Vocal Load of University Professors: Preliminary Results

Purpose: To describe the acoustic characteristics of a classroom, voice quality, fatigue, and vocal load of university professors. Methods: Exploratory, observational, longitudinal, and descriptive study with a single group of participants, including vocal monitoring data over two weeks. Acoustic characterization of the classroom, perceptual-auditory evaluation, and acoustic analysis of voice samples were conducted before and after classes. Vocal dosimetry was performed during classes, and the Vocal Fatigue Index (VFI) was assessed at the beginning of each week. Descriptive analysis of the findings was conducted, and randomization test was performed to verify the internal reliability of the judge. Results: All participants reported speaking loudly in the classroom, with the majority reporting vocal changes in the past six months, and only one participant reported a current vocal change. The classroom had acoustical measures and estimations that deviated from established standards. The professors used high vocal intensities during classes. After the classes, an increase in the absolute values of the aggregated data for CAPE-V, jitter, and fundamental frequency was found, varying within the range of normality. Furthermore, there was an observed increase in both post-lesson intensity and VFI when comparing the two-week period. Conclusions: Vocal intensities and VFI were possibly impacted by the acoustics of the classroom. The increase in average VFI between the weeks may be attributed to a cumulative fatigue sensation. Further research with a larger number of participants and in acoustically conditioned classrooms is suggested in order to evaluate collective intervention proposals aimed at reducing the vocal load on teachers.

Objetivo: Describir las características acústicas, calidad vocal, fatiga y carga vocal de profesores universitarios. Métodos: Estudio exploratorio, observacional, longitudinal, descriptivo con un solo grupo de participantes y datos de monitoreo vocal durante dos semanas. Se realizó caracterización acústica de la sala, evaluación auditiva-perceptiva y acústica de muestras de voz antes y después de las clases. Se realizó dosimetría vocal durante las clases y se verificó el Índice de Fatiga Vocal (IFV) en dos semanas. Se realizó un análisis descriptivo de los hallazgos y una prueba de aleatorización para verificar la confiabilidad interna del juez. Resultados: Todos los participantes informaron hablar en voz alta en clase, la mayoría informó cambios vocales en los últimos seis meses y solo uno informó cambios vocales actuales. La sala presentó mediciones y estimaciones acústicas fuera de las normas establecidas. Los profesores utilizaron intensidades vocales altas durante las clases. Hubo un aumento en los valores absolutos de los datos agrupados para CAPE-V, jitter y frecuencia fundamental, variando dentro de los límites normales, después de las clases. La intensidad después de las clases y el IFV, en la comparación entre las dos semanas, mostraron un aumento. Conclusiones: La dosis vocal y el IFV posiblemente se vieron afectados por la acústica del aula. El aumento del IFV medio entre semanas pudo deberse a la sensación de cansancio acumulada. Se sugieren nuevas investigaciones con un mayor número de participantes y que se realicen en la sala acondicionada acústicamente para evaluar propuestas de intervención colectiva, con el objetivo de reducir la carga vocal de los docentes.

White noise effect on listening effort among patients with chronic tinnitus and normal hearing thresholds

Abstract Objective This study investigated the effects of WN on LE in subjects with chronic tinnitus and normal hearing thresholds. The study was a prospective, non-randomized, before-and-after, intra-participant intervention. Methods Twenty-five subjects performed the following tests: conventional and high-frequency audiometry, acuphenometry, screening questionnaires for depression and anxiety symptoms, Tinnitus Handicap Inventory (THI), Montreal Cognitive Assessment, and high WM test from the Working Memory Assessment Battery, Federal University of Minas Gerais (WMAB) as the LE measure in two conditions: No Added Noise (NAN) and with Added Noise (AN). Results Seventeen participants (68%) performed better on AN condition. Data analysis revealed a 45% improvement in the WMAB total span count on AN setting, with a significant p value (p = 0.001). Conclusion The subgroup of participants without traces of anxiety symptoms, up to mild traces of depressive symptoms, having unilateral tinnitus, and a THI level up to grade 2, had improved WM performance in the presence of WN, which suggests a release of cognitive resources and less auditory effort under these combined conditions. Evidence level 4.

Tecnologia auditiva assistiva em usuários de implante coclear em ambientes reverberantes com múltiplas fontes de ruído / Assistive listening technology in cochlear implant users in reverberant environments with multiple noise sources

RESUMO Objetivo Avaliar a contribuição da tecnologia de escuta assistida em usuários de implante coclear (IC) em situações de reverberação e ruído. Métodos Estudo transversal prospectivo aprovado pelo Comitê de Ética Institucional (CAAE 8 3031418.4.0000.0068). Foram selecionados adolescentes e adultos usuários de IC com surdez pré ou pós-lingual. Para usuários bilaterais, cada orelha foi avaliada separadamente. O reconhecimento de fala foi avaliado por meio de listas gravadas de palavras dissílabas apresentadas a 65 dBA a 0° azimute com e sem o Mini Microfone2 (Cochlear™) conectado ao processador de fala Nucleus®6. A reverberação da sala foi medida como 550 ms. Para avaliar a contribuição do dispositivo de escuta assistida (DEA) em ambiente reverberante, o reconhecimento de fala foi avaliado no silêncio. Para avaliar a contribuição do DEA em reverberação e ruído, o reconhecimento de fala foi apresentado a 0° azimute com o ruído proveniente de 8 alto-falantes dispostos simetricamente a 2 metros de distância do centro com ruído de múltiplos falantes usando relação sinal-ruído de +10dB. Para evitar viés de aprendizado ou fadiga, a ordem dos testes foi randomizada. A comparação das médias foi analisada pelo teste t para amostras pareadas, adotando-se nível de significância de p<0,005. Resultados Dezessete pacientes com idade média de 40 anos foram convidados e concordaram em participar, sendo 2 participantes bilaterais, totalizando 19 orelhas. Houve contribuição positiva significante do Mini Mic2 na reverberação e ruído+reverberação (p<0,001). Conclusão DEA foi capaz de melhorar o reconhecimento de fala de usuários de IC tanto em situações de reverberação quanto ruidosas.

