Comment on 'Are some people suffering as a result of increasing mass exposure of the public to ultrasound in air?'

Validity of the 1984 Interim Guidelines on Airborne Ultrasound and Gaps in the Current Knowledge

ABSTRACT

Airborne ultrasound is used for various purposes both in industrial and public settings, as well as being produced as a by-product by a range of sources. The International Radiation Protection Association (IRPA) published interim guidelines on limiting human exposure to airborne ultrasound in 1984, based on the limited scientific evidence that was available at that time. In order to investigate whether research since 1984 requires the development of revised exposure guidelines we considered (a) within the context of ultrasound exposure the relevance to health of the biological endpoints/mechanisms listed in the IRPA guidelines, (b) the validity of the exposure limits, and (c) whether there are biological endpoints/mechanisms not covered in the guidelines. The analysis of the available evidence showed that the biological endpoints that form the basis of the guidelines are relevant to health and the guidelines provide limits of exposure based on the evidence that was available at the time. However, the IRPA limits and their associated dosimetry were based on limited evidence, which may not be considered as scientifically substantiated. Further, there is no substantiated evidence of biological endpoints/mechanisms not covered by the IRPA guidelines. These two observations could mean that IRPA's limits are too low or too high. Research since the IRPA guidelines has made some improvements in the knowledge base, but there are still significant data gaps that need to be resolved before a formal revision of the guidelines can be made by ICNIRP, including research needs related to health outcomes and improved dosimetry. This statement makes a number of recommendations for future research on airborne ultrasound.

Introduction to the special issue on perception and production of sounds in the high-frequency range of human speecha)

The frequency range audible to humans can extend from 20 Hz to 20 kHz, but only a portion of this range-the lower end up to 8 kHz-has been systematically explored because extended high-frequency (EHF) information above this low range has been considered unnecessary for speech comprehension. This special issue presents a collection of research studies exploring the presence of EHF information in the acoustic signal and its perceptual utility. The papers address the role of EHF hearing in auditory perception, the impact of EHF hearing loss on speech perception in specific populations and occupational settings, the importance of EHF in speech recognition and in providing speaker-related information, the utility of acoustic EHF energy in fricative sounds, and ultrasonic vocalizations in mice in relation to human hearing. Collectively, the research findings offer new insights and converge in showing that not only is EHF energy present in the speech spectrum, but listeners can utilize EHF cues in speech processing and recognition, and EHF hearing loss has detrimental effects on perception of speech and non-speech sounds. Together, this collection challenges the conventional notion that EHF information has minimal functional significance.

Investigation of resolution and microphone size for measurements of airborne ultrasound

The growth of ultrasound technologies has entailed the presence of airborne ultrasound emissions in industry and public and private spaces. For occupational safety and health, procedural and technical recommendations are needed that allow measurements to be performed in the field within a short time and with little effort. This study aims to answer two research questions concerning the minimum spatial resolution and microphone size required to determine a spatial distribution of sound pressure levels with sufficient accuracy within a given measurement uncertainty. The investigation focused on high spatial resolution datasets of the airborne ultrasound field of an ultrasonic welding machine acquired using a laboratory measuring system. Based on these datasets, datasets with lower resolutions were generated and measurements with microphones of different sizes were simulated. Subsequently, four different methods of parameterization were applied to the datasets to characterize the airborne ultrasound field with respect to the structure and sound pressure levels. Comparing the parameters of datasets with high precision (high resolution and small microphone size) to those of datasets with reduced precision (lower resolution and larger microphone size) allowed a quantitative assessment of the influence of the reduction in precision. Corresponding recommendations on resolution and microphone size are given.

