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Musicians make Arts Picnic harmonious affair
Jennifer Roedel
Twenty-year-old Ben Puchalski has been attending the Greeley Arts Picnic for as long as he can remember. This weekend will be different, he'll be looking at the picnic from a whole new angle.
On Sunday, the Greeley West High School graduate will fulfill one of his goals by moving from the picnic sidelines to the center stage. Or rather, he will be on the Union Colony Bank Plaza Stage, one of two stages that will feature live music from bands throughout the two-day festival. From 2:45-3:15 p.m. Sunday, Puchalski will take the stage to perform music he describes as a "cool mix of alternative and blues."
Puchalski has been wanting to perform at the Arts Picnic for a couple of years, but it never worked out. He said he's excited to finally perform there because the picnic really caught his eye as a great gig.
"It mixes all the creativity of music and arts," Puchalski said.
Rhonda Welch, an Arts Picnic coordinator, said his performance Sunday will bring a really wonderful surprise to the Arts Picnic.
"It's such a treat to hear someone as young as Ben play the guitar and sing as well as he does," Welch said.
Puchalski has been playing music for almost half of his life. He began playing guitar at age 11 and said once he started learning, he evolved his own musical style.
He also has five years of songwriting experience under his guitar strap. He took his own lyrics and sound and "crafted it into my own little genre," he said. His song lyrics reflect a great variety of topics ranging from love won or lost with the songs "Make Me Right" and "You're Wrong?" to the normal things that happen to everybody. He said that mainly he likes to emphasize the simple things in life, as in "Summer Joys," he writes:
"You're feeling low? Here's what you do about it — you take things slow,it's so fun, so why don't we just sit and watch the stars,the simple joys embraced by your arms. …"
Puchalski hopes that after listening to his music, fans walk away with the feelings of relaxation, having fun and just kicking back.
He hopes his music gives off a "summertime kind of vibe."
Puchalski and his manager, Chris Manichanh, are working hard in the studio to have his new album — tentatively titled "Buying Songs from a Lemonade Stand" — for sale at his performance Sunday.
Manichanh and Puchalski met each other as freshmen at Greeley West. That year they played tennis together. Manichanh started asking Puchalski about his music because he heard Puchalski was good. Soon, Manichanh said, people started asking him about how they could book Puchalski. From there, he said, everything just fell into place. There was no official statement, the manager/artist relationship was just understood.
Manichanh said he thinks Puchalski's music has deve-loped on many levels.
"I especially love the way his songwriting has grown. I used to like his songs, but now I'm really loving his songs. They are getting heavy time on my CD player," Manichanh said.
Puchalski who's been performing as a solo artist for the past three years loves the creative energy of songwriting.
"It's a good way to express myself and get my talent in there," Puchalski said.
He wasn't always running a solo act though. vIn junior high, Puchalski formed his first band, Freezer Burn, after he was told he couldn't join the school jazz band. Band leaders had informed him that the guitar was not a "traditional" band instrument. Luckily those band leaders didn't dim his dreams.
Freezer Burn began playing for school functions such as talent shows, sporting events, homecoming rallies and at a variety of other city events. The band later renamed itself Push Here and released its first CD, "Support Local Talent." After recently releasing their second CD, "Main Entrance," the band members still play together as much as they can.
Puchalski said finding time to perform by himself and with his band is all part of a balancing act. When he's not playing with Push Here or jamming solo at parties or school functions, he's a psychology student at Fort Lewis College in Durango.
Come Sunday, Puchalski will take his music to Lincoln Park.
Besides the live entertainment, the 24th annual Arts Picnic will get to the heart of its name this weekend.
The event will feature more than 180 booths in the park featuring artists from around the country. Pottery, jewelry and porcelain dolls will be just a few of the items for sale. Patrons can also sample many types of international food and watch artisans demonstrate their talents. Children can head to the Hands-on Area where they can participate in a variety of summer craft projects.
"There will be lots of arts and crafts that even the men will like," Welch said.
This year's event will bring new artists and crafters from Greeley and the surrounding communities and what Welch calls "wonderful diverse performers."
"People can spend the entire weekend at Lincoln Park," she said.
Manichanh thinks Puchalski will be one of the reasons why people stick around.
"A lot of people aren't going to have seen this type of music and I think he's so talented he's going to open some eyes," Manichanh said.
Arts picnic schedule
9-11 a.m. — Make a tambourine in the children's Hands-on Area
9:30-10 a.m. — The Greeley Conservatory of Dance will perform hip-hop, jazz, tap and more, Weld County Garage Center Stage.
10 a.m. — Stephanie Sipres of Thyme & Season will transform trash to treasure, Demolition Area.
10:15-11 a.m. — The Greater Metropolitan Greeley Kiwanis Club Silver Cornet Concert Band, Weld County Garage Center Stage
11-11:30 a.m. — Eric West creates a musical experience for kids, Union Colony Bank Plaza Stage.
11 a.m.-1 p.m. — Paint your own design on a flower pot, Hands-on Area.
11 a.m.-3 p.m. — The Great Loudini performs magic and comedy throughout the park.
11:30 a.m.-12:15 p.m. — Music by Maxine & Co., Weld County Garage Center Stage.
Noon — Bonsai Master Barbara Rich explains the Japanese art of growing a tree in a tray, Demonstration Area.
12:15-12:45 p.m. — Alison Hamling performs acoustic contemporary folk music, Union Colony Bank Plaza Stage.
