Research on early warning model of the hearing loss of workers exposed to noise / 中华劳动卫生职业病杂志

Objective: To explore the change of hearing threshold of workers exposed to noise, establish an individual-based hearing loss early warning model, accurately and differentiated the health of workers exposed to noise. Methods: In September 2019, all physical examination data of 561 workers exposed to noise from an enterprise were collected since their employment. Three indicators of average hearing threshold of the better ear, namely, at high frequency, 4000 Hz and speech frequency, were constructed. The generalized estimating equation (GEE) was used to adjust gender and age and establish the warning model of each indicator. Finally, sensitive indicators and warning models were screened according to AUC and Yoden index. Results: Among the 561 workers exposed to noise, 26 (4.6%) workers had hearing loss. The sensitivity indicators were the average hearing threshold at speech frequency ≥20 dB, high frequency ≥30 dB and 4000 Hz ≥25 dB. The AUC of each index was 0.602, 0.794 and 0.804, and the Youden indexes were 0.204, 0.588 and 0.608, respectively. In GEE of hearing loss warning models, high-frequency hearing threshold ≥20 dB and 4000 Hz hearing threshold ≥25 dB were the optimal models, with AUC of 0.862. Conclusion: Combined with the changes of individual hearing threshold over the years, can accurately assess the risk of individual hearing loss of workers exposed to noise.

Auditory effects of recreational and occupational noise exposure among dental students: a cross-sectional study / Efectos auditivos producto de la exposición a ruido recreacional y dental en estudiantes de odontología: un estudio transversal

ABSTRACT Purpose: to determine the auditory effects of noise exposure from recreational and occupational sources among dentistry students. Methods: forty-two dentistry students, routinely exposed to occupational noise, and 72 students from other health science schools were recruited (control group). Audiometric testing, otoacoustic emissions and questionnaires to assess recreational and occupational noise were applied to the sample. The presence of a notch was determined for each participant audiometry´s test based on the criteria proposed by Coles et al. Differences in notch prevalence were analyzed by applying univariate regression models as well as a multivariate model adjusted by covariates. Results: non-significant differences in auditory thresholds between groups were found. The controls exhibited a significantly higher prevalence of a notch at 4 kHz than the group exposed to noise. However, the differences were not statistically significant in the multivariate model adjusted by recreational noise exposure. Conclusions: the occupational noise exposure was not significantly associated to auditory system dysfunction. In addition, the differences in notch prevalence could be related to recreational noise exposure.

RESUMEN Objetivo: determinar los efectos auditivos producto de la exposición a ruido recreacional y ocupacional en estudiantes de Odontología. Métodos: se reclutó a 42 estudiantes de odontología expuestos rutinariamente a ruido ocupacional, y a 72 estudiantes de otras carreras del área de la salud (grupo control). Se evaluó mediante audiometría, emisiones otoacústicas, junto con aplicar cuestionarios para determinar la exposición a ruido ocupacional y recreacional. A partir de los umbrales audiométricos e determinó la presencia de escotoma usando el criterio de Coles et al. Se analizaron las diferencias en prevalencia de escotomas entre los grupos mediante regresiones logísticas, ajustando por otras variables. Resultados: no existieron diferencias significativas en los umbrales audiométricos entre los grupos estudiados. El grupo control mostró mayor prevalencia de escotoma en 4 kHz al ajustar por sexo y edad, sin embargo, dejó de ser significativa al ajustar adicionalmente por exposición a ruido recreacional. Conclusiones: la exposición a ruido ocupacional no se asoció a alteraciones auditivas. Además, las diferencias en prevalencia de escotomas estarían relacionadas a exposición a ruido recreacional.

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.

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.

Estudio Transversal: Hipoacusia Laboral Inducida por Ruido en Personal de Aeronáutica del Ejército Ecuatoriano y Factores Asociados. Quito ­ Ecuador, 2014 - 2016 / Cross-sectional research: Noise-induced Occupational Hypoacusis in Aeronautical Personnel of the Ecuadorian Army and Associated Factors. Quito - Ecuador, 2014 - 2016

