Bibliometric and bioinformatics analysis of genetic literature on susceptibility to noise induced hearing loss / 中华劳动卫生职业病杂志

Objective: To summarize and analyse of literature on the susceptibility genes of noise induced hearing loss (NIHL) , and the key genes were screened and obtained by bioinformatics method, so as to provide reference for the prevention research of NIHL. Methods: In September 2021, Based on CNKI, NCBI Pubmed database and Web of Science database, this paper conducted bibliometric analysis and bioinformatics analysis on the genetic literature related to the susceptibility to noise-induced hearing loss from 1999 to 2020. Endnote X9 software and the WPS office software were used for bibliometric analysis, and online software STRING and Cytoscape software were used for bioinformatics analysis. Results: A total of 131 literatures were included in the study, involving 40 genes in total. Bibliometric analysis shows that 131 papers which included 36 Chinese articles and 95 English articles were published in 63 biomedical journals; the highest number of published articles was 19 in 2020. Bioinformatics analysis suggests that GAPDH、SOD2、SOD1、CAT、CASP3、IL6 and other genes play a key role in the interaction network. The involved pathways mainly include MAP2K and MAPK activations, PTEN regulation, P53-depardent G1 DNA damage response, signaoling by BRAF and RAF fusions and soon. Conclusion: The study of noise induced hearing loss involves multi gene biological information, and bioinformatics analysis is helpful to predict the occurrence and development of noise induced hearing loss.

Impacto das ações do centro de referência em saúde do trabalhador nos dados de notificação compulsória de pair no Distrito Federal: um estudo qualitativo / The impact of the measures by the reference centers in worker's health on the compulsory notification nihl data in the Brazilian Federal District: a qualitative study / Impacto de las acciones del centro de referencia de salud del trabajador en los datos de notificación obligatoria de pair en el Distrito Federal: un estudio cualitativo

Introdução: A Perda Auditiva Induzida por Ruído (PAIR) é um agravo que acomete os trabalhadores expostos a ruídos e está entre os agravos que devem ser notificados no Sistema de Informação de Agravos de Notificação (SINAN). Objetivo: Analisar o impacto das ações desenvolvidas pelo Centro de Referência em Saúde do Trabalhador (CEREST-DF) em relação às notificações de PAIR no Distrito Federal. Métodos: Foi realizado um estudo longitudinal, retrospectivo com base na análise de dados secundários de notificações de PAIR do SINAN-DF, desde sua implementação; foram levantados relatórios dos CEREST-DF sobre as ações desenvolvidas; e análise de documentos dos CEREST procurando pelas ações que foram realizadas sobre PAIR e o impacto que causaram. Resultados: utilizando ações, como: projetos, palestras, busca-ativa, entre outros, o CEREST realiza a prática da educação em saúde, e, com o conhecimento fornecido ao público-alvo, é perceptível o aumento de notificações nos mesmos períodos de realização das ações com os trabalhadores e empregadores. Além disso, a contratação de fonoaudiólogo para a equipe do CEREST também eleva estes números, pois é o profissional envolvido na saúde auditiva de modo geral. Conclusão: A partir deste estudo foi possível observar que as ações do CEREST se refletem no número de notificações de PAIR no SINAN, reduzindo a subnotificação.

Introduction: Noise-Induced Hearing Loss (NIHL) is a hearing impairment that affects workers exposed to loud noises and is one of the conditions that must be reported to the Brazilian Disease Reporting Information System (SINAN). Objective: To analyze the impact of the measures developed by the Reference Centers in Workers' Health (CEREST-DF) in relation to NIHL notifications in the Brazilian Federal District. Methods: A longitudinal, retrospective study was carried out based on the analysis of secondary data of NIHL notifications from SINAN-DF. Since its implementation. CEREST-DF reports were collected on the measures developed and analysis of CEREST documents looking for measures that were carried out with NIHL and the effect they caused. Results: Utilizing educational measures such as projects, lectures, active search, among others CEREST carries out health education, and to target audiences, there was a noticeable increase in notifications in the same periods of these measures being carried out with employees and employers. In addition, a speech therapist was hired by the CEREST team what also helped to increase these numbers, since speech therapists are professionals involved in the health of hearing. Conclusion: This study made it possible to see that the measures carried out by CEREST are reflected in the number of NIHL notifications in SINAN which helped to reduce under-reporting.

Introducción: La Pérdida Auditiva Inducida por Ruido (PAIR) es un problema que afecta a los trabajadores expuestos al ruido y se encuentra entre los problemas que deben ser reportados en el Sistema de Informação de Agravos de Notificação (SINAN; Sistema de Información Sanitaria Notificable).Objetivo:Analizar si las acciones desarrolladas por el Centro de Referência em Saúde do Trabalhador do Distrito Federal (CEREST-DF; Centro de Referencia de Salud Ocupacional) reflejan en el número de notificaciones de PAIR en el DF. Métodos:Se realizó un estudio longitudinal, retrospectivo, basado en el análisis de datos secundarios de notificaciones de PAIR del SINAN-DF, desde su implementación; Se recopilaron informes de CEREST-DF sobre las acciones desarrolladas; y análisis de documentos de CEREST buscando las acciones que se tomaron sobre PAIR y el impacto que causaron. Resultados: Utilizando acciones como: proyectos, conferencias, búsqueda activa, entre otras, CEREST realiza la práctica de educación en salud, y, con el conocimiento proporcionado al público objetivo, se nota el incremento de notificaciones en los mismos períodos de acciones con trabajadores y empleadores. Además, la contratación de un (a) logopeda para el equipo de CEREST también eleva estos números, ya que éste (ésta) es el (la) profesional relacionado (a) con la salud auditiva en general. Conclusión: A partir de este estudio se pudo observar que las acciones de CEREST se reflejan en el número de notificaciones de PAIR en SINAN, reduciendo el subregistro.