12:45-1:30 p.m. — First-time Arts Picnic performers Newcomers Home, Weld County Garage Center Stage.
1-3 p.m. — Make a rainstick, Hands-on Area.
1:30-2 p.m. — The Hopeful Kitchen Quartet, Union Colony Bank Plaza Stage.
2-2:30 p.m. — Don Cossack's Russian Dance Troupe, Weld County Garage Center Stage.
2 p.m. — Colette Pitcher of Showcase Art Center will turn everyday items into mosaic masterpieces, Demonstration Area.
2:30-3 p.m. — Bring the kids to hear Sue Schnitzer, Union Colony Bank Plaza Stage.
3-3:45 p.m. — Cool Shooz plays unique a cappella doo-wop, Weld County Garage Center Stage.
3-5 p.m. — Make macaroni necklaces or participate in fingerweaving, Hands-on Area.
3:45-4:15 p.m. — Original folk music of TBA Live!, Union Colony Bank Plaza Stage.
4:15-5 p.m. — Kizumba, Latin music, Weld County Garage Center Stage.
10:15-11 a.m. — Sherwood Park Flute Ensemble, Weld County Garage Center Stage.
10 a.m.-Noon — Beautify the front of your fridge with a Butterfly Magnet, Hands-on Area.
11-11:30 a.m. — Soul Affect, contemporary rhythm & blues, Union Colony Bank Plaza Stage.
11 a.m. — Stephen Travis of Kricket Kreations Catering shows the basics of fruit and vegetable carvings, Demonstration Area.
11 a.m.-3 p.m. — Look for Ginger the Clown by the park gazebo.
11:30 a.m.-12:15 p.m. — Kream of the Krop, Big Band swing music, Weld County Garage Center Stage.
Noon-2 p.m. — Decorate a visor, Hands-on Area.
12:15-12:45 p.m. — Shawn Waggoner and the Tumbleweeds, alternative country folk music, Union Colony Bank Plaza Stage.
12:45-1:30 p.m. — Lalla Rookh, Celtic folk music, Weld County Garage Center Stage.
1 p.m. — Laura Leslie-Sell of Pleasant Valley Designs turns walls into masterpieces with faux-painting techniques, Demonstration Area.
1:30-2 p.m. — Peter Davison, dancer-juggler-gymnast, Union Colony Bank Plaza Stage.
2-2:45 p.m. — The 17th Avenue All-Stars, vocals and a unique a cappella style, Weld County Garage Center Stage.
2-4 p.m. — Design and decorate a drum, Hands-on Area.
2:45-3:15 p.m. — Ben Puchalski, alternative blues, Union Colony Bank Plaza Stage.
3:15-3:45 p.m. — Denver Taiko, traditional Japanese drumming, Weld County Garage Center Stage.
3:45-4:15 p.m. — Carol Frazier, jazzy swing-flavored pop music, Union Colony Bank Plaza.
4:15-5 p.m. — The Bluegrass Patriots close out the 2002 Arts Picnic, Weld County Garage Center Stage.


Welcome to the Graveyards of Omaha.
My goal has always been to make The Graveyards of Omaha the definitive site for information and history on Omaha, Bellevue and Council Bluffs people, and on the cemeteries of eastern Nebraska and western Iowa; it will be as comprehensive as possible. My husband Steve and I now live in Bellevue, within walking distance of historic Bellevue Cemetery.
Over 95% of Prospect Hill markers are now online at this site. Click the Prospect Hill menu item to the left to see them!
The "What's New" page will always have the newest changes listed, and I'm trying to add new links and photos often.
If you have questions on genealogy or where relatives might be buried, please visit the Greater Omaha Genealogical Society's website. I don't get into genealogy on my website, and really have no resources for these types of questions.
I began this site in 1995, when the Internet was still new, with the idea of posting some individual histories and a few photos of the graveyards and small family cemeteries that I had always been interested in here in Omaha. At the time it was one of the first graveyard sites on the Internet, and I feel that it continues to be one of the most informative graveyard and history websites that is still active. It has been expanded over the years to include every cemetery in the Omaha/Bellevue/Council Bluffs area, and any other cemetery I find, no matter where they are. The greatest concentration will be in eastern Nebraska/western Iowa, since those are closest to my home.
I will gladly accept photos from other cemeteries in any locale, family stories, history, biographies and photos of the people whose markers appear on this website; anything that you might have that pertains to a graveyard on this list, or a new one. I'll see that your name is posted as the contributor. I am also especially interested in hearing anything on Sperling Gardens or Fisher Farm.
I would like the information on this site to be correct, but there is always the possibility that information may have changed since I posted it. If you know of any updates or additions to any information on this site please let me know and I'll make the correction.
My thanks to Karen at GOGS and Amy in Valley, who have directed me to many out-of-the-way graveyards, to the webmasters of the Sarpy County and Douglas County GenWeb, to Bill Savage for his photo contributions, to Stacey for her photo contributions, and to my husband Steve who has suffered through many trips to cemeteries he never wanted to visit.
To navigate the website, use the hyperlinks on this page, in the left-hand column; the links on this main page will open a new browser window for each cemetery. Within each individual cemetery, use the left-hand column buttons to navigate. You can always get back to this main page by using the Home button found on each page.
I would also like to thank the Greater Omaha Genealogical Society for some of the background information about the cemeteries on this website.
This Cemetery Photo site is owned by Marta Dawes.
Want to join the ring? Click here for information!
There is a new history tour group in Omaha!
