Noise exposure and its impact on health in an auto parts manufacturing enterprise / 中华劳动卫生职业病杂志

Objective: To learn about the noise exposure and health status of workers and analyze factors that may affect the health outcomes of workers in an auto manufacturing enterprise in Tianjin City. Methods: In September 2020, occupational hygiene survey, noise exposure level detection and occupational health examination data collection were carried out in an auto parts manufacturing enterprise. Chi square test and unconditional logistic regression analysis were used to analyze the health effects of noise exposure and hearing loss of 361 noise exposure workers. Results: The rates of over-standard noise exposure, hearing loss and hypertension were 69.39% (34/49) , 33.24% (120/361) and 11.36% (41/361) , respectively. There were upward trends on age and noise-working years for hearing loss and hypertension rates (χ(2)=-5.95, -6.16, -2.81, -2.74, P<0.05) . Unconditional logistic regression analysis showed that age>35 years old, noise exposure length of service >10 years and noise L(EX, 8 h)>85 dB (A) were risk factors for hearing loss (OR=3.57, 95%CI: 1.09, 11.75; OR=4.05, 95%CI: 1.97, 8.25; OR=1.75, 95%CI: 1.00, 3.05; P=0.036, 0.001, 0.047) . Conclusion: This company has a high rate of job noise exceeding the standard, and noise-exposed workers have more serious hearing loss. Age, noise exposure and high noise exposure are risk factors for hearing loss.

Presenteísmo e fatores de saúde associados ao ruído ocupacional: estudo de associação em uma empresa do ramo de extrativismo mineral / Presenteeism and health factors associated with occupational noise: association study in a company of the extraction industry / Presentismo y factores de salud asociados con el ruido ocupacional: Estudio de la asociación en una empresa de la industria de extracción

O ruído ocupacional representa um risco à saúde dos trabalhadores, como perda auditiva e zumbido, ainda muito predominante em diversos ambientes e processos. O presenteísmo é definido como um fenômeno em que o trabalhador se encontra fisicamente no trabalho, mas por diversos fatores tem sua concentração e dedicação prejudicadas na realização da atividade. Este estudo tem como objetivo identificar que fatores estão associados, incluindo aqueles relacionados à exposição ao ruído, à ocorrência de presenteísmo. O estudo se caracteriza como exploratório, com abordagem quantitativa. No delineamento foi realizado um estudo de caso em uma empresa localizada no Vale do Paraíba, com uma amostra de 23 trabalhadores da indústria da mineração. Os dados foram obtidos por meio da aplicação do protocolo Work Limitations Questionnaire de presenteísmo e de questionário de dados sociodemográficos. A análise de associação dos desfechos foi realizada por meio de regressão logística múltipla. Foi possível verificar que, a demanda física foi a que teve maior escore, bem como o fator zumbido pode ser considerado como variável que influencia o presenteísmo.

Occupational noise represents a risk to workers' health, such as hearing loss and tinnitus, still very prevalent in various environments and processes. Presenteeism is defined as a phenomenon in which the worker is physically at work, but due to various factors, his concentration and dedication are impaired in performing the activity. This study aims to identify which factors are associated, including those related to noise exposure, to the occurrence of presenteeism. The study is characterized as exploratory, with quantitative approach. In the design a case study was carried out in a company located in the Vale do Paraíba, with a sample of 23 workers from the mining industry. Data were obtained by applying the Work Limitations Questionnaire presenteeism protocol and the sociodemographic data questionnaire. The outcome association analysis was performed by multiple logistic regression. It was possible to verify that the physical demand was the one with the highest score, and the tinnitus factor can be considered as a variable that influences the presenteeism.

El ruido laboral representa un riesgo para la salud de los trabajadores, como la pérdida de audición y el tinnitus, que sigue siendo muy frecuente en diversos entornos y procesos. El presentismo se define como un fenómeno en el que el trabajador está físicamente en el trabajo, pero debido a varios factores, su concentración y dedicación se ven perjudicados para realizar la actividad. Este estudio tiene como objetivo identificar qué factores están asociados, incluidos los relacionados con la exposición al ruido, a la ocurrencia de presentismo. El estudio se caracteriza por ser exploratorio, con enfoque cuantitativo. En el diseño se realizó un estudio de caso en una empresa ubicada en Vale de Paraíba, con una muestra de 23 trabajadores de la industria minera. Los datos se obtuvieron aplicando el protocolo de presentismo WLQ y el cuestionario de datos sociodemográficos. El análisis de asociación de resultados se realizó mediante regresión logística múltiple. Fue posible verificar que la demanda física fue la que obtuvo la puntuación más alta, y el factor tinnitus puede considerarse como una variable que influye en el presentismo.