Perda auditiva induzida por ruído no Brasil: descrição de 14 anos de notificação / Noise-induced hearing loss in Brazil: a description of 14 years of notifications

RESUMO Objetivo descrever as notificações de perda auditiva induzida por ruído (PAIR) no Brasil, segundo aspectos sociodemográficos e laborais, no período de 2006 a 2019. Métodos estudo transversal e descritivo, realizado com dados das fichas de notificação de PAIR no Brasil, oriundos do Sistema de Informações de Agravos de Notificação. Os dados foram acessados por meio da página do Centro Colaborador de Vigilância aos Agravos à Saúde do Trabalhador. Foram analisadas as frequências absolutas e relativas de variáveis sociodemográficas e de características do trabalho. Resultados no período, foram notificados 7.819 casos de PAIR no Brasil. O ano de 2016 e o estado de São Paulo registraram o maior número de notificações, com 1.106 e 2.488 casos, respectivamente. Em todo o período, houve maior proporção de casos em indivíduos com carteira assinada (55,0%), gênero masculino (88,2%), cor de pele branca (59,1%) e faixa etária de 50 a 59 (33,7%). O ruído contínuo foi predominante no ambiente de trabalho (41,1%) e 51,1% dos indivíduos faziam uso de medidas de proteção individual, enquanto para 12,6% a proteção foi coletiva. Conclusão foram notificados 7.819 casos de PAIR no Brasil no período analisado, número que pode ser considerado desproporcional, em relação à prevalência desse agravo. A subnotificação observada impacta a compreensão da magnitude do problema e, consequentemente, o desenvolvimento e implementação de ações e programas de saúde pública, voltados para a saúde e segurança do trabalhador.

ABSTRACT Purpose To describe the notifications of NIHL in Brazil, according to sociodemographic and labor aspects, in the period from 2006 to 2019. Methods Cross-sectional and descriptive study carried out with data from notification forms for noise-induced hearing loss in Brazil, from SINAN. The data were accessed through the page of the Collaborating Center for Surveillance of Workers' Health Disorders (ISC-UFBA). Absolute and relative frequencies of sociodemographic variables and work characteristics were analyzed. Results During the period, 7,819 cases of NIHL were reported in Brazil. The year 2016 and the state of São Paulo registered the highest number of notifications, with 1,106 and 2,488 cases, respectively. Throughout the period, there was a higher proportion of cases in: individuals with a formal contract (55.0%), male (88.2%), white (59.1%) and aged between 50 and 59 years (33.7%). Continuous noise was predominant in the work environment (41.1%) and 51.1% of the individuals used individual protection measures, while 12.6% were protected collectively. Conclusion A total of 7,819 cases of NIHL were reported in Brazil in the period analyzed, a number that can be considered disproportionate in relation to the prevalence of this condition. The observed underreporting impacts on the understanding of the magnitude of the problem, and, consequently, on the development and implementation of public health actions and programs, aimed at worker health and safety.

Association between occupational noise exposure and the risk of cardiovascular diseases / 中华劳动卫生职业病杂志

Objective: To explore the association between occupational noise exposure and cardiovascular disease (CVD) risk in a large Chinese population. Methods: In December 2019, the study included 21412 retired participants from the Dongfeng-Tongji Cohort Study at baseline from September 2008 to June 2010, occupational noise exposure was evaluated through workplace noise level and/or the job titles. In a subsample of 8931 subjects, bilateral hearing loss was defined as a pure-tone mean of 25 dB or higher at 0.5, 1 , 2, and 4 kHz in both ears. Logistic regression models were used to explore the association of occupational noise exposure, bilateral hearing loss with 10-year CVD risk. Results: Compared with participants without occupational noise exposure, the 10-year CVD risk was significantly higher for noise exposure duration ≥20 years (OR=1.20, 95%CI:1.01-1.41 , P=0.001) after adjusting for potential confounders. In the sex-specific analysis, the association was only statistically significant in males (OR=2.34, 95%CI: 1.18-4.66, P<0.001) , but not in females (OR=1.15, 95%CI:0.97-1.37, P=0.153). In the subsample analyses, bilateral hearing loss, which was an indicator for exposure to loud noise, was also associated with a higher risk of 10-year CVD (OR= 1.17, 95% CI:1.05-1.44, P <0.001) , especially for participants who were males (OR =1.24, 95% CI:1.07-2.30, P<0.001) , aged equal and over 60 years old (OR=2.30, 95%CI: 1.84-2.88, P<0.001) , and exposed to occupational noise (OR=1.66, 95%CI: 1.02-2.70, P=0.001). Conclusion: Occupational noise exposure may be a risk factor for CVD.

Fatores associados à notificação de perda auditiva induzida por ruído no Brasil, 2013-2015: estudo ecológico / Factores asociados a la notificación de pérdida auditiva inducida por ruido en Brasil, 2013-2015: estudio ecológico / Factors associated with notification of noise-induced hearing loss in Brazil, 2013-2015: an ecological study

Objetivo: Investigar fatores associados à notificação de perda auditiva induzida por ruído (Pair), no Sistema de Informação de Agravos de Notificação no Brasil. Métodos: Estudo ecológico para estimar a proporção de municípios notificantes de Pair. Foram empregados modelos de regressão logística para identificar fatores associados. Resultados: Entre 2013 e 2015, 277 (5,0%) municípios notificaram Pair. A notificação foi mais comum entre municípios com cobertura por Cerest (OR=1,62 - IC95% 1,02;2,59) ou que sediavam unidade de Cerest em seu território (OR=4,37 - IC95% 2,75;6,93), a menor distância da capital do estado (OR=1,43 - IC95% 1,06;1,92) e com alto índice de desenvolvimento humano (OR=2,35 - IC95% 1,16;4,75). Entre os municípios situados em área com cobertura de Cerest, a notificação foi mais comum quando na equipe havia fonoaudiólogo (OR=1,96 - IC95% 1,47;2,63) e era baixa a rotatividade de profissionais (OR=1,88 - IC95% 1,40;2,52). Conclusão: Fatores contextuais influenciam na notificação de Pair, notadamente a existência e qualificação dos Cerest.