INTRODUCCIÓN: La hipoacusia laboral inducida por ruido es una patología ocupacional frecuente, responsable de pérdidas de la audición sino se controla a tiempo. El objetivo del estudio fue establecer la prevalencia de hipoacusia laboral inducida por ruido y factores relacionados en el personal de aeronáutica del ejército. MÉTODOS: Estudio transversal analítico en el personal tripulación del ejército ecuatoriano, Quito ­ Ecuador, período 2014 ­ 2016 que relacionó asociación causal entre hipoacusia laboral inducida por ruido con variables como edad, función, rango, antecedentes de hipoacusia en el servicio militar. Se trabajó con todo el personal de vuelo, 112 militares en servicio activo. RESULTADOS: El promedio de edad fue de 37 años. Todos eran varones. El 55.4 % pertenecía a tropa y 44. 6 % eran oficiales. El 44.6 % eran pilotos; 28.6 % mecánicos y 26.8 % ingenieros de vuelo. La prevalencia de hipoacusia general fue del 35.6 %; la de hipoacusia unilateral fue del 19.6 % y de la bilateral del 16 %. La frecuencia de antecedentes de hipoacusia laboral asociada a ruido en la aeronáutica fue del 60.7 %. La prevalencia de hipoacusia leve fue del 17.8 %; moderada con 6.7 % y severa con 1.35 %. Las variables asociadas a hipoacusia laboral inducida por ruido en el personal militar en funciones de vuelo fueron: la edad, el rango, la función y antecedentes de hipoacusia. El oído izquierdo suele afectarse más que el derecho. La hipoacusia bilateral más frecuente fue la leve derecha con agudeza normal izquierda (10.7 %). CONCLUSIONES: La hipoacusia laboral inducida por ruido es multifactorial y puede ser reversible si se detiene el causal o si se llevan a cabo medidas de protección adecuadas. El nivel de hipoacusia en el personal militar de vuelo tiene asociación con: la edad, el rango, la función y los antecedentes de hipoacusia laboral en funciones de vuelo.

BACKGROUND: Hearing loss is induced by noise in job and is a frequent illness, responsible of hearing loss if it is not controlled on time. The aim of this study is establish the prevalence of hearing loss and related factors in army aviation personnel. METHODS: An analytical cross - sectional study of the Ecuadorian army crew, Quito - Ecuador, between 2014 and 2016, which related a causal association between hearing loss induced by noise in job with variables such as age, function, rank and backgrounds of hearing loss in military service. It worked with all the personnel of flight 112 military in active service. RESULTS: The mean age was 37 years. All were male. 55.4% belonged to troops and 44. 6 % were officers. 44.6 % were pilots; 28.6 % were mechanics and 26.8 % were flight engineers. The prevalence of general hearing loss was 35.6 %. The prevalence of unilateral hearing loss was 19.6 % and bilateral prevalence was 16 %. The frequency of antecedents of occupational hearing loss associated with aviation noise in this staff was of 60.7 %. The prevalence of mild hearing loss was 17.85 %; moderate hearing loss 6.7 % and severe of 1.35 %, no profound hearing loss was reported. The variables associated with decreased auditory acuity are: age, aviation exercise time, range, function, and history of hearing loss within the aeronautical field. Bilateral damage has a statistical tendency with age and association with the range. No deep hearing loss was found. CONCLUSION: Noise-induced occupational hearing loss is multifactorial and may be reversible if the cause is stopped or appropriate protective measures are taken. The level of hearing loss in military flight personnel has an association with: age, range, function, and history of occupational hearing loss in flight functions.

Percepção e conhecimento dos profissionais da saúde da atenção primária sobre notificação da perda auditiva induzida pelo ruído em Curitiba - Paraná / Primary care health professionals' perception and knowledge on notification of noise-induced hearing loss in Curitiba - Paraná

