Monthly Archives: March 2020

What You Should Know about Coronavirus

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With the increasing concern of COVID-19 in our communities, our first and foremost concern is for the health and safety of our patients and our people. We want you to know what you can do to prepare for the coronavirus at home and if you need to visit a healthcare center.

What you should know
• COVID-19 is a respiratory disease caused by a novel (new) coronavirus that was first detected in China. It is now being spread from person to person in multiple locations across the U.S.
• Health experts are still learning the details. Currently it is thought to spread:
o Between people who are in close contact with one another (within about 6 feet).
o Via respiratory droplets produced when an infected person coughs or sneezes.

Personal precautions
Here are a few tips to help prevent infection:
• Wash your hands often with warm, soapy water for at least 20 seconds and/or use hand sanitizer.
• Cough into your elbow. Cover your mouth and nose with flexed arm or tissue when coughing and sneezing. Clean hands with hand sanitizer or wash hands thoroughly after.
• Avoid touching your eyes, nose and mouth.
• Clean and disinfect high touch areas such as desks, doorknobs, keyboards, phones, etc.

Medical care
• If you are sick and have a fever, or signs of cough/flu/pneumonia, shortness of breath, or other respiratory conditions please stay home from work or school.
• Call your primary care provider before traveling to a care center to understand the appropriate plan of care if you know you have been exposed to somebody with the COVID-19 virus or if you have a fever above 100.4 associated with a cough.
• Consider a telephone visit for simple illness if possible.
• If you arrive at a care center with respiratory symptoms, ask for a mask to wear.

More information and resources
• For all that you need to know, including travel advisories:
• For specific questions, see the CDC’s FAQ section:
• For information about COVID-19 in your state, search your state’s health department, which works with the CDC to monitor and implement all recommendations:…/healthdirectories/healthdepartments.html

Say Again??

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Have you ever experienced difficulty in hearing after a night at a concert?  Have you had an exposure to a sudden loud noise that caused reduced hearing in one or both ears for any period of time?   How about a buzzing or ringing in your ears after noise exposure?  If any of those rings a bell (which you may or may not be able to hear), you may be experiencing Noise Induced Hearing Loss (NIHL).  In fact, about fifteen percent of Americans between twenty and seventy may have hearing loss from exposure to noise at work or in leisure activities according to the National Institute of Deafness,

There is not one simple situation that causes NIHL.  The damage to hearing after loud noise exposures may not be immediately apparent.  Commonly it is a subtle, progressive damage caused by repeated exposure to loud noises, many times from varying sources over years.  The individual may not even be aware until family members or friends point out the concern.  The repeated damage from loud noise even from short exposures over time may progress to permanent loss.  It is important to wear hearing protection when you anticipate such exposures.

Excessive noise exposure in the workplace is readily recognized as a potential hazard for as many as 30 million Americans.  Employers are required by law to evaluate and monitor noise exposure levels that identifies workers at risk.  The threshold to provide an OSHA Hearing Conservation Program is that of 85 decibels (dB) or above averaged over an eight hour day. But as damage may also occur accruing from sporadic and intermittent noise, the range of exposure must be monitored from 80 dB to 130 dB.  Employers must provide hearing protection in the workplace for these individuals, the type and extent of such can be calculated from the average noise exposure level.  Baseline and annual hearing tests must also be provided to these individuals to assure adherence to the Hearing Conservation Program, that progressive hearing loss does not occur.  Prevention is paramount, as NIHL is progressive and permanent.

Although the higher pitches of hearing (frequency) are usually the first lost, it is the volume (amplitude), of sound, measured in decibels (dB), that causes damage.  Examples of common volumes are: whisper at three feet = 30 dB, conversation at three feet = 60 dB, vacuum cleaner at three feet = 70dB, busy road at fifteen feet = 80 dB, diesel truck at thirty feet = 90 dB, concert three feet from a speaker = 100dB, chainsaw at three feet = 110dB, ambulance siren at 100 feet = 130 dB.  The OSHA standard for the work environment is 85 dB averaged over eight hours of exposure.  For every three dB of volume increase, the “safe” exposure time is cut in half.  At 88 dB, the limit of exposure is now cut to four hours before hearing will become further damaged.

As the work environment is only responsible for about eight hours of our daily living (for most of us), consider the cumulative effect of noise exposure throughout the twenty-four hour day.  What is the “safe” level of noise exposure then?  According to the only evidence-based safe noise level for hearing is a surprisingly low 70 dB when it is averaged over twenty-four hours.  Consider personal hearing protection when working with power tools or at sporting events.  You may want to turn down the volume on your headphones or earbuds.  At maximum volume, you may be generating 100 dB volume, loud enough to begin causing hearing damage at only fifteen minutes of exposure per day. Additional information on NIHL may be obtained from the Occupational Safety and Health Administration link:  or your PCP.

Bradford Croft, DO

East Flagstaff Family Medicine