Objetivo: Investigar factores asociados con la notificación de pérdida auditiva inducida por ruido (Pair) en el Sistema de Información de Agravamientos de Notificación Obligatoria en Brasil. Métodos: Estudio ecológico para estimar la proporción de municipios notificantes de Pair. Se utilizaron modelos de regresión logística para identificar factores asociados. Resultados: Entre 2013-2015, 277 (5,0%) municipios notificaron Pair. La notificación fue más común entre los municipios con cobertura de los Centros de Referencia en Salud Ocupacional (Cerest) (OR=1,62 - IC95% 1,02; 2,59), o que albergaron Cerest (OR=4,37 - IC95% 2,75; 6,93), cercanos a la capital (OR=1,43 - IC95% 1,06; 1,92) y con alto índice de desarrollo humano (OR=2,35 - IC95% 1,16; 4,75). Entre los municipios en área de cobertura de Cerest, la notificación fue más alta cuando había fonoaudiólogo en el equipo (OR=1,96 - IC95% 1,47; 2,63) y baja rotación de profesionales (OR=1,88 - IC95% 1,40; 2,52). Conclusión: Factores contextuales influyen en la notificación de Pair, en particular, la existencia y cualificación de los Cerest.

Objective: To investigate factors associated with the notification of noise-induced hearing loss (NIHL), on the Notifiable Health Conditions Information System (SINAN) in Brazil. Methods: This was an ecological study to estimate the proportion of municipalities that had notified NIHL. Logistic regression models were used to identify associated factors. Results: Between 2013-2015, 277 (5.0%) municipalities notified NIHL. Notification was more prevalent among municipalities in an Occupational Health Referral Center (CEREST) coverage area (OR=1.62 - 95%CI 1.02;2.59) or those that had a CEREST in their territory (OR=4.37 - 95CI% 2.75;6.93), those that were closer to the state capital (OR=1.43 - 95%CI 1.06;1.92) and those with a high human development index (OR=2.35 - 95%CI 1.16;4.75). Among the municipalities located in a CEREST coverage area, notification was more frequent when there was a speech-language-hearing professional in the team (OR=1.96 - 95%CI - 1.47;2.63) and when employee turnover was low (OR=1.88 - 95%CI 1.40;2.52). Conclusion: Contextual factors influence NIHL notification, particularly the presence of CERESTs and their qualification.

Hearing function of gold miners with and without a history of tuberculosis treatment: a retrospective data review / Função auditiva de garimpeiros com e sem história de tratamento de tuberculose: uma revisão retrospectiva dos dados

Abstract Introduction: South Africa has a high prevalence of co-existing tuberculosis and HIV. As ototoxicity linked to the treatments for these conditions occurs with concomitant exposure to other ear toxins such as hazardous noise exposure, it is important to investigate the combination impact of these toxins. Limited published evidence exists on the co-occurrence of these conditions within this population. Objectives: The objective of this study was to compare the hearing function of gold miners with (treatment group) and without (non-treatment group) the history of tuberculosis treatment, in order to determine which group had increased risk of noise induced hearing loss. Furthermore, possible influence of age and HIV in these two groups was examined. Methods: A retrospective record review of 102 miners' audiological records, divided into two groups, was conducted, with data analyzed both qualitatively and quantitatively. Results: Findings suggest that gold miners with a history of tuberculosis treatment have worse hearing thresholds in the high frequencies when compared to those without this history; with evidence of a noise induced hearing loss notch at 6000 Hz in both groups. Pearson's correlations showed values between 0 and 0.3 (0 and −0.3) which are indicative of a weak positive (negative) correlation between HIV and hearing loss, as well as between hearing loss and age in this population. Conclusions: Current findings highlight the importance of strategic hearing conservation programs, including ototoxicity monitoring, and the possible use of oto-protective/chemo-protective agents in this population.

Resumo Introdução: A África do Sul apresenta uma alta prevalência de coinfecção de tuberculose e HIV. Como a ototoxicidade associada aos tratamentos para essas condições é observada na exposição concomitante a outros agentes ototóxicos, como a exposição a ruídos perigosos, é importante investigar o impacto da combinação desses agentes. São poucas as evidências publicadas sobre a co-ocorrência dessas condições nessa população. Objetivo: Comparar a função auditiva de garimpeiros com (grupo tratamento) e sem (grupo sem tratamento) história de tratamento de tuberculose, a fim de determinar que grupo apresentava maior risco de perda auditiva induzida por ruído. Além disso, avaliou-se a possível influência da idade e do HIV nesses dois grupos. Método: Os registros audiológicos de 102 garimpeiros, divididos em dois grupos, foram revisados de forma retrospectiva; os dados foram qualitativa e quantitativamente analisados. Resultados: Os achados indicam os garimpeiros com histórico de tratamento de tuberculose apresentam piores limiares auditivos nas altas frequências quando comparados àqueles sem esse histórico; em ambos os grupos, observou-se perda auditiva induzida por ruído com entalhe audiométrico a 6.000 Hz. As correlações de Pearson mostraram valores entre 0 e 0,3 (0 e -0,3), que são indicativos de uma fraca correlação positiva (negativa) entre o HIV e a perda auditiva, bem como entre a perda auditiva e a idade nessa população. Conclusões: Os resultados atuais destacam a importância de programas estratégicos de conservação auditiva, inclusive monitoramento de ototoxicidade, e o possível uso de agentes oto-/quimioprotetores nessa população.