Utilidad diagnóstica de la audiometría de alta frecuencia en sujetos expuestos a ruido recreacional / Diagnostic utility of high frequency audiometry in subjects exposed to recreational noise

INTRODUCCIÓN: Recientes investigaciones mencionan que, debido a los altos niveles de ruidos, el 75% de los habitantes en las ciudades industrializadas padecen algún tipo de deficiencia auditiva. La audiometría de alta frecuencia es un examen complementario importante para detectar tempranamente la pérdida de audición. OBJETIVO: Determinar la utilidad diagnóstica de la audiometría de alta frecuencia en la detección temprana de la hipoacusia en sujetos expuestos a ruido recreacional. MATERIAL Y MÉTODO: Estudio analítico de corte transversal. Se evaluaron 87 estudiantes de fonoaudiología. Se aplicó una audiometría convencional y de alta frecuencia mediante audiómetro clínico. RESULTADOS: La audiometría de alta frecuencia presenta una sensibilidad del 100%, especificidad del 64,60%. El valor predictivo (+) es de 14,70%, mientras que el valor predictivo (-) es del 100%. La razón de verosimilitud (+) es de 2,28, y para la razón de verosimilitud (-) es de 0,0. CONCLUSIÓN: La audiometría de alta frecuencia puede ser utilizada para monitorizar la audición de los sujetos, comprobando que efectivamente los umbrales auditivos de alta frecuencia se encuentren dentro de rangos normales. Lo anterior, dado por sus valores de sensibilidad, valor predictivo negativo, razón de verosimilitud negativa y por el aumento entre la probabilidad preprueba y posprueba.

INTRODUCTION: Recent research mentions that, due to the high noise levels, 75% of the habitants in industrialized cities suffer from some type of hearing impairment. High frequency audiometry is an important complementary test to detect early hearing loss. AIM: To determine the diagnostic utility of high frequency audiometry in the early detection of hearing loss in subjects exposed to recreational noise. MATERIAL AND METHODS: Study analytical type and cross section. 87 speech therapy students were evaluated. A conventional and high frequency audiometry was applied, using a clinical audiometer. RESULTS: High frequency audiometry has a sensitivity of 100%, specificity of 64,60%. The predictive value (+) is 14,70%, while the predictive value (-) is 100%. The likelihood ratio (+) is 2,28, and for the likelihood ratio (-) it is 0,0. CONCLUSION: High frequency audiometry can be used to monitor the hearing of the subjects, checking that effectively the high frequency hearing thresholds are within normal ranges. The above, given by their values of sensitivity, negative predictive value, negative likelihood ratio and the increase between the pre-test probability and the posttest probability.

Utilização de estéreos pessoais por alunos do ensino médio: mensuração da intensidade utilizada e hábitos de uso / Use of digital audio players by high school students: measurement of use intensity and usage habits

RESUMO Objetivo Esta pesquisa teve como objetivo mensurar em um ambiente ruidoso o nível de pressão sonora dos estéreos pessoais de jovens do ensino médio, levantar suas queixas auditivas e extra-auditivas e seus hábitos de uso. Considerando-se ainda a preocupação com a saúde auditiva e as fontes utilizadas pelos jovens para obtenção de informações sobre o assunto. Método Trata-se de um estudo observacional, descritivo, quantitativo, de delineamento transversal, do qual participaram jovens do ensino médio. Inicialmente foi realizado o exame de emissões otoacústicas evocadas por estímulos transientes, seguido da resolução de um questionário e a mensuração do nível de pressão sonora dos reprodutores de música utilizados em situação ruidosa simulada. Resultados A partir da mensuração dos estéreos pessoais, foram encontradas as intensidades mínima, de 69 dB(A), e máxima, de 93 dB(A). Os resultados mostraram hábitos nocivos à saúde auditiva sendo realizados pelos jovens, tais como tempo de uso (horas, dias e anos) e intensidade utilizada nos estéreos pessoais, assim como sintomas que podem indicar suscetibilidade a perdas auditivas. Observou-se que os jovens, em sua maioria, afirmam preocupar-se com sua audição, no entanto não há mudança de atitude diante dessas situações. Conclusão O hábito do uso do estéreo pessoal é iniciado muito cedo dentro da população escolar e, em muitos casos, esse costume é praticado com o equipamento em intensidades elevadas, o que pode acarretar diversos prejuízos a esses alunos.

