Perceptions of Adults With Hearing Loss About the Communication Difficulties Generated by the COVID-19 Preventive Measures: A Qualitative Study.

PURPOSE: The COVID-19 pandemic led to the implementation of preventive measures that exacerbated communication difficulties for individuals with hearing loss. This study aims to explore the perception of adults with hearing loss about the communication difficulties caused by the preventive measures and about their experiences with communication 1 year after the adoption of these preventive measures. METHOD: Individual semistructured interviews were conducted via videoconference with six adults who have hearing loss from the province of Québec, Canada. Data were examined using qualitative content analysis. RESULTS: The study found that face masks and in-person work (i.e., in opposition to remote work) were important barriers to communication because of hindered lipreading and competing noise in many workplaces. In contrast, preventive measures that allowed visual information transmission (e.g., transparent face masks, fixed plastic partitions) were considered favorable for communication. Communication partners were perceived as playing an important role in communication success with preventive measures: Familiar communication partners improved communication, whereas those with poor attitude or strategies hindered communication. Participants found that videoconferences could provide satisfactory communication but were sometimes hindered by issues such as bad audiovisual quality or too many participants. CONCLUSIONS: This study identified reduced access to speech reading and lack of general awareness about hearing issues as key barriers to communication during the pandemic. The decreased communication capabilities were perceived to be most problematic at work and during health appointments, and tended to cause frustration, anxiety, self-esteem issues, and social isolation. Suggestions are outlined for current and future public health measures to better consider the experience of people with hearing loss.

Audiological Tests Used in the Evaluation of the Effects of Solvents on the Human Auditory System: A Mixed Methods Review.

This study aimed to scope the literature, identify knowledge gaps, appraise results, and synthesize the evidence on the audiological evaluation of workers exposed to solvents. We searched Medline, PubMed, Embase, CINAHL, and NIOSHTIC-2 up to March 22, 2021. Using Covidence, two authors independently assessed study eligibility, risk of bias, and extracted data. National Institute of Health Quality Assessment Tools was used in the quality evaluation of included studies; the Downs and Black checklist was used to assess the risk of bias. Of 454 located references, 37 were included. Twenty-five tests were studied: two tests to measure hearing thresholds, one test to measure word recognition in quiet, six electroacoustic procedures, four electrophysiological tests, and twelve behavioral tests to assess auditory processing skills. Two studies used the Amsterdam Inventory for Auditory Disability and Handicap. The quality of individual studies was mostly considered moderate, but the overall quality of evidence was considered low. The discrepancies between studies and differences in the methodologies/outcomes prevent recommending a specific test battery to assess the auditory effects of occupational solvents. Decisions on audiological tests for patients with a history of solvent exposures require the integration of the most current research evidence with clinical expertise and stakeholder perspectives.

Audiological findings of family farmers exposed to pesticides. / Achados audiológicos de agricultores familiares paranaenses expostos a agrotóxicos.

PURPOSE: To analyze the possible differences among the hearing of farmers and their families when compared to the population not exposed to pesticides. METHODS: Cross-sectional study with 70 smallholder family farmers (research group), with the mean age of 39.7 years, of both sexes and a mean of 23.7 years of exposure to pesticides. We included a control group with 71 participants of both sexes with the mean age of 39.5 years, not exposed to either noise or chemical substances, to compare the results. In stage 1, both groups were submitted to conventional and high-frequency audiometry, and acoustic immittance. In stage 2, only people with normal hearing were submitted to the evoked otoacoustic emissions and suppression effect on transient otoacoustic emissions. RESULTS: Significant differences were observed between the groups in the conventional pure-tone and in the high-frequency audiometry, as well as in the acoustic reflex. The most affected frequencies in the conventional pure-tone audiometry ranged from 3 to 6 kHz and, in the high-frequency audiometry, from 9000 to 11200 Hz. As for the transient otoacoustic emissions, the worse suppression effect results were found in the research group. CONCLUSION: There were differences among the hearing of family farmers and the control group. The conventional auditory thresholds are related to the group, age and sex. Farming is associated with impairments in the basal region of the cochlea, absence of acoustic reflex, reduced signal-to-noise ratio of the transient otoacoustic emissions, and dysfunction in the olivocochlear efferents of the auditory system.