Review of Audiovestibular Symptoms Following Exposure to Acoustic and Electromagnetic Energy Outside Conventional Human Hearing

Objective: We aim to examine the existing literature on, and identify knowledge gaps in, the study of adverse animal and human audiovestibular effects from exposure to acoustic or electromagnetic waves that are outside of conventional human hearing. Design/Setting/Participants: A review was performed, which included searches of relevant MeSH terms using PubMed, Embase, and Scopus. Primary outcomes included documented auditory and/or vestibular signs or symptoms in animals or humans exposed to infrasound, ultrasound, radiofrequency, and magnetic resonance imaging. The references of these articles were then reviewed in order to identify primary sources and literature not captured by electronic search databases. Results: Infrasound and ultrasound acoustic waves have been described in the literature to result in audiovestibular symptomology following exposure. Technology emitting infrasound such as wind turbines and rocket engines have produced isolated reports of vestibular symptoms, including dizziness and nausea and auditory complaints, such as tinnitus following exposure. Occupational exposure to both low frequency and high frequency ultrasound has resulted in reports of wide-ranging audiovestibular symptoms, with less robust evidence of symptomology following modern-day exposure via new technology such as remote controls, automated door openers, and wireless phone chargers. Radiofrequency exposure has been linked to both auditory and vestibular dysfunction in animal models, with additional historical evidence of human audiovestibular disturbance following unquantifiable exposure. While several theories, such as the cavitation theory, have been postulated as a cause for symptomology, there is extremely limited knowledge of the pathophysiology behind the adverse effects that particular exposure frequencies, intensities, and durations have on animals and humans. This has created a knowledge gap in which much of our understanding is derived from retrospective examination of patients who develop symptoms after postulated exposures. Conclusion and Relevance: Evidence for adverse human audiovestibular symptomology following exposure to acoustic waves and electromagnetic energy outside the spectrum of human hearing is largely rooted in case series or small cohort studies. Further research on the pathogenesis of audiovestibular dysfunction following acoustic exposure to these frequencies is critical to understand reported symptoms.

Exposure to High-Frequency Sound and Ultrasound in Public Places: Examples from Zurich, Switzerland

The public is unknowingly exposed to very high-frequency sound (VHFS; 11.2–17.8 kHz) and ultrasound (US; >17.8 kHz) signals in air in public places, as evidenced by previously published reports. The present report provides evidence for the presence of VHFS/US signals in the air at public places in Zurich, Switzerland. The analysis of the signals measured revealed that they: (i) contain one, two or multiple frequencies; (ii) comprise frequencies ranged from 15.5 kHz to 36.0 kHz; (iii) were either quasi constant in their amplitude or exhibit a clear amplitude modulation; and (iv) were in their characteristics (frequencies, modulation, intensity) specific for each place. Based on the signal characteristic it is likely that the signals are generated by public-address voice-alarm (PAVA) systems. The work presented: (i) documents the presence of VHFS/US signals at public places in Zurich, possibly caused by PAVA systems; and should (ii) show that is easily possibly to measure the signals with an affordable measurement equipment as a “citizen scientist”, and stimulate others also to measure and analyse VHFS/US signals with this citizen scientist approach in other cities worldwide. Due to the possible negative health-related effects of a human exposure to VHFS/US signals, further research is needed to document VHFS/US signals at public places and to evaluate biological effects of this exposure with laboratory studies.

Ultrasonic noise measurements in the work environment

In many countries, ultrasonic noise is included in the list of factors harmful to health in the work environment. For the frequency range above 20 kHz, there is no clear and complete information on the factors influencing the result of a measurement of sound pressure level. Moreover, there are no current international standards for performing measurements of ultrasonic noise at work stations. This article presents a possibility for the adaptation of the existing measurement methods [e.g., ISO 9612:2009 (2009)] to the ultrasonic range. In particular, it discusses the requirements for measuring instruments, procedures to be followed while performing measurements, the application of a correction to measurement results, and the determination of measurement uncertainty. The development of a consistent method of ultrasonic noise measurement is of utmost importance in carrying out an assessment and reducing the risk of exposure to this physical factor in the work environment.