Alteraciones auditivas, percepción y conocimientos de estudiantes sobre ruido en una clínica de enseñanza odontológica / Auditory alterations and student knowledge and perception on noise at a dental teaching clinic

RESUMEN Objetivo Identificar alteraciones auditivas en estudiantes de odontología y evaluar el nivel de conocimiento con relación a la pérdida auditiva inducida por ruido. Metodología Estudio transversal, se realizaron encuestas a estudiantes del tercer año curso diurno y cuarto año del curso nocturno de estomatología. Las variables estudiadas: trastornos auditivos y conocimiento sobre PAIR (pérdida auditiva inducida por ruido). Resultados Muestran la presencia de trastornos auditivos en 14,8% de los estudiantes, de los que 7,4% recibieron tratamiento. El 28,4% había realizado exámenes audio métricos. De los estudiantes, 24,6% tenían familiares con problemas de audición; 11,1% enfermedades preexistentes;49,3% necesitan repetición durante una conver-sación;34,4% estaba irritado en el ambiente de clases prácticas y consideraban las piezas de mano de alta rotación el instrumento más ruidoso; el 75,3% refirió usar audífonos y un 72,1% por más de 5 años. En relación a los resultados sobre conocimientos 93,8% afirmaron que el dentista es un profesional con riesgo de pérdida auditiva por ruido, pero el 83,9% no había recibido orientación sobre el PAIR. Respecto al protector auricular 77,7% lo conocía, pero sólo 3,7% lo había usado. Conclusión Los estudiantes de estomatología presentaron alteraciones auditivas inducidas por el ruido, y consideraban el local de las clases prácticas un ambiente ruidoso; es necesario un mayor conocimiento en los alumnos de las consecuencias negativas del ruido en la salud y la utilización de medidas de prevención para evitar la pérdida de la audición a largo plazo.(AU)

ABSTRACT Objective To identify auditory alterations in dentistry students and evaluate the level of knowledge in relation to noise-induced hearing loss. Materials and Methods Cross-sectional study. Surveys applied to third-year students of the day school, and fourth-year students of the night stomatology school. The variables studied were auditory disorders and knowledge about NIHL (noise-induced hearing loss). Results Hearing disorders were found in 14.8% of the students, of whom 7.4% were receiving treatment. Audiometric examinations were performed in 28.4% of the students. It was also found that 24.6% of the students had relatives with hearing problems; 11.1% had pre-existing conditions; 49.3% needed repetition during a conversation; 34.4% felt irritated during practical classes and considered high rotation hand pieces to be the noisiest instrument; and 75.3% reported using hearing aids (72.1% for more than 5 years). With regard to knowledge, 93.8% said that dentists are professionals at risk of hearing loss due to noise, but 83.9% had not received guidance on NIHL. Regarding the hearing protector, 77.7% knew about it, but only 3.7% had used it. Conclusion Stomatology students have noise-induced hearing loss, and also considered that the places where practical classes are given are a noisy environment. More knowledge is needed in students about the negative consequences of noise in health and the use of preventive measures to avoid hearing loss in the long term.(AU)

Hábitos auditivos recreacionales y umbral tonal en la frecuencia audiométrica 6. 000 Hz en jóvenes universitarios / Recreational hearing habits and pure tone threshold at 6. 000 Hz frequency in university students

RESUMEN Introducción: La Organización Mundial de la Salud (OMS) (2013) define entre las causas de pérdida auditiva, la exposición a ruido. Una fuente de este ruido son los reproductores personales de música, cuyo uso representa una conducta de riesgo emergente. Es así como, existen estudios que registran daño auditivo inducido por ruido en los usuarios de reproductores personales en comparación con los no usuarios. Objetivo: Investigar la relación entre hábitos auditivos recreacionales y el rendimiento audiométrico en la frecuencia 6.000 Hz en jóvenes universitarios. Material y método: Se evaluaron 50 sujetos entre 18 y 26 años sin antecedentes otológicos. Se aplicó el Cuestionario CHAR y se realizó una audiometría tonal por vía aérea de 125 Hz a 8.000 Hz. Resultados: El análisis audiométrico, determinó la existencia de escotoma en el umbral auditivo de la frecuencia 6.000 Hz en 52% de los sujetos evaluados. Además se encontraron diferencias estadísticamente significativas entre los grupos con umbral bajo y sobre 20 dB en dicha frecuencia, relacionado con los años de exposición y volumen de uso del dispositivo. Conclusión: La exposición a ruido recreacional puede producir daño auditivo a temprana edad, generando la necesidad de planes para prevenir el daño prematuro de la audición en jóvenes.

ABSTRACT Introduction: Noise exposure is one of most common causes of hearing loss according to the World Health Organization (WHO). The use of personal music players is one of the sources of this harmful noise, which has been demonstrated to constitute a risky habit. Previous studies have found hearing loss produced by noise in users of music players compared to subjects who do not used them. Aim: The present study aimed to investigate the relationship between recreational hearing habits and hearing performance at 6000 Hz frequency in university students. Material and method: Fifty subjects (age range of 18-26 years), without history of otologic disorders were assessed. The CHAR questionnaire and an air conduction pure tone audiometry (125 Hz-8000 Hz) were administered to each participant. Results: Findings from pure tone audiometry demonstrated the presence of hearing scotoma at 6000 Hz frequency in fifty-two percent of subjects. Moreover, statistically significant differences were found when comparing subjects with normal threshold and subjects with threshold greater than 20 dB at 6000 Hz. This was related to years and intensity of noise exposure. Conclusion: Recreational noise exposure may cause hearing loss in early stages of lifespan. Prevention strategies to avoid early hearing loss in young subjects are required.