RESUMO Objetivo Analisar a percepção e o conhecimento dos profissionais de saúde que atuam na rede de Atenção Primária à Saúde do Município de Curitiba - Paraná sobre a notificação compulsória da Perda Auditiva Induzida pelo Ruído (PAIR) no, Sistema de Informação de Agravos de Notificação (SINAN). Método Utilizando como método o estudo transversal na cidade de Curitiba, analisando a percepção e o conhecimento dos profissionais de saúde que atuam na rede de Atenção Primária à Saúde do Município de Curitiba sobre a notificação compulsória da PAIR no SINAN. Aplicou-se ainda um questionário semiaberto em profissionais de saúde da atenção básica sobre conhecimento sobre a PAIR e sua notificação. Resultados Dos profissionais da atenção básica, 50% eram médicos com faixa etária de 26 a 30 anos. Dentre os profissionais, 56,2% relataram estarem preparados para identificar problemas de saúde relacionados ao trabalho, porém apenas 43,7% sentem-se aptos a identificar casos de PAIR. Entre as facilidades na notificação, relataram descentralização da assistência à saúde próxima à residência do usuário, encaminhamento para referência em medicina do trabalho e prontuário eletrônico na UBS; como dificuldades, relataram a não formação específica em saúde do trabalhador e falta de capacitação, tempo reduzido para consultas e receio. Conclusão os profissionais de saúde conhecem as características e sentem-se aptos para identificar os casos de PAIR, mas ainda não notificam os casos suspeitos de PAIR e não percebem a Saúde do Trabalhador como um programa institucionalizado fazendo parte do serviço.

ABSTRACT Objective The article aims to analyze the perception and knowledge of health professionals working in primary health care networks in the Municipality of Curitiba – Paraná, regarding the compulsory notification of Induced Hearing Loss Noise (NIHL) in the National Notifiable Diseases Information System (SINAN). Methods We performed a transversal cohort study in Curitiba, analyzing perception and knowledge of health professionals working in the primary health care networks in the Municipality of Curitiba, regarding the compulsory notification of NIHL in SINAN, from 2007 to 2014, featuring the reported cases and exploring the situational analysis of the NIHL notification, through a questionnaire and a structured news conference. Results The primary care professionals’ survey showed that 50% were doctors and the predominant age group was 26-30 years, with 56.2% reported as being able to identify health problems related to work, but only 43.7% feel able to identify cases of NIHL. Conclusion It was found that health professionals know the features and feel able to identify cases of NIHL, but still do not report suspected NIHL cases and do not consider occupational health an institutionalized program that is part of the service.

Pitch and Loudness from Tinnitus in Individuals with Noise-induced Hearing Loss

Abstract Introduction Tinnitus is one of the symptoms that affects individuals suffering from noise induced hearing loss. This condition can be disabling, leading the affected individual to turn away from work. Objective This literature review aims to analyze the possible association between gender and tinnitus pitch and loudness, the degree of hearing loss and the frequencies affected in subjects with noise-induced hearing loss. Methods This contemporary cohort study was conducted through a cross-sectional analysis. The study sample consisted of adults with unilateral or bilateral tinnitus, who had been diagnosed with noise-induced hearing loss. The patients under analysis underwent an otorhinolaryngological evaluation, pure tone audiometry, and acuphenometry. Results The study included 33 subjects with noise-induced hearing loss diagnoses, of which 22 (66.7%) weremen. Authors observed no statistical difference between gender and loudness/pitch tinnitus and loudness/pitch in subjects with bilateral tinnitus. Authors found an inverse relation between tinnitus loudness with intensity greater hearing threshold and the average of the thresholds and the grade of hearing loss. The tinnitus pitch showed no association with higher frequency of hearing threshold. Conclusion Data analysis shows that, among the individuals evaluated, the greater the hearing loss, the lower the loudness of tinnitus. We did not observe an association between hearing loss and tinnitus pitch.

High-frequency Audiometry Hearing on Monitoring of Individuals Exposed to Occupational Noise: A Systematic Review

Abstract Introduction The literature reports on high-frequency audiometry as one of the exams used on hearing monitoring of individuals exposed to high sound pressure in their work environment, due to the method́ s greater sensitivity in early identification of hearing loss caused by noise. The frequencies that compose the exam are generally between 9 KHz and 20KHz, depending on the equipment. Objective This study aims to perform a retrospective and secondary systematic revision of publications on high-frequency audiometry on hearing monitoring of individuals exposed to occupational noise. Data Synthesis This systematic revision followed the methodology proposed in the Cochrane Handbook, focusing on the question: "Is High-frequency Audiometry more sensitive than Conventional Audiometry in the screening of early hearing loss individuals exposed to occupational noise?" The search was based on PubMed data, Base, Web of Science (Capes), Biblioteca Virtual em Saúde (BVS), and in the references cited in identified and selected articles. The search resulted in 6059 articles in total. Of these, only six studies were compatible with the criteria proposed in this study. Conclusion The performed meta-analysis does not definitively answer the study's proposed question. It indicates that the 16 KHz high frequency audiometry (HFA) frequency is sensitive in early identification of hearing loss in the control group (medium difference (MD = 8.33)), as well as the 4 KHz frequency (CA), this one being a little less expressive (MD = 5.72). Thus, others studies are necessary to confirm the HFA importance for the early screening of hearing loss on individuals exposed to noise at the workplace.

