Noise Levels in the Health Club Setting

Abstract

Nonoccupational noise exposure increasingly has become an issue in society as a possible cause of noise-induced hearing loss. Leisure activities such as rock concerts, snowmobiling and auto racing have been shown to produce dangerous levels of noise exposure.
Noise-induced hearing loss also has become problematic in the health club setting. A study of the noise levels measured during 125 aerobics classes revealed that club noise levels often exceeded those recommended for occupational noise exposure. Average noise levels during aerobics classes ranged from 78 to 106 dB(A), with 79% of readings reaching 90 dB(A) or more for 60 minutes of class time. Instructors reported that, after class, they received subjective complaints of fluctuating hearing loss and tinnitus from class members 50% of the time. Education of participants and instructors should be encouraged, to increase their awareness that loud noise levels can cause permanent hearing loss and to prevent the occurrence of such loss.

Full text

Noise Levels in the Health Club Setting
Kathleen L. Yaremchuk, MDa
Detroit, Michigan
Janet C. Kaczor, MDb
Park Ridge, Illinois
Table. Recommendations for Permissible Noise
Exposures and Duration.*
' From Part 50-204 Safety and Health Standards for Federal Supply
Contra cts, Federal Register, May 20,1969, with c orrect ion of July 15,
1969.
with loud noise level s. Because of indi vidual susceptib il-
ity to noise, however, the current regulations will protect
85% of indi vidual s expo sed to reco mmende d noise level s
during a lifetime.'
Many repo rts of nonoccupational or leisure noise expo-
sure that causes hearing loss appear in the literature.>"
Becau se the effect of noise on hearing is cumulative,
individuals must be aware of the risk that certain leisure
activities have in terms of noise exposure.
Music is an integral part of many so cial activities a nd is
played loudly intentionally for the desired effe ct. Rock
concerts and discotheques have been found to be a major
source of noise expo sure .7-10 Rock concerts use high-gain
amplifiers and large speaker systems, the output of which
is usually reamplified by powerful sound reinforcement
systems. The audience is routinely exposed to sound
levels of 120 dB(A) to 140 dB (A). Tempo rary thresh old
shifts of up to 30 dB(A) at 4 kHz have been documented,
with reco very occurring within a few hours to a few days
after expos ure. The risk to performers for noise-induced
hearin g loss is greater than that for the audience and
would be considered occup ational in nature.
Abstract
Nonoccupational noise exposure increasingly has be-
come an issue in society as a possible cause
of
noise-
induced hearing loss. Leisure activities such as rock
conce rts, snowmobiling and auto racing have been shown
to produce dangerous levels
of
noise exposure.
Noise-induced hearing loss also has become problem-
atic in the health club setting. A study
of
the noise levels
measu red during 125 aerobics classes revealed that club
noise levels
of
ten excee ded those recommend
edf
or occ u-
pational noise exposure. Ave rage noise levels during
aerobi cs cla sses ranged fr om 78 to 106 dB(A), with 79%
of
readings reaching 90 dB(A) or mo refor 60 minutes
of
class time. Instructors reported that,
af
ter class, they
received sub
jec
tive comp laints
of
flu ctuatin g hearing loss
and tinnitus f rom class members 50 %
of
the time. Educa-
tion of pa rticipants and instructors should be encour-
aged, to increase their awareness that loud noise levels
can cause permanent hearing loss and to prevent the
occurrence
of
such loss.
Introduction
Occupational noise is known to be a cause of noise-
induced hearing loss.
The
US Department of Occupa-
tional Safety and Health Administration (OSHA) devel-
oped the Hearin g Con ser vation Am endm ent (De partment
of Labor 1983) that limited occupational exposure to
noise.1The regulations recommend allowable noise lev-
els and duration of noise exposure (Table).
The
regula-
tions apply to all industries with gov ernment contracts or
to those that engage in interstate commerce. Whenever
recommended noise level s are exceeded, emplo yees are
requ ired to partic ipate in a hearing conservation program.
The intent of the regulations was to cover most industries
' Senior St aff, Department of Oto laryngolog
y-H
ead a nd Neck Sur gery.
Henry Ford Hospital, Detroit , MI.
"North Shore Ear Nose &Th roat, PC, Park Ridge, IL.
Reprint requests to: Kathleen L. Yaremchuk, MD, Department of
Oto laryngo logy- Head an d Neck Surgery , Henr y Ford Hospi tal ,
2799 West Grand Boulevard, Detroit, MI 48202. Phone : (3 13)
876-3282. Fax: (3 13) 876-7263.
Duration (Hr/Day)
8
6
4
3
2
1 1/2
1
1/2
1/4 or less
Sound Level dB(A)
Slow Response
90
92
95
97
100
102
105
110
115
54 ENT-Ear, Nose &Throat
Journal'
January 1999