Ações para a melhoria do conforto acústico em instituições de educação infantil / Noise in early childhood education institutions

Resumo Elevados níveis de pressão sonora têm sido observados em escolas e, por sua interferência na saúde das crianças e professores, teve-se por objetivo analisar esses níveis em centros de educação infantil que atendem crianças com idades entre zero e seis anos, investigar a percepção dos funcionários quanto à exposição ao ruído e identificar a audição desses trabalhadores. O estudo foi realizado em dez instituições que empregam 320 trabalhadores. Os níveis de pressão sonora foram medidos segundo as normas técnicas, os funcionários preencheram questionário sobre a percepção do ruído e passaram por avaliação auditiva. Observou-se elevado nível de pressão sonora e diferenças entre as instituições, situações e locais. A maioria dos funcionários se considerou exposta ao ruído com dificuldades de atenção e concentração, ansiedade e dor de cabeça. Cerca de 30% dos funcionários apresentaram perda auditiva neurossensorial bilateral em frequências específicas. Os níveis de pressão sonora encontrados podem comprometer a aprendizagem das crianças e a saúde de todos. Os funcionários percebem o ruído e indicam prejuízos em sua rotina de trabalho. Ações para melhorar o conforto acústico nessas instituições foram discutidas e estão sendo implementadas.

Abstract High sound pressure levels have been observed in schools, and its interference in the health of children and teachers it was taken to analyze these levels in childhood education centers serving children aged zero to six years, investigate the staff's perceptions concerning noise exposure and identify the auditory conditions of these workers and the occurrence of diseases. The study was conducted in ten institutions employing 320 workers. Sound pressure levels were measured according to the technical norms; employees completed a questionnaire on the perception of noise and underwent auditory evaluation. There was high sound pressure level and differences between institutions, situations and places. Most employees are considered exposed to noise with attention and concentration difficulties, anxiety and headache. About 30% of employees had bilateral sensorineural hearing loss in specific frequency. The sound pressure levels found can affect children's learning and the health of all. The employees also perceived elevated levels of noise and indicated some possible negative aspects in their work routine. Actions to improve the acoustic comfort in these institutions will be discussed with the management teams.

Evaluation de la surdite professionnelle dans un departement du sud tunisien

Objectif: La surdite professionnelle (SP) est une atteinte auditive acquise due a une exposition excessive au bruit au travail. Elle represente une cause frequente des surdites de l'adulte. Le but de notre travail est de rapporter les caracteristiques epidemiologiques; cliniques et audiometriques des patients presentant une SP. Methode : Il s'agit d'une etude retrospective concernant 200 patients presentant une SP declaree dans le gouvernorat de Sfax durant la periode (1990-2007). Un interrogatoire; un examen ORL complet ainsi qu'une audiometrie tonale ont ete realises pour tous les malades. Nous avons etudie l'incidence annuelle; l'age; le sexe; le secteur d'activite ainsi que les donnees audiometriques de ces patients. Une etude analytique univariee a recherche une correlation entre la perte auditive moyenne (PAM); l'age; la duree d'exposition au bruit et le secteur d'activite. Resultats : Une predominance masculine a ete notee (99). La moyenne d'age etait de 46 ans. Les secteurs d'activite les plus incrimines etaient la metallurgie (27;5); la menuiserie (10) et le secteur automobile (6). 26;5 des patients rapportaient des acouphenes et 3;5 se plaignaient de troubles de l'equilibre. La surdite professionnelle etait perceptionnelle; bilaterale et symetrique dans 93 des cas. L'analyse statistique univariee n'a pas objective de correlation entre la PAM; l'age; la duree d'exposition au bruit et le secteur d'activite. Conclusion : A notre connaissance; il s'agit de la premiere etude publiee rapportant les caracteristiques de la SP chez des travailleurs dans le sud Tunisien. Cette etude montre le manque de sensibilisation du public vis-a-vis de l'importance de la preservation de l'audition du bruit. Elle met en evidence aussi le manque d'outils de prevention; leur inefficacite voire les deux

Firefighters' noise exposure: A literature review

Aim: To review the literature about the effects of environmental noise on the hearing ability of firefighters. Method: The PubMed and Scielo databases were searched and studies from 2002 to 2012 that included the keywords firefighters, noise, and hearing loss were identified. Initially, 24 studies were selected, but only 10 met the inclusion criteria of investigating the effects of occupational noise on firefighters. Results: Only 2 (20%) studies quantified levels of sound pressure and performed audiological tests to identify associations with noise intensity and 3 (30%) questionnaire-based studies reported that these professionals are more susceptible to hearing loss. Four (50%) studies found that noise exposure damages the auditory system in this population. Discussion: These findings indicate that there is a necessity for preventive measures to be adopted by this population since it is considered to be at risk. Conclusion: In recent years, there have been few studies of firefighters' exposure to occupational noise, but our findings show the importance of new studies that include proper means of quantifying their exposure to noise in different work environments, in order to identify possible adverse conditions as well as to aid in the diagnosis of hearing loss...