Modelamiento predictivo de la pérdida auditiva laboral, relacionada con el tratamiento de absorción acústica en una industria metal-mecánica en Chile / Predctive modeling of labor hearing loss, related to the treatment of acoustic absorption in metal-mechanic industry in Chile

La presente investigación evalúa el impacto que tiene en la protección de la audición de los trabajadores, la incorporación del tratamiento acústico del entorno laboral correspondiente al sector metal-mecánico de la industria Inchalam, ubicada en Santiago de Chile, cuyo entorno es tratado con materiales absorbentes certificados, ubicados estratégicamente en las zonas de mayor exposición al ruido en dicha industria, considerado este sector productivo como el más vulnerable en cuanto a patologías auditivas. Los resultados de la investigación evidencian que diversos escenarios propuestos para el tratamiento acústico absorbente pueden llegar a valores de reducción máximos de 2 dB en la exposición a ruido de algunos puestos de trabajo, concluyéndose que es una alternativa efectiva en términos de reducción de la exposición ocupacional a ruido de los trabajadores, cuando la actividad laboral y maquinarias no permite tratar acústicamente la fuente ni el receptor. Respecto de la proyección de la Pérdida Auditiva, según los criterios de la Norma ISO1999 (Determination of occupational noise exposure and estimation of noise induced hearing impairment) y Prexor (Protocolo de Exposición Ocupacional al Ruido), se modeló una población de trabajadores varones de 50 años de edad y 30 años de exposición al ruido. La configuración diseñada permite predecir una disminución de hasta 5 dB en la banda más crítica, lo que implica una disminución de 3 dB promedio en la curva audiométrica, que a su vez incide en el 50% de disminución de la energía acústica recibida en 30 años de exposición y que para el caso estudiado aleja a esta población de un daño médico-legal y con ello de las eventuales indemnizaciones.

The investigation will assess the impact on hearing protection for workers, a metal mechanic sector Inchalam industry located in Santiago of Chile, the incorporation of acoustic treatment of the working environment, with certified absorbent materials, strategically located in areas greater exposure to noise in the industry. The project includes the use and acquisition of acoustic software Rap-One a Soft-dB Canadian Company, that allows input measurements Sound Pressure Level Equivalent directly to software from the activity measured. The results of the research conducted show that various scenarios proposed for the absorbent acoustic treatment, can reach maximum values of 2dB reduction in noise exposure of some jobs, concluding that it is an effective alternative in terms of reduction occupational noise exposure of workers when the work activity and machinery does not allow acoustically treat to the source or receiver. About the projection of Hearing Loss, according to the criteria of the Standard ISO1999 and Prexor, a population of male workers 50 years old and 30 years working, was modeled noise exposure, the configuration modeled to predict a decrease of up to 5 dB in the most critical band, which implies a decrease of 3 dB average audiometric curve, corresponding to 50% decrease of the acoustic energy received by 30 years of exposure and for the case studied this population away from harm legal medical and thus of any indemnities.

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.

High levels of sound pressure: acoustic reflex thresholds and auditory complaints of workers with noise exposure / Níveis elevados de pressão sonora: limiares dos reflexos estapedianos e queixas auditivas de trabalhadores expostos

INTRODUCTION: The clinical evaluation of subjects with occupational noise exposure has been difficult due to the discrepancy between auditory complaints and auditory test results. This study aimed to evaluate the contralateral acoustic reflex thresholds of workers exposed to high levels of noise, and to compare these results to the subjects' auditory complaints.METHODS: This clinical retrospective study evaluated 364 workers between 1998 and 2005; their contralateral acoustic reflexes were compared to auditory complaints, age, and noise exposure time by chi-squared, Fisher's, and Spearman's tests.RESULTS: The workers' age ranged from 18 to 50 years (mean = 39.6), and noise exposure time from one to 38 years (mean = 17.3). We found that 15.1% (55) of the workers had bilateral hearing loss, 38.5% (140) had bilateral tinnitus, 52.8% (192) had abnormal sensitivity to loud sounds, and 47.2% (172) had speech recognition impairment. The variables hearing loss, speech recognition impairment, tinnitus, age group, and noise exposure time did not show relationship with acoustic reflex thresholds; however, all complaints demonstrated a statistically significant relationship with Metz recruitment at 3000 and 4000 Hz bilaterally.CONCLUSION: There was no significance relationship between auditory complaints and acoustic reflexes.

