A Quick Question — Double Protection & 114 dB

Hello all,

the story:

I was driven to one of the hospitals in Prague where they specialize in Tinnitus in a crappy old ambulance. Each time the driver would slam the sliding door shut it'd generate a noise of 114 dB (obviously not a long time in duration but still, it was inside a small closed area - a van).

And that was about 8 - 9 times during the whole journey as I wasn't the only passenger.

I was using double hearing protection 32 dB SNR earplugs + 27 dB SNR Peltor Muffs. I figure that makes - 37 dB. In total I was then exposed to 77 dB each time the driver opened and shut the sliding door.

the question:

Do you think something like this could cause a further hearing damage or a tinnitus spike?

Thanks,

Jiri

 

I think you will be fine...
Don't worry and Hey soon the weekend chill and relax and it will help.
Love glynis

 

Thanks for the reply @glynis

I just feel everytime I try to help my ears now I cause them more damage instead.

I'm still not sure how the double hearing protection and bone conduction works.

Best,

Jiri

 

And what do you think, guys? Did I mess up badly this time, even tho unintentionally? @Bill Bauer @Markku

 

77 decibels @ less than a second each... No way. You'll be okay man.

 

Even without hearing protection, 77dB will not damage your hearing. I can empathize with those worries, but volume under 80dB is safe for many hours of exposure. The time is took to close a vehicle door is very brief.

Hyperacusis and tinnitus anxiety can make us worry and think everything is unsafe. Especially if you are wearing ear protection everytime you leave your home. I know for me, once I take off my earmuffs, I feel like everything is louder if I spend a long amount of time wearing them.

 

I don't think you need to worry about hearing damage, but a new T spike is certainly a likely possibility. The spike shouldn't be permanent, but still it makes sense to minimize the number of times you are exposed to loud noises like that.

 

Well, that's just according to my 'calculations'.. I could be wrong too, you know. I mean it could turn out it was way over 80 dB - I do linguistics not math. Is why I said I'm not too sure about how the double hearing protection and bone conduction works, I only heard about it recently. But thanks for the response anyway

Yeah, like I mentioned I could be wrong in my 'calculations'. I do have an H and I never leave the house without my muffs on. This time I brought the earplugs into the game too. It just felt so damn loud every time he did that. Like throwing firecrackers right in front of you. Should have used a bus instead *slams head against desk*

 

I think part of why it seemed so loud was because you were utilizing double protection. It was probably so quiet and then bam, the sound of the door closing disrupts the silence and is perceived as being louder than it actually is... Just a theory.

 

Ok, so I understand it certainly hasn't promoted my recovery. This past week was totally ridiculous: Mon a car honks at me at a zebra crossing, Tue the ear drops I was given by my GP turned out to be Ciprofloxacin (fluoroquinolone group of antibiotics) they did give me a spike in my bad ear, Thu the hyperbaric oxygen chamber started either malfuctioning or someone didn't have their gas mask properly put on, so they started to pressurise the chamber again through 2 pistons under high pressure (the super loud gas hissing sound), I swear it that sounded like it was somewhere between 80 - 90 dB and you're not allowed to wear ear protection inside, just pyjamas. And today, yes that ambulance door slamming. No matter what I do or how much I try to protect my ears these things just keep happening to me... like what th is going on? What time frame do you think I should expect the T spike?

I lost all our convo due to that maintance thing on here. So I guess my possible recovery is now down from 50% to somewhere around 20% according to your standards?

 

Yeah, could be. I had my sound meter on me (it's got time weighting fast: 125 ms) so on one occasion I took it out when he was 'closing' the damn door and when I saw 114 dB on it I began s* my pants and blaming myself for not using the public transportation instead. The free ride just wasn't worth it.

The irony tho, you go to see the best outta the best tinnitus specialists, you think to yourself 'oh an ambulance - I'll be safe' and then this keeps happening.... I'd slap myself now.