ABSTRACT Purpose This study aimed to evaluate the contribution of assistive listening technology with wireless connectivity in cochlear implant (CI) users in reverberating and noise situations. Methods Prospective cross-sectional study approved by the Institutional Ethics Committee (CAAE 8 3031418.4.0000.0068). Adolescents and adults CI users with pre- or post-lingual deafness were selected. For bilateral users, each ear was assessed separately. Speech recognition was assessed using recorded lists of disyllabic words presented at 65 dBA at 0° azimuth with and without the Wireless Mini Microphone 2 (Cochlear™) connected to the Nucleus®6 speech processor. Room reverberation was measured as 550 ms. To assess the contribution of the assistive listening device (ALD) in a reverberating environment, speech recognition was assessed in quiet. To assess the contribution of the ALD in reverberation and noise, speech recognition was presented at 0° azimuth along with the noise coming from 8 loudspeakers symmetrically arranged 2 meters away from the center with multi-talker babble noise using signal to noise ratio of +10dB. To avoid learning bias or fatigue, the order of the tests was randomized. Comparison of means was analyzed by t test for paired samples, adopting significance level of p <0.005. Results Seventeen patients with a mean age of 40 years were invited and agreed to participate, with 2 bilateral participants, totaling 19 ears assessed. There was a significant positive contribution from the Mini Mic2 in reverberation, and noise+reverberation (p <0.001). Conclusion ALD was able to improve speech recognition of CI users in both reverberation and noisy situations.

Enfrentamento da subnotificação da perda auditiva induzida por ruído relacionada ao trabalho: a experiência de uma oficina educativa em planejamento e programação local em saúde do trabalhador / Addressing underreported occupational noise-induced hearing loss: the experience of an educational workshop on local occupational health planning and program

Resumo Introdução: a subnotificação da Perda Auditiva Induzida por Ruído (Pair) relacionada ao trabalho é um problema que contribui para a invisibilidade e falta de prioridade deste agravo nos programas de Saúde do Trabalhador (ST). Logo, ações de educação permanente voltadas ao planejamento estratégico-situacional podem contribuir para o enfrentamento desta realidade. Objetivo: apresentar e discutir a experiência de uma intervenção educativa com técnicos da ST de uma macrorregião de saúde do estado da Bahia, Brasil, sobre o uso do Planejamento e Programação Local em Saúde (PPLS) como ferramenta para ampliação da notificação da Pair relacionada ao trabalho Métodos: a intervenção consistiu em uma oficina estruturada em cinco etapas, as quais proporcionaram discussão sobre a Pair, conhecimento do PPLS, prática do PPLS, socialização dos resultados e avaliação do evento. Resultados: a prática do PPLS, a partir de um problema real, viabilizou o delineamento de ações concretas de enfrentamento da subnotificação da Pair a serem implementadas nos Centros de Referência em Saúde do Trabalhador (Cerest) e no estado como um todo. Conclusão: a experiência mostrou-se bem-sucedida ao fomentar a tomada de consciência e mobilização dos técnicos para enfrentamento da subnotificação da Pair, ao tempo que propiciou qualificação em PPLS dos participantes.

Abstract Introduction: underreported occupational noise-induced hearing loss (ONIHL) is an issue that increases the invisibility and lack of priority of this condition in occupational health (OH) programs. Hence, permanent education actions focused on strategic-situational planning may help address the situation. Objective: to present and discuss the experience of an educational intervention in OH technicians of a larger health region in the state of Bahia, Brazil, approaching the use of the Local Health Planning and Program (PPLS, in Portuguese) as a toll to increase reports of ONIHL. Methods: the intervention had a workshop structured into five stages, which approached ONIHL discussions, PPLS knowledge, PPLS practice, result socialization, and event evaluation. Results: real-problem PPLS practice made it possible to outline concrete actions to address underreported ONIHL, which can be implemented in Occupational Health Reference Centers (Cerest) and other settings statewide. Conclusion: the experience proved to be positive, raising technicians' awareness of underreported ONIHL and mobilizing them to address the underreporting of ONIHL, while also effectively training participants to use PPLS.

Characteristics and influencing factors of hearing loss among noise-exposed workers in a large machinery maintenance enterprise / 环境与职业医学

Background The current increasing trend of new cases of occupational noise-induced deafness indicates that the hearing loss of occupational population has not been effectively controlled in China. It is of great significance to study the characteristics of hearing loss among noise-exposed workers and its related factors. Objective To investigate characteristics and influencing factors of hearing loss among occupational noise-exposed workers in a large machinery maintenance enterprise, and to provide a scientific basis to prevent and control noise-induced hearing loss. Methods A cross-sectional survey was conducted to investigate male Han occupational noise-exposed workers in a large mechanical maintenance enterprise. We acquired demographic characteristics, occupational exposure history, and individual life behavior characteristics of the workers through questionnaires, collected occupational exposure level data from annual occupational disease hazard factor surveillance reports, obtained pure tone hearing threshold test data through occupational health examinations, and estimated individual noise exposure levels using cumulative noise exposure (CNE). According to the results of pure tone air conduction hearing threshold test, the workers were divided into a hearing loss group and a normal hearing group. The chi-square test was employed to compare the occupational exposure characteristics and individual life behavior characteristics between the two groups. Additionally, the trend chi-square test was utilized to analyze the changing trends of age, length of service, CNE, and hearing loss rate within the two groups. The relationship between high-frequency hearing loss in both ears and its related influencing factors was assessed by a multiple logistic regression model. Results The M (P25, P75) of CNE for the 2531 occupational noise-exposed workers was 97.51 (95.39, 99.96) dB(A)·year. The incidence of hearing anomaly, binaural high-frequency hearing anomaly, random ear high-frequency hearing anomaly, binaural low-frequency hearing anomaly, and random ear low-frequency hearing anomaly were 22.48%, 16.59%, 22.13%, 2.77%, and 3.52%, respectively. High-frequency hearing threshold increase was the main reason for hearing anomaly (98.42%). In comparison to the CNE ≤ 97 dB(A)·year group, the 97 dB(A)·year<CNE≤ 100 dB(A)·year group and the CNE>100 dB(A)·year group experienced a 36.4% and 52.3% increase in the risk of bilateral high-frequency hearing loss, respectively. The smoking group exhibited a 43.5% elevated risk of bilateral high-frequency hearing loss when compared to the non-smoking group. Conversely, the group frequently wearing hearing protection equipment demonstrated a 23.6% lower risk of bilateral high-frequency hearing loss in comparison to the group occasionally wearing protective equipment. The data suggested that CNE＞97 dB(A)·year and smoking might be independent risk factors for bilateral high-frequency hearing loss, and frequently wearing hearing protection equipment might be an important protective factor. Conclusion Increased CNE and smoking can elevate the risk of high-frequency hearing loss, while personal hearing protection can effectively reduce the risk of hearing loss.