Public exposure to ultrasound and very high-frequency sound in air

Recent work showing the presence of a new generation of ultrasound (US) sources in public places has reopened the debate about whether there are adverse effects of US on humans, and has identified weaknesses in standards and exposure guidelines. Systems that rely on very high-frequency sound (VHFS) and US include public-address voice-alarm (PAVA) systems (whose operational status is often monitored using tones at ∼20 kHz) and pest deterrents. In this study, sound pressure levels (SPLs) produced by 16 sources that were either publically available or installed in busy public spaces were measured. These sources were identified through a citizen science project, wherein members of the public were asked to provide smartphone recordings of VHFS/US sources. With measurements made in realistic listening positions, pest deterrents were found that produced levels of up to 100 dB SPL at ∼20 kHz, and a hand dryer was found to produce 84 dB SPL at 40 kHz. PAVA systems were found to emit lower levels of up to 76 dB SPL at ∼20 kHz. Pest deterrents measured breach recommended safe listening limits for public exposure for people who are nearby even for relatively short periods.

Effects of very high-frequency sound and ultrasound on humans. Part II: A double-blind randomized provocation study of inaudible 20-kHz ultrasound

Some people have reported symptoms such as nausea, dizziness, and headaches that they attribute to ultrasound (US) emitted by devices in public places. The primary aim of the present study was to investigate whether inaudible US can provoke adverse symptoms compared to a sham presentation, under double-blind conditions. A second aim was to investigate whether the expectation of US being present could provoke adverse symptoms (a nocebo response). The US stimulus was a 20 kHz tone presented continuously for 20 min set to at least 15 dB below the participants' detection threshold, giving a typical sound pressure level (SPL) of 84 dB. No evidence that US provoked symptoms was found, but there was evidence of small nocebo effects. A case study on an individual with high self-reported sensitivity to US gave similar results. The present study did not reproduce the severe symptoms reported previously by some members of the public; this may be due to the SPL or duration of the stimulus, or strength of the nocebo stimulus. These findings cannot be used to predict outcomes from exposures to sounds that are audible to the individual in question, or to sounds with higher SPLs, longer durations, or different frequency content.

Measurements of ultrasonic deterrents and an acoustically branded hairdryer: Ambiguities in guideline compliance

Acoustic radiation from three commercial pest deterrents and two hair dryers were measured in an anechoic chamber. The deterrents were chosen because the frequency range at which they emit the most energy is either in the very high-frequency sound band (11.2-17.8 kHz) or the ultrasound band (greater than 17.8 kHz). These are sources that may be heard by a subset of the general population, with the young typically having better high frequency sensitivity. A hairdryer reported to increase the frequency of the motor noise above the audible hearing range was compared with a standard hairdryer. The outputs of the deterrents are compared against six international regulations and guidelines for audible and ultrasound exposure. Multiple ambiguities in the application of these guidelines are discussed. These ambiguities could lead to a device being considered as in compliance despite unconventionally high levels. Even if a device measured here meets a guideline, actual exposures can exceed those taken here and may therefore breach guidelines if the listener is closer to the device or reflections increase the exposure level.

Assessment of short-term exposure to an ultrasonic rodent repellent device

The objectives of the present study were to investigate the acoustical properties of the very high frequencies and/or ultrasound signals produced by a repellent device and to investigate potential adverse factors as a result of short-term exposure to these signals. Potential adverse effects were evaluated perceptually with 25 young and 25 middle-aged persons, all with normal hearing thresholds, in a quiet room using different outcome measures, including a 15-item survey presented before and immediately after each condition. Spectral analyses showed that, besides emitting frequency modulated sounds in the expected frequency ranges, a faint but audible sound in the 4-5 kHz range was present. On average, a relatively short exposure to the sound produced by a repellent device did not lead to significant adverse effects. Yet, when the signal was perceived, as it was frequently for the younger population at the two lower frequencies settings (12-14 kHz, 25-25 kHz) and with 2 sources emitting, it was considered to be disturbing by several participants. Given the increasing usage of ultrasonic devices as well as the much longer exposure of high frequency and ultrasound in domestic usage, careful consideration and better guidelines are required, especially for those who are most sensitive to sound.