INTRODUÇÃO: A avaliação clínico-ocupacional de trabalhadores expostos a ruído é dificultada pela discrepância entre queixas auditivas e resultados dos exames audiológicos. Este estudo pretende avaliar limiares dos reflexos estapedianos contralaterais em sujeitos expostos a níveis elevados de pressão sonora, relacionando-os com queixas auditivas.MÉTODO: Estudo clínico retrospectivo que analisou 364 trabalhadores e seus limiares de reflexos estapedianos contralaterais, relacionado-os com queixas auditivas, idades e tempos de exposição ao ruído.RESULTADOS: Dos trabalhadores avaliados, com idades de 18 a 50 anos (média 39,6) e tempos de exposição entre um e 38 anos (média 17,3); 15,1% (55) tinham queixa de perda auditiva bilateral, 38,5% (140) zumbidos bilaterais, 52,8% (192) irritação ao ouvir sons intensos e 47,2% (172) dificuldades para reconhecer a fala. As variáveis: perda auditiva, dificuldade para reconhecimento da fala, zumbidos, faixa etária e tempo de exposição ao ruído não se relacionaram significativamente com limiares dos reflexos estapedianos, mas todas as queixas apresentaram relação estatisticamente significante com o recrutamento de Metz nas frequências de 3000 e 4000 Hz, bilateralmente.CONCLUSÃO: Não houve relações significativas entre limiares dos reflexos estapedianos e queixas auditivas.

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. .

Audiometric profile of civilian pilots according to noise exposure / Perfil audiométrico segundo exposição de pilotos civis ao ruído

OBJECTIVE To evaluate the audiometric profile of civilian pilots according to the noise exposure level. METHODS This observational cross-sectional study evaluated 3,130 male civilian pilots aged between 17 and 59 years. These pilots were subjected to audiometric examinations for obtaining or revalidating the functional capacity certificate in 2011. The degree of hearing loss was classified as normal, suspected noise-induced hearing loss, and no suspected hearing loss with other associated complications. Pure-tone air-conduction audiometry was performed using supra-aural headphones and acoustic stimulus of the pure-tone type, containing tone thresholds of frequencies between 250 Hz and 6,000 Hz. The independent variables were professional categories, length of service, hours of flight, and right or left ear. The dependent variable was pilots with suspected noise-induced hearing loss. The noise exposure level was considered low/medium or high, and the latter involved periods > 5,000 flight hours and > 10 years of flight service. RESULTS A total of 29.3% pilots had suspected noise-induced hearing loss, which was bilateral in 12.8% and predominant in the left ear (23.7%). The number of pilots with suspected hearing loss increased as the noise exposure level increased. CONCLUSIONS Hearing loss in civilian pilots may be associated with noise exposure during the period of service and hours of flight. .

OBJETIVO Analisar o perfil audiométrico de pilotos civis segundo grau de exposição ao ruído. MÉTODOS Trata-se de um estudo observacional, transversal, com 3.130 pilotos civis do sexo masculino de 17 a 59 anos submetidos a exames audiométricos iniciais ou de revalidação de Certificado de Capacidade Física em 2011. Os sujeitos foram categorizados segundo perda auditiva como: normais, sugestivos de perda auditiva induzida por ruído, e outros fatores associados e não sugestivos. A audiometria tonal liminar utilizada foi por via aérea, com a utilização de fones supra-aurais, por meio do estímulo acústico do tipo tom puro, contendo os limiares tonais das frequências de 250 a 6.000 Hz. As variáveis independentes foram as categorias dos pilotos, tempo de serviço, horas de voo e orelha direita ou esquerda. A variável dependente corresponde aos casos sugestivos de perda auditiva induzida por ruído. O grau de exposição foi considerado baixo/médio ou alto, sendo este último com horas de voo maiores que 5.000 e tempo de serviço maior que 10 anos. RESULTADOS Foram observados 29,3% casos sugestivos de perda auditiva induzida por ruído, 12,8% bilaterais com predomínio do lado esquerdo (23,7%). Com o aumento do grau de exposição ao ruído, o número de casos sugestivos de perda auditiva também aumentou. CONCLUSÕES A perda auditiva nos pilotos civis pode estar associada à exposição ao ruído ao longo do tempo de serviço e das horas de voo. .