OBJETIVO: Analisar as possíveis diferenças na audição de agricultores e suas famílias em comparação com população não exposta aos agrotóxicos. MÉTODO: Estudo transversal, com 70 participantes (grupo pesquisa), com média de idade de 39,7 anos, de ambos os sexos, proprietários de pequenos estabelecimentos agrícolas vinculados a agricultura familiar e tempo de exposição médio aos agrotóxicos de 23,7 anos. Um grupo controle com 71 participantes de ambos os sexos, sem exposição a ruído e agentes químicos, com idade média de 39,5 anos, foi incluído para a comparação dos resultados. Na etapa 1, ambos os grupos foram submetidos a audiometria convencional e de altas frequências e imitanciometria. Na etapa 2, somente os normoouvintes foram submetidos as emissões otoacústicas evocadas e efeito de supressão das emissões otoacústicas transientes. RESULTADOS: Observou-se diferenças significativas entre os grupos para audiometria tonal convencional e de altas frequências, e no reflexo acústico. As frequências mais afetadas na audiometria tonal convencional foram 3 a 6kHz e na audiometria de altas frequências foram as frequências de 9.000 e 11.200 Hz. Nas emissões otoacusticas transientes, observou-se no efeito de supressão piores resultados no grupo de pesquisa. CONCLUSÃO: Conclui-se que houve diferenças na audição dos agricultores familiares em comparação com o grupo controle. Os limiares auditivos convencionais estão relacionados em função do grupo, idade e gênero. O trabalho na agricultura está associado com o comprometimento na região basal da cóclea, à ausência de reflexo acústico, à redução da relação sinal/ruído das emissões otoacústicas transientes e à disfunção do sistema auditivo eferente olivococlear.

Changes in cognitive performance after cochlear implantation in adults and older adults: a systematic review and meta-analysis.

OBJECTIVES: To conduct critical assessment of the literature on the effects of cochlear implantation on adults' cognitive abilities. DESIGN: PubMed, Scopus, Lilacs, Web of Science, Livivo, Cochrane, Embase, PsycInfo, and grey literature were searched. Eligibility criteria: age 18 or over with severe-to-profound bilateral hearing loss, cochlear implantation, cognitive test before and after implantation. Risk of bias was assessed using ROB, ROBINS-I and MASTARI tools. Meta-analysis was performed. STUDY SAMPLE: Out of 1830 studies, 16 met the inclusion criteria. RESULTS: On AlaCog test, significant improvement was found after implantation [MD = -46.64; CI95% = -69.96 to -23.33; I2 = 71%]. No significant differences were found on the Flanker, Recall, Trail A and n-back tests (p > 0.05). For MMSE, no significance was found [MD 0.63; CI 95% = -2.19 to 3.45; I2 = 88%]. On TMT, an overall significant effect with a 9-second decrease in processing speed post-implantation [MD = -9.43; CI95% = -15.42 to -3.44; I2 = 0%]. CONCLUSION: Cognitive improvements after cochlear implantation may depend on time and the cognitive task evaluated. Well-designed studies with longer follow-up are necessary to examine whether cochlear implantation has a positive influence on cognitive abilities. Development of cognitive assessment tools to hearing-impaired individuals is needed.

Communication during the COVID-19 pandemic: the hearing-impaired perspective.

OBJECTIVE: To understand the communicational and psychosocial effects of COVID-19 protective measures in real-life everyday communication settings. DESIGN: An online survey consisting of close-set and open-ended questions aimed to describe the communication difficulties experienced in different communication activities (in-person and telecommunication) during the COVID-19 pandemic. STUDY SAMPLE: 172 individuals with hearing loss and 130 who reported not having a hearing loss completed the study. They were recruited through social media, private audiology clinics, hospitals and monthly newsletters sent by the non-profit organisation "Audition Quebec." RESULTS: Face masks were the most problematic protective measure for communication in 75-90% of participants. For all in-person communication activities, participants with hearing loss reported significantly more impact on communication than participants with normal hearing. They also exhibited more activity limitations and negative emotions associated with communication difficulties. CONCLUSION: These results suggest that, in times of pandemic, individuals with hearing loss are more likely to exhibit communication breakdowns in their everyday activities. This may lead to social isolation and have a deleterious effect on their mental health. When interacting with individuals with hearing loss, communication strategies to optimise speech understanding should be used.

