Why are loud restaurants bad for your health?
In the first of a series of medical guest posts, Daniel Fink MD explains why loud restaurants are bad for patrons and venue employees.
Daniel Fink MD
Why are loud restaurants bad for patrons? Because many of them are loud enough to cause hearing loss.
The National Institute for Deafness and Other Communication Disorders states, “Long or repeated exposure to sound at or above 85 decibels can cause hearing loss.”  But 85 decibels (dB) is not a safe noise exposure level for the public, especially without any time limit being specified. 85 A-weighted decibels (dBA, weighted to reflect the sounds of human speech) is an occupational noise exposure standard that does not protect all exposed workers from noise-induced hearing loss. 
Noise is different from other occupational exposures, e.g., toxic solvents or ionizing radiation, because noise exposure continues outside the workplace, all day long, all year long, for a lifetime. In 1974, the Environmental Protection agency adjusted the occupational standard for additional exposure time- 24 hours a day instead of 8 hours a day, 365 days a year instead of 250 days at work- to calculate the only evidence-based safe noise level to prevent hearing loss. This is a time weighted average of 70 decibels for a day.  This number is cited by the World Health Organization  and other researchers. [5,6,7,8] The real safe noise level to prevent hearing loss is probably lower than 70 dB, because the EPA only used the 40 year occupational exposure times. When the average American is living almost to 80, the additional years of noise exposure are a problem. This may be why hearing loss is so common in older Americans. 
Hearing damage from noise begins at only 75 dBA  And the laws of mathematics mean that after two hours of exposure to 85 dBA sound, it’s impossible to reach the 70 dB average sound level for the day, even if one has zero sound exposure, which of course is impossible.
Remember: if it sounds too loud, it is too loud. Ask the restaurant manager to turn down the volume of amplified sound, insert ear plugs, or need hearing aids later.
- National Institute on Deafness and Other Communication Disorders. Noise-induced hearing loss. Available at https://www.nidcd.nih.gov/health/noise-induced-hearing-loss.
- Kardous CE, Themann CL, Morata TC, Lotz WG. Understanding noise ex- posure limits: occupational vs. general environmental noise. 2016. Available at: http://blogs.cdc.gov/niosh-science- blog/2016/02/08/noise
- . US Environmental Protection Agency. Information on levels of environmental noise requisite to protect public health and welfare with an adequate margin of safety. 1974. Available at: https://www.nonoise.org/library/levels74/levels74.htm
- Berglund B, Lindval T, Schwela DH, (Eds.) & World Health Organization Occupational and Environmental Health Team. World Health Organization: Guidelines for Community Noise, 1999 Available at http://www.who.int/iris/handle/10665/66217
- Passchier-Vermeer W, Passchier WF, Noise exposure and public health. Environ Health Perspect 2000 Mar;108 Suppl 1:123-131 Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1637786/
- Hammer MS, Swinburn TK, Neitzel RL, Environmental noise pollution in the United States: a public health perspective. Environ Health Perspect 2014;122:115-119 Available at http://dx.doi.org.10.1289/ehp.1307272
- Basner M, Babisch W, Davis A, et al. Auditory and non-auditory effects of noise on health. Lancet 2014;383:1325-1332 Available at http://dx.doi.org/10.1016/S0140-6736(13)61613-X
- Fink DJ, What is a safe noise level for the public? Am J Publ Health 2017;107:4-45 Available at https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.2016.303527
- Lin FR, Niparko JK, Ferruci L, Hearing loss prevalence in the United States. Arch Int Med 2011;171(20):1851-1852. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3564588/#
- Flamme GA, Stephenson MR, Deiters K et al. Typical noise exposure in everyday life. Int. J. Audiol 2012;r51: S 3-11 Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4685462/#