History Walks LLC provides guided history tours that are enlightening, accurate and entertaining. Join us as we take a stroll through local cemeteries and admire the artistic splendor of the monuments erected to remember those laid to rest. Learn about their lives and the rich history of the communities they created. To visit their website, click here.
Please visit the Hearts United for Animals site at the link above, a local no-kill animal shelter, and donate some dollars to this wonderful organization or adopt one of the animals they have rescued. Our Sweetie Darling, an adorable rat terrier, is a former Hearts United rescuee. We are forever grateful that they took her in as a stray hit by a car, paid to have her broken leg set, and allowed us to adopt her.


Meteorologist associated with NBC News who has appeared on Weekend Today, Today, and The Weather Channel.
She has worked at several local stations including the NBC affiliated WHDH in Boston.
She was driving to cover a blizzard story when she got into an accident and suffered a concussion.
She married Brian Fichera in 2012. They had a son named Calvin in December of 2016.
She has filled in for Al Roker on the morning show Today.


You'll need to compose an effective covering letter, except for those job advertisements where it's specifically mentioned you shouldn't. You CV cover letter should produce the search committee want to establish an interview alongside you. Sometimes you're going to be requested to send your cover letter as an email rather than a distinct document. A lot of people wonder how to compose the ideal job application cover letter.
When you're making your letter, you wish to to begin with make sure it has short paragraphs and sentences. Busy folks don't wish to read long letters from folks they don't know. You don't need a deep complicated cove letter, be certain that it is not difficult to read and that the man or woman can receive the information that they need promptly.
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Hi Annemarie, only wanted to allow you to know that I got the job. You've done an excellent job. You've done a distinguished job and I don't have any hesitation in recommending you again. You could be applying for a specific, advertised job, or you may be contacting a possible employer to see whether they have got any vacancies. Always take the chance to submit a cover letter if you're given the chance. Should you own a company, you will have to supply extra info. Make sure to know just what the company does and how they're placed amongst their competitors.
Your letter should incorporate a succinct overview of your abilities and experiences that match the work description. At the rest of the times you should have a cover letter. You need to always spellcheck your cover letter. The entire cover letter for research paper ought to be double-spaced, much like the entire research paper.
Don't forget, the reviewer will be inclined to find the covering letter initially and every one of us knows how important first impressions are. Finding out more about a business is also a great approach to work out the way to tailor your cover letter. Figure out the man or woman to whom you need to deal with the covering letter. Your covering letter for job application may be a major aid in times such as these. Covering letters ought to be taken seriously. Writing a covering letter is among the absolute most amazing things you can do. If you're likely to be emailing your resume then it's a good idea to incorporate the covering letter within the body of your email.


If you need Windows 2000 hosting, the average provider will charge you around $20 or more per month with a setup fee. Easy CGI is an exception to that, with Windows 2000 hosting accounts starting at $7.96 per month. For Windows web hosting, Easy CGI is a very solid choice. They also offer Coldfusion and JSP, which are items you do not find everywhere. Easy CGI, Inc. also offers co-location services. With this type of forward-looking offerings, we were most disappointed in the 'etch-a-sketch' control panel. We could not get a lot of information on where it came from, but the features that you would find on most the CPs offered by Internet Web hosting providers were lacking.
Easy CGI, Inc. was founded in 1998 by Dan Richfield and is based in Nyack, NY (20 miles north of New York City), this company is managed by personnel with prior experience at an Internet Service Provider beginning in 1994, giving them something unusual in the industry – nearly 10 years of experience. They are a full scale Web Hosting / E-Commerce company. The Easy CGI data center is in the same building as their corporate headquarters – beyond that we did not get a lot f G2 about the data center.
On the customer support side, our emails were answered within a day, we could live with that for lower level issues that are not mission critical. When we did need phone support, even though it is offered we were not able to get in touch with anyone. We ended up leaving a message and we did get a quick response to that (less than one business day). It still left us feeling frustrated.
Easy CGI meets expectations but that is all. With both a lackluster control panel and support that was not thrilling, we felt that despite a great start (we really like what we read about them and what they had to offer) they just have to get on top of at least the customer service thing to go head to head with competitors who also meet expectations but are blowing the doors off in other areas that customers want these days.
© Copyright 1999-2012. Upperhost Independent Business Web Hosting Reviews & quality comparisons. All rights are reserved.


If you're anything like me, you spend hours of valuable time writing blog articles because a blog is an effective tool for driving website traffic, increasing your expert status, and showing off your company's brand and value. But to enjoy these benefits, you obviously need your target audience to come to your blog and read your articles.
So how can you get more eyeballs on your blog?
Twitter is one of the best platforms for driving blog traffic. If you apply the tips below, your Twitter account will become a vehicle in which you gently transport your social media followers to your website, transforming them from Intrigued Prospect to Loyal Fan (and ultimately… Happy Customer).
These tweets are more fluent and twitter-friendly. And you can get more than one tweet from one title! For clients in our Twitter management programs, we write at least 5 tweets for every article they post.
A super simple way to create tweets from your blog is to take quotes directly from your article. Tweet them out with links back to the blog post. You can paraphrase, shorten, or add hashtags for more effective delivery.
In addition, pick some thought-provoking lines from your article and turn them into graphic quotes. Typorama is my current fave phone app for creating quick and easy typographic designs.