NOISE LEVELS IN THE HEALTH CLUB
SETII
NG
Figure 1. Aerobics classes use music as background sound during
structured exercise activities.
,.
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Figure 2. Sound pressure
levels were measured with a
portable sound level meter
(Realistic, Model 42-3019).
Methodsand Materials
For
our study, sound-
pressure levels were mea-
sured
d uri ng
aero
bics
classes at five different
local health clu bs for a
total
of
125 classes. Read-
ings were taken at five-
minute intervals using a
porta ble sound-level me ter
(Realistic,Mode142-3019)
with a unidirectional con-
den ser micr
oph
one and
the A
-weig
hting
sca
le
(Fig ure 2). Twelve read-
ings wer e obt ain ed fo r
bic exercise classes are led by an instructor in a health club
setti ng and generally la st for an hour .
The
instructordirects
participants while music is playe d in the background.
As in the previously discussed situations, the music
tends to be loud to mo tivate participants. Inst ructor s often
find them selve s shouting com mands to par ticip ants, wh ich
may result in vocal fold
abnormalities. To over-
come the strain
of
shout-
ing over mu sic, some in-
structors will use micro-
phon es that are louder than
the bac k
ground
music.
Unf
ortunately,thi s allows
music to be played at an
even louder volume .
Elec tronic arcade
games
are a popular pas-
time amo ng the yo uth in Japan. Mirbod et al
visited three ga me centers and measured noise
levels
of
88 to 90 dB (A).11They estimated that
these levels
of
noise might cause 4-8 dB(A)
of
t
emp
orar y thresh old shift at 4.0 kHz in indi vidu-
als with less than one hour
of
exposure.Em ploy-
ees wo uld be at eve n grea ter risk beca use of th
eir
increasedduration
of
noi se expos ure.
Bess and Pozner evaluated the effects of high -
speed snowmobile engine noise on drivers and
participants.'? Sound pressure level measure-
ment s were obtained on representative samples
of snowmobile eng ines and on spectator areas
aro und th e track . The racing s now mobiles pro-
duced maximum sound levels
of
136 dB(A) at
ear
level. Measurements in the spec tator area
range d from 85 dB(A
)t
o 11
3dB
(A).Audiography
performed on the drivers a nd pit m echa nics de m-
onstrated the t ypical hi gh-f requ ency no tchin g co mmon ly
seen in noise-induced hearing loss. These losses were
considered to be greater than expected by age when the
threshold s were co
mpa
red with a similar age group with
no known noise exposure. T he study indica ted that rac ing
snow mo biles caused hearing damage to drivers and pit
mechanics and suggested that the audie nce was in poten-
tial danger, as well.
Participant s often view noisy enviro nments as excitin g
and necessary to their enjoyment
of
a parti
cular
activity.
Calvert and Clark described this view as a
"so
cial noise
phen om
enon
." In other word s, the "loude r
...
the
mor
e
s
uccessf
ul" the activity is con sider ed to be.1
3N
oise also is
associated with power; for instance, a motorcycle engi ne
that is l
oud
is associated with a more
powerf
ul delivery
system.
Car
"so
und-of
f'
competitio ns are held for automobile
audio enthus iasts who co mpe te o n a udio p erform an ce,
frequency response and noise levels
of
car
audio sys-
terns."The ma
ximum
sou nd level measured in thi s study
was 154.7 dB (A). Ear protection was not advised for
participants unless so und levels exceeded 115 dB (A).
Th e use
of
personal head cassetteplayers was studied in
48 7 you ths aged 15 to 24 yea rs in Ho ng Kong.
1-1
The mean
ear
canal so und level was
70.4
dB (A ). Fo ur yo uths mai n-
tained levels greater than 85 dB(A). Anot
her
youth chose
a level
of
116 dB (A) ; subsequent audio metric ev aluation
of
this individual revealed a high-frequ ency hearing loss.
The prese nce of dangerou s noise levels during aerobics
classes in he alth club s has not b een pre viousl y described.
Aerobics is a form of exe rcise set to music, with planned,
structured, repetitive bodily movements performed to
improve or to maintain phy sical fitness (Figure I). Aero-
Volume 78, Number 1 55

