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EDITORIAL COMMENTARY
Year : 2017  |  Volume : 63  |  Issue : 4  |  Page : 213-214

Upwardly mobile: Lowered hearing?


ENT Department, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham University, Kochi, Kerala, India

Date of Web Publication11-Oct-2017

Correspondence Address:
U K Menon
ENT Department, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham University, Kochi, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jpgm.JPGM_257_17

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How to cite this article:
Menon U K. Upwardly mobile: Lowered hearing?. J Postgrad Med 2017;63:213-4

How to cite this URL:
Menon U K. Upwardly mobile: Lowered hearing?. J Postgrad Med [serial online] 2017 [cited 2017 Dec 15];63:213-4. Available from: http://www.jpgmonline.com/text.asp?2017/63/4/213/216440




The mobile phone is not just a “good old instrument” for communication. It has insinuated into nearly every aspect of human activity. However, like any useful amenity, the potential for misuse exists. The blame for a number of social and health hazards has been laid at the door of the mobile phone. While some in the former category are undeniably true, direct health issues are yet to be unequivocally proven. At the same time, it must be kept in mind that the mobile phone provides socioeconomic benefits too.[1] Hence, a blanket ban is out of the question. Coming to the topic at hand, the ear becomes the chief target organ of this assault of the mobile phone, in the form of noise, electromagnetic radiation (EMR) and heat. Needless to say, the effects of this assault must be studied, by the preventive medicine and otology/audiology fraternity. As such, the present research study by Das et al. is a commendable effort.[2]

A look at basic sciences tells us that mobile phones use EMR in the microwave range (450–2100 MHz). The interaction between electromagnetic fields and living tissue constitutes what is called as “bioelectromagnetics.” This has been an active area of study, although a lot of gray area still persists. Biological phenomena in animals have been proven. Thermal and behavioral effects in humans have been reported. However, direct evidence of harm to human health has not been forthcoming. After the explosion of mobile phone use in the present age, there has been no dearth of research trying to swing the discourse to either side. Among the many negative effects reported has been that on semen quality and male fertility in rats.[3] There has also been everyone's favorite bugbear – carcinogenicity (brain tumors). At the same time, vehement denial of any significant harm on humans has also been documented. In this context, it is interesting to note the conclusion arrived at in one study:[4] “Studies funded exclusively by industry reported the largest number of outcomes but were least likely to report a statistically significant result. The interpretation of results from studies of health effects of radiofrequency radiation should take sponsorship into account.”

Many studies have been undertaken all over the world with objectives more or less similar to the present one. And, with very few exceptions, most have revealed the deleterious effect on hearing, to a greater or lesser extent. The methodologies adopted reveal an attempt to study the spectrum of usage of different types of mobile phones. In this context, I have a few concerns with the methodology adopted for this study. First of all, was the objective to study the effects of only EMR on the cochlea? In which case, that should be specified. It need not be a given that it is only EMR that is “under the scanner,” so to speak. Does the effect of noise not matter? It has been calculated that the maximum volume of a smartphone can reach concert-hall levels (around 105 decibels). Even if a reckless youngster employs some moderation in intensity, the duration would be an issue. Needless to say, this has a proven deleterious effect on the cochlea, separate from that of EMR. Should that also not be factored while doing such studies? It must also be pointed out at this juncture that studies have not conclusively proven the harmful effects of EMR on the cochlea.[5],[6] Be that as it may, literature search reveals that most studies have focused on EMR exposure. Next, the cutoff of 2 h for the duration of individual mobile phone use seems arbitrary. It would probably have been worth classifying into more groups, namely, <2 h, 2–4 h, and so on. This could have brought out the effects of duration of use in a better way. One Indian study has adopted this method.[7] Having said that, the researchers must be commended for meticulous selection of the study group, especially the handedness aspect. Furthermore, the choice of medical students is an apt one, as there is some evidence of overuse of mobile phones in this population.[8]

Specific absorption ratio has been mentioned in passing; it is an important aspect of the measure of EMR exposure. The stated value in the study is in the acceptable range, as per the Federal Communications Commission.[9] One study has commented on the need for separate normatives for children.[10]

From the results, it is interesting, and probably heartening, to note that nearly half the included students' usage of mobile phones was <2 h. This could probably be due to the location of the study (Sikkim). Would it be much different if it were in the bigger towns and metros of India, one wonders! The proof of the pudding is in the eating: In this study, statistical proof of prolonged phone use affecting the hearing threshold in the (ab) used ear has been forthcoming. Hence, kudos to the research team for achieving this end. The other noticeable thing is that there is no particular worsening at 4000 Hz – indicating an absence of noise-induced hearing loss.