ABSTRACT Purpose The main goal of this study was to measure the sound pressure level of digital audio players of high school students and investigate their auditory and non-auditory complaints, and their hearing habits. Another goal was to consider the concern with hearing health and the knowledge sources used by young people to gather information about the subject. Methods This is an observational, descriptive, quantitative, and cross-sectional study, which had the participation of high school students. The first step was an examination of transient-evoked optoacoustic emissions, followed by the application of a questionnaire and the measurement of the volume of audio players. Results The results showed harmful habits of young people regarding hearing health, such as an excessive time of use (hours, days and years) and high volume levels of digital audio players (DAPs), as well as symptoms that may point to hearing loss. It was found that most young people seem to be concerned about their hearing; however, there is no change of attitude to such situations. Conclusion The students develop the habit of using DAPs at very early ages and, in many cases, this habit is practiced with the equipment operating at high intensities, which can cause several hearing losses in these students.

The audiological profile of adults with and without hypertension

OBJECTIVE: To determine whether there is any influence of systemic arterial hypertension on the peripheral auditory system. METHODS: This was a cross-sectional study that investigated 40 individuals between 30 and 50 years old, who were divided into groups with and without systemic arterial hypertension, using data from high-frequency audiometry, transient-evoked otoacoustic emissions and distortion-product otoacoustic emissions. The results were compared with those from groups of normal-hearing individuals, with and without systemic arterial hypertension, who underwent the pure-tone audiometry test. All individuals also underwent the following procedures: otoscopy, acoustic immittance measures, pure-tone audiometry at frequencies from 250 to 16000 Hz, transient-evoked otoacoustic emissions test and distortion-product otoacoustic emissions test. RESULTS: No statistically significant difference was observed between the groups with and without systemic arterial hypertension in either conventional or high-frequency audiometry. Regarding transient-evoked otoacoustic emissions, there was a trend toward statistical significance whereby the systemic arterial hypertension group showed lower results. Regarding distortion-product otoacoustic emissions, the systemic arterial hypertension group showed significantly lower results at the following frequencies: 1501, 2002, and 3003 Hz. A discriminant analysis indicated that the distortion-product otoacoustic emissions variables best distinguished individuals with and without systemic arterial hypertension. CONCLUSION: Data from this study suggest cochlear dysfunction in individuals with systemic arterial hypertension because their otoacoustic emission results were lower than those in the systemic arterial hypertension group.

High-frequency profile in adolescents and its relationship with the use of personal stereo devices / Perfil de alta frequência em adolescentes e sua relação com o uso de MP3 players

Abstract Objective: To analyze and correlate the audiometric findings of high frequencies (9–16 kHz) in adolescents with their hearing habits and attitudes, in order to prevent noise-induced hearing loss. Method: This was a descriptive cross-sectional study, which included 125 adolescents in a sample of normal-hearing students, at a state school. The subjects performed high-frequency audiometry testing and answered a self-administered questionnaire addressing information on sound habits concerning the use of personal stereo devices. The sample was divided according to the exposure characteristics (time, duration, intensity, etc.) and the results were compared with the observed thresholds, through the difference in proportions test, chi-squared, Student's t-test, and ANOVA, all at a significance level of 0.05. Results: Average high-frequency thresholds were registered below 15 dB HL and no significant correlation was found between high frequency audiometric findings and the degree of exposure. Conclusion: The prevalence of harmful sound habits due to the use of personal stereo devices is high in the adolescent population, but there was no correlation between exposure to high sound pressure levels through personal stereos and the high-frequency thresholds in this population.

Resumo Objetivo: Analisar e correlacionar os achados audiométricos de altas frequências (9-16 kHz) em adolescentes com seus hábitos e atitudes de audição para prevenir perda auditiva induzida por ruído. Método: Este é um estudo transversal descritivo que incluiu 125 adolescentes em uma amostra de alunos ouvintes em uma escola estadual. Os indivíduos foram submetidos a testes de audiometria de altas frequências e responderam a um questionário autoadministrado que abordava informações sobre hábitos sonoros com relação ao uso de MP3 players. A amostra foi dividida de acordo com as características de exposição (tempo, duração, intensidade etc.) e os resultados foram comparados com os limites observados, por meio dos testes de diferença de proporções, qui-quadrado, t de Student e análise de variância (Anova), todos em um nível de significância de 0,05. Resultados: Foi registrada média de limiares de altas frequências abaixo de 15 dB HL e não foi encontrada correção significativa entre os achados audiométricos de altas frequências e o grau de exposição. Conclusão: A prevalência de hábitos sonoros prejudiciais devido ao uso de MP3 players é alta na população adolescente, porém não houve correlação entre a exposição a altos níveis de pressão sonora por meio de MP3 players e os limiares de altas frequências nessa população.

