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Noel Jabbour MD, Heather Weinreich, MD MPH, Samuel Levine MD, Bevan Yueh MD MPH, University of Minnesota Department of Otolaryngology – Head & Neck Surgery

INTRODUCTION

CONCLUSIONS

DISCUSSION

REFERENCES

ABSTRACTABSTRACT

CONTACTCONTACT

RESULTS

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Objective: 1) To assess the noise level of toys from the Sight & Hearing Association 2010 Noisy Toys List. 2) To empiracially evaluate the change in toy noise levels using two conditions: covering the speakers with tape and covering the speakers with glue.

Methods: Sight & Hearing Association 2010 Noisy Toys List (n=18) toys were tested at a distance of 0 cm and 25 cm from the sound source in a soundproof booth using a digital sound-level meter. Toys with speakers (n=16) were tested before and after covering the speakers with plastic packing tape and non-toxic glue.

Results: Mean noise level for unaltered toys at 0 cm and 25 cm was 107.6 dBA(SD ±8.5) and 82.5 dBA (SD ±8.8), respectively. With tape, there was a statistically significant decrease in noise level at 0 cm and 25 cm: 84.2 dBA and 68.2 dBA (p < 0.001). With glue, there was a statistically significant decrease in noise level at 0 cm and 25 cm (p< 0.001). The average duration of sound produced was 9.2 seconds.

Conclusions: Both tape and glue significantly decreased the noise level produced by the toy without significant difference between tape or glue. Overall, altering the toy in either manner can significantly decrease the sound a child may experience when playing with toys.

All toys from the 2010 SHA list (n=18) were tested with a handheld digital sound meter in a standard audio booth at 0 cm (estimating toy near face) and 25 cm (estimating toy at child’s arm’s length) from the speaker for each of three conditions: open speaker, taped speaker, and glued speaker.

Paired t-tests were performed to assess mean dBA differences between the following conditions: Open speaker vs. Tape at 0 cm, 25 cm, Open speaker vs. Glue at 0 cm, 25 cm, Tape vs. Glue at 0 cm, 25 cm. The null hypothesis tested was that there was no difference between observations. A two-tailed P-value with Bonferroni adjustment was performed. A P-value <0.008 was considered statistically significant because of six comparisons.

Fisher’s exact test was performed to assess percentage of toys 85 dBA and greater before and after interventions. Eighty-five decibels was chosen as a cut off due to published literature indicating that levels below that are safe for most people.

The present study demonstrates that several common, commercially available toys are exceedingly loud, with A-weighted decibel levels of 83 to 122 at 0 cm and 65.3 to 107.3 at 25 cm. Covering the speaker of these toys with tape or glue significantly reduces noise exposure. Altering the speaker dropped the noise exposure to between 60-85 dBA. When compared to the unaltered toy, this is almost a 30 dB difference at 0 cm and about a 15 dB difference at 25 cm.

There was no statistical difference in noise level between tape or glue. Tape can be easily applied and the toy can be ready for use immediately. However, parents should be cautioned that in young children, a small piece of tape may be removed by the child and has the low but real risk of serving as a choking hazard. Glue offers a more permanent solution with less risk of aerodigestive foreign body. In the set of toys tested, placement of tape or glue did not seem to alter the function of the toy. It is possible that in some toys, the ventilation of the electronic components may rely on the openings overlying the speaker outlet.

There are many common, commercially available toys that produce electronic noises that are exceedingly loud. Simple alterations to the toy with tape or glue can significantly reduce the noise produced making them safer for children. Further work is needed to cooperate with toy manufacturers to create toys that are quieter. Until then, this simple method may be included as part of safety counseling of parents or caregivers during normal well-child checks.

There has been increasing interest in recent years in noise-induced hearing loss among youth from headphone use. However, noise-induced threshold shifts have been noted to occur at much earlier ages. Niskar et al. have estimated the prevalence of noise-induced threshold shifts in children age 6-11 to be about 8.5%. It is unclear what risk factors may be present for young infants and children. However, loud toys may be a risk factor in younger children who are not old enough to regularly wear headphones.

There are no specific guidelines for the safe limits of exposure to noisy toys for children. Federal regulations specify continuous sounds produced by toys close to the ear should not exceed 65 dBA while all other toys shall not exceed 85 dBA . Nevertheless, many toys exceed these exposure limits.