Estimación de riesgos y hábitos de uso de reproductores de música personal en una muestra de población chilena / Personal music player usage habits and risks in a Chilean population sample

Introducción: El uso irresponsable de reproductores de música personal ha sido determinado como una conducta de riesgo en salud, en relación al trauma acústico crónico que inducirían. La proporción de usuarios en niveles de riesgo, así como los factores que se relacionan con una escucha riesgosa no han sido evaluados en nuestro país. Objetivo: Describir características de uso de reproductores de música personal en una muestra chilena de población, estimando niveles de riesgo de trauma acústico e identificando factores de riesgo asociado. Material y método: Se aplicó un cuestionario a pacientes de consulta otorrinolaringológica, estudiantes universitarios y a contactos de redes sociales mediante versión on-line, indagando sobre conductas de uso de reproductores musicales. En base a datos de estudios anteriores se estimó el nivel de presión sonora y la dosis de ruido a la que cada usuario estaría expuesto según sus preferencias de uso. Resultados: De 508 encuestados el 12 por ciento superó la máxima exposición a ruido permitida por la legislación chilena. Los factores que más se correlacionaron con alcanzar niveles de riesgo fueron la intensidad del volumen escogida por el usuario (r =0,76), seguido por el tiempo de uso semanal (r =0,51) y, más débilmente, por el tipo de audífono utilizado (r =0,31). Destaca que ninguno de los encuestados que usan audífonos supraauriculares está en riesgo de desarrollar trauma acústico crónico. Discusión: Se estima que el trauma acústico recreacional sobrepasaría en los próximos años al trauma acústico ocupacional como problema de salud pública. Una proporción importante de usuarios estaría en niveles de riesgo. Los factores encontrados como determinantes de riesgo indican que las estrategias de intervención deben enfocarse hacia la escucha responsable por parte del usuario (escuchar al menor volumen confortable posible) más que en la implementación o selección de determinadas tecnologías.

Introduction: The irresponsible use of personal music players has been identified as an emerging health risk behavior related to the noise induced hearing loss they would produce. Listening habits and risk factors involved have not been assessed in our country. Aim: To assess personal music player usage habits in a Chilean sample, estimating noise-induced hearing loss and to identify risk factors. Material and method: A questionnaire was applied to patients attending ENT consult, university students and social networks contacts through on-line version. Listening habits were explored. Based on data from previous studies, we estimated the sound pressure level and the noise-dose to which each user would be exposed according to their specific listening preferences. Results: Of 508 respondents, 12 percent exceeded the maximum noise exposure allowable by Chilean law. The factors that stronger correlated with risk levels were the intensity chosen by the user by (r =0.76), followed by cumulative weekly listening time (r =0.51) and in a weaker relation, by type of headset used (r =0.31) nevertheless none of supra-auricular hearing devices reached risk levels. Discussion: It's estimated that in the next decade, music and recreational exposure will become the leading noise induced hearing loss source. One of each eight users exceeds maximum recommended levels. Risk factors analysis indicated that intervention strategies must focus on responsible listening by the user, lowering chosen-intensity, rather than selecting a specific type of player or earphone.

Evaluation of acoustic shock induced early hearing loss with audiometer and distortion product otoacoustic emissions.

Background: Acoustic shock injury has been described as a permanent injury to the auditory system either due to daily noise dose of in excess of 85 decibels or very loud impulse sound reputed to be in excess of 120 decibels and acoustic incidents. This study was performed to compare the results of audiogram and the newer diagnostic method distortion product otoacoustic emissions (DPOAEs) parameters due to acoustic shock injury in call center professionals working in a noisy environment and prone to acoustic injury. Materials and Methods: Hearing functions of 340 subjects were first assessed with pure tone audiometry and then DPOAEs results were compared among acoustic shock exposed subjects with normal audiogram and those with abnormal audiogram. Results: Out of 340 acoustic shock exposed subjects 304 were normal on audiometric testing and 34 had abnormal audiograms. Subsequently on DPOAE testing out of 304 acoustic shock exposed subjects with normal audiogram 125 failed and 181 passed. Conclusions: This study showed that DPOAEs are more sensitive than audiometry to detect pre-symptomatic inner ear damage. It may play a role as screening and monitoring test for acoustic shock-exposed workers.

Occupational Hearing Loss in Korea

In this article, current status of noise exposure in workplaces, trend of workers with noise-induced hearing loss (NIHL), and prevalence of NIHL in workers by industry and job category in Korea were reviewed. In addition, trends of research on the audiological effects such as hearing loss from noise and occupational hearing loss from non-noise in Korea were addressed through reports in industrial audiology. Though noise exposure level has improved, noise still shows the highest rate of cases exceeding exposure limit among workplace hazards. NIHL is the most common occupational disease except work-related disease such as musculoskeletal disorders and cerebrovascular diseases, and NIHL prevalence is thought to be much higher than reported in official publications. Noise affecting hearing comes from various sources such as workplaces, military settings, areas with exposure to high noise, and specific noise sources. There is also occupational hearing loss by non-noise including chemicals such as organic solvents and heavy metals, barotrauma, and trauma due to welding spark. Noise affects daily life through audiological effects such as hearing loss and tinnitus, non-audiological physical effects (e.g., cardiovascular), and psychosocial and behavioral effects. Development of systematic and comprehensive hearing conservation programs for lowering the noise level in workplaces and preventing the NIHL, and preparation of technological, administrative system for its settlement at workplace are urgently needed.