Effects of long-term noise exposure during sleep on liver circadian clock and lipid metabolism / 环境与职业医学

Background Long-term exposure to noise during sleep may has adverse effects on metabolic system, and liver lipid metabolism is closely related to circadian clock genes. Objective To investigate the effects of long-term noise exposure during sleep on liver circadian clock and lipid metabolism in mice and its related mechanism. Methods Twenty C57BL/6J male mice were randomly divided into two groups: a noise exposure group and a control group with 10 mice in each group. The mice in the noise exposure group were exposed to white noise at 90 dB sound pressure level (SPL) for 30 consecutive days, 8 h a day, from 9:00 to 17:00. The mice in the control group were exposed to background noise ≤40 dB SPL. After noise exposure, the animals were neutralized at 14:00 (ZT6) and 2:00 (ZT18), 5 animals at each time spot, and the liver tissues were collected. Total cholesterol and triglyceride in liver were determined by cholesterol oxidase method and glycerol phosphate oxidase method respectively. The expressions of circadian clock genes (Clock, Bmal1, Rev-erbα, and Rev-erbβ) and lipid metabolism genes (Srebp1c, Hmgcr, Fasn, Lxrα, Acc1, and Chrebp) in liver were detected by quantitative real-time PCR. Results Compared with the control group, the content of total cholesterol in liver in the noise exposure group increased by 48% (P<0.05) and the content of liver triglyceride increased by 61% (P<0.05) at ZT18. The mRNA expression levels of circadian clock genes Clock and Bmal1 in the noise exposure group was significantly increased at ZT18 and decreased at ZT6 (P<0.05). The mRNA expression level of Rev-erbα decreased at both ZT6 and ZT18 (P<0.05). The mRNA expression level of Rev-erbβ had no significant change at ZT6 and ZT18. The mRNA expression levels of liver lipid metabolism related genes Srebp1c, Hmgcr, Chrebp, and Lxrα in the noise exposure group were higher than those in the control group at ZT18 (P<0.05). The mRNA expression levels of Acc1 and Fasn showed no significant change at ZT6, then an upward trend at ZT18, but no significant difference between the two time spots (P>0.05). Conclusion Long-term noise exposure during sleep can cause circadian clock and lipid metabolism disorders in mice. Among them, suppression of key circadian clock genes may be associated with Rev-erbα-mediated upregulation of the nuclear receptors Srebp1c and Chrebp for lipid synthesis and deposition in the liver, resulting in lipid metabolism disorder.

Occupational health risk assessment of noise in a coal mining enterprise in Shaanxi Province / 公共卫生与预防医学

Objective To evaluate the noise hazard level of a coal mining enterprise, and identify high-risk operation types and people, and to provide a basis for preventing and controlling the health damage caused by noise. Methods A large coal mining enterprise in Shaanxi Province was selected as the research object. The noise monitoring data of the coal mine over the years was used to calculate the noise exposure matrix of each post in the enterprise, and the classification of occupational hazards at workplaces (GBZ/T 229.4-2012) was used to assess the occupational health risk levels. Results Among the 22 noise-exposed positions in the enterprise, the 8-hour working day equivalent sound level in positions of shearer driver, horseshoe driver, crusher driver, shuttle driver, relaxation screen driver, and grading screen driver were all higher than the occupational exposure limit of noise. In 2021, the noise exposure levels of shearer drivers, crusher drivers, and coal-selecting workers were all higher than 90 dB (A), and the occupational hazard level was moderate hazard level. In addition, the noise exposure levels of most other jobs also exceeded the occupational exposure limit. Conclusion The noise hazards in the coal mine industry are mainly concentrated in the posts of the coal mining system, tunneling system, and screening workshop. Among them, the shearer driver, the crusher driver, and the coal preparation workers have higher noise exposure levels. It is recommended to take corresponding noise reduction measures and strengthen the protection level to reduce the noise exposure risk of workers.

Hearing loss and its relationship with blood pressure among workers exposed to noise in a brewery / 公共卫生与预防医学

Objective To investigate the health status of workers exposed to noise in a brewery in Beijing and to analyze the relationship between hearing loss and blood pressure. Methods A total of 949 noise-exposed workers in a brewery who participated in occupational health examination were selected as the investigation subjects. A survey was conducted to investigate the pure tone hearing threshold and abnormal blood pressure of the workers with different characteristics, and to analyze the relationship between the two. Results Among the noise-exposed workers, the detection rates of hearing abnormality, hypertension, and increased systolic and diastolic blood pressure were 73.55%, 52.37%, 43.84% and 46.47%, respectively. The detection rates of hearing abnormality, indicators of hypertension, high frequency hearing threshold abnormality and increased binaural high frequency hearing threshold on average in males were higher than those in females (P 0.05), the detection rates of other hearing abnormality, indicators of hypertension, speech frequency hearing threshold abnormality, high frequency hearing threshold abnormality，increased binaural high frequency hearing threshold on average and the weighted value of the better ear's hearing threshold all increased or had an increasing trend with the increase of age or working years (P< 0.05). The detection rates of hypertension in the groups with high frequency hearing threshold abnormality and increased binaural high frequency hearing threshold on average were higher than those in the normal group (P＜0.05). Conclusion The noise-exposed workers in the brewery have hearing impairment, which is related to the occurrence of hypertension. It is recommended to strengthen the publicity and education on noise protection and take protective measures to reduce the occurrence of occupational noise injury.