The Sight and Hearing Association (SHA) is a nonprofit organization located in St. Paul, Minnesota with a mission to identify preventable loss of vision and hearing in children. Each year, the organization selects a sample of twenty loud toys off of retailers’ shelves. The noise levels of these toys are measured in the Department of Otolaryngology at the University of Minnesota and published on the SHA website in advance of the holiday shopping season. Each year, the SHA finds that many of these toys exceed these safe limits.

The SHA and the American Speech-Language-Hearing Association recommend covering the toy’s speaker with tape to minimize noise. Anecdotally, parents have reported covering speakers with non-toxic glue for the same purpose.

The purpose of this study is to empirically assess the noise reduction impact of these simple measures—applying tape or glue to the speakers—on a standard group of toys.

1. Vogel, Ineke, et al. "Adolescents and MP3 players: too many risks, too few precautions." Pediatrics 2009; 123.6:e953-e958.

2. Henderson E, Testa MA, and Hartnick C. "Prevalence of noise-induced hearing-threshold shifts and hearing loss among US youths." Pediatrics 2001; 127.1:e39-e46.

3. Niskar AS, Kieszak SM, Holmes AE, Esteban E, Rubin C, and Brody DJ. Estimated Prevalence of Noise-Induced Hearing Threshold Shifts Among Children 6 to 19 Years of Age: The Third National Health and Nutrition Examination Survey, 1988–1994, United States. Pediatrics 2001;108;40-43.

4. ASTM F 963-08, Standard Consumer Safety Specification for Toy Safety. West Conshohocken: ASTM-International. Available online at www.astm.org

5. Yaremchuk K, Dickson L, Burk K, Shivapuja BG. Noise level analysis of commercially available toys. International Journal of Pediatric Otorhinolaryngology. 1997; 41:187-197.

6. McMillian PM, Kileny PR. Hearing loss from a bicycle horn. Journal of the American Academy of Audiology: 1994; 5:7-9.

7. Smoorenburg GF. Risk of noise-induced hearing loss following exposure to Chinese firecrackers. Audiology. 1993 Nov-Dec;32(6):333-43.

8. Segal S, Eviatar E, Lapinsky J, Shlamkovitch N, Kessler A. Inner ear damage in children due to noise exposure from toy cap pistols and firecrackers: a retrospective review of 53 cases. Noise Health. 2003 Jan-Mar;5(18):13-8.

9. Hellstrom PA, Dengerink HA, Axelsson A. Noise levels from toys and recreational articles for children and teenagers. Br J Audiol. 1992 Oct;26(5):267-70.

10.Criteria for a Recommended Standard. Occupational Noise Exposure. Revised Criteria 1998. US Department of Health and Human Services. Public Health Service. Centers for Disease Control and Prevention. National Institute for Occupational Safetyand Health. Cincinnati, OH. June 1998. p. 25-29.

11.Axelsson, A, Jerson T. , Lindbert U. and F. Lindgren. Early Noise-Induced Hearing Loss in Teenage Boys. Scan Audiol. 1981; 10 91 96

Table 1. 2010 Sight and Hearing Association Noisy Toys List with dBA levels at 0 cm and 25 cm from open sound source

The average duration of sound produced by a toy was 9.2 seconds (SD ±8.6). Without means of sound reduction, an average of 107.6 dBA (range 83.1-122.6, SD ±8.5) was recorded at 0 cm and 82.5 dBA (range 65.3-107.0, SD ±8.8) at 25 cm from the speaker.

For toys under taped condition, an average of 84.2 dBA (range 58.5-115.4, SD 11.6) was recorded at 0 cm and 68.2 dBA (range 45.3-94.5, SD 9.7) at 25 cm from the speaker. For toys under glued condition, an average of 79.7 dBA (range 53.5-95.0, SD 9.1) was recorded at 0 cm and 66.4 dBA (range 46.8-73.8, SD 6.9) at 25 cm.

Without sound reduction, 94.4% toys were above 85 dBA at 0 cm. This dropped to 38.9% after taping (p<.001) and 25% after gluing (p<.001).

Noel Jabbour, MD Department of OtolaryngologyUniversity of Minnesotajabb0005@umn.eduwww.ent.umn.edu

METHODS AND MATERIALS

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a

Fig 1. a) Open speaker of Road Rippers Rush and Rescue Firetruck, b) Occluding speaker with Scotch® Shipping Packaging Tape, c-d) Occluding speaker with Elmer’s School Glue®.

Fig 2. Mean dBA at 0cm and 25 cm for each speaker position: open, taped, and glued. Error bars represent 1 SD above and below mean.

Fig 3. Percentage of toys above 85 dBA at 0cm and 25cm for each speaker position: open, taped, and glued.

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