio directly into their hearing aids. The new Widex Clear 440 family of hearing aids provides wireless streaming of cell phone and television signals directly into the hearing aids, without cables or wires, and the Oticon Streamer has been transmitting Bluetooth signals from a distance of up to 20 inches into hearing aids since its introduction along with the Oticon Epoq family of hearing aids in 2007. So it’s worth a close look at how GN ReSound is the “first” or “only.”

• UPDATE (Aug. 9): According to Karen Sams, a marketing representative for GN ReSound (see her comment at the end of this post), the Alera hearing aids’ proprietary 2.4 GHz transmission scheme eliminates the transmission delay that causes echoing and signal degradation in other wireless hearing aid products. It also transmits over longer distances than other hearing aid manufacturers’ wireless products, with the Alera Unite TV streamer broadcasting directly from your television set into your hearing aids — without requiring a second device worn on the body to relay the signal into your hearing aids. Not requiring an intermediary relay streamer is a real advantage that I’ve only seen with the GN ReSound Alera products. Most wireless hearing-aid products still use near-field magnetic induction, transmitting from the streamer through an  induction loop into the telecoils in your hearing aids. I’ve experienced widely varying results with wireless induction, especially the signal distortions and delays that GN ReSound says it is solving with the Alera wireless products featuring near-field induction technology. So GN ReSound is backing up its claim to be first to deliver new technology with new user benefits.

However, while bragging rights about who is first may be important for a while, at the end of the day the market will vote for “best.” And on that score it’s clear GN ReSound is in a neck-and-neck competition with other makers of premium-brand hearing aids to lead in delivering new wireless features that will substantially improve the experience of hearing-aid users. In the past, the only way to get audio from an MP3 player or your cell phone or your TV was to either plug them directly into a Direct Audio Interface (DAI) shoe, a clumsy connector at the base of your behind-the-ear hearing aid that wires you directly to the device, or else stream the audio through an induction loop you wear around your neck which transmits through the telecoils in your hearing aids. The new technologies from Widex, Oticon and GN ReSound skip that intermediary step with devices that transmit directly into your hearing aids from distances ranging from 20 inches to more than 20 feet.

The Bluetooth phone streamers are small and have enough range to transmit from within your coat pocket; however, as you need to speak as well as listen, you need to fasten the microphone to your lapel (GN ReSound Unite Phone Clip) or hang the device from your neck (Oticon Streamer) or hold it up and speak into it like any cell phone (Widex M-DEX). The TV streamers are more interesting, with the new GN ReSound Alera’s Unite TV Streamer an impressive product that plugs into the TV and transmits TV audio directly into your hearing aids over a distance of up to 7 meters (23 feet).

So I am looking forward to the marketplace voting on which of the new packages of wireless features from high-end hearing-aid manufacturers is best. Most likely, different brands will meet slightly different sets of needs for different users, who will gravitate to the solutions based on whether they are heavy Bluetooth phone users or whether they watch a lot of TV. In any case, the new wireless technologies are setting the bar a notch higher for all makers of high-end hearing aids, where the market soon will be demanding more and better ways of integrating hearing-aid users with all the listening, communication and entertainment environments they encounter.

Massachusetts Attorney General Martha Coakley Makes Movie Theaters Agree To Provide More Closed Captions

On the same day that the U.S. Justice Department was asking for comments on a proposed rule requiring movie theaters to provide closed captions for hard-of-hearing customers along with audio descriptions for blind theatergoers, Massachusetts Attorney General Martha Coakley was finalizing an agreement with three of the biggest movie theater chains to dramatically increase accessibility options at movie theaters throughout the state.

It’s no coincidence that the major theater chains are finally agreeing to provide more accessibility services at the same time the government is making noises about strengthening its mandates. In Massachusetts, the agreement was a settlement of a formal civil rights complaint brought by deaf and blind residents alleging discrimination because of the absence of accessible technology.

The Justice Department put theater owners on notice it was considering changing its regulations under the Americans with Disabilities Act (ADA) to mandate closed captioning and audio descriptions at all theater locations. In a notice published in the Federal Register, the Justice Department noted the slow progress the industry had made in providing accessibility options in spite of advances in technology making captioning and audio descriptions easier than in the past:

The Department is concerned about what appears to be a significant disconnect between the production of movies that have captioning and video description capabilities and the actual exhibition or availability of such movies to individuals with sensory disabilities. The Department also is concerned that even when captioned and video described movies are exhibited, their showings appear to be relegated to the middle of the week or midday showings.

The publication of the notice about the proposed rule change is the start of a three-to-six month process that will include comments by all parties, hearings, and ultimately a decision to revise the regulations or maintain the status quo.

The consent agreement in Massachusetts may indicate which way the political winds are blowing and presage similar agreement to increase accessibility nationally. Three of the nation’s biggest theater owners, National Amusements, Inc. (which runs Showcase Cinemas), American Multi-Cinema (AMC Theaters) and the Regal Entertainment Group (Regal Theaters) agreed to ensure that every location in Massachusetts is equipped with accessible technology that will provide meaningful access to the hearing and visually impaired, including captioning technology and description technology.

Captioning technology takes a movie’s sound (dialogue, music, sound-effects) and converts it to a captioned format that a hearing impaired audience member can read.  Description technology provides a narration of what is displayed visually on the movie screen (action, scene changes, facial expressions) during natural pauses in the movie’s soundtrack through headphones worn by the visually impaired.

Additionally, the theaters agreed that multiplexes with 10 or more screens will have at least two accessible auditoriums, one of which will be in the locations’ largest auditorium — a huge benefit to theatergoers frustrated that the captioned movies are never the ones they want to see. By requiring captioning and audio descriptions in the largest auditorium, hearing and visually impaired patrons won’t have to wait for blockbuster films to make their way to the smaller auditoriums that have historically been equipped with accessibility equipment.

All in all, a banner week for captioning advocates, capping the celebrations of the 20th Anniversary of the signing of the ADA legislation and passage in the U.S. House of Representatives, by a huge margin, of H.R. 3101, the 21st Century Communications and Video Accessibility Act, that will require more accessibility over the Internet including closed captioning of TV shows broadcast on the web.