Effects of COVID-19 on auditory and vestibular function in an adult patient: a longitudinal case study / Efeitos da COVID-19 na função auditiva e vestibular em paciente adulta: um estudo de caso longitudinal

ABSTRACT COVID-19 is a viral infection that mainly affects the lower respiratory tract and with the affinity of the Spike protein to the Angiotensin 2 converter enzyme, inducing a prothrombotic state which may lead to compromising of the cardiovascular, central nervous, auditory, and vestibular systems. Viral infections knowingly affect vestibular and auditory systems. This study aimed to present the auditory and vestibular findings of a woman without otoneurological complaints, before the infection with SARS-CoV-2. This is a longitudinal case report, presenting the evolution of the otoneurological clinical picture accompanied by the results of a battery of tests. The results evidenced a unilateral, permanent, cochlear sensorineural hearing loss through altered otoacoustic emissions albeit with normal tonal thresholds, accompanied by peripheral vestibular hypofunction which worsened with time, without any other factor that could justify these findings. This study shows the importance of the complete protocol of tests performed over time for a better understanding of long-time implications of the SARS-CoV-2 infection.

RESUMO A COVID-19 é uma infecção viral que afeta, principalmente, a via respiratória inferior e, com a afinidade da proteína Spike com a Enzima Conversora de Angiotensina 2, gerando estado protrombótico, pode haver comprometimento dos sistemas cardiovasculares, nervoso central e renal. As infecções virais são capazes, também, de causar alterações nos sistemas auditivo e vestibular. O presente estudo teve por finalidade apresentar os achados auditivos e vestibulares de uma mulher sem queixas otoneurológicas, previamente à infecção pela SARS-CoV-2. Trata-se de um relato de caso longitudinal, com apresentação da evolução do quadro clínico otoneurológico acompanhado de uma bateria de exames. Os resultados evidenciaram o aparecimento de uma perda auditiva neurossensorial unilateral prevista por emissões otoacústicas alteradas na presença limiares tonais normais. Com a sequência de exames, observou-se piora dos limiares auditivos e alteração da função vestibular, de maneira permanente, sem qualquer outro histórico que pudesse justificar a instalação do quadro. Em quadros infecciosos faz-se importante a longitudinalidade de avaliação com uso de protocolo completo de exames para melhor compreensão dos efeitos tardios.

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

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

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

Achados audiológicos de agricultores familiares paranaenses expostos a agrotóxicos / Audiological findings of family farmers exposed to pesticides

RESUMO Objetivo Analisar as possíveis diferenças na audição de agricultores e suas famílias em comparação com população não exposta aos agrotóxicos. Método Estudo transversal, com 70 participantes (grupo pesquisa), com média de idade de 39,7 anos, de ambos os sexos, proprietários de pequenos estabelecimentos agrícolas vinculados a agricultura familiar e tempo de exposição médio aos agrotóxicos de 23,7 anos. Um grupo controle com 71 participantes de ambos os sexos, sem exposição a ruído e agentes químicos, com idade média de 39,5 anos, foi incluído para a comparação dos resultados. Na etapa 1, ambos os grupos foram submetidos a audiometria convencional e de altas frequências e imitanciometria. Na etapa 2, somente os normoouvintes foram submetidos as emissões otoacústicas evocadas e efeito de supressão das emissões otoacústicas transientes. Resultados Observou-se diferenças significativas entre os grupos para audiometria tonal convencional e de altas frequências, e no reflexo acústico. As frequências mais afetadas na audiometria tonal convencional foram 3 a 6kHz e na audiometria de altas frequências foram as frequências de 9.000 e 11.200 Hz. Nas emissões otoacusticas transientes, observou-se no efeito de supressão piores resultados no grupo de pesquisa. Conclusão Conclui-se que houve diferenças na audição dos agricultores familiares em comparação com o grupo controle. Os limiares auditivos convencionais estão relacionados em função do grupo, idade e gênero. O trabalho na agricultura está associado com o comprometimento na região basal da cóclea, à ausência de reflexo acústico, à redução da relação sinal/ruído das emissões otoacústicas transientes e à disfunção do sistema auditivo eferente olivococlear.