 

I wouldn't worry about impulse noises, less than a second with double protection isn't gonna hurt you unless we're talking about explosions and such.

 

I can only pray now you're right. It's just it was inside the small cabin, so you got a full hit by the sound wave, pressure and all... hope at least I had the earplugs inserted in properly.

Anyways, I talked about this with one of my pals who goes to a shooting range and they use the exact same muffs Peltor Bull's Eye 1 (-27 NRR) and you can imagine they use glocks (120 - 130 dB) and semi-automatic machine guns. Not one of them has either a hearing loss or tinnitus. It just doesn't add up..

 

Believe it or not most mid caliber handguns are actually hitting 160 decibels, sometimes more... Some people just don't get tinnitus, no matter how damaged their hearing gets. I know a guy with 75% hearing loss, not even the faintest ring, the human body is an anomaly.

 

Agreed.

I think I'm gonna spend some more time now studying how double hearing protection works and the bone conduction. Just to make sure.. I don't want the ringing to get louder, that'd be IT.

People around me, docs included want me to stop using the hearing protection so that my brain gets used to the "normal environmental sounds" again. I just feel with my luck I'll get hit by a train or smth..

Also, this test might be useful:

1. Distortion-product otoacoustic emissions (DPOAEs) are generated in the cochlea in response to two tones of a given frequency and sound pressure level presented in the ear canal. DPOAEs are an objective indicator of normally functioning cochlea outer hair cells.

 

If you don't feel anything within 24 hours, chances are you are going to be ok, and if there is nothing in 48 hours, then I am pretty sure you can stop worrying about it. In other words, even though these spikes can take a couple of days to get to their peak, in my experience the first time when they get loudER is within 24 hours.

Is the spike from the ototoxic drug over now?

I was also told that I was not allowed to take anything inside of the HBOT chamber. But when I insisted, and promised to only insert the earplugs when the chamber got pressurized (and to take them out when the chamber begins depressurizing), they allowed me to wear earplugs.

If you can, talk to all of the HBOT attendants. Explain your situation, and ask them to ensure not to do whatever it is they did on Thursday. In fact, it is possible that they can reduce the volume by reducing the "flow rate".

The above might have been the case had you been experiencing serious spikes as a result of the events that happened to you during this week. But it sounds like despite these shocks your T is at its baseline. Let's hope this means that your body is resilient and that the probability that you hear silence again is still 50% (or more).

 

Ok, but what about my calculations? Was I correct or not? 32 dB NRR earplugs + 27 dB Peltor Muffs. 114 dB impact noise (8 times) means 77 dB for Jiri each time? OR 32-dB plug and a 27-dB muffs does not yield 59-dB overall but rather 40 because of the bone conduction that limits the attentuation?

The spike was over within 5 hrs after onset. The pharmacist told me that if I didn't have a penetrated ear drum I had nothing to worry about. As in even if a molecule of the toxin got through it'd not likely wreak havoc in my ear. It's mainly the tablets and intravenous injections that cause these permanent ototoxic reactions in some people.

It's like talking to a brick wall. I asked them SO many times and they would not allow me to bring anything inside apart from a paper tissue in my pyjamas pocket. They're too scared of fire (which I can understand to some degree 100% oxygen can be pretty inflamable) but c'mon some people are allowed to bring in even ear muffs in other hbo chambers I heard. I think it's the lack of their education and I did have a proper go at the HBOT operator after the 'therapy' was finished. You have a patient with a hearing damage inside ffs - you cannot allow such thing to happen. They should've terminated the whole processs fix the problem and then start again. Unreal.

I'm 100% positive it was possible. They just chose not to do it. Outrage.

Losing my hope here, Bill. No matter how hard I try to protect myself these things just keep happening to me. As a matter of fact the harder I try the worse it gets it seems. What's next, a foghorn?

