Physician's Perspective

Baltimore Grand Prix—“The Buzz” May Last a Lifetime!

Steven R. Gambert, MD, AGSF, MACP Editor-in-Chief, Clinical Geriatrics

As some of you may know, I live in Baltimore, MD, a great city that has many wonderful offerings for its citizens and the myriad of tourists who come to partake in the festivities surrounding our Inner Harbor and elsewhere throughout the year. For the past few months, there has been a “buzz” heard around town—the Baltimore Grand Prix, of course!

We endured months of city planning for this event followed by weeks of street closures and construction as we witnessed our fair city being redesigned to accommodate Indy race cars. The inaugural race, which took place during Labor Day weekend, drew an estimated crowd of more than 150,000 people of all ages who came to watch the race up close. For several days, I heard the engines roar—and I live approximately 5 miles from the racing site! I can only imagine the noise level at the track.

While the debate continues over whether this now annual event will be a boom or a bust to the city and its commuters, citizens, and businesses in the long term, I remain troubled over its potential consequences to the hearing of unsuspecting spectators and innocent city dwellers living near the race course. I have not heard of any public warnings issued or widely publicized notices urging people to wear earplugs when entering “critical” noise zones. While earplugs were not an automatic “gift” upon purchasing tickets, I have heard that they were available upon request after entering the Grand Prix gates—hopefully in sufficient quantities for all—and were also available for sale outside of the course at several vendors. I strongly suggest that in future years, the healthcare community take a stand and advise what steps should be taken to protect the public’s hearing and health.

There are approximately 40 million Americans suffering from hearing loss, with at least 10 million cases attributed to noise-induced hearing loss (NIHL). NIHL can be caused by even a one-time exposure to loud sound and by repeated exposure to sounds at various loudness levels over an extended period of time. Hearing is lost when microscopic hair cells inside the cochlea that respond to mechanical sound vibrations by sending an electrical signal to the auditory nerve are damaged. The healthy human ear can usually hear frequencies ranging from 20 to 20,000 Hz. As individuals age, we lose high-frequency hearing, a process that is accelerated by environmental exposure to excessive noise. This results early on in an inability to discriminate sounds in noisy areas; speech also sounds mumbled as we lose our ability to hear high-frequency consonants. While we may hear sounds if one speaks loudly, our ability to comprehend what is being said is impaired in a process known as sensorineural hearing loss. Not only may this reduce one’s ability to hear, but it also increases one’s chances of developing tinnitus, a ringing and/or buzzing in the ear that can greatly reduce quality of life, interfere with sleep, and result in depression.

A typical conversation occurs between 50 and 60 dB. An idling bulldozer, on the other hand, gives off approximately 85 dB of sound, which can lead to permanent hearing loss within hours. It is not uncommon for children to set their portable media player earphones so that they deliver sounds in excess of 100 dB, which is a sound loud enough to cause permanent hearing loss after just 15 minutes.

Indy cars racing through cities like Baltimore have recorded sounds as high as 118 dB. A study that used the Long Beach Grand Prix as a reference projected sound levels along the Baltimore race course from 95 dB near the Babe Ruth Birthplace Museum near Dover Street to 118 dB across from the Maryland Science Center near the hairpin turn at Light Street. The National Institute on Deafness and Other Communication Disorders reported that being exposed to sounds >110 dB for even as little as 1 minute risks permanent hearing loss. While I have no specific data from the Baltimore Grand Prix race, and I’m unsure whether any will ever be published, it would be prudent to analyze the event and others similar to this in scope in great detail to prepare for any impact that future races may have on our citizens’ health.

As a medical community, I hope that in the future we will better prepare those who live near race courses such as this one; attendants of future races, waiting to see the blur of cars pass them by; or anyone in any city in America who might be at risk of being exposed to excessive noise levels for whatever reason. Earplugs, if properly used, can greatly reduce the impact of loud noises, but they must be made available and individuals must be urged to use them properly when necessary. As a public service, it would make great sense to provide posters showing people how to properly use earplugs; to distribute earplugs, along with information on the necessity of their use and clear warnings on the hazards of noise pollution upon entering high noise areas such as the Grand Prix region; and to make earplugs available to all citizens of the neighboring communities and to those walking within “danger zones,” who might be exposed to excessive noise from the race. Additionally, education regarding the potential hazards of exposure to excessive noise, whether at home or outside of the home, should be a part of every school curriculum and something that all physicians include in their preventive advice to all patients, regardless of their age. This is one way to prevent the acceleration and magnification of what is already considered to be a normal age-related decline in high-frequency hearing.

Sadly, reports have been made of higher rates of hearing loss among the youth of America since the introduction of devices that use earphones, such as MP3 players and portable game devices. Aging is accompanied by a loss of reserve, and the earlier we lose vital function in any area, the earlier we will be at risk of disability and impaired functioning. While full disclosure may not always be good for business, in this case, education on the proper use of earplugs and the hazards of noise pollution may go a long way to help protect the health and well-being of our local citizens and ultimately, in my opinion, is the right thing to do!

Dr. Gambert is Professor of Medicine and Associate Chair for Clinical Program Development, Co-Director, Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Director, Geriatric Medicine, University of Maryland Medical Center and R Adams Cowley Shock Trauma Center, and Professor of Medicine, Division of Gerontology and Geriatric Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.

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