What are people really searching for when they choose to click a link on Twitter? Valuable Information! Tips. Secrets. Guidelines. Hints. Yes, people want helpful ideas. Take the great tips that you have already written in your article and turn them into tweets.
Don't make the mistake of writing just one tweet per article. You spent all that time composing your brilliance; make sure it gets out to as many people as possible. A good rule of thumb is to create 5 – 10 tweets per article.
The biggest mistake I see when people tweet out their blog is that they tweet it once. All that work for one tweet (which has a very short lifespan) is a crying shame! 99% of your followers will miss your post if it isn't repeated. Set up a schedule to release each blog article's tweets consistently, for as long as the article is relevant. This will keep your Twitter content full, and increase your blog traffic.
And now that you know how to write tweets from your articles, keep these tips in mind when creating your stories in the first place. It will help you to turn your articles into tweets that much quicker, accelerating the process of driving traffic to your blog.


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Vital Signs: Noise-Induced Hearing Loss Among Adults — United States 2011–2012
Weekly / February 10, 2017 / 66(5);139–144
On February 7, 2017, this report was posted online as an MMWR Early Release.
Yulia I Carroll, MD, PhD1; John Eichwald, MA1; Franco Scinicariello, MD2; Howard J. Hoffman, MA3; Scott Deitchman, MD4; Marilyn S. Radke, MD5; Christa L. Themann, MA6; Patrick Breysse, PhD4 (View author affiliations)
View suggested citation
•Noise exposure at home and in the community can permanently damage hearing.
•Almost one in four adults who reported excellent to good hearing already have measurable hearing loss.
•The presence of noise-induced hearing loss increased from one in five among young adults aged 20–29 years to one in four among adults aged 50–59 years.
•Additional information is available at https://www.cdc.gov/vitalsigns/.
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Podcast: Healthy Hearing
Podcast: Healthy Hearing (A Minute of Health)
Podcast: Healthy Hearing (A Cup of Health)
Introduction: The 2016 National Academies of Sciences report "Hearing Health Care for Adults: Priorities for Improving Access and Affordability" included a call to action for government agencies to strengthen efforts to collect, analyze, and disseminate population-based data on hearing loss in adults.
Methods: CDC analyzed the most recent available data collected both by questionnaire and audiometric tests of adult participants aged 20–69 years in the 2011–2012 National Health and Nutrition Examination Survey (NHANES) to determine the presence of audiometric notches indicative of noise-induced hearing loss. Prevalence of both unilateral and bilateral audiometric notches and their association with sociodemographics and self-reported exposure to loud noise were calculated.
Results: Nearly one in four adults (24%) had audiometric notches, suggesting a high prevalence of noise-induced hearing loss. The prevalence of notches was higher among males. Almost one in four U.S. adults who reported excellent or good hearing had audiometric notches (5.5% bilateral and 18.0% unilateral). Among participants who reported exposure to loud noise at work, almost one third had a notch.
Conclusions and Implications for Public Health Practice: Noise-induced hearing loss is a significant, often unrecognized health problem among U.S. adults. Discussions between patients and personal health care providers about hearing loss symptoms, tests, and ways to protect hearing might help with early diagnosis of hearing loss and provide opportunities to prevent harmful noise exposures. Avoiding prolonged exposure to loud environments and using personal hearing protection devices can prevent noise-induced hearing loss.
Hearing plays an important role in communication, health, function, and quality of life. Hearing loss is the third most common chronic physical condition in the United States and is twice as prevalent as diabetes or cancer (1).
Untreated hearing loss is associated with decreased social, psychological, and cognitive functioning. Hearing ability is inversely associated with distress, somatization, depression, and loneliness among all age groups (2,3). The economic cost to society of age-related hearing loss has been estimated to be $297,000 over the lifetime of every affected person. Hearing loss is associated with low employment rates, lower worker productivity, and high health care costs. Adults with hearing loss are more likely to have low income and be unemployed or underemployed than adults with normal hearing (2,3). Nationally, the total cost of first-year hearing loss treatment is projected to increase fivefold between 2002 and 2030, from $8.2 billion to $51.4 billion (4).
Noise is the most common modifiable environmental cause of hearing loss among young and middle-aged adults, and the most common self-reported cause of hearing loss among men (5). In 2014, an estimated 21.0% of adults aged ≥18 years had difficulty following a conversation amid background noise, 11.2% had tinnitus (i.e., the perception of ringing in the ears or other sounds such as buzzing, hissing, and clicking), and 5.9% had sensitivity to everyday sounds (hyperacusis).* In addition to hearing loss, chronic exposure to noise has been associated with increased stress, anxiety, depression, blood pressure, heart disease incidence, distractibility, annoyance, tinnitus, hyperacusis, and other health problems (6).
The 2016 National Academies of Sciences report included a call to action for government agencies to strengthen efforts to collect, analyze, and disseminate population-based data on hearing loss in adults (2). CDC analyzed data from the 2011–2012 National Health and Nutrition Examination Survey (NHANES) to estimate the prevalence of audiometric notches and exposure to noise among adults aged 20–69 years.