Vocal Demand Response to the Educational Setting Based Communication Scenarios: A Single Subject Study

Objectives: This was a single-subject study, aimed to demonstrate different vocal demand situations that are typical for primary school and teacher's vocal demand response under two acoustical conditions, with and without voice amplification, during five working days. Methods: The long-term voice dosimetry with Vocal Holter Med (PR.O. Voice Srl) was carried out on a 49-year-old female teacher with voice disorders during daily teaching activities. A sound field amplification system (SFAS) PentaClass Runa was installed in the classroom. Voice dosimetry was provided under two different acoustical conditions: without SFAS (2 days) and with SFAS (3 days). Results: Phonation time percentage, sound pressure level (SPL), SPL SD, fundamental frequency (F0), F0 SD, cycle, and distance doses were investigated in seven communication scenarios (lessons, group/individual classes, sports lessons in the gym and schoolyard, breaks, lunch breaks, and other activities). The median scores of all voice parameters differed significantly between different vocal demand contexts. The significant statistical difference in the vocal demand response was in the communication situations with and without SFAS. In addition, the number of children, reverberation time, and ambient air relative humidity impacted voice SPL and the cycle dose. Conclusions: Lessons, sports lessons held in the gym or schoolyard, breaks, and lunch breaks were considered as high vocal demand communication situations requiring higher voice intensity and fundamental frequency, higher phonation time percentage, cycle, and distance doses. Group/individual work and other teacher activities during the day, unrelated to direct work with students, were categorized as low vocal demand communication scenarios.

Objetivos: Este fue un estudio de sujeto único, cuyo objetivo fue demostrar diferentes situaciones de demanda vocal típicas de la escuela primaria y la respuesta vocal de los docentes bajo dos condiciones acústicas, con y sin amplificación de voz, durante cinco días laborables. Métodos: Se llevó a cabo dosimetría vocal a largo plazo con Vocal Holter Med (PR.O. Voice Srl) durante las actividades diarias de enseñanza en una docente de 49 años con trastornos de la voz. Se instaló un sistema de amplificación de campo sonoro (SFAS) PentaClass Runa en el aula. La dosimetría vocal se realizó bajo dos condiciones acústicas diferentes: sin SFAS (2 días) y con SFAS (3 días). Resultados: Se investigaron el porcentaje de tiempo de fonación, el nivel de presión sonora (SPL), SPL SD, la frecuencia fundamental (F0), F0 SD, ciclos y dosis de distancia en siete escenarios de comunicación diferentes (clases, clases grupales/individuales, clases de educación física en el gimnasio y el patio de la escuela, recreos, almuerzos y otras actividades). Las puntuaciones medias de todos los parámetros vocales diferían significativamente entre los diferentes contextos de demanda vocal. La diferencia estadísticamente significativa en la respuesta a la demanda vocal se observó en las situaciones de comunicación con y sin SFAS. Además, el número de niños, el tiempo de reverberación y la humedad relativa del aire ambiente afectaron al SPL de la voz y la dosis de ciclo. Conclusiones: Las lecciones, las clases de educación física en el gimnasio o el patio de la escuela, los recreos y los almuerzos se consideraron situaciones de comunicación de alta demanda vocal, que requerían una mayor intensidad y frecuencia fundamental de la voz, un mayor porcentaje de tiempo de fonación y dosis de ciclo y distancia más altas. El trabajo grupal/individual y otras actividades del profesor durante el día no relacionadas con el trabajo directo con los estudiantes se categorizaron como escenarios de comunicación de baja demanda vocal.

Self-Reported Voice-Related Quality of Life in Cochlear Implant Users

Objective: The aim of this study was to identify if cochlear implant (CI) users are perceiving a decrease in life quality due to voice problems. This study evaluated 43 CI user's perception of their voice and how it affects their quality of life through a survey. Approach: Forty-three CI users responded to a survey regarding their demographics, details about their CI, the Hearing Health Quick Test (HHQT), the Voice Related Quality of Life (V-RQOL), and the Voice Handicap Index-10 (VHI-10). The survey responses were analyzed using univariate linear regression analysis. Results: Few of the CI users scored below the cut off for normal voice related quality of life. CI users averaged 93.4 out of 100 on the V-RQOL and only four scored abnormally for the VHI-10. Lower scores on the V-RQOL were correlated with the participants having an associate degree and with participants visiting friends, family, and neighbors less often due to hearing loss. The VHI-10 scores were correlated with gender, education levels, difficulty in social situations due to hearing loss, noise exposure, and tinnitus. Limitations of the study: The small n was the primary limitation of this study. Originality: This study was one of the first to examine the voice-related quality of life in CI users. Conclusions: Overall, respondents did not perceive much voice-related difficulty. However, they were more likely to perceive voice-related difficulty if they experienced difficulty hearing in noise and avoided social situations due to hearing loss.