ABSTRACT Purpose To analyze the possible differences among the hearing of farmers and their families when compared to the population not exposed to pesticides. Methods Cross-sectional study with 70 smallholder family farmers (research group), with the mean age of 39.7 years, of both sexes and a mean of 23.7 years of exposure to pesticides. We included a control group with 71 participants of both sexes with the mean age of 39.5 years, not exposed to either noise or chemical substances, to compare the results. In stage 1, both groups were submitted to conventional and high-frequency audiometry, and acoustic immittance. In stage 2, only people with normal hearing were submitted to the evoked otoacoustic emissions and suppression effect on transient otoacoustic emissions. Results Significant differences were observed between the groups in the conventional pure-tone and in the high-frequency audiometry, as well as in the acoustic reflex. The most affected frequencies in the conventional pure-tone audiometry ranged from 3 to 6 kHz and, in the high-frequency audiometry, from 9000 to 11200 Hz. As for the transient otoacoustic emissions, the worse suppression effect results were found in the research group. Conclusion There were differences among the hearing of family farmers and the control group. The conventional auditory thresholds are related to the group, age and sex. Farming is associated with impairments in the basal region of the cochlea, absence of acoustic reflex, reduced signal-to-noise ratio of the transient otoacoustic emissions, and dysfunction in the olivocochlear efferents of the auditory system.

Hearing impairment among workers and satisfaction with the use of hearing aids.

BACKGROUND: Hearing problems can have adverse effects on an individual's job performance, as well as on unemployment or underemployment and increased risk of stress-related sick leave. OBJECTIVE: To investigate hearing impairment among workers and satisfaction with the use of hearing aids. METHODS: Cross-sectional study with workers who are hearing aid users. Subjects underwent pure tone audiometry and answered the Hearing Handicap Inventory for Adults and the Satisfaction with Amplification in Daily Life questionnaires. RESULTS: Participants were 36 workers between 36 and 75 years old, with an average age of 53.47 years, 52.7% male and 47.3% female. There was a mild to moderate hearing handicap perception, with worse results for women in the emotional domain. As hearing loss increased, workers' frustration increased when talking to coworkers. Everyone was satisfied with the use of their hearing aids. Satisfaction increased with increasing age and decreased with increasing hearing loss. The greater the frustration when talking to co-workers, the lower the overall satisfaction with hearing aid use; the lower the satisfaction with the competence of the professional who assisted in adapting the hearing aid; the lower the satisfaction in environments with background noise and overall worse personal image. The worse the attitudes and emotional responses of workers regarding their hearing impairment, the lower the overall satisfaction with the hearing aid. CONCLUSIONS: Despite the use of hearing aids, workers perceive having a hearing impairment, especially women. As hearing loss and frustration in talking with co-workers increased, satisfaction decreased.

Findings on the Central Auditory Functions of Endemic Disease Control Agents.

This study aimed to assess the central auditory functions of endemic disease control agents. This cross-sectional cohort study comprised two groups: the exposed group, with 38 male endemic disease control agents with simultaneous occupational noise and pesticide exposure; and the control group, with 18 age- and sex-matched workers without occupational noise and/or pesticide exposure. All participants underwent pure-tone audiometry, brainstem auditory evoked potentials, dichotic digits test, and transient-evoked otoacoustic emissions suppression effect. There was a significant inter-group difference in waves III and V absolute latencies, and interpeak I-III and I-V latencies bilaterally, with worse results found in the exposed group. Abnormal dichotic digits test results occurred more often in the exposed group, with a significant association between pesticide- and noise-exposure and the abnormal results (p = 0.0099). The transient-evoked otoacoustic emissions with suppression effect did not yield significant inter-group differences. It was concluded that pesticide and noise exposure induce harmful effects on the central auditory functions, particularly on the brainstem and figure-ground speech-sound auditory skills.

