Occupational noise-induced hearing loss in platinum miners: what do the data tell us?

Background: Occupational noise-induced hearing loss (ONIHL) is one of the most common occupational health diseases affecting miners in South Africa. Accurate and appropriate medical data are essential for making valid diagnoses. Objectives: The purpose of this study was to describe the electronic records of a South African platinum mine's audiometry medical surveillance system and their role in early diagnosis of ONIHL. Ear-related conditions of affected miners, occupations, and noise levels were concurrently reviewed, and the characteristics of miners with and without ONIHL were described. Methods: This was an analysis of secondary data from the electronic audiometry and employee occupational records of 305 platinum mine workers for the period 2014 to 2017. Data were analysed using descriptive statistics. Results: Although the audiometry records contained appropriate and relevant data, including annual hearing screening percentage loss of hearing (PLH) shifts, there was evidence of inaccurate and insufficient recording of risk factors for hearing loss in the medical surveillance records. The records indicated that the miners in some occupations were exposed to dangerously high noise levels, exceeding 85 dB(A). Miners as young as 21 years of age were diagnosed with ONIHL. Conclusion: The insufficient and inaccurate data captured in the miners' records has important implications for the mine's efficient implementation of hearing conservation programme (HCP) elements aimed at mitigating ONIHL. The hazardous noise levels recorded call for increased attempts to meet noise level regulations, while the presence of conditions such as pseudohypacusis highlights the need for exploration of more reliable assessment measures

Universal newborn hearing screening in public healthcare in South Africa: Challenges to implementation

Background. The implementation of early hearing detection and intervention (EHDI) remains a challenge in developing countries, despite the known benefits.Objectives. To investigate challenges encountered during implementation of universal newborn hearing screening (UNHS) at a secondarylevel public hospital in Johannesburg, South Africa.Methode. A prospective cohort study design that assessed the feasibility of conducting UNHS was adopted. This feasibility assessment was conducted during a 3-month period, and all challenges encountered were identified and documented. Screening time was also recorded for each neonate. Data were entered into Excel, and later analysed using Stata version 11.Results. Of 2 740 neonates born during the study period, 490 (17.9%) were identified for screening, and distortion product otoacoustic emissions screening was conducted on 121 (4.4%). The majority (74.4%) were screened in the first 24 hours of life. Repeat screening was required in 57 (47.1%) neonates, but only 20 returned for follow-up. The most important challenges to the feasibility of UNHS implementation were the insufficient number of audiologists available to provide screening, the high rate of false positive test results and the unacceptably high rates of loss to follow-up. Two modifiable factors, namely the presence of vernix caseosa in the external ear canal and high ambient noise levels, were found to have significantly influenced the screening process. Conclusion. The identified challenges are important considerations for any successful implementation of universal screening protocols.Careful planning to mitigate the challenges will have a positive impact on EHDI initiatives in these contexts

The Use of Hearing Protection Devices in South Africa: Exploring the Current Status in a Gold and a Non-Ferrous Mine

This study investigated mine workers' current use of hearing protection devices (HPDs) in South African gold and non-ferrous mining subsectors. A descriptive study design was employed using structured interviews.Ninety participants were interviewed. Descriptive statistics and the chi-square test were used to analyse data.All participants reported wearing HPDs; with custom-made earplugs being preferred by those with more years of work experience and used by those most at risk to noise exposure. Comfort; design and work-related communication were factors infl uencing use of HPDs. Relationships between participants' demographic factors and use of HPDs were not statistically signifi cant. Participants seemed reasonably aware of HPD importance which highlights progress. Findings further highlight the importance of occupational audiologists in improving hearing conservation programmes (HCPs) in this sector

HIV/AIDS and Auditory Function in Adults: the Need for Intensified Research in the Developing World

This article reviews published research on auditory function in HIV-infected adults; while also highlighting the need for intensified research on this topic in Africa. It begins with an introduction to the effects of HIV disease and treatment on the auditory system; and so highlights the need to put auditory function in adults with HIV or AIDS on the healthcare and research agenda in developing countries. The discussion refers to this population in regard to: published prevalence and incidence data related to auditory manifestations; most prevalent types of auditory manifestations and hearing loss; degree; configuration; and symmetry of the hearing loss; types of onset of hearing loss; and the proposed direct and indirect causes of auditory manifestations in HIV disease. Finally; the possible effects of HIV/AIDS drug treatments on the auditory system; as an indirect cause of hearing loss; are also discussed. A review of the literature revealed that auditory manifestations in adults with HIV or AIDS are heterogeneous in nature and are possibly due to various causes. Auditory presentations; including hearing loss; tinnitus and vertigo (in varied combinations) can occur with hearing loss; which includes conductive; mixed; sensorineural; and central types of hearing loss. The severity of hearing loss can range from mild to profound; occurring either unilaterally or bilaterally; with the types of onset including sudden or gradual and progressive. The varied causes of hearing loss include HIV infection or AIDS illness as a primary cause; opportunistic infections; and antiretroviral treatments. The studies discussed are mainly from developed countries where the presentation and management of HIV and AIDS can be different to that in developing countries because the context is different. This suggests a need for more research in this area since the numbers of adults living with HIV or AIDS in developing countries like South Africa is relatively high