 

With double protection, the rule of thumb is supposed to be "take max NRR of the two, and add 5 dB". That's 37 dB of protection, in your case, which is 114 - 37 = 77 dB.

Great! You dodged a bullet there.

Ridiculous! I had been getting that too, and as a result I didn't have earplugs during the first three sessions. I had them during the last two sessions, and there was no fire...

All we can do, is try to hope for the best...

 

You probably didn't get the whole 32 dB protection out of the earplugs (depends on how deep they're inserted) but regardless, I think it will take a very extreme noise to get permanent damage when you wear double protection. A slamming car door? No way.

 

I think that that noise (experienced without hearing protection) is enough for a healthy week-long spike, and a bunch of those are enough for a permanent spike. No ear damage, though.

 

The way this is written tells me that you are suffering extreme anxiety. Multiple door slams at 114db? Exposure at 77 db?

That's awfully specific.

The door closing is NOT 114 db. not even close. Smart phone apps are notoriously inaccurate, and they get worse as it gets louder. Every 10db is 100x more powerful, and sounds 2x as powerful to our brains. The margin of error on trying to perceive decibel levels without pro equipment is HUGE.

Ministry of Sound, one of the loudest clubs in the world, averages 105db. That should keep the door closing in perspective.

 

forgive me. every 20db is 100x

 

I've inserted those plugs properly at home and deep. I've done it 100x before. It was when I was talking to the doc when I removed the muffs and plugs. Then in the rush it is possible that I didn't insert the earplugs in properly. Idk.
You know how loud those sliding old van doors are? In the new ones there's lots of rubber to lower the noise but in the old ones it's virtually metal hitting metal. I now blame myself for not taking the coach. I could've been ok.

No ear damage? How do you mean that?? My right ear is ringing loud today unfortunately, I fear my double-protection didn't work or that I miscalculated the protection. So it's a spike - that means ear damage, those microscopic hairs that form a fringe on the surface of each auditory cell in cochlea were moved again or broken, hence the spike I'm experiencing now. I can only hope and pray it's a temporary one and not a permanent one (again, 8x 110 -120 dB ish sound impact).

Oh and btw you said:

I was using this site to get an idea on how to calculate how the double protection works: https://www.audiologyonline.com/articles/extra-protection-wearing-earmuffs-and-1218
"the sum of the individual attenuation values (Berger, 1983), as illustrated in Figure 1. Note for example; at 1000 Hz the combination of a 26-dB plug and a 34-dB muff does not yield 60-dB overall, but rather about 41 dB. The principal reason is the bone-conduction (BC) limits to attenuation, which are also illustrated in Figure 1."

I was always a very anxious person and so were my parents. Perhaps the reason I lost them a long time ago.

Yes, that's the thing I didn't use a smart phone app. It was a sound meter recommended by the user Alue, it's got good reviews on Amazon and elsewhere on the internet too (URCERI Noise Decibel Meter 35dB-135dB with time weighting fast: 125 ms). Like I said it's literally slamming metal on another piece of metal - the protective rubber that should quiten the noise was gone missing - an old crappy ambulance. It is quite possible that each time he slammed the door shut the noise impact was always somewere between 110 and 120 dB. 8 f* times.

Bottom line is, the .gif below should give an idea of what I think happened to my hairs inside cochlea each time the door was shut and I was going there to see a tinnitus specialist, just imagine. FAIL

 

We have no idea what is causing those spikes. For example, several days ago, I had a spike (that lasted a little less than 36 hours) as a result of a stapler making a loud noise. I can't imagine that noise actually causing any damage, and yet I had a spike. And it is not as if I got stressed out as a result of the noise, and got a spike. I Didn't get stressed as I know that it is impossible for that sound to cause any damage. It is just a stapler! And yet, my T had spiked (taking me by surprise).

Adding 5 is a conservative estimate. I am glad to hear that a more realistic estimate is higher than 5.

Same here. I have always been an anxious person.

After the first time it happened, did you try asking him to try to minimize the force with which he was slamming that door shut?