NHANES† is a continuous, cross-sectional health interview and examination survey designed to assess the health and functional status of the civilian, noninstitutionalized U.S. population. The 2011–2012 NHANES cycle included audiometric testing and hearing-related questions for a nationally representative sample of adults aged 20–69 years. Using the standard NHANES audiometric protocols, audiograms were analyzed using an algorithm (7) to identify high-frequency audiometric notches that suggest hearing loss caused by exposure to noise. An audiometric notch is a deterioration in the hearing threshold (the softest sound a person can hear). This study defined the presence of a high-frequency audiometric notch when any threshold at 3, 4, or 6 kHz exceeded the average threshold at 0.5 and 1 kHz by ≥15 decibel (dB) hearing level (HL) and the 8 kHz threshold was at least 5 dB HL lower (better) than the maximum threshold at 3, 4, or 6 kHz. Statistical analyses were weighted as recommended for NHANES data. Logistic regression was performed to evaluate the notch prevalence among age groups and its association with sociodemographic factors (sex, race/ ethnicity, education, income) and exposure to noise. NHANES 2011–2012 defined "loud" noise as when "you had to speak in a raised voice to be heard," and "very loud" as when "you have to shout in order to be understood by someone standing 3 feet away from you."
During NHANES 2011–2012, a total of 3,583 participants aged 20–69 years had complete audiometric data (response rate 76.6%, among 4,677 participants who completed household interviews). The weighted prevalence of an audiometric notch among U.S. adults aged 20–69 years was 39.4 million or 24.4% (6.2% bilateral notch and 18.2% unilateral notch) (Table 1).
Differences were identified by age, sex, and race/ethnicity, and by whether participants were exposed to loud noise at work. The presence of an audiometric notch increased with age (p<0.01), ranging from 19.2% among persons aged 20–29 years to 27.3% among persons aged 50–59 years (Table 1). The prevalence of notches was consistently higher in males than in females for both reported work exposure to noise and for no reported work exposure to noise (Table 2). This was true for both unilateral and bilateral notches (Figure).
Twenty-one million U.S. adults (19.9%) who reported no exposure to loud or very loud noise at work had an audiometric notch (bilateral or unilateral) (Table 1). Persons exposed to loud noise at work were twice as likely to have bilateral or unilateral notches (Table 1) than those not exposed. However, 23.5% of persons who self-reported excellent or good hearing (irrespective of noise exposure reported) had bilateral or unilateral notches (5.5% and 18.0%, respectively) (Table 1). These numbers were higher (31.0%) among persons reporting exposure to noise at work and lower (20.1%) among those who were not exposed to noise at work (Table 2). Seventy percent of persons exposed to loud noise in the past 12 months never or seldom wore hearing protection.
Conclusions and Comments
Noise-induced hearing loss is a significant health problem among U.S. adults, is more prevalent among males, and increases with age. Persons with auditory damage caused by noise frequently do not recognize it; one in four U.S. adults who reported excellent or good hearing had an audiometric notch. Among persons who reported work exposure to loud noise, one third had a bilateral or unilateral notch.
Noise exposure is the second most common cause of acquired hearing loss (after aging) (8). An estimated 24% of hearing loss in the United States has been attributed to workplace exposures (9). Noise exposure is associated with numerous adverse health effects, and reducing noise exposure is likely to improve health. A recent study suggested that reducing environmental noise exposure might save lives by decreasing the prevalence of cardiovascular heart disease (10). Avoiding exposure to loud environments and effective use of personal hearing protection devices (earplugs or earmuffs) have been shown to prevent hearing loss (3). Evidence also exists that stronger occupational regulation leads to decreased noise levels (11). Persons who already have impaired hearing from noise exposure can benefit from clinical rehabilitation, such as amplification through hearing aids, learning to read lips, and other compensation strategies (2). Use of technology, such as smart phone apps to measure sound level, provides new ways of informing decisions and actions.§
Noise reduction and avoidance can prevent hearing loss or slow its progression. This can be accomplished by avoiding high volumes on personal listening devices; reducing listening time to high volumes of music; taking breaks from exposure; requesting lower volumes in public settings (restaurants, movie theaters); using quieter products (e.g., household appliances, power tools, recreational vehicles); reducing equipment noise by replacing worn or unbalanced machine parts; moving as far as possible from the loudest sound-producing source, such as loudspeakers or cannons at college stadiums; and using hearing protection devices (2,3). Hearing protectors need to fit well to reduce noise exposure effectively.
Noise exposure at younger ages needs particular attention. Damage to hearing accumulates over time so that hazardous exposure that begins earlier in life has the potential to be more damaging as persons age. The high prevalence of audiometric notches (one in five) among persons aged 20–29 years suggests that early life interventions need to be developed.
Hearing screenings can help reduce delays in diagnosis and improve access to hearing aids for those with hearing loss, thus improving health-related quality of life (12), yet a 2014 report found that only 46.0% of adults who had any trouble hearing had seen a health care professional about their hearing in the past 5 years (5). Hearing loss often progresses for years before being self-perceived or diagnosed (13,14). Talking to one's personal health care provider about hearing loss symptoms, tests, and ways to protect hearing, might support early diagnosis and access to hearing rehabilitation if needed.
During routine exams, primary care providers can examine patients' hearing; ask about patients' hearing and noise exposures and inform them about the benefits of hearing protection; monitor patients with hearing loss symptoms, recommend or provide hearing tests when indicated; and counsel patients with hearing loss (2,8,15). Studies indicate, however, that 40%–77% of primary care providers have not asked about or screened for hearing loss (16,17). Patients reporting hearing-related symptoms (15) or risk factors such as noise exposure need to be referred for objective hearing assessment.¶,** Although there is currently a lack of data to support the benefits of regular hearing screening in adults aged >50 years, the American Speech-Language-Hearing Association†† recommends that adults be screened at least every decade through age 50 years and every 3 years thereafter. Healthy People 2020§§ includes objectives to increase the proportion of adults who have had a hearing examination in the past 5 years and to increase the number referred by their health care provider for hearing evaluation and treatment.