So what is the solution? The much-neglected cliche holds true in the present context too: Prevention is better than cure. The WHO has recommended the voluntary adoption of the “precautionary principle.” An interesting study has looked at the effect of people's knowledge about this.[11]

To conclude, keeping in mind the demographic of our country, where we have a burgeoning young, upwardly mobile population, with ever increasing “nomophobia,” there is a definite need to map the effect of this “necessary evil.” Hence, studiesuch as the present one are to be encouraged as a means to prevent a potential epidemic of early hearing disability. Overall, this study should be replicated in as many medical colleges in India as possible. And, to go a step further, my suggestion would be a cohort study to follow a group of mobile users over a period to check for worsening hearing, and possibly a prospective study taking into account the level of exposure to radiation.



 
 :: References Top

1.
Abraham R. Mobile Phones and Economic Development: Evidence from the Fishing Industry in India. International Conference on Information and Communication Technologies and Development [Serial on the Internet]; May, 2006. p. 48-56. Available from: http://www.ieeexplore.ieee.org/abstract/document/4085513/?reload=true. [Last accessed on 2007 Feb 12].  Back to cited text no. 1
    
2.
Das S, Chakraborty S, Mahanta B. A study on the effect of prolonged mobile phone use on pure tone audiometry thresholds of medical students of Sikkim. J Postgrad Med 2017;63:221-5.  Back to cited text no. 2
[PUBMED]  [Full text]  
3.
Mailankot M, Kunnath AP, Jayalekshmi H, Koduru B, Valsalan R. Radio frequency electromagnetic radiation (RF-EMR) from GSM (0.9/1.8GHz) mobile phones induces oxidative stress and reduces sperm motility in rats. Clinics (Sao Paulo) 2009;64:561-5.  Back to cited text no. 3
    
4.
Huss A, Egger M, Hug K, Huwiler-Müntener K, Röösli M. Source of funding and results of studies of health effects of mobile phone use: Systematic review of experimental studies. Cien Saude Colet 2008;13:1005-12.  Back to cited text no. 4
    
5.
Thomas S, Kühnlein A, Heinrich S, Praml G, Nowak D, von Kries R, et al. Personal exposure to mobile phone frequencies and well-being in adults: A cross-sectional study based on dosimetry. Bioelectromagnetics 2008;29:463-70.  Back to cited text no. 5
    
6.
Kaprana AE, Karatzanis AD, Prokopakis EP, Panagiotaki IE, Vardiambasis IO, Adamidis G, et al. Studying the effects of mobile phone use on the auditory system and the central nervous system: A review of the literature and future directions. Eur Arch Otorhinolaryngol 2008;265:1011-9.  Back to cited text no. 6
[PUBMED]    
7.
Karthikeyan P, Christian JS, Audhya A. Hearing evaluation in mobile phone users at a tertiary care hospital. Indian J Otol 2014;20:24-8.  Back to cited text no. 7
  [Full text]  
8.
Datta S, Nelson V, Simon S. Mobile phone use pattern and self-reported health problems among medical students. J Evol Med Dent Sci 2016;5:1116-9.  Back to cited text no. 8
    
9.
Specific Absorption Rate (SAR) for Cell Phones: What It Means for You [homepage on the Internet]. Washington: Federal Communications Commission. Available from: https://www.fcc.gov/guides/specific-absorption-ratesar-cell-phones-what-it-means-you. [Last accessed on 2016 Oct 25; Last updated on 2016 Dec 15].  Back to cited text no. 9
    
10.
Gandhi OP, Morgan LL, de Salles AA, Han YY, Herberman RB, Davis DL. Exposure limits: The underestimation of absorbed cell phone radiation, especially in children. Electromagn Biol Med 2012;31:34-51.  Back to cited text no. 10
[PUBMED]    
11.
Cousin ME, Siegrist M. Cell phones and health concerns: Impact of knowledge and voluntary precautionary recommendations. Risk Anal 2011;31:301-11.  Back to cited text no. 11
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