Objetivo: Este estudio identificó si los usuarios de implantes cocleares (IC) están percibiendo una disminución en la calidad de su vida debido a problemas de voz. Además, evaluó la percepción de la voz de 43 usuarios de IC y cómo afecta su calidad de vida a través de una encuesta. Enfoque: Cuarenta y tres usuarios de IC respondieron a una encuesta sobre su demografía, detalles sobre su IC, la Hearing Health Quick Test (HHQT), la Voice Related Quality of Life (V-RQOL) y el Voice Handicap Index-10 (VHI-10). Las respuestas de la encuesta se analizaron mediante un análisis de regresión lineal univariado. Resultados: Pocos usuarios de IC puntuaron por debajo del límite para calidad de vida relacionada con la voz. El promedio V-RQOL fue de 93,4/100; solo 4 participantes tuvieron puntuación anormal en VHI-10. Las bajas puntuaciones en V-RQOL se correlacionaron con título de asociado y menos visitas por pérdida auditiva; las puntuaciones VHI-10, con sexo, educación, dificultad en situaciones sociales, exposición al ruido y tinnitus. Limitaciones del estudio: La pequeña n fue la principal limitación de este estudio. Originalidad: Este estudio fue uno de los primeros en examinar la calidad de vida relacionada con la voz en usuarios de CI. Conclusiones: En general, los encuestados no percibieron mucha dificultad relacionada con la voz. Sin embargo, era más probable que percibieran dificultades relacionadas con la voz si tenían dificultades para oír en ruido y evitaban situaciones sociales debido a la pérdida auditiva.

Nível de ruídos na unidade neonatal / Noise level in the neonatal unit / Nivel de ruido en la unidad neonatal

Objetivo: verificar os níveis de pressão sonora, a influência do turno e das ocorrências nesses níveis em uma unidade neonatal do Rio de Janeiro. Método: estudo longitudinal, exploratório, descritivo, com dados coletados entre novembro de 2021 e janeiro de 2022. As variáveis categóricas foram descritas por meio de frequências absoluta e relativa. A aderência à distribuição normal foi verificada pelo teste Shapiro-Wilk. Para a análise da associação entre variáveis de exposição e desfecho, utilizou-se teste Mann-Whitney, Kruskal Wallis e Qui-quadrado. Considerou-se estatisticamente significativos resultados de p<0,05. Resultados: foram coletados 10.122 registros de decibéis e 56 eventos relacionados as atividades, que ocorreram predominantemente no período diurno. Houve variação de 38,6 a 93,1 decibéis (dB). Em 96,3% do período observado, os níveis de pressão sonora estiveram acima do recomendado. Na comparação entre os períodos, o noturno apresentou menores níveis (p=0,000). Conclusão: os níveis de pressão sonora registrados estão acima do recomendado para um ambiente seguro.

Objective: to verify the sound pressure levels (SPL) and the influence of the shift and the occurrences in these levels in a neonatal unit in Rio de Janeiro. Method: longitudinal, exploratory, descriptive study. Collected from November 2021 to January 2022. Categorical variables were described using absolute and relative frequencies. To verify adherence to the normal distribution, the Shapiro-Wilk test was used. For the association between exposure and outcome variables, the Mann-Whitney, Kruskal Wallis and Qui-square tests were used. Results of p < 0.05 were considered statistically significant. Results: 10,122 decibel records and 56 events related to activities were collected, these occurred predominantly during the day. There was a variation from 38.6 to 93.1 decibels (dB). In 96.3% of the observed period, the NPS were above the recommended. Comparing the periods, nighttime had lower SPL (p=0.000). Conclusion: the registered NPS are above the recommended for a safe environment.

Objetivo: Verificar los niveles de presión sonora y la influencia del turno y de las incidencias en esos niveles en una unidad neonatal en Rio de Janeiro. Método: Estudio longitudinal, exploratorio, descriptivo, cuyos datos se recopilaron de noviembre de 2021 a enero de 2022. Las variables categóricas se describieron mediante frecuencias absoluta y relativa. Para verificar la adherencia a la distribución normal se utilizó la prueba de Shapiro-Wilk. Para el análisis de la asociación entre variables de exposición y de resultado se utilizaron las pruebas de Mann-Whitney, Kruskal Wallis y Qui-quadrado. Los resultados de p < 0,05 se consideraron estadísticamente significativos. Resultados: se recolectaron 10.122 registros de decibelios y 56 eventos relacionados con actividades, que ocurrieron predominantemente durante el día. Hubo una variación de 38,6 a 93,1 decibelios (dB). En el 96,3% del período observado, los niveles de presión sonora estuvieron por encima de lo recomendado. Comparando los períodos, el nocturno presentó niveles más bajos (p=0,000). Conclusión: Los niveles de presión sonora registrados están por encima de lo recomendado para un ambiente seguro.

Percepção de professores quanto ao impacto do ruído no ambiente escolar / Teachers' perception of the impact of noise in the school environment / Percepción del docente sobre el impacto del ruido en el entorno escolar

Introdução: a poluição sonora está presente na escola, sendo assim, é importante conhecer as fontes de ruído, o impacto na saúde do professor e no ensino. Objetivo: avaliar a percepção de professores do ensino fundamental I quanto ao impacto do ruído no ambiente escolar, bem como seus sintomas vocais. Método: estudo observacional, descritivo, analítico, transversal. Aplicou-se inventário, do qual participaram 26 professoras da rede municipal da cidade de Santo Amaro da Imperatriz, SC. Aplicou-se um questionário com questões referentes à idade, sexo, tempo de trabalho, carga horária diária, impacto e percepção do ruído no ambiente escolar. Utilizou-se o Índice de Triagem para Distúrbios da Voz, uma triagem para identificação de risco para distúrbio de voz em professores. Para a análise de associação dos resultados foi utilizado o teste de Qui Quadrado, com nível de significância de 5%. Resultados: 53,57% das professoras responderam que há excesso de ruído na escola e 57,14% consideram que o ruído dentro da sala prejudica as atividades. As fontes externas e internas de ruído que mais atrapalham são: pátio, corredor, conversas paralelas e ventilador. Quanto aos sintomas vocais referidos, destacaram-se: garganta seca, cansaço ao falar, pigarro e rouquidão. Professoras que lecionam em período integral apresentaram mais queixas para o pigarro. Conclusão: os sujeitos têm a percepção de que o ambiente escolar é excessivamente ruidoso e causa prejuízos no desenvolvimento das atividades. As participantes têm poucas queixas relacionadas à voz, sendo a mais frequente, garganta seca. Além disso, professoras que lecionam em período integral apresentaram, significativamente, mais queixas de pigarro. (AU)