YA
R
EMC
H
UK
,KACZO
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Figure
3. Average sound pressure levels (S PL) were measured every five
minutes during classes. The number of readings were plotted against the
average SPL dB(A).
Classes vs. Average Sound Pressure Level
11090 100
dB(A)
8070
A
B
C
o
E
.c
:::s
13
Figure
4. Individual clubs were compa red for average
noise levels . Sound pressure levels were found to be
highest at the club that utilized a microphone during
classes.
cause
of
their increased freq uency
of
exposure. Because
many instructors are pa rt-time employees at health clubs,
they also may have anot her occupation with noise expo-
. sure.
This study also showed that noise levels were 100
dB( A) or higher inclubs in w hich a micro pho ne was used .
This practice sho uld be aba ndoned because it predisposes
to continual increases in sound levels.
40
35
30
25
20
15
10
5
Discussion
Currently, no reg ulations exist for acceptable levels
of
noise exposure during leisure activities, even though po-
tentially hazardous noise levels have been widely docu-
me nted. Cohe n et al hav e suggested criteria for nonoccu-
patio nal noise exposure; these standards are 15 dB(A) less
than those provided by OSHA.5Itis important to recognize
the cumulative effect
of
noise
-w
hether occupational or
nonoccupational
-o
n hearing.
A review
of
the so und levels measured during 125
aerobics classes demonstrates that participants need to be
informed if noise levels are greater than 90 dB(A), espe -
cially if they also experience occ upational noise expo-
sure. Instructors are at greater risk than participants be-
Results
Noise levels ranged from 78 to 106
dB(A) . Seventy-nine percent (92/125)
of
readi ngs meas ured be tween 90 and 98
dB(A), and six readings were above 100
dB(A) . Only 2 1%(27)
of
readings were
below 90 dB(A) (Fig ure 3).
W hen indiv idual health cl ubs were co m-
pared, all values
of
100 d B(A) or grea ter
were from the same health club. The instructor at this
healt h club used a m icroph one dur ing classes . All val ues
less than 90 dB(A) also were from one club (Fig ure 4) .
Questionn aire resul ts showed that instructors' ages
ranged from 24 to 38 years, with an average
of
31. The
number
of
classes taught per weekranged from two to ten,
with an average
of
five. The average len gth
of
time
instructors had bee n teachin g was four years , with a range
from one to eight years. Fo ur
of
the 20 instructors sur-
veyed believed that their hearing fluctuated after class
more than 50%
of
the tim e. Six
of
the instructors said that
they had tinnitus more than 50%
of
the time. Audiometric
eva
luations we re offered to instructors to determine
base line hearing levels , but no ne
of
the ins tructors was
inte rested in an eval uation.
each class, which lasted 60 minutes eac h.
The resultant sound-pressure levels we re
then averaged to obtain one value per
class. Questionnaires were distributed to
20 instructors to determine age, years
of
experience and number of classes taught
per week. The q uestio nna ire also surveyed
for history of hearing loss, head trauma,
previous otologic surgery, exposure to
ototoxic antibio tics and presence
of
symp-
tom sre ferable to temporary threshold shift,
such as tinnitus or aural fullness.
56 ENT-Ear, Nose &Throat
Journal"
January 1999

NOISE LEVELS IN THE HEALTH CLUB SETTIN G
Instructors' subjective co mplaints of tinnitus and fluc-
tuating hearing correlate with temporary threshold shifts
and hearing loss. Unfo rtunately, the instructors surveyed
were not interested in audiometric evaluation. This is not
an unusual response for a young, healthy population that
enjoys loud music. Although this popul ation may be
awar e that loud music can ca use hearing loss ,they have no
real concerns that a disability will occur.
The Centers for Disease Control and Prevention re-
cently have issued a publi c health recommendation that
every adult participate in moderate-intensi ty physical
activity on most, preferably all, days of the week.IS This
recommend ation could increase involvement in aerobic
group activities and put a substantial number of adults at
risk for hazardous noise exposure.
Conclusion
The ae robics classes that were studied have noiselevels
that may expose participants and instructors to acoustic
trauma, espec ially if these individuals are sub
jec
ted to
occupational noise exposure, as well. Because increased
emphasis rece ntly has been placed on participation in
physical activity and exercise, th e risks of noise expos ure
during these activities needs to be stressed.
The practice of increas ing sound levels to moti vate
participants during aerobics classes is dangerous and
should be abando ned. Health club s should monitor so und
levels in classes to ensure a safe environment for their
members and employees.
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tment of Lab
or-
Occu pation al
Saf
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and Health Administra tion-Occ upational Noise E xposure ; Hear-
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