Validación de criterio y constructo para la creación de un cuestionario de exposición a ruido / Validation of criteria and construct for the creation of a questionnaire on noise exposure

Introducción: La exposición a ruido recreacional y su repercusión sobre la audición es un problema al cual la investigación presta cada vez mayor atención. Objetivo: Determinar la validez de criterio y constructo de un cuestionario de exposición a ruido recreacional ("CHAR"), así como los factores asociados a ésta. Material y método: Se realizó un estudio de validación de cuestionario, de corte transversal, en estudiantes universitarios. El protocolo incluyó evaluación audiométrica, consulta de síntomas auditivos relacionados con la exposición a ruido y el cuestionario "CHAR". Se construyeron modelos mediante regresión logística, obteniendo sus respectivas áreas bajo la curva ROC. Resultados: Se incluyó a 258 estudiantes de la carrera de fonoaudiología. La presencia de escotoma en 4 kHz en el oído derecho obtuvo un área bajo la curva correspondiente a 0,72 (IC 95%: 0,60-0,84), mientras que en el oído contralateral ésta fue de 0,57 (IC 95%: 0,49-0,65). El presentar síntomas auditivos luego de asistir a conciertos podría influir en las medidas de validez. Conclusión: El Cuestionario "CHAR" permite discriminar la presencia de escotoma en la frecuencia 4 kHz del oído derecho. El puntaje de corte va a depender de los objetivos de uso del instrumento; ya sea el orientar en el diagnóstico, o el tamizaje.

Introduction: Recreational noise exposure and its impact on hearing is a problem that the investigation is paying more and more attention to. Aim: To determine the validity of the criteria and construct for the questionnaire on recreational noise exposure (CHAR) and the factors associated. Materials and Methods: We conducted a validation study for the questionnaire, transversal, using university students. The protocol included audiometric evaluation, consultation on auditory symptoms related to noise exposure and the "CHAR" questionnaire. We constructed it using logistic regression models, obtaining their respective areas under the ROC curve. Results: It included 258 students in the audiology program. The presence of notch at 4 kHz in the right ear obtained an area under the curve corresponding to 0.72 (95% CI: 0.60-0.84) while in the contralateral ear, it was 0.57 (95% CI: 0.49-0.65). The auditory symptoms present after attending concerts could influence measures of validity. Conclusion: The "CHAR" questionnaire allows for discrimination for the presence of notch in the 4 kHz frequency in the right ear. The cutoff score will depend on the objectives for the use of the instrument; to guide the diagnosis or screening.

Prevalence of noise induced hearing loss among dentists working in Karachi, Pakistan

Dentists are exposed to noise of varying intensities while working in dental clinics. This paper discusses the different sources and characteristics of noise in the dental clinics. Questionnaire surveys from three hundred and thirty-three dentists [male and female] were collected for a cross-sectional study conducted in Karachi, Pakistan. The collected data were analyzed using SPSS version 17. The study concludes that noise originating from the dental tools appears to have an effect on the dentists and contributes to their headache, irritation, tinnitus and in some cases hearing damage. Further investigation is required to study the possible risks of induced hearing loss due to these dental tools

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

Estudo do espectro sonoro nos limiares de altas frequências em trabalhadores expostos ao ruído / Study of the noise spectrum on high frequency thresholds in workers exposed to noise

O grau de nocividade do ruído pode ser quantificado e qualificado com base em algumas características do som como sua intensidade, o tipo de espectro, duração e a distribuição da exposição ao ruído durante a jornada de trabalho. OBJETIVO: Avaliar o espectro de ruído e a configuração audiométrica em trabalhadores. MATERIAIS E MÉTODOS: Estudo de coorte contemporânea com corte transversal, realizado no Distrito Federal. Realizou-se avaliação ambiental (análise espectral) do ruído em empresas de diferentes ramos de atividade econômica e avaliação audiológica em 347 trabalhadores. RESULTADOS: A análise espectral revelou picos em diferentes frequências em cada ramo de atividade (8 kHz-metalúrgico, 4 kHz-marmoraria e 2 kHz-madeireira). Verificou-se que as frequências de 14 kHz e 16 kHz apresentaram diferenças significativas entre os ramos de atividade, com maior prevalência no metalúrgico. CONCLUSÃO: A utilização de medidor de nível de pressão sonora, acoplado a analisador de frequência e a avaliação audiométrica de altas frequências possibilitam a detecção precoce de danos auditivos que, por sua vez, viabiliza melhor direcionamento das ações preventivas.