The impact of noise exposure on workers in Mobile Support Units / O impacto do ruído em trabalhadores de Unidades de Suporte Móveis

PURPOSE: To investigate the presence of auditory and nonauditory symptoms in professionals working in ambulances. METHODS: This was a descriptive cross-sectional study with a convenience sample. Thirty-six professionals working in mobile support units, including drivers and nursing technicians from two private urgency and emergency services in the city of Belo Horizonte, Minas Gerais, Brazil, participated in the study. A questionnaire containing 17 multiple-choice questions was applied to the participants with questions regarding life history and occupation, family history of hearing loss, use of medications, and presence of auditory and nonauditory symptoms, among others. The professionals answered the questionnaire individually, in their workplaces, and received help from the researcher to understand the content of questions, if needed. Data were statistically analyzed using the Statistical Package for the Social Sciences (SPSS) software, version 16.0. RESULTS: The most reported auditory symptoms were tinnitus, intolerance to intense sounds, and ear plenitude. The most reported nonauditory symptoms were irritability, headache, talking difficulties in noisy environments, and sleep alterations. A difference (p≤0.05) was observed when the relation between self-perception of drivers and nursing technicians on hearing acuity, presence of tinnitus, irritability, and communication difficulty was analyzed. CONCLUSION: Auditory and nonauditory symptoms are frequent in workers from mobile support units. An association between the worker's symptoms and the performed function was also observed. The results indicate a need of developing preventive actions regarding general health, which are aimed at the preservation of hearing health and quality of life of these professionals. .

OBJETIVO: Investigar a presença de sintomas auditivos e não auditivos em profissionais que atuam em ambulâncias. MÉTODOS: Estudo transversal descritivo com amostra de conveniência. Participaram 36 profissionais que atuam em unidades de suporte móveis, incluindo motoristas e técnicos de enfermagem de dois serviços particulares de urgência e emergência na cidade de Belo Horizonte, Minas Gerais. Foi aplicado um questionário contendo 17 questões de múltipla escolha sobre a história de vida e ocupação, antecedente familiar de perda auditiva, uso de medicamentos, presença de sintomas auditivos e não auditivos, entre outras investigações. Os profissionais responderam o questionário individualmente, no seu ambiente de trabalho, e, na existência de dificuldade de compreensão das questões, a pesquisadora explicou o conteúdo da questão. Os dados foram analisados estatisticamente utilizando-se o software Statistical Package for the Social Sciences (SPSS) 16.0. RESULTADOS: Os sintomas auditivos mais relatados pelos profissionais foram zumbido, intolerância a sons intensos e plenitude auricular. Os sintomas não auditivos mais frequentes foram irritabilidade, dor de cabeça, dificuldade de conversar em ambiente ruidoso e alteração do sono. Foi observada diferença (p≤0,05) ao se analisar a relação entre autopercepção de motoristas e técnicos de enfermagem sobre acuidade auditiva, presença de zumbido, irritabilidade e dificuldade de comunicação. CONCLUSÃO: Sintomas auditivos e não auditivos são frequentes em trabalhadores de unidades de suporte móveis. Pôde-se observar associação entre sintomas e função desempenhada pelo trabalhador. Dessa forma, verifica-se a necessidade do desenvolvimento de ações preventivas voltadas à saúde geral, visando à preservação da saúde auditiva e qualidade de vida desses profissionais. .

Pérdida auditiva inducida por ruido en estudiantes de la carrera de odontología / Noise induced hearing loss in dentistry students

Introducción: Los odontólogos se exponen desde su formación universitaria a sonidos potencialmente dañinos en forma rutinaria. Objetivo: Determinar si la presencia de escotoma en las frecuencias 3,4 y 6 kHz está asociada a la exposición a ruido de implementos dentales. Material y método: Se realizó un estudio de corte transversal en estudiantes expuestos a ruido en sus actividades prácticas dentales y otro grupo no expuesto. Se realizaron evaluaciones auditivas a ambos grupos, además de una sonometría y dosimetría en el laboratorio dental. Resultados: Se incluyeron 50 estudiantes de odontología expuestos a ruido de implementos dentales y 107 de otras carreras no expuestos. No se observaron diferencias significativas al comparar los umbrales de ambos grupos. Sin embargo, la frecuencia de escotoma en 4 kHz como en 6 kHz del oído izquierdo fue significativamente mayor en el grupo expuesto. Finalmente, la posibilidad de presentar un escotoma en 4 y 6 kHz del oído izquierdo estuvo significativamente asociada a exposición a ruido dental. Conclusión: La exposición a ruido derivado de prácticas dentales está asociado a escotoma en las frecuencias agudas. Sin embargo, la gran mayoría de los sujetos expuestos no evidenció una elevación de los umbrales por sobre el límite considerado normal.

