This section (and the following one on Medical Guidelines) is reproduced here courtesy of the British Cochlear Implant Group (BCIG) which represents the professionals working in the field of implants. It is available from BCIG here. These Guidelines are dated June 2008.
These guidelines have been produced by the BCIG with input from the major UK suppliers of cochlear implants and members of several UK cochlear implant teams. The information listed here aims to provide realistic guidance to cochlear implant users to enable them to gain the maximum benefit from their implants and to minimise potential problems, but is given as general guidance, parts of which may not be applicable to all cochlear implant users. All cochlear implant users should read and understand the instructions given by the manufacturer / supplier of their cochlear implant and should take advice from their clinician on their own particular circumstances. But do remember that most people with cochlear implants are able to lead normal lives as long as they take a few sensible precautions. Although this information may seem daunting, in most cases the risks are very small !
Sport, leisure and play
The following guidelines may help, but you need to weigh up the issues involved, including:
Protecting the equipment
Protecting the head
Protecting the head
Avoiding moisture damage
Heeding instructions and warnings
Practicality
Comfort
Individual cochlear implant centres may give more specific instructions.
You should remember that the implant is quite vulnerable in the first 6 weeks after surgery, so special care should be taken at this time.
Standard play activities and non-contact sports (e.g. tennis, golf, badminton, running, rounders)
The headset and speech processor should be securely worn and protected from physical damage such as knocks, water, sand, etc.
Vigorous sports (e.g. football, netball, hockey and squash)
It may be advisable to remove the external parts of the system. If there is some risk of blows to the head the external parts should be removed and a form of head protection worn (e.g. a scrum cap).
Contact sports (e.g. boxing, kick boxing, rugby, and ice hockey)
Cochlear implant users should not participate in sports where physical injuries, pressure and blows to the head are inevitable or likely.
Martial arts which involve throwing
There is a risk of blows to the head which could damage the implant so cochlear implant users should not participate in these activities.
Sports where a helmet is recommended (e.g. cycling, riding and sailing)
These sports are acceptable. A helmet will help to protect the cochlear implant site from any blows. The helmet should be of high quality. If possible the external equipment should be left on. It is advisable to try different makes and types and to check for comfort and fit. It is especially important that the helmet fits well around the site of the implant to make sure that no pressure is applied directly onto the body of the implant or the scar. You should discuss this further with your cochlear implant centre.
Gymnastics
Gymnastics should be undertaken with caution. A scrum cap will provide some protection. Once again the external parts of the implant system should be removed.
Swimming, snorkeling and most water sports
Most water sports should cause no problems as long as the external parts of the implant system are removed. If goggles are worn care should be taken to ensure that the strap is not too tight over the site of the implant receiver under the skin. For sailing and canoeing a helmet is advisable.
Some implant wearers have balance problems and they should never swim alone. They may become disorientated if they swim under water and must be taught how to identify the direction of the surface.
Shallow diving and scuba diving
There may be risks from scuba diving, or diving to any depth, because of the pressure, wearing tight fitting masks/headgear, and other possible medical risks. Different models of cochlear implant are approved to different depths but all are safe to at least 10 metres.
Bungee jumps, artificial ski slopes, etc
It is not known if there are any extra risks for cochlear implant users associated with these activities, but they are certainly not advisable in the first 6 weeks after surgery. If cochlear implant users do decide to undertake them, they should remove the external equipment to prevent it from flying off.
Activity park rides
Rides which involve high speeds and / or extreme forces may risk dislodging the internal parts of the cochlear implant and are therefore not recommended.
Sky Diving
This is not reccommended.There is a risk of dislodgement of internal implanted components due to high acceleration forces. There is also a risk of disorientation from possible compromised balance function and there is a risk of possible head trauma.
Virtual reality headsets
Rides which involve high speeds and / or extreme forces may risk dislodging the internal parts of the cochlear implant and are therefore not recommended.
Sky Diving
This is not reccommended.There is a risk of dislodgement of internal implanted components due to high acceleration forces. There is also a risk of disorientation from possible compromised balance function and there is a risk of possible head trauma.
Virtual reality headsets
These headsets are thought to be safe but the user should ensure that they do not fit too tightly over the site of the implant. The sound quality may be poor and the microphone may be on only one side so it is important to check if it is on the same side as the implant.
Sun beds
Using sun beds cannot damage the internal components of your implant, but the external equipment should be removed to protect it from perspiration.
Damage to external equipment.
Remember at all times to keep all the cochlear implant equipment dry and free of sand and dust.