Sensorineural hearing loss in high school teenagers in Mexico City and its relationship with recreational noise / Las alteraciones auditivas de escolares adolescentes en la Ciudad de México pueden estar relacionadas al ruido recreativo

The aim of this study was to measure the frequency of hearing loss in a sample of typical public high-school students exposed to recreational noise, and determine associated risk factors. The sample was made up of 214 teenagers from a high-school in Mexico City; subjects were selected randomly per strata. We applied a questionnaire to identify risk factors for hearing loss and performed a battery of audiologic tests consisting of otoscopy, tympanometry, and pure-tone audiometry. The mean age of the sample was 16 ± 1.07 years; 73 percent were male and 27 percent, female. Hearing loss was found in 21 percent of students. The main hearing loss-related risk factor was exposure to recreational noise: frequent attendance at discotheques and pop-music concerts; use of personal stereos; and noise exposure in school workshops. The high frequency of hearing loss in high school students from one Mexico City school (nearly one fifth of the sample) was found to be related to noise exposure mainly during recreational activities.

El objetivo de este estudio fue medir la frecuencia de alteraciones auditivas en una muestra de escolares de educación media superior expuestos a ruido recreativo y determinar algunos factores de riesgo asociados. La muestra estuvo constituida por 214 adolescentes de una escuela de la Ciudad de México. Los sujetos fueron seleccionados al azar por medio de una computadora. Se aplicaron cuestionarios con el objeto de identificar los factores de riesgo para alteraciones auditivas y se les practicaron diversos estudios audiológicos consistentes en: otoscopía, timpanometría y una audiometría a tonos puros. La edad media de la muestra fue de 16 ± 1,07 años, 73 por ciento fueron del sexo masculino y 27 por ciento femenino. Se encontraron alteraciones auditivas en 21 por ciento de los estudiantes. Los principales factores de riesgo asociados a alteraciones auditivas fueron: exposición al ruido recreativo al asistir a discotecas, conciertos de música popular, el uso de equipos de sonido personales y la exposición al ruido en los talleres escolares. Se halló una alta frecuencia (casi una quinta parte) de alteraciones auditivas en alumnos de educación media superior asociada a la presencia de ruido recreativo excesivo.

The noise spectrum influence on Noise-Induced Hearing Loss prevalence in workers / A influência do espectro de ruído na prevalência de Perda Auditiva Induzida por Ruído em trabalhadores

Noise Induced Hearing Loss (NIHL) is an insidious and cumulative disease that worsens over the years with work-related noise exposure. AIM: To evaluate the noise spectrum influence on NIHL prevalence in workers. MATERIALS AND METHODS: This a cross-sectional historical cohort carried out in steel mills, lumber mills and marble shops, with noise levels above 85dB, in which we evaluated the auditory thresholds for frequencies from 250Hz to 8,000Hz. To evaluate the work environment, we observed the entire setting, aiming at checking sound intensities in an eighth frequency filter. RESULTS: We carried out 192 hearing threshold evaluations after an occupational anamnesis. Concerning NIHL, we noticed that 49 percent of the audiometry results presented hearing deterioration in the acute frequencies. We studied the mean values and standard deviations for frequencies over 3,000Hz, in all workers, and we observed that the highest average values were in the frequency of 6,000Hz. We did not notice any association among frequency bands carrying intense noise levels and the hearing damage frequency. CONCLUSION: Noise intensity seems to be the main risk factor for loss hearing, regardless of frequency range.

A Perda Auditiva Induzida por Ruído (PAIR) é uma doença insidiosa cumulativa, que cresce ao longo dos anos de exposição ao ruído associado ao ambiente de trabalho. OBJETIVO: Avaliar a influência do espectro de ruído na prevalência de PAIR em trabalhadores. MATERIAL E MÉTODO: Trata-se de estudo de coorte histórica com corte transversal realizado em indústrias metalúrgicas, madeireiras e marmorarias, com níveis de ruído acima de 85dB, nas quais avaliou-se o limiar auditivo para as frequências de 250Hz a 8.000Hz. Na avaliação ambiental verificou-se a distribuição da intensidade sonora em filtro de frequência de oitava. RESULTADOS: Foram realizadas 192 avaliações do limiar auditivo precedidas de anamnese ocupacional. Em relação à PAIR observou-se que 49,0 por cento dos resultados audiométricos apresentam entalhe em frequências agudas no audiograma. Foram verificadas as médias e o desvio padrão das frequências a partir de 3.000Hz em todos os trabalhadores, e observa-se que as maiores médias encontram-se na frequência de 6.000Hz. Não foi observada associação entre as bandas de frequência com níveis intensos de ruído e a frequência da lesão auditiva. CONCLUSÃO: A intensidade do ruído parece ser o principal fator de risco para perda auditiva, independentemente da banda de freqüência.

Perfil epidemiológico e audiológico dos trabalhadores atendidos pelo Serviço Social da Indústria de Brusque – Santa Catarina / Epidemiological and audiological profile of workers cared for at the Social Service of the Industry of Brusque, SC, South Brazil

Introdução: A deficiência auditiva pode ser conseqüência de exposições a ruídos e/ou agentes ototóxicos. É importante que se reconheça a potencialidade de outros agentes e sua possível interação com o ruído sobre a saúde auditiva dos trabalhadores. Objetivo: Traçar o perfil epidemiológico e audiológico das empresas atendidas pelo Serviço Social da Indústria de Santa Catarina SESI/ SC na cidade de Brusque. Metodologia: estudo exploratório, transversal, incluindo todos os exames audiológicos registrados no banco de dados do programa Winaudio® 6.0 da Unidade de Operações Sociais de Brusque. Resultados: Mais de 81 por cento dos trabalhadores referiram estar expostos ao ruído. O uso de protetor auricular foi referido por 66,6 por cento. A prevalência de perda auditiva foi de 24,7 . O tipo de perda mais prevalente foi o bilateral, com 17,1 por cento. A perda auditiva à esquerda foi 62 por cento maior que a perda auditiva à direita (RP=1,62; p<0,001). Da mesma forma, o rebaixamento dos limiares de 250Hz, 6000Hz e/ou 8000Hz à esquerda foi mais prevalente que à direita. Conclusões: A opinião dos trabalhadores sobre a própria audição tem um baixo valor preditivo para diagnóstico de perda auditiva. A perda auditiva ainda é pouco percebida e não causa desconforto social, interferindo pouco na qualidade de vida do indivíduo. Os sintomas clínicos iniciais da disacusia sensório-neural ocupacional por ruído não são detectados pelo trabalhador.