Introducción: la contaminación acústica está presente en la escuela, entonces es importante conocer las fuentes del ruido, el impacto en la salud del docente y en la enseñanza. Propósito: evaluar la percepción de docentes sobre el impacto del ruido en el ambiente escolar, así como sus síntomas vocales. Método: estudio observacional, descriptivo, analítico, transversal. Se aplicó un inventario, en el que participaron 26 docentes de la red municipal de la ciudad de Santo Amaro da Imperatriz, (SC). con preguntas relacionadas con edad, género, tiempo de trabajo, carga diaria de trabajo, impacto y percepción del ruido en el ambiente escolar. Se utilizó el Índice de Detección de Trastornos de la Voz para identificar el riesgo de trastornos de la voz. Para el análisis de asociación se utilizó la prueba de chi-cuadrado, con un nivel de significación del 5%. Resultados: 53,57% respondió que en la escuela hay exceso de ruido y 57,14% consideram que el ruido dentro del salón perjudica las actividades. Las fuentes de ruido más molestas son: patio, pasillo, conversaciones paralelas y ventilador. En cuanto a los síntomas vocales reportados destacan sequedad de garganta, cansancio al hablar, carraspeo y ronquera. Los maestros de tiempo completo se quejaron más de carraspear. Conclusión: los sujetos tienen la percepción de que el ambiente escolar es excesivamente ruidoso y provoca perjuicios para el desarrollo de las actividades. Los participantes tienen pocas quejas relacionadas con la voz, siendo la garganta seca la más frecuente. Además, los maestros que enseñan a tiempo completo tenían muchas más quejas de carraspeo. (AU)

Introduction: noise pollution is present at school; therefore, it is important to know the sources of noise, the impact on the teacher's health and on teaching. Purpose: to evaluate the perception of elementary school teachers regarding the impact of noise in the school environment, as well as their vocal symptoms. Method: observational, descriptive, analytical, cross-sectional study. An inventory was applied, in which 26 teachers from the municipal network of the city of Santo Amaro da Imperatriz, (SC). participated. A questionnaire was applied with questions related to age, gender, working time, daily workload, impact and perception of noise in the school environment. The Voice Disorders Screening Index was used, a screening to identify risk for voice disorders in teachers. For the analysis of the association of results, the chi-square test was used, with a significance level of 5%. Results: 53.57% of the teachers answered that there is excessive noise in the school and 57.14% consider that the noise inside the room harms the activities. The most disturbing external and internal sources of noise are courtyard, corridor, parallel conversations and fan. As for the reported vocal symptoms, the following stand out: dry throat, tiredness when speaking, throat clearing and hoarseness. Full-time teachers complained more about throat clearing. Conclusion: the subjects have the perception that the school environment is excessively noisy and causes damage to the development of activities. The participants have few voice-related complaints, the most frequent being dry throat. In addition, teachers who teach full-time had significantly more complaints of throat clearing. (AU)

Asymmetry of Occupational Noise Induced Hearing Loss: An Electrophysiological Approach

Abstract Introduction The question as to whether occupational noise exposure causes symmetrical or asymmetrical hearing loss is still controversial and incompletely understood. Objective Two electrophysiological methods (cortical evoked response audiometry: CERA and auditory steady state responses: ASSR) were used to address this issue. Method 156 subjects with a well-documented history of noise exposure, a wide range of noise induced hearing loss (NIHL) and without middle ear pathology underwent both a CERA and an ASSR examination in the context of an exhaustive medicolegal expert assessment intended for possible compensation. Results Whatever the method (CERA or ASSR), the average electrophysiological hearing thresholds (1-2-3 kHz) are significantly worse in the left ear. The right - left differences in CERA and ASSR thresholds are strongly correlated with each other. No significant effect of frequency is found. No correlation is observed between right - left differences in hearing thresholds and either age or degree of hearing loss. Conclusion In NIHL, there is an actual average right - left difference of about 2.23 dB, i.e., 3.2%, the left ear being more impaired.

Bluetooth Coupling in Hearing Aids: Effect on Audiovisual Speech Recognition and Quality Rating of Compressed Speech in Older Individuals with Sloping Hearing Loss

Abstract Introduction Older individuals often report that they find it difficulty in enjoying watching television since they find it hard to follow the rapid intensity variations, and voice changes from scene to scene. Objective The present study investigated the effect of coupling the hearing aid with the television via Bluetooth on audiovisual speech recognition and quality rating of compressed speech in older individuals with hearing loss. Method Twenty participants in the age range of 60 to 75 years who had moderate to moderately severe sloping sensorineural hearing loss were bilaterally fitted with digital receiver in the canal hearing aids. The hearing aid was coupled with a television via Bluetooth using a streamer. The video recorded stimuli were presented at 65 dB SPL at normal rate, 35% compression and 45% compression conditions. Speech recognition scores and quality ratings were obtained for each condition with and without the Bluetooth streamer connected to the hearing aids. Results Speech recognition scores were significantly better with Bluetooth coupling compared with conventional hearing aid use at 40% compressed speech rate. The quality was also rated higher in almost all parameters across speech rates when Bluetooth was used. Conclusions The improved clarity and nullification of room reverberation offered by Bluetooth coupling can potentially compensate for the age-related temporal processing deficit contributing to ease of listening.

