Survivors with Hearing Loss: Beware of Emerging Cicadas
Pediatric cancer survivors with chemotherapy-induced hearing loss represent a community with great unmet medical and psychosocial need across the developmental spectrum.
In September 2018, we hosted a conference under the auspices of the Food and Drug Administration’s externally led Patient-Focused Drug Development (PFDD) program to provide FDA with patient and family perspectives about the dramatic impact that hearing loss has had on their lives.
Children’s Cancer Cause continues to look for areas where we can spotlight this important quality-of-life issue. We were pleased to see an article published in The Lancet earlier this year that highlighted the important issue of cisplatin-induced hearing loss: Prevalence and Risk Factors for Cisplatin-Induced Hearing Loss in Children, Adolescents, and Young Adults.
One of our 2018 conference speakers, Kristin Knight - an Associate Professor of Pediatrics and Audiology Training Coordinator of the LEND Program at Oregon Health and Science University - is an author on that paper. We reached out to her this week on a timely issue of concern for this survivor population: cicadas.
Cicadas are a winged insect that makes a distinct sound. Brood X cicadas are a periodic brood that emerge every 17 years - by the billions! - with a season expected to start in early-to-mid-May and run through the beginning of June.
“Cicadas produce sound that can reach 90 to 100 decibels and this level of sound can damage hearing. Everyone should be careful about noise exposure, but especially children who have hearing loss from cancer therapy. The risk depends on the loudness of the sound and how long and how often the person is exposed to the sound,” says Ms. Knight.
She offers suggestions for mitigating risk during cicada season:
Download the National Institute for Occupational Safety and Health (NIOSH) Sound Level Meter App, a tool that measures sound levels that provides noise exposure guidelines. The app is available to the public to download on mobile iOS devices.
Consider limiting the amount of time children spend outdoors.
When outside, use hearing protection such as earmuffs or earplugs to reduce the level of sound that reaches the ears.
The prevention-focused initiative PREP4Gold put together a flier with information from the American Speech-Language-Hearing Association providing similar guidance to families, which we encourage institutions and organizations to share with childhood cancer families: View PDF.
Ms. Knight emphasizes that “noise exposure isn’t only a risk during cicada season. Other sources of potentially dangerous sound levels are power tools, gas-powered lawnmowers and leaf blowers, motorcycles, sporting events, concerts, sirens, firecrackers, and personal listening devices. Children can be protected by reducing the exposure time, moving further away from the noise, limiting the volume on personal listening devices, and using hearing protection devices when needed.”
As we heard during the 2018 meeting, caregivers’ and survivors’ most dire concern is that hearing loss will worsen and become more debilitating. Those with fragile hearing living in the following cicada-impacted states should take careful note of these expert recommendations: Delaware, Illinois, Georgia, Indiana, New York, Kentucky, Maryland, North Carolina, New Jersey, Ohio, Pennsylvania, Tennessee, Virginia, West Virginia, Michigan, and Washington, D.C. In the DC region, the Washington Post predicts that these cicadas should begin emerging between May 3-6, with large numbers arriving between May 10-12.
In related news:
At that same 2018 meeting, hearing-impaired survivors spoke of severe social isolation and anxiety as their most damaging quality-of-life issue. “I have very few friends now that I’m hard-of-hearing, as I’ve become somewhat anti-social and introverted,” said an 18-year-old survivor. “I avoid people in general now, which makes me feel lonely. I feel like no one understands what I’m dealing with.”
New study results presented during the virtual Oncology Nursing Society Congress back that up with data, finding that slightly more than one in five survivors (21.5%) reported enduring periods of loneliness. (Source: Fayad AAA, et al. Loneliness perception among childhood cancer survivors. Presented at: Oncology Nursing Society Congress (virtual meeting); April 20-29, 2021)
“Despite the advances in therapies and supportive care for childhood cancer survivors, the potential adverse effects of loneliness on psychological and physical health is an understudied phenomenon [among] childhood cancer survivors,” Ameera Adel Amin Fayad, BSN, RN, PhD candidate at University at Buffalo, said during a presentation. Read more about this study.
“Participating in the PFDD conference was an honor, and it was one of the most important and impactful events that I have had the opportunity to be involved in.”