Introduction: Starting with their time at college, dentists are routinely exposed to potentially harmful sounds. AIM: To determine whether the presence of notch in 3, 4 and 6 kHz frequencies is associated with exposure to noise from dental tools. Material and method: A cross-sectional study was performed with a group of students exposed to noise in their dental practices and with another group that was not exposed. Hearing tests were performed with both groups, along with a sound measurement and dosimetry in the dental laboratory. Results: Fifty dental students were exposed to the noise of dental implements and 107 students were not exposed. No significant differences were observed when comparing the thresholds of both groups. However, the frequency of notch at 4 kHz, as at 6 kHz in the left ear, was significantly higher in the exposed group. Conclusion: Noise exposure derived from dental practices is associated with notch at high frequencies. However, the vast majority of the subjects showed no evidence of a threshold higher than the limit that is considered normal.

Limiares auditivos em músicos militares: convencionais e altas frequências / Auditory thresholds among military musicians: conventional and high frequency

OBJETIVO: Analisar e caracterizar os limiares auditivos tonais entre 500 Hz e 16.000 Hz de músicos profissionais, integrantes de uma banda militar. MÉTODOS: Realizou-se um estudo de coorte histórico, que comparou um grupo de 50 músicos profissionais (banda militar) com um grupo sem histórico de exposição profissional a som intenso (44 sujeitos); e homogêneos (p<0,05) em relação ao gênero (masculino) e à idade (em torno de 35 anos). Foram realizados exames de audiometria tonal limiar convencional e de altas frequências (de 9.000 a 16.000 Hz). RESULTADOS: A exposição à música desencadeou alterações auditivas permanentes. Quanto aos limiares auditivos convencionais, no grupo exposto encontrou-se 32% dos músicos com alterações auditivas neurossensoriais e no grupo não exposto encontrou-se 2,27%. Os sujeitos expostos à música tiveram 14,54 vezes mais risco de adquirir alterações auditivas neurossensoriais do que o grupo não exposto. Após 20 anos de exposição à música foram observadas pioras significativas nos limiares auditivos, principalmente nas altas frequências, e ocorreram diferenças entre os grupos a partir de 30 anos de idade. CONCLUSÃO: A exposição à música desencadeou alterações auditivas permanentes, evidenciando diferenças em relação ao grupo não exposto à música, registradas na avaliação audiológica convencional e em altas frequências.

PURPOSE: To analyze and characterize tonal auditory thresholds between 500 Hz and 16,000 Hz of professional musicians, specifically members of a military band. METHODS: A historic cohort study was carried out comparing one group of 50 professional musicians (military band) with another group (44 subjects) without history of professional exposure to intense sound; the groups were homogenous (p<0.05%) in relation to gender (male) and age (about 35 years old). Tone threshold audiometry for conventional (from 500 to 8,000 Hz) and high frequencies was applied (from 9,000 to 16,000 Hz). RESULTS: Exposure to music triggered permanent hearing impairment. As to conventional auditory thresholds, the exposed and non-exposed groups presented sensorineural hearing loss of 32 and 2.27%, respectively. The subjects exposed to music had 14.54 times more risks of acquiring sensorineural hearing loss than the non-exposed group. After 20 years of exposure to music, significant worsening was observed in auditory thresholds, especially at extended high frequencies, and differences occurred between the groups from the age of 30 on. CONCLUSION: Exposure to music caused permanent hearing impairment, showing differences in relation to the non-exposed group, registered in conventional audiometry and at high-frequency audiometry.

Aspectos epidemiológicos del trauma acústico en personal expuesto a ruido intenso / Epidemiological aspects of acoustic trauma found in the staff exposed to intensive noise

Introducción: el trauma acústico, ligado a las enfermedades profesionales, comenzó a estudiarse con profundidad a raíz de la segunda guerra mundial, y por los alarmantes resultados se implantaron una serie de medidas de prevención para evitar esta agresión. No obstante, estas no fueron eficaces debido a la falta de educación y de concientización del personal al cual iban dirigidas. Objetivos: determinar las manifestaciones auditivas en pacientes expuestos a ruidos intensos, teniendo en cuenta la edad, el sexo y el tiempo de exposición, y tomando como base los resultados audiométricos. Métodos: se realizó una encuesta epidemiológica a un grupo de 50 casos expuestos a ruidos intensos, en el período comprendido de enero de 2007 a enero de 2008. La muestra estuvo compuesta por pacientes entre los 20 y 55 años, en los cuales la manifestación auditiva más frecuente fue la hipoacusia. Resultados: en los resultados audiométricos se observó que la gran mayoría de los casos presentó una hipoacusia de tipo neurosensorial, con predominio del sexo masculino. Conclusiones: el sexo masculino fue el más afectado y la edad de 41 a 55 años, además, la intensidad de la hipoacusia fue mayor en correspondencia con el tiempo de exposición más prolongado(AU)