Presenteeism and noise perception at work: a cross-sectional study using association analysis

ABSTRACT BACKGROUND: Presenteeism refers to the presence of a worker at work with reduced performance due to illness, and it is a common public health problem. Exposure to noise during production processes brings risk to workers' health. OBJECTIVE: To analyze the health profile of workers in the automotive industry and identify the association between noise perception and presenteeism among workers in the Brazilian automotive industry. DESIGN AND SETTING: This was a cross-sectional study utilizing a case study design analyzing the automotive industry in the interior of São Paulo state, Brazil. METHODS: This study included 306 workers using the Presenteeism Work Limitations Questionnaire protocol. Multiple logistic regression was used for data analysis. RESULTS: Male workers with reports of headache, tension, and limited well-being at work, having perceived that noise exposure interferes with productivity, showed a positive association with the occurrence of presenteeism. Physical demand had the highest score in terms of interfering with the presenteeism index. CONCLUSION: Workers' perceptions of noise were associated with presenteeism.

Autorrelato de dificuldades auditivas e desempenho em teste de fala com ruído - o que podemos encontrar por trás de um audiograma "normal"? / Self-reported hearing difficulties and speech-in-noise test performance - what can we find behind a "normal" audiogram?

RESUMO Objetivo Investigar a queixa de dificuldade de inteligibilidade na presença de ruído, em sujeitos sem perda auditiva e compará-la com o desempenho em um teste de fala no ruído. Método A casuística foi constituída por 39 sujeitos de 18 a 59 anos e 11 meses foram divididos em quatro grupos em função da década de vida. Estes foram submetidos à audiometria, timpanometria, testes de processamento auditivo, mini exame do estado mental, autorrelato da percepção auditiva com o Pt-AIADH e a um teste de sentenças no silêncio e no ruído. Resultados Todos os grupos pontuaram para os domínios do Pt-AIADH, com maior pontuação média para o domínio de inteligibilidade no ruído. Houve diferenças entre o G18 vs G40, G18 vs G50, e G30 vs G50 para a autopercepção auditiva na inteligibilidade no ruído; e diferenças entre o G18 e os demais grupos no teste de fala com ruído, com menor relação sinal-ruído para os adultos mais velhos. Houve correlação moderada e significativa para a inteligibilidade no ruído e o teste de fala no ruído. Conclusão Normo-ouvintes de todas as faixas etárias estudadas apresentaram queixa de inteligibilidade no ruído. Quanto maior a dificuldade auditiva neste domínio pior o desempenho no teste de fala com ruído, sendo mais significativo em adultos de meia idade.

ABSTRACT Purpose To investigate complaints of difficulty understanding speech in the presence of noise in subjects without hearing loss and their performance on a speech-in-noise test. Methods Thirty-nine subjects aged 18 to 59 years and 11 months were divided into four groups according to their decade of life. They underwent audiometry, tympanometry, auditory processing tests, the Mini-Mental State Examination, a self-report on auditory perception combined with the Amsterdam Inventory for Auditory Disability and Handicap (Pt-AIADH), and a sentence test in silence and in noise. Results All groups scored high on the Pt-AIADH domains, with the highest average score obtained for the noise intelligibility domain. There were differences between G18 vs. G40, G18 vs. G50, and G30 vs. G50 for auditory self-perception in noise intelligibility, and differences between the youngest and all other groups on the speech-in-noise test in particular, with a lower signal-to-noise ratio for older adults. We also identified a moderate and significant correlation between intelligibility in noise and the speech-in-noise test. Conclusion Normal hearers of all age groups complained of intelligibility in noise. We found that the higher an individual's auditory difficulty in this domain, the worse their performance on the speech-in-noise test; this is especially true for middle-aged adults.

Resistance to the use of the FM System by children and adolescents: fact or myth? An analysis of records of patients assisted in a hearing health center / Resistência ao uso do Sistema FM por crianças e adolescentes: fato ou mito? Uma análise de prontuários de pacientes atendidos em um serviço de saúde auditiva

ABSTRACT Purpose: to compare the use of the Frequency Modulation (FM) System by children and adolescents in a public hearing health center in the state of São Paulo. Methods: the analysis of medical records based on eligibility criteria. Data were collected from 340 participants born between 1998 and 2011, fitted with FM System, and who attended the follow-up appointment after fitting the device. Data were analyzed descriptively and inferentially. Results: hard-of-hearing children and adolescents of both genders from all over Brazil, attending elementary, middle or high school in public or private schools, participated. The data showed that 115 children and 155 adolescents effectively used the device, especially at school. The main difficulty for children was the lack of support from teachers; for adolescents, it was the feeling of embarrassment. Conclusion: some difficulties, especially on children, in adhering to the use of FM Systems were identified. Hence, to ensure the FM System's effective use, the importance of providing guidance and awareness of its benefits to patients, and their family members and teachers, during the fitting appointment and follow-up consultations, is emphasized.

RESUMO Objetivo: comparar o uso do Sistema de Frequência Modulada por crianças e adolescentes em um Serviço Público de Saúde Auditiva do estado de São Paulo. Métodos: análise de prontuários, balizada pelos critérios de elegibilidade. Foram coletados dados de 340 participantes adaptados com o Sistema de Frequência Modulada, nascidos entre 1998 e 2011 e que compareceram à consulta de retorno pós-adaptação do dispositivo. Os dados foram analisados de forma descritiva e inferencial. Resultados: participaram crianças e adolescentes de ambos os gêneros provenientes de todo Brasil, com deficiência auditiva, cursando o ensino fundamental I ou II e ensino médio na rede pública ou privada de ensino. Os dados revelaram que 115 crianças e 155 adolescentes faziam uso efetivo do dispositivo, especialmente na escola. As principais dificuldades relatadas foram a falta de apoio dos professores entre as crianças e o sentimento de vergonha entre os adolescentes. Conclusão: foram identificadas dificuldades na adesão ao uso do Sistema FM, sobretudo por parte das crianças. Diante disso, ressalta-se a importância da orientação e da conscientização dos benefícios do uso do Sistema FM aos pacientes, familiares e seus professores, tanto no momento da adaptação do dispositivo quanto nas consultas de acompanhamento, a fim de assegurar o seu uso efetivo.

