Christa Lockyer

Tinnitus in the City

How can the built environment help attenuate the hidden pain?

Tinnitus is a condition where there is the perception of monotonous sound resonating in your ears and yet no corresponding external noise to explain it. The condition is estimated to affect some 10-15% or more of the world’s population. It is not painful, and many sufferers can become accustomed to their internal invisible noise. However, others are severely affected psychologically by the internal ringing even after seeking medical treatment. Whilst usually associated with the elderly, recent studies point to increasing levels of hearing disorders and Tinnitus amongst younger adults (up to 20%) due to greater exposure to recreational noise. The CDC (Center for Disease Control and Prevention) in the US highlights concerns as to how this will play out as that population ages. Beyond exposure to loudness (representing around 14% of cases), there is little psychological or medical understanding of its causes, limited guidance on its alleviation, and no proven cure.

Regarding urbanism, studies have demonstrated that intense urban noise contributes to developing Tinnitus. Once afflicted, sufferers are known to avoid busy environments due to their Hyperacusis (noise hypersensitivity). Yet there is little discussion on the acoustic design of architecture or urbanism to alleviate those particular triggers. A recent study in Denmark on how urban traffic noise can cause Tinnitus is a rare example of academic literature underlining the need for urban acoustic solutions to achieve better social well-being.
This thesis is motivated by my personal experience with Tinnitus and my frustration with the gap in academic literature or effective professional advice on how to manage my symptoms daily – a frustration exaggerated by those around me having little understanding or empathy with the invisible stress. For me, the built environment has a significant effect on my symptoms. Some spaces aggravate the noise in my head, some attenuate it. If other patients make similar observations, can we better identify common triggers in the city and thus explore potential architectural solutions? I aim to also shed light on new understandings to increase awareness, especially among non-sufferers. By using my own experience as a guiding basis, my space-based research will cross reference interdisciplinary literature with the experience of other Tinnitus patients through interviews and on-site experiments.

The Liverpool University researcher Dr. William Hurst is one of few who have published specifically on helping Tinnitus patients in the built environment. His work “Predicting City Noise Levels to Support Tinnitus Sufferers” focuses on mapping trigger zones by measuring the quantum of noise (volume, as measured in decibels dB).5 Hurst’s premise is that patients should avoid noisy spaces and indicates these in real time on his city map application. I will argue that volume alone is not a sufficient basis, as personally, I can tolerate some loud spaces (Euston Road or discotheques) and yet not tolerate relatively quiet areas (for example, the Bartlett entrance hall).

I will therefore argue that it is also the quality of sound, not just the quantum, that needs consideration. In the context of Tinnitus, the quality of sound is a combination of (a) its pitch/frequency (Hz) and (b) the ambient acoustic echo (reverberation time measured in RT). The distinction is important for architecture as they can be treated differently through material and layout choice.

My findings confirm that typical trigger zones have common architectural features – mostly high echo/reverberation environments. Whilst I propose architectural solutions for attenuating echo, it is not often practical or economical to implement them in existing spaces. With an interdisciplinary approach to helping sufferers, I therefore also put forward other practical actions, for example through social media, that can help improve social perception and influence consumer/commercial choices - and thus help motivate architectural change.