 

As long as they entered the inner ear canal, you got some protection out of them.

Honestly, when disaster struck, you had both ear plugs and ear muffs. You should congratulate yourself for thinking ahead.

 

What if one doesn't experience spikes but still has tinnitus? This is a not one size fits all condition...

The only place I've used plugs since tinnitus is a couple of concerts I went to or if I've been in a loud environment like a bar 80+db. Certainly not in my everyday life like commuting to work etc.

 

My guess is the travelling sound wave at high velocity that moves again in other direction or breaks completely the microscopic hairs? If just a stampler gave you a 36 hrs lasting spike then by that logic I have a permanent spike now

Great. Just great. Somebody shoot me please.

Yes, ofc, I asked him even BEFORE I got in the ambulance. I was somewhat hoping that he'd allow me to sit with him in the drivers cabin front seat. He had just so much stuff in there on the seat including some oxygen canisters that it was not possible and, as usual, he didn't give a damn and slammed the doors each time the same way...

You know what's "funny"? A great majority of the success stories on here is people actually finding a way to habituate to their tinnitus. Not the tinnitus fading away or getting rid of it completely. Just habituation.

Like what other options do you have? It's either death or this.

Right off the top of my head I can only think of @jjflyman who got successfully rid of his noise-induced tinnitus. That's it. Where's the statistics? I mean if 10 - 15% of Earth's population suffers from T you'd think each countrie's, let's say specialized hospital would have some sort of stats. They're just not willing to share them. Perhaps, bec the probability of eventually getting rid of it is so so low.

Also, I kept discussing yesterday with my friend your 70%(or many) recover thread. I kept telling him that possibly the military camps abroad on a mission are well structured and have a good idea of the noise-induced tinnitus - you know that's freaking granades exploding and machine guns. That's a lot of noise trauma. So each time they'd return back to the camp(those who have had made it) they were put on a heavy course of steroids and HBOT thus at the end - many recovered. "Funniest" thing is I just ended my 10th HBOT and then the very next effin day the ambulance accident happens (114 - 120 dB 8 times) right on your way to see a t. specialist. Isn't life a joke???

They did enter the ear cannal but if you read this thread I still might be ending up with a permanent spike... Congratulating myself would be in place if I was more of an ass and told the ambulance driver that I have a hearing damage and would love for him to remove all that rubbish from his cabin driving seat so that I'd not be endagered by the freaking sliding doors slamming. I mean it's his job so... it seems to me I can only congratulate my own stupidity.

Also, I told him before I got in the amb. to go easy on those sliding doors as you know, I have a freaking hearing damage! But no, he's had places to be on time so.. probably didn't care one bit. How surprising.

 

The best thing for you sanity right now would be to just forget that it ever happened. You had two layers of protection on, they noises you were exposed to with impulse in nature, lasting less than a second, there's just no way that you caused any damage. If your T is spiking right now I can almost guarantee you that it's a combination of stress and concentrating on your T rather than actual damage. Stop beating yourself up, you had the foresight to utilize double protection and I can promise you that it did it's job, @Vincent R is the person to listen to here.

 

You've just no idea how much I wish you were right! But there's a 50:50 % probability that you may or may not be correct. I know I'm stressed out to the max. now but that's because no matter how hard I try to fight this condition, do literally all I can, travel the whole country, spending most of my money to be able to AT LEAST make it fade away a little and get back to living my normal life again, sh*t like this just keeps happening to me all the time! It makes so angry and weak at the same time.

"The 50-50-90 rule: Anytime you have a 50-50 chance of getting something right, there's a 90% probability you'll get it wrong." ~ Andy Rooney

It did some job. To which extend only time will show... I just fear the worst. #permanentspike #permanentdamage

 

I know. It's sickening. It's just that this time around, you've dramatically improved your odds of not getting any worse. Double levels of hearing protection is nothing to take lightly.