Measurements of ultrasound from public address and voice alarm systems in public places

Concerns have been raised about potential health effects of public exposure to ultrasound; however, there are few published surveys of measurements taken in public places. Results are presented of measurements taken in a selection of public places including train stations, shopping centres, galleries and museums, and the difficulties of taking measurements with conventional equipment are highlighted. Tones were identified in the 20 kHz third-octave band at 8 of the 14 locations tested; the characteristics of the tones are consistent with their source being Public Address or Voice Alarm systems. The measured results do not exceed existing interim guidelines for public exposure to ultrasound, and existing research suggests that no significant undesirable effects would be anticipated following exposure to ultrasound of this nature for short periods. The measured data may be reviewed against future public exposure guidelines which consider the variation in response across the population and between continuous and pulsed sources.

Frequency bands for ultrasound, suitable for the consideration of its health effects

It is proposed that the ultrasound frequency spectrum should be divided into three bands in order to facilitate a more rational assessment of its health effects. Whilst statement of the frequencies at the borders of these bands facilitates their definition, it is recognized that these observables vary continuously with frequency and consequently these border frequencies should not be used to rule out the possibility of a given effect occurring. The lowest band, US(A), lies between 17.8 and 500 kHz. In this band acoustic cavitation and its associated forces form the dominant process resulting in biological effects in liquids and soft tissues, whereas health effects from airborne ultrasound have been reported but are far less researched. In the middle band, US(B), between 500 kHz and 100 MHz, temperature rise in tissues becomes the most important biological effect of exposure. The highest band, US(C), covers frequencies above 100 MHz, for which the radiation force becomes an increasingly important biophysical mechanism. A justification for the selection of 17.8 kHz in preference to any other threshold for the lower frequency limit for ultrasound is given.

Ultrasound in air-Guidelines, applications, public exposures, and claims of attacks in Cuba and China

This editorial introduces a Special Issue of the Journal of the Acoustical Society of America, on "Ultrasound in Air." In this Special Issue, one paper covers ways of categorizing the ultrasonic regimes, and three papers cover human effects. One of those three, plus five others, constitute the six papers that report on the measured outputs of commercial devices. Two cover calibration, and the final three papers cover novel applications. This editorial outlines the context in which these papers provide individual studies, including the development of technology and guidelines for safe exposure, and ending with an analysis of what is currently known about claims of sonic attacks on embassy staff in Cuba and China.

Effects of very high-frequency sound and ultrasound on humans. Part I: Adverse symptoms after exposure to audible very-high frequency sound

Various adverse symptoms resulting from exposure to very high-frequency sound (VHFS) and ultrasound (US) have previously been reported. This study aimed to establish whether these symptoms are experienced under controlled laboratory conditions and are specific to VHFS/US. To do this, participants were exposed to VHFS/US (at frequencies between 13.5 and 20 kHz and sound pressure levels between 82 and 92 dB) and to a 1 kHz reference stimulus, both at 25 dB above their hearing threshold. The VHFS/US and reference stimuli were presented 4 times, each time for 3 min, during which participants performed a sustained attention task, rated their symptom severity, and had their galvanic skin response (GSR) measured to assess their level of anxiety. Prior to exposure, participants were assigned either to a symptomatic or an asymptomatic group, based on their prior history of symptoms that they attributed to VHFS/US. In both groups, overall discomfort ratings were higher in the VHFS/US condition than the reference condition. In the symptomatic group only, difficulty concentrating and annoyance were also rated higher in the VHFS/US than the reference condition. No difference between the two stimulus conditions was seen in performance on the attention task or on average GSRs for either group.