Although there are no federal regulations regarding exposure to nonoccupational noise, a 1974 Environmental Protections Agency report¶¶ identified 70 dB over 24 hours (75 dB over 8 hours) as the average exposure limit for intermittent environmental noise. World Health Organization (WHO) 1999 Guidelines for Community Noise*** recommend avoiding noise exposure levels that exceed 70 dB(A)††† over a 24-hour period or 85 dB(A) over a 1-hour period. CDC's National Institute for Occupational Safety and Health (NIOSH) has established an 8-hour, time-weighted average 85 dB(A) recommended exposure limit to protect most workers from developing hearing loss from noise exposure over a 40-year career. However, at that sound pressure level [85 dB(A) time-weighted average], approximately 8% of workers could still develop hearing loss, and thus NIOSH recommends that hearing protection be worn whenever noise levels exceed 85 dB(A), regardless of the length of exposure.
The U.S. Department of Health and Human Services (DHHS) and WHO are raising awareness about noise-induced hearing loss. DHHS is collecting data on hearing status and risk factors, as well as developing guidelines on hearing aids. WHO is developing guidelines on noise exposure. Other public entities, such as states and counties, partner with community groups to reduce noisy environments and use evidence to inform policies that decrease noise exposures. Other ways to reduce environmental noise exposure include using sound-absorbent materials in office buildings and public venues, erecting highway barriers, and passing noise ordinances. Managers and owners of public venues can decrease the loudest sound levels at those locations to help decrease noise exposure.
The findings in this report are subject to at least two limitations. First, this is a report of audiometric notches as a proxy for noise-induced hearing loss, and it is possible that some of the hearing loss observed through this method could be caused by factors other than noise. Second, establishing prevalence rates of hearing damage attributed to risk factors such as noise is confounded by multiple data limitations, such as reliance on self-reported rather than measured noise exposures, complexity of categorizing hearing loss; and co-occurrence of risk factors, including genetic predisposition, and aging.
Data Needs
This study examines evidence of hearing loss related to noise exposure in a single NHANES 2-year data cycle. It does not provide a longitudinal assessment of persons over time, nor does it compare the results of hearing examinations across different NHANES cycles. A need exists for longitudinal data that measure cumulative effects of noise exposure on hearing over time. These data also show high prevalence of audiometric notches in young adults. Recent studies have shown an increase in the number of young persons exposed to loud noise and music via personal listening devices and at entertainment venues. Future work is needed on early life exposure to noise and its relation to hearing later in life.
National Center for Health Statistics, National Institutes of Health's National Institute on Deafness and Other Communication Disorders, audiologists from the National Institute for Occupational Safety and Health.
Corresponding author: Yulia Carroll, YCarroll@cdc.gov, 770-488-3912.
1Office of Science, National Center for Environment Health, CDC; 2Division for Toxicology and Human Health Services, Agency for Toxic Substances and Disease Registry, Atlanta, Georgia; 3National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Maryland; 4Office of the Director, National Center for Environment Health, CDC; 5Division of Emergency and Environmental Health Services, National Center for Environment Health, CDC; 6 National Institute for Occupational Safety and Health, CDC.
* National Health Interview Survey, 2014 data. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6437a8.htm.
† https://www.cdc.gov/nchs/nhanes/.
§ https://blogs.cdc.gov/niosh-science-blog/2014/04/09/sound-apps/.
¶ U.S. Preventive Services Task Force. Report no. 11-05153-EF-1. Hearing loss in older adults: screening. https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/hearing-loss-in-older-adults-screeningExternal.
** NIOSH. Criteria for a recommended standard — occupational noise exposure: revised criteria. Publication No. 98–126. https://www.cdc.gov/niosh/docs/98-126/pdfs/98-126a.pdfCdc-pdf.
†† http://www.asha.org/uploadedFiles/aud/InfoSeriesAudScreen.pdfCdc-pdfExternal.
§§ https://www.healthypeople.gov/2020/topics-objectives/topic/physical-activity/objectives?topicId=33External.
¶¶ https://nepis.epa.gov/Exe/ZyPDF.cgi/2000L3LN.PDF?Dockey=2000L3LN.PDFExternal.
*** http://www.euro.who.int/en/health-topics/environment-and-health/noise/publicationsExternal.
††† dBA indicates A-weighted decibels, an expression of the relative loudness of sounds in air as perceived by the human ear. In the A-weighted system, the decibel values of sounds at low frequencies are reduced, compared with unweighted decibels, in which no correction is made for audio frequency.
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TABLE 1. Percentages of adults aged 20–69 years with an audiometric notch* in one ear (unilateral notch) or both ears (bilateral notch), by selected characteristics — National Health and Nutrition Examination Survey, United States, 2011–2012
Characteristic (No.)