Introduction: acoustic trauma is linked to professional diseases and began to be studied in depth after the Second World War. Due to the alarming results obtained, a number of preventive measures to avoid this aggression were implemented; however, they were not effective because of the lack of education and awareness of the staff to which they were directed. Objectives: to find out the auditory manifestations in patients exposed to intensive noise, taking age, sex, time of exposure and the audiometric results into consideration. Methods: an epidemiological survey was carried out in a group of 50 cases exposed to intensive noises from January 2007 to January, 2008. The sample was made up of 20-55 years-old patients and the most common auditory manifestation was hypoacusis. Results: the audiometric results showed that most of patients presented with neurosensory hypoacusis, being the males predominant. Conclusions: males were the most affected along with the 41-55 years-old age group; the hypoacusis intensity increased as the time of exposure was longer(AU)

Efeitos do ruído de impacto na audição de militares / Effects of impact noise on the hearing of military personnel

A prática de tiro é uma atividade que expõe o policial militar ao ruído de impacto, o que pode causar efeitos irreversíveis na audição. OBJETIVO: Avaliar o conhecimento sobre o ruído e os efeitos do ruído de impacto entre policiais militares que fazem prática de tiro. FORMA DE ESTUDO: Caso controle retrospectivo. MATERIAL E MÉTODO: Participaram 115 militares, sendo 65 expostos ao ruído de impacto e 50 não expostos. Foi realizada a avaliação do nível de ruído das armas de fogo, aplicado um questionário, realizada audiometria tonal limiar e teste de emissões otoacústicas transiente e produto de distorção. RESULTADOS: O nível médio de ruído foi de 125Db (C), a maioria (78 por cento) acredita que o ruído pode causar perda auditiva, 92,3 por cento utilizam protetor auricular nas práticas de tiro, mas grande parte (32,3 por cento) nunca recebeu orientação quanto ao seu uso, o sintoma mais referido foi o zumbido (23 por cento) e 25 por cento dos expostos apresenta perda auditiva sugestiva de induzida por ruído. Houve diferença significativa entre os grupos em relação às alterações auditivas. CONCLUSÃO: Os militares expostos ao tiro são mais suscetíveis a desenvolver perdas auditivas. Há necessidade do desenvolvimento de Programas de Preservação Auditiva nesta população.

Shooting is an activity that exposes military personnel to noise impact, which may cause irreversible effects on hearing. OBJECTIVE: To evaluate impact noise on the hearing of military personnel that practice shooting. STUDY DESIGN: A case-control retrospective study. METHODS: 115 military personnel were enrolled; 65 had been exposed to impact noise and 50 were non-exposed. Firearm noise levels were evaluated, subjects answered a questionnaire and underwent threshold tonal audiometry and otoacoustic emissions testing. RESULTS: The average noise level was 125dB(C). Most subjects (78 percent) believe that noise may cause hearing loss; nearly all (92.3 percent) used ear noise protectors while shooting, but most (32.3 percent) had never received guidance for using this equipment. There were significant differences between the two groups in relation to changes suggesting impact noise-induced hearing loss. CONCLUSION: The differences between groups show that noise-exposed military personnel are more likely to develop hearing loss. The goal of a hearing conservation program for this population should be to preserve hearing and educate these individuals about the importance of using hearing protection correctly.

Incidence of tinnitus in mp3 player users / Incidência de zumbido em usuários de estéreos pessoais

Exposure to loud noise is one of the main causes of tinnitus. AIM: To analyze the incidence of tinnitus in mp3 player users and non-users. MATERIAL AND METHOD: One hundred subjects aged from 15 to 30 years were enrolled, 54 of them were regular mp3 player users and 46 were not. Patients with continuous tinnitus for at least 6 months completed the Tinnitus Handicap Inventory (THI) and were tested with high frequency audiometry and transient-evoked otoacoustic emissions (TAOE). STUDY DESIGN: A cross-sectional cohort study. RESULTS: The incidence of tinnitus in non-users was about 8 percent; in mp3 player users it was about 28 percent, a statistically significant difference. Hearing thresholds at 8kHz were significantly higher in tinnitus patients that used mp3 portable players.TAOE were reduced at 2 kHz in the users group. No statistically significant difference was found in the THI scores between the two groups. CONCLUSION: Tinnitus was more frequent in teenagers and young adults who regularly listen to mp3 music in players. Moreover, the incidence of tinnitus among mp3 player users was associated with higher hearing thresholds at 8 kHz and lower TOAE at 2 kHz.