Security systems
1.Shops
The most common type of security system is the one found in many shops, where an alarm goes off if an item goes through which has not been paid for. There is no risk of damage to the implant or equipment from these detectors but some users prefer to switch off their speech processor because they may hear a sound as they pass through. Occasionally the security system may be activated by the implant so it is a good idea to have the ID card to hand.
2. Airports, etc
More sophisticated security systems, such as those in airports, produce magnetic fields which can cause the speech processor’s programme to become corrupted. These systems will carry a warning that people with heart pacemakers should not go through. If you see this type of sign remove the speech processor and switch it off. The speech processor may be passed through an X- ray machine safely as long as it is switched off. Carry your ID card and user manual to show to the staff. Again, the internal parts of the implant may activate the alarm so ask for a hand scan to be done. If you are in an airport which has a special check-in facility for disabled people you are recommended to use it.
If a speech processor’s map does become corrupted it can easily be reprogrammed at the cochlear implant centre. If the processor allows storage of more than one programme you can usually use one of the others in the meantime.
Employment issues
Car repairs
If working on a running car engine, normal safety procedures should be followed. Care must be taken to avoid high voltage electric shocks, which could damage the implant even if the external equipment is removed.
Welding
Arc and MIG welding do not pose a threat to the implant but the user may hear interference. Ideally the external parts should be removed to protect them from sparks, but the user needs to weigh up the relative risk of not being able to hear.
Use of hard hats
Please refer to advice regarding helmets for use when cycling etc in the ‘Sporting Activity and Play’ section above.
Industrial magnets
If you are working in an environment where there are high magnetic fields you should contact your Cochlear Implant Centre for advice.
Air travel
It may be necessary to switch off the speech processor during take off and landing while the plane has the ‘Fasten Seatbelts’ sign illuminated. You should check with the airline staff. You should follow any instructions issued by the airline with regard to the use of personal computers and other electronic devices, and if you are travelling alone then do tell the staff that you are deaf. You should also refer to the previous section which contains information about airport security systems.
If you wish to connect your speech processor to the headphone socket on the plane, you must use a cable designed for use with mains powered equipment.
If you wish to connect your speech processor to the headphone socket on the plane, you must use a cable designed for use with mains powered equipment.
Static electricity
Static electricity used to be a theoretical concern for cochlear implant users but the risk (which was already small) is now much less, especially for newer models of speech processor.
Children’s play equipment and toys
When children are using plastic slides, crawl tunnels, ball pools and bouncy castles, carers should balance the risk of corrupting the programme in the speech processor with any risks that would be incurred because the child was unable to hear. In ball pools in particular care should be taken that the processor does not get lost.
School science lessons
Cochlear implant users should never use Van der Graaf generators as these produce very high levels of static electricity.
When experimenting with static electricity as part of science lessons the speech processor and headset should be removed (not just switched off).
TV screens and computer monitors
Implant users should not touch the screen of ‘old style’ cathode ray tube TVs and plasma screen TVs. However LCD screen TVs do not pose any risk.
There is no risk from computer screens and users can safely use ‘touch-screen’ equipment.
Interference (something not to worry about!)
Cochlear implant users sometimes hear interference from equipment round about them. This is temporary and will not damage any part of the implant system or the ear. You may hear a buzzing noise when you are:
*Near to over head power lines
*Within 2km of TV or radio transmission masts, including those used by taxis, emergency services, etc
*Within 2m of a mobile phone. (It is often possible for implant users to use mobile phones but it is essential to try them first).
*Using a games console with wireless controller
*In the same room as the server for a wireless computer network
*Using an interactive white board
You are not likely to experience any interference from:
*Mobile phone transmitter masts
*Wireless computer networks (unless you are in the same room as the server)
Sometimes the cochlear implant may cause interference to computer speakers, radio controlled toys, etc. This will not cause any damage to the implant equipment or the user, but may cause the other equipment to perform in abnormal ways.
Personal stereos, audio equipment, TV, etc
Never connect a speech processor directly to any equipment powered by mains electricity. Always use the special adaptor recommended for your device. Different cables will be needed depending on whether you are connecting to battery or mains operated equipment.
Electric fences
Cochlear implant users should take care not touch or crawl underneath electric fences because if the head touches the fence there is a risk of damage to the implant.
Induction cookers
If a speech processor is within 50cm of the cooking surface it could heat up, so extra care should be taken by adults using body worn speech processors on a belt, and children. Users may hear a clicking sound when close to the cooker.
Toys causing deliberate electric shocks
These toys are not advisable for people with cochlear implants.
Miscellaneous