Bilateral or unilateral notch
Bilateral notch
Unilateral notch
% (SE)
Overall (3,583) 24.4 (1.73) — 6.2 (0.57) — 18.2 (1.32) —
Male (1,841) 31.6 (1.89) Referent 8.6 (0.76) Referent 23.0 (1.53) Referent
Female (1,742) 17.0 (1.90) 0.44 (0.35–0.56) 3.7 (0.95) 0.35 (0.19–0.66) 13.3 (1.23) 0.48 (0.40–0.57)
Age group (yrs)
20–29 (803) 19.2 (2.34) Referent 4.2 (1.31) Referent 14.9 (1.95) Referent
30–39 (721) 24.9 (2.95) 1.40 (0.98–2.00) 4.6 (0.84) 1.16 (0.50– 2.67) 20.4 (2.65) 1.47 (0.99–2.17)
40–49 (682) 29.0 (2.86) 1.72 (1.28–2.31) 7.70 (1.31) 2.07 (1.05–4.09) 21.3 (2.21) 1.62 (1.22–2.16)
50–59 (715) 27.3 (2.05) 1.58 (1.04–2.42) 8.7 (1.56) 2.27 (0.92–5.56) 18.7 (2.21) 1.39 (0.86–2.24)
White, non-Hispanic (1,240) 24.0 (2.08) Referent 6.5 (0.67) Referent 17.6 (0.67) Referent
Black, non-Hispanic (996) 21.1 (1.54) 0.85 (0.64–1.13) 3.6 (0.47) 0.54 (0.35–0.82) 17.5 (1.62) 0.96 (0.72–1.28)
Mexican American (381) 31.8 (3.12) 1.48 (1.06–2.05) 11.1 (2.63) 1.93 (1.09–3.42) 20.6 (2.21) 1.31 (0.94–1.83)
Less than high school (690) 29.7 (3.91) 1.49 (1.00–2.21) 8.1 (2.09) 1.75 (0.89–3.42) 21.6 (3.24) 1.41 (0.92–2.15)
Completed high school (737) 28.4 (2.87) 1.40 (1.10–1.77) 8.4 (0.86) 1.78 (1.26–2.51) 20.0 (2.43) 1.28 (0.98–1.68)
More than high school (2,156) 22.1 (1.63) Referent 5.1 (0.60) Referent 17.0 (1.24) Referent
Poverty income ratio
≤1 (848) 22.9 (1.81) 1.17 (0.87–1.58) 5.3 (0.80) 0.90 (0.49–1.62) 17.6 (1.62) 1.29 (0.92–1.80)
>1 to <5 (1,876) 27.0 (2.02) 1.46 (1.13–1.89) 6.7 (1.01) 1.20 (0.65–2.23) 20.3 (1.31) 1.57 (1.14–2.17)
≥5 (607) 20.2 (1.94) Referent 6.1 (1.19) Referent 14.1 (1.98) Referent
Self-reported work exposure to noise†
No (2,360) 19.9 (2.04) Referent 5.1 (0.73) Referent 14.8 (1.53) Referent
Yes (1,223) 32.6 (2.48) 1.95 (1.40–2.72) 8.2 (1.09) 1.91 (1.17–3.11) 24.4 (2.20) 1.96 (1.37–2.81)
Self-reported hearing status§
Excellent or good (2,953) 23.5 (1.92) Referent 5.5 (0.63) Referent 18.0 (1.57) Referent
Little, moderate, or a lot of trouble hearing (626) 28.3 (2.99) 1.29 (0.91–1.82) 9.0 (1.53) 1.73 (1.07– 2.78) 19.4 (2.66) 1.15 (0.74–1.79)
Abbreviations: CI = confidence interval; dB = decibel; OR = odds ratio; SE = standard error.
* An audiometric notch is a deterioration in the hearing threshold (the softest sound a person can hear). An audiometric notch is present when one or more of the thresholds at 3–4, or 6 kHz exceeds the pure-tone average of the 0.5 and1 kHz thresholds by 15 dB hearing level (HL) or more, and the 8 kHz threshold is at least 5 dB HL lower (better) than the highest threshold in the 3–6 kHz range. Audiograms were not accepted if the test and retest results were greater of 10 dB. The average 1-kHz frequency was the value used in this study. Participants were excluded if they had partial audio exam, ear compliance ≤0.2mL or pressure more negative than -150 dekapascals (daPa) (normal air pressure is approximately equal on both sides of the tympanic membrane [zero daPa]).
† Persons with no work exposure to noise included both those who reported off-work exposure to noise (e.g. noise from power tools, lawn mowers, farm machinery, cars, trucks, motorcycles, motor boats or music for 10 or more hours a week) and those who did not report exposure to off-work noise. Persons with work exposure to noise reported exposure to loud or very loud noise at work.
§ Participants were asked: "Which statement best describes your hearing (without a hearing aid)? Would you say your hearing is excellent, good, that you have a little trouble, moderate trouble, a lot of trouble, or are you deaf?"