Introduction: Hearing deficiency may be a consequence of exposure to noises and/or ototoxic agents. It is important to recognize the potentiality of other agents and their possible interaction with noise on the worker’s hearing health. Aim: To outline the epidemiological and audilogical profile of workers cared for at the Social Service of the Industry of Santa Catarina (SESI/SC) in the municipality of Brusque. Methods: This is an exploratory transversal study of all the audiological tests registered in the databank of the Winaudio® 6.0 program of the Social Operations Unity of Brusque. Results: More than 91 percent of the workers reported being exposed to noise. The use of ear protection was reported by 66.6 percent. The prevalence of hearing loss was 24.7 percent. The most prevalent type of loss was the bilateral, in 17.1 percent of the cases. Hearing loss on the left ear was 62 percent greater than hearing loss on the right ear (RP=1.62; p<0.001). Similarly, the downgrading in thresholds of 250Hz, 6000Hz and/or 8000Hz on the left was more prevalent than on the right. Conclusions: Workers’ self-reports on their hearing have a low predictive value for the diagnosis of hearing loss. Hearing loss still goes unnoticed and does not cause much social discomfort, interfering little in the quality of life of the individual. The early clinical symptoms of occupational sensory-neural dysacousia due to noise are not detected by the workers.

Prevalência de sintomas auditivos e vestibulares em trabalhadores expostos a ruído ocupacional / Prevalencia de síntomas auditivos y vestibulares en trabajadores expuestos al ruido ocupacional / Prevalence of auditory and vestibular symptoms among workers exposed to occupational noise

O objetivo do estudo foi estimar a prevalência de sintomas auditivos e vestibulares em trabalhadores expostos a ruído ocupacional. Foram analisados os prontuários de 175 trabalhadores com perda auditiva induzida por ruído, atendidos em um centro de referência de saúde ocupacional de Campinas, SP, de 1997 a 2003. As variáveis estudadas foram freqüência dos sintomas de hipoacusia, zumbido e vertigem. As associações com idade, tempo de exposição ao ruído e limiares auditivos tonais foram analisadas utilizando-se os testes estatísticos qui-quadrado e exato de Fisher. Foram relatados hipoacusia em 74 por cento dos casos, zumbidos em 81 por cento e vertigem em 13,2 por cento. Verificou-se associação entre hipoacusia e idade, tempo de exposição ao ruído e limiares auditivos tonais e entre vertigem e tempo de exposição ao ruído, não sendo encontradas outras associações significativas.

The purpose of the study was to assess the prevalence of auditory and vestibular symptoms in workers exposed to occupational noise. There were examined medical records of 175 workers with noise-induced hearing loss who attended an occupational health reference center in the city Campinas, Southeastern Brazil, from 1997 to 2003. The variables studied were frequency of symptoms of hypoacusis, tinnitus, and vertigo. Association with age, noise exposure time, and auditory thresholds were analyzed using the chi-square test and Fisher's exact test. Hypoacusis was reported in 74 percent of cases, tinnitus in 81 percent, and vertigo in 13.2 percent. There was found an association between hypoacusis and age, noise exposure time, and auditory thresholds and between vertigo and noise exposure time. No other significant associations were found.

El objetivo del estudio fue estimar la prevalencia de síntomas auditivos y vestibulares en trabajadores expuestos al ruido ocupacional. Fueron analizados los prontuarios de 175 trabajadores con pérdida auditiva inducida por ruido, atendidos en un centro de referencia de salud ocupacional de Campinas, Sureste de Brasil, de 1997 a 2003. Las variables estudiadas fueron frecuencia de los síntomas de hipoacusia, zumbido y vértigo. Las asociaciones con edad, tiempo de exposición al rudio y límites auditivos tonales fueron analizados utilizándose las pruebas estadísticas chi-cuadrado y exacto de Fisher. Fueron relatados hipoacusia en 74 por ciento de los casos, zumbidos en 81 por ciento y vértigo en 13,2 por ciento. Se verificó asociación entre hipoacusia y edad, tiempo de exposición al ruido y límites auditivos tonales y entre vértigo y tiempo de exposición al ruido, no siendo encontradas otras asociaciones significativas.

Hearing Threshold of Korean Adolescents Associated with the Use of Personal Music Players

PURPOSE: Hearing loss can lead to a number of disabilities and can reduce quality of life. Noise-induced hearing losses have become more common among adolescents due to increased exposure to personal music players. We, therefore, investigated the use of personal music player among Korean adolescents and the relationship between hearing threshold and usage pattern of portable music players. MATERIALS AND METHODS: A total of 490 adolescents were interviewed personally regarding their use of portable music players, including the time and type of player and the type of headphone used. Pure tone audiometry was performed in each subject. RESULTS: Of the 490 subjects, 462 (94.3%) used personal music players and most of them have used the personal music player for 1-3 hours per day during 1-3 years. The most common type of portable music player was the MP3 player, and the most common type of headphone was the earphone (insert type). Significant elevations of hearing threshold were observed in males, in adolescents who had used portable music players for over 5 years, for those over 15 years in cumulative period and in those who had used earphones. CONCLUSION: Portable music players can have a deleterious effect on hearing threshold in adolescents. To preserve hearing, adolescents should avoid using portable music players for long periods of time and should avoid using earphones.