Hearing health educational interventions for school students / Intervenções educativas em saúde auditiva para escolares

ABSTRACT Purpose: to implement and assess hearing health interventions for school students, using Dangerous Decibels® Program activities in partnership with the Young Doctor Project, approaching noise-induced hearing loss prevention. Methods: the study encompassed 41 students, aged 12 to 14 years, from two schools in inland São Paulo and a social institution for public school students. Activities were based on the Young Doctor Project and the Dangerous Decibels® Brazil Program. The students answered a questionnaire administered in three situations: before the intervention (pre), right after the intervention (post), and 4 months after the intervention. The ANOVA, Friedman (p < 0.001), and Tukey´s (p < 0.05) statistical tests were used. Results: the 41 students who participated in the program were protagonists of knowledge, spreading the content they learned to another 954 students in the three schools through cultural workshops. The analysis of program effectiveness revealed improved results right after the intervention and 4 months afterward. Conclusion: combining these two programs encouraged the protagonism of young people to increase their involvement with the community. Moreover, the students changed their attitude toward potentially dangerous sounds.

RESUMO Objetivo: implementar e avaliar intervenções em saúde auditiva para escolares, utilizando as atividades do Programa Dangerous Decibels ®, em parceria com o Projeto Jovem Doutor, abordando aspectos preventivos da perda auditiva induzida por níveis de pressão sonora elevados. Métodos: participaram do estudo 41 escolares, com idade entre 12 e 14 anos, de duas escolas no interior de São Paulo e uma Instituição Social direcionada a estudantes de escolas públicas. As atividades foram baseadas no Projeto Jovem Doutor e no programa Dangerous Decibels ® Brasil. Os escolares responderam a um questionário aplicado em três situações, antes da intervenção (pré), logo após a intervenção (pós) e quatro meses após a intervenção. Foram utilizados os testes estatísticos ANOVA, FRIEDMAN; p<0,001 e TUKEY; p<0,05. Resultados: os 41 escolares que participaram do programa atuaram como protagonistas do conhecimento, multiplicando o conteúdo aprendido através das oficinas culturais, envolvendo 954 escolares das três escolas. Ao analisar a eficácia do programa, observou-se melhora nos resultados logo após a intervenção e, também, após 4 meses. Conclusão: a união desses dois programas incentivou o protagonismo juvenil, objetivando o maior envolvimento dos estudantes junto da comunidade. Foi possível observar a mudança de atitude dos escolares frente aos sons potencialmente perigosos.

Sintomas auditivos e vocais: uma análise da autopercepção de jogadores de jogos digitais / Auditory and vocal symptoms: an analysis of the self-perception of digital game players

RESUMO Objetivo identificar os fatores associados a zumbido, percepção auditiva e risco de distúrbio vocal entre jogadores de jogos digitais. Métodos estudo transversal realizado com jogadores de jogos digitais por meio de questionários eletrônicos para coletar dados relacionados à saúde auditiva e vocal. Foram analisados três desfechos principais: zumbido, percepção auditiva (sensação da diminuição da audição) e risco de distúrbio de voz, mensurado pela Escala de Sintomas Vocais. As variáveis independentes referiram-se às características sociodemográficas, perfil dos jogadores e sinais e sintomas. Aplicaram-se os testes Qui-quadrado de Pearson e Exato de Fisher. Resultados a amostra foi composta por 59 jogadores, sendo a maioria do gênero masculino (79,7%), com idade entre 18 e 24 anos (69,5%). Com relação aos desfechos, 27,6% dos participantes apresentaram zumbido, 57,6%, risco de distúrbio vocal e 13,6% referiram sensação de diminuição da audição. Observou-se associação entre zumbido e cefaleia (p=0,024), zumbido e uso de smartphone (0,012), sensação de diminuição da audição e presença de ansiedade (p=0,049). O risco de distúrbio de voz associou-se ao maior tempo de horas jogadas por semana (p=0,020). Conclusão a autopercepção de zumbido esteve associada à cefaleia e ao uso de smartphone. Houve, ainda, associação entre ansiedade e sensação de diminuição da audição, além de risco de distúrbio de voz e maior tempo de horas jogadas por semana.

ABSTRACT Purpose to identify factors associated with tinnitus, auditory perception and risk of voice disorders among digital game players. Methods cross-sectional study carried out with digital game players through electronic procedures to collect data related to hearing and vocal health. Three main outcomes were analyzed: tinnitus; auditory perception (sensation of diminished hearing) and risk of voice disorders, measured by the Vocal Symptoms Scale (VSS). The independent variables were related to sociodemographic characteristics, player profile and signs and symptoms. Pearson's chi-square test and Fisher's exact test were applied. Results the sample consisted of 59 players. Most were male (79.7%) and ages between 18 and 24 years (69.5%). Regarding the terms, 27.6% had tinnitus, 57.6% were at risk of vocal disorder and 13.6% reported hearing loss. There was an association between tinnitus and headache (p=0.024), tinnitus and smartphone use (0.012), hearing loss and anxiety (p= 0.049). A risk of voice disorder(s ) was associated with more hours played per week (p=0.020). Conclusion self-perceived tinnitus was associated with headache and smartphone use; there was also an association between anxiety and the feeling of hearing impairment, in addition to the risk of voice disorders and more hours played per week.

Noise Exposure and Stress Hormone Levels:A Review / 中国医学科学院学报

Noise is one of the most common environmental hazards to which people are exposed,and the exposure to noise can cause not only hearing but also non-hearing damage.Although noise under safety limits may not affect the auditory system,it can cause changes in stress hormone levels,which is harmful to health.However,the current studies about the impact of noise on health mainly focus on the auditory system,and little is known about the relationship between noise and stress hormone levels.Therefore,this paper reviews the studies involving noise exposure and stress hormone levels,aiming to provide ideas for strengthening the prevention and control of noise hazards.