TABLE 2. Percentages of adults aged 20–69 years with an audiometric notch* in one ear (unilateral notch) or both ears (bilateral notch), by reported work exposure to noise status,† and selected characteristics — National Health and Nutrition Examination Survey, United States, 2011–2012
No reported work exposure to noise (n = 2,360)
Work exposure to noise (n = 1,223)
Overall 19.9 (2.04) — 5.1 (0.73) 14.8 (1.53) 32.6 (2.48) — 8.2 (1.09) 24.44 (2.20)
Male 24.7 (2.61) Referent 7.2 (1.22) 17.6 (2.20) 39.1 (2.24) Referent 10.2 (1.24) 28.9 (2.18)
Female 16.6 (2.17) 0.61 (0.44–0.83) 3.7 (0.89)§ 12.9 (1.53)§ 18.3 (3.65) 0.35 (0.22–0.55) 3.7 (1.99)§ 14.6 (3.52)§
20–29 17.6 (2.91) Referent 3.6 (1.69) 14.0 (1.78) 22.9 (5.07) Referent 5.7 (2.21) 17.2 (4.67)§
30–39 18.6 (2.82) 1.07 (0.65–1.77) 3.4 (0.94) 15.2 (2.47) 37.3 (4.97) 2.00 (1.15–3.47) 6.9 (1.34) 30.4 (4.91)§
40–49 25.0 (3.74) 1.56 (0.91–2.68) 7.9 (1.95) 17.1 (3.05) 36.0 (3.46) 1.90 (1.05–3.43) 7.4 (2.37) 28.7 (1.66)
50–59 20.3 (3.04) 1.19 (0.73–1.95) 6.1 (1.43) 14.2 (2.46) 35.8 (2.73) 1.88 (1.01–3.50) 11.8 (2.60) 24.0 (2.87)
60–69 17.7 (3.06) 1.01 (0.59–1.72) 4.5 (1.12) 13.2 (2.91) 27.3 (5.23) 1.26 (0.60–2.66) 7.34 (1.57) 19.92 (5.37)
White, non-Hispanic 19.4 (2.85) Referent 5.1 (0.95) 14.3 (2.19) 31.9 (2.60) Referent 8.7 (1.50) 23.2 (2.24)
Black, non-Hispanic 17.7 (1.47) 0.89 (0.58–1.38) 3.3 (0.56) 14.4 (1.40) 28.6 (2.62) 0.86 (0.64–1.14) 4.2 (1.14)§ 24.4 (2.79)
Mexican American 24.2 (3.86) 1.39 (0.85–2.29) 8.7 (2.81) 14.8 (1.53) 43.0 (4.45) 1.61 (1.16–2.28) 14.8 (3.16)§ 28.2 (3.58)§
Less than high school 22.0 (2.78) 1.17 (0.81–1.69) 8.2 (1.80)§ 13.8 (2.41) 37.6 (6.52) 1.50 (0.89–2.53) 8.0 (3.26) 29.5 (5.43)
Completed high school 20.7 (3.70) 1.08 (0.73–1.61) 5.7 (1.65) 15.0 (2.87) 37.6 (4.06) 1.50 (0.98–2.32) 11.6 (2.42)§ 26.0 (3.01)
More than high school 19.4 (2.07) Referent 4.5 (0.85 14.9 (1.62) 28.6 (2.45) Referent 6.7 (1.01) 21.9 (2.24)
≤1 21.2 (1.76) 1.27 (0.94–1.72) 4.2 (0.78) 17.0 (1.56) 25.9 (3.24) 0.81 (0.33–1.99) 7.3 (1.60) 18.5 (3.22)
>1 to <5 20.8 (3.04) 1.24 (0.93–1.65) 5.2 (1.18) 15.6 (2.29) 35.8 (2.65) 1.30 (0.61– 2.77) 8.8 (2.05) 27.0 (2.23)
≥5 17.5 (1.64) Referent 5.7 (1.27) 11.8 (1.80) 30.1 (7.64) Referent 7.7 (3.41) 22.4 (7.87)
Self-reported hearing status¶
Excellent or good 20.1 (2.25) Referent 5.0 (0.77) 15.0 (1.68) 31.0 (3.24) Referent 6.6 (1.22) 24.4 (2.99)
Little, moderate, or lot of trouble 18.9 (3.94) 0.93 (0.51–1.69) 5.4 (2.26) 13.4 (3.10) 36.8 (2.36) 1.30 (0.93–1.81) 12.1 (2.01)§ 24.7 (2.69)
* An audiometric notch is a deterioration in the hearing threshold (the softest sound a person can hear). An audiometric notch is present when one or more of the thresholds at 3, 4, or 6 kHz exceeds the pure-tone average of the 0.5 and1 kHz thresholds by ≥15 dB hearing level (HL), and the 8 kHz threshold is at least 5 dB HL lower (better) than the highest threshold in the 3–6 kHz range. Audiograms were not accepted if the test and retest results were greater of 10 dB. The average 1-kHz frequency was the value used in this study. Participants were excluded if they had partial audio exam, ear compliance ≤0.2mL or pressure more negative than -150 dekapascals (daPa) (normal air pressure is approximately equal on both sides of the tympanic membrane [zero daPa]).
§ Statistical difference at p<0.5 compared with the referent group.
¶ Participants were asked: "Which statement best describes your hearing (without a hearing aid)? Would you say your hearing is excellent, good, that you have a little trouble, moderate trouble, a lot of trouble, or are you deaf?"
FIGURE. Percentage of persons with unilateral (in one ear) and bilateral (both ears) audiometric notches* in audiograms among adults aged 20–69 years who reported exposure to loud or very loud noise at work† and those who reported no noise exposure at work, by sex — National Health and Nutrition Examination Survey, United States, 2011–2012
* An audiometric notch is a deterioration in the hearing threshold (the softest sound a person can hear).
† Persons with no noise exposure at work included both persons who reported off-work exposure to noise (e.g., noise from power tools, lawn mowers, farm machinery, automobiles, trucks, motorcycles, motor boats, or music for 10 or more hours a week) and persons who did not report exposure to off-work noise.
Suggested citation for this article: Carroll YI, Eichwald J, Scinicariello F, et al. Vital Signs: Noise-Induced Hearing Loss Among Adults — United States 2011–2012. MMWR Morb Mortal Wkly Rep 2017;66:139–144. DOI: http://dx.doi.org/10.15585/mmwr.mm6605e3External.
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