Uma das principais causas de zumbido é a exposição a ruído. OBJETIVO: Comparar a incidência de zumbido entre usuários e não usuários de estéreos pessoais. MATERIAL E MÉTODO: Cem indivíduos entre 15 e 30 anos foram recrutados, 54 deles usuários regulares de estéreos pessoais e 46 não-usuários. Pacientes com zumbido preencheram a versão validada para o português brasileiro do Tinnitus Handicap Inventory (THI). Todos foram submetidos à audiometria de altas frequências (AAF) e otoemissões acústicas transientes (OEAT). DESENHO CIENTÍFICO: Estudo de coorte contemporânea com corte transversal. RESULTADOS: A incidência de zumbido entre os usuários de estéreos pessoais foi significativamente maior (aproximadamente 28 por cento x 8 por cento). Os limiares auditivos em 8 kHz foram maiores nos portadores de zumbido usuários dos referidos aparelhos. As OEAT apresentaram-se reduzidas na frequência de 2 kHz no grupo de usuários. Não houve diferenças significativas entre os escores do THI dos dois grupos. CONCLUSÕES: O zumbido é mais prevalente em adolescentes e adultos jovens que usam estéreos pessoais de forma regular. A incidência de zumbido entre os usuários foi acompanhada por limiares auditivos maiores em 8 kHz e por redução nas OEAT em 2 kHz.

Acoustic and psychoacoustic analysis of the noise produced by the police force firearms / Análise acústica e psicoacústica do ruído de armas utilizadas pela Polícia Militar

Police officers are exposed to impact noise coming from firearms, which may cause irreversible injuries to the hearing system. AIM: To evaluate the noise exposure in shooting stands during gunfire exercises, to analyze the acoustic impact of the noise produced by the firearms and to associate it with tonal audiometry results. STUDY DESIGN: Cross-sectional. MATERIALS AND METHODS: To measure noise intensity we used a digital sound level meter, and the acoustic analysis was carried out by means of the oscillations and cochlear response curves provided by the praat software. 30 police officers were selected (27 males and 3 females). RESULTS: The peak level measured was 113.1 dB(C) from a .40 pistol and 116.8 dB(C) for a .38 revolver. The values obtained for oscillation and praat was 17.9±0.3 Barks, corresponding to the rate of 4,120 and 4,580 Hz. Audiometry indicated greater hearing loss at 4,000Hz in 86.7 percent of the cases. CONCLUSION: With the acoustic analysis it was possible to show cause and effect between the main areas of energy excitation of the cochlea (praat cochlear response curve) and the frequencies of low hearing acuity.

Os policiais militares estão expostos a ruídos de impacto provenientes de armas de fogo, os quais são capazes de causar lesões irreversíveis ao sistema auditivo. OBJETIVO: Avaliar a exposição ao ruído no estande de tiros durante os exercícios de tiro, analisar acusticamente o ruído de impacto e relacioná-lo com os resultados de audiometria tonal. FORMA DE ESTUDO: Transversal. MATERIAL E MÉTODO: A medição do ruído foi feita por meio de decibelímetro digital e a análise acústica foi feita no software Praat, levantando as curvas de oscilograma e cocleograma. Foi selecionada uma amostra de 30 policiais militares (27 masculinos e 3 femininos). RESULTADOS: Os picos máximos medidos no estante de tiros foram de 113,1 dB(C) para pistola .40 e 116,8 dB(C) para revólver .38. Os valores obtidos por meio da relação entre o oscilograma temporal e cocleograma Praat ficaram entre 17,9±0,3 Barks, correspondendo à faixa entre 4120 e 4580 Hz. As medidas da audiometria indicaram maior perda auditiva na faixa de 4000Hz em 86,7 por cento dos casos. CONCLUSÃO: A partir da análise acústica dos tiros, foi possível demonstrar causa e efeito entre as principais áreas de excitação de energia na cóclea (cocleograma Praat) e as frequências com diminuição de acuidade auditiva.

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.

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.

Reproductores de música personal: una conducta de riesgo emergente / Personal music players: an emerging health risk behavior

Introducción: El uso irresponsable de reproductores de música personal ha sido considerado como una conducta de riesgo en salud emergente. Objetivos: Determinar el perfil sonorométrico de distintos tipos de reproductores, con distintos tipos de fonos y a distintos niveles de control de volumen, estimando niveles de trauma acústico mediante normas para trauma acústico ocupacional. Material y método: Estudio descriptivo. Con sonómetro en cámara silente y utilizando muestra estandarizada de música se evaluaron 3 tipos de reproductor y 2 tipos de fonos a 25 por ciento, 50 por ciento, 75 por ciento y 100 por ciento del nivel máximo de salida. Resultados: El nivel de salida alcanzó un máximo de 119 dB SPL(A). Existen diferencias entre tipos de reproductor. Fonos supraauriculares reducen de manera constante alrededor de 12 dB el nivel de salida, independientemente del aparato o nivel de volumen utilizado. Bajo 50 por ciento del volumen máximo ningún tipo de reproductor alcanza una dosis de ruido (equivalente a 85dB en 8 horas) en menos de 24 horas. A 75 por ciento de volumen se alcanza una dosis de ruido hasta en 1,9 horas, pero a 100 por ciento se alcanza hasta en 4,5 minutos. Discusiones: Los reproductores de música personal pueden emitir altas presiones sonoras consideradas riesgosas según normas para trauma acústico ocupacional. Aparentemente el uso de audífonos supraauriculares pudiese ser beneficioso, aunque finalmente el daño acústico potencial depende del nivel de intensidad escogido por el usuario, y el tiempo de uso. Esperamos que este trabajo contribuya a tomar conciencia sobre esta nueva conducta de riesgo en salud auditiva.