Noise level can be quantified and qualified based on sound characteristics such as intensity, type of spectrum, duration and distribution of the noise exposure during one's working hours. OBJECTIVE: To assess noise spectrum and the audiometric configuration of workers. MATERIALS AND METHODS: Contemporary cross-sectional cohort carried out in the Federal District - Brazil. We did an environmental analysis (spectral analysis) of the noise in companies from different industries, with audiological assessment of 347 workers. RESULTS: The spectral analysis revealed peaks at different frequencies for each industry investigated (8 kHz-metallurgical, 4 kHz-stone Works and 2 kHz-wood works). We noticed that the frequencies of 14 kHz and 16 kHz had significant differences between the various industries, with a greater prevalence of the metallurgical. CONCLUSION: The use of noise pressure measuring device, coupled to a frequency analyzer and high frequency audiometric assessment yielded an early detection of hearing damage, helping better organize preventive measures.

Timpanoplastia en perforación timpánica secundaria a trauma por onda explosiva: comparación entre fascia temporal y cartílago auricular / Tympanoplasty in tympanic membrane perforation caused by blast injury: fascia temporalis vs. auricular cartilage

Objetivo: Comparar los resultados de timpanoplastia entre fascia temporal (GI) y cartílago auricular (GII) en perforación timpánica secundaria a trauma por onda explosiva. Diseño: Estudio de cohorte histórica. Métodos: Se incluyeron pacientes llevados a timpanoplastia tipo I, intervenidos entre febrero 1.º del 2007 y diciembre 31 del 2009. Los sujetos son miembros de las Fuerzas Armadas de Colombia, heridos en combate. Fueron excluidos aquellos sometidos a mastoidectomía u osciculoplastia. El resultado anatómico se evaluó mediante prueba exacta de Fisher, y el funcional, mediante Anova. Resultados: Se incluyeron 36 sujetos, GI = 16 y GII = 20. No hubo diferencias en el éxito anatómico entre GII = 95% (19/20) y GI = 87,5% (14/16), a los 12 meses (p = 0,57). En pacientes con cadena íntegra-móvil, la brecha aire-hueso a los seis meses (n = 30) fue de 5,8 dB (DE = 8 dB), y a los doce meses (n = 26) fue de 5,4 dB (DE = 8 dB). No hubo asociación entre el resultado funcional y el tipo de injerto utilizado (p > 0,05). Conclusiones: la timpanoplastia en perforación secundaria a trauma por onda explosiva ofrece resultados satisfactorios y estables a los doce meses, tanto con fascia como con cartílago...

Objective: to compare tympanoplasty outcomes between fascia temporalis (GI) and auricular cartilage (GII) in tympanic membrane perforation caused by blast injury. Design: historical cohort study. Methods: patients underwent tympanoplasty type I, between February 1-2007 and December 31-2009, were included. The study subjects are members of the armed forces of Colombia that were wounded in combat. Patients who underwent mastoidectomy or ossiculoplasty were excluded. The Fisher’s exact test was performed to assess the anatomical outcome, and the ANOVA test to assess the functional outcome. Results: 36 subjects were included, GI = 16 and GII = 20. Regarding the anatomical success, there was no differences between GI = 95% (19/20) and GII = 87.5% (4/16), at 12 months of follow-up (p = 0.57). In patients with an intact ossicular chain, the airbone gap at 6 months (n = 29) was = 5.8 dB (SD = 8 dB); while at 12 months (n = 26) it was = 5.4 dB (SD = 8 dB). There was no relationship between the functional outcome and the kind of graft used (p > 0.05). Conclusions: the surgical outcomes of the tympanoplasty in tympanic membrane perforation caused by blast injury are satisfactory and stable at 12 months, with fascia and cartilage...