Introduction: An irresponsible use of personal music players has been considered as an emerging health risk behavior. Aim: To determine output profiles of different personal music players, considering different phone types and different volume/output control levels, thus estimating exposure limits by noise-induced hearing loss guidelines. Material and methods: Descriptive study. We evaluated sound pressure outputs within an audiometric silent chamber using a standardized music sample in 3 types of players and 2 types of phones at 25 percent, 50 percent, 75 percent and 100 percent of maximum output. Results: The peak output pressure was 119 dB SPL (A). There were significant differences between players. Supra-ear phones steadily reduced about 12 dB of output pressure, regardless of the device or volume level selected. Under 50 percent of maximum output no player reached one noise-dose (equivalent to 85 dB at 8 hours, maximum noise exposure permitted in many guidelines) within 24 hrs. At 75 percent of maximum output one noise-dose was reached up to 1.9 hours. At 100 percent of output it was achieved as short as in 4.5 minutes. Discussions: Personal music players can emit high sound pressures considered risky by noise-induced hearing loss standards. Apparently the use of supra-ear headphones could be beneficial, but ultimately the potential acoustic damage depends on the intensity/output level chosen by the user and the usage time. We hope this work will help raise awareness about this emerging health risk behavior.

Brainstem evoked response in bus drivers with noise-induced hearing loss / Audiometria de tronco encefálico em motoristas de ônibus com perda auditiva induzida pelo ruído

Studies carried out by Brainstem Evoked Auditory Potentials (BEAP) in Noise-Induced Hearing Loss (NIHL) workers show different results in relation to neuronal involvement, not involving bus drivers as study object. AIM: to use BEAP in a prospective case/control clinical study to check whether or not there is neural auditory pathway involvement in bus drivers with NIHL. MATERIALS AND METHODS: we selected 50 bus drivers between 27 and 40 years with mild to moderate NIHL, and 20 individuals between 29 and 40 years with normal hearing and without prior history of noise exposure. BEAP tests were carried out and the traces were analyzed. RESULTS: in the NIHL group, the auditory thresholds in 3, 4 and 6 kHz were significantly higher in the left ear. In the NIHL group, potentials PI, PIII and/or PV were not present in a small number of the individuals; we observed a statistically significant increase in PI, PIII and PV absolute latencies, (LIP) LIP I-III interpeak latencies, bilaterally and LIP I-V in the left ear. CONCLUSION: in the NIHL group, besides sensorial injury, changes in BEAP latencies suggest an early functional injury of the first auditory pathway afferent neuron.

Estudos realizados com os Potenciais Auditivos Evocados de Tronco Encefálico (PEATE) em trabalhadores com Perda Auditiva Induzida pelo Ruído (PAIR) apresentam resultados díspares em relação ao comprometimento neuronal, além de não contemplar motoristas de ônibus como objeto de estudo. OBJETIVO: Avaliar pelo PEATE, em estudo clínico de série caso/controle, prospectivo, se há comprometimento das vias auditivas neurais em motoristas de ônibus com PAIR. MATERIAL E MÉTODO: Foram selecionados 50 motoristas de ônibus entre 27 e 40 anos portadores de PAIR leve a moderada; e 20 sujeitos entre 29 e 40 anos com audibilidade normal e sem antecedentes de exposição a ruído. Os PEATEs foram realizados e os traçados analisados. RESULTADOS: No grupo PAIR, os limiares auditivos em 3, 4 e 6 kHz foram significativamente maiores na orelha esquerda. No grupo PAIR, os potenciais PI, PIII e/ou PV foram ausentes em uma pequena parcela; foi observado prolongamento estatisticamente significante das latências absolutas de PI, PIII e PV, das latências interpicos (LIP) LIP I-III, bilateralmente e da LIP I-V na orelha esquerda. CONCLUSÃO: No grupo PAIR, além da lesão sensorial, as modificações das latências do PEATE sugerem lesão funcional do primeiro neurônio aferente da via auditiva, de forma precoce.