Communication With Older Adults in Times of a Pandemic: Practical Suggestions for the Health Care Professionals.

In order to limit the spread of the coronavirus, several protective measures have been put in place in the community, in private and public residences and in health care centers. Some measures have a negative impact on communication. They include physical distancing, the use of face masks and shields as well as the increased use of telephone and videoconferencing for distance communication. The effects of COVID-19 are particularly harsh on older adults. Consequently, older adults, especially those with hearing loss, are particularly at risk of experiencing communication breakdowns and increased social isolation. Health care professionals should learn about and be encouraged to use communication strategies to maintain good interactions with their patients. This article proposes practical suggestions to health professionals who interact with older adults, especially those who have difficulty understanding speech. The goal of this article is to inform on the prevalence of hearing loss, the hearing difficulties experienced by older adults, the manifestations of hearing problems, the effects of pandemic protection measures on communication and the strategies that can be used to optimize professional-patient communication during a pandemic.

Noise exposure and effects on hearing in Brazilian fishermen.

BACKGROUND: Several health conditions among professional fishermen have been reported. Among the risks to the health of fishermen, it should be noted that high noise levels cause hearing loss and general health problems. OBJECTIVE: to investigate the effects of exposure to occupational noise on hearing in professional fishermen at the main large-scale commercial fishing center in Brazil. METHODS: A cross-sectional study, 466 Brazilian commercial fishermen participated in the study, all males, ages range 18-67 years. A total of 15 vessels were included in the study. The first phase involved assessment of the sound pressure levels (SPLs) in the vessels, the second phase involved the use of a questionnaire and audiological assessment. RESULTS: Most compartments registered SPLs greater than 80 dBA and the noisiest compartment was the engine-room, where the vessel pilot works. Among the fishermen, tinnitus was the most commonly reported symptom (48.63%). A higher prevalence of hearing loss was observed in engine-room keepers. Longer the length of time in service, and consequently, exposure to noise (in years), were associated with higher auditory thresholds. CONCLUSION: the tolerance limits to noise exposure were exceeded according to legislation. Fishing activities are associated with noise-induced hearing loss, with the risk increasing with the length of service.

The use of the Dangerous Decibels® program for refrigeration company workers and their children: an intergenerational pilot study / Uso do programa Dangerous Decibels® para trabalhadores de empresa frigorífica e seus filhos: estudo piloto intergeracional

ABSTRACT Objective: to report the use of the Dangerous Decibels® program for workers of a refrigeration company and their children as an intervention strategy for hearing health. Methods: an intervention study conducted in the city of Chapecó, SC, Brazil. Eight workers from a refrigeration company and their children participated in the study. The strategies adopted were those proposed by the Dangerous Decibels® program. Results: the Dangerous Decibels® program strategies contributed to the reflection on noise and favored interaction among participants. Workers and their children mutually committed to protecting and preserving hearing by passing on the knowledge gained to other family members, friends, and co-workers. The three basic principles of the Dangerous Decibels® program adopted by the participants were: Move away from noise, turn down the volume and protect the ears. Conclusion: the Dangerous Decibels® program developed in an intergenerational context was well received and accepted by workers and their children. As an educational intervention strategy for hearing health, it proved to be viable, convenient and with adequate content to be used simultaneously in populations of different age groups.

RESUMO Objetivo: relatar o uso do programa Dangerous Decibels® para trabalhadores de uma empresa frigorífica e seus filhos como estratégia de intervenção em saúde auditiva. Métodos: o estudo caracteriza-se como um estudo de intervenção, realizado na cidade de Chapecó, no estado de Santa Catarina. Participaram do estudo, oito trabalhadores de uma empresa frigorífica e seus filhos. Foram utilizadas as estratégias propostas pelo Programa Dangerous Decibels®. Resultados: as estratégias do programa Dangerous Decibels®, contribuíram para a reflexão sobre o ruído e favoreceram a interação entre os participantes. Os trabalhadores e seus filhos assumiram o compromisso mútuo de proteger e preservar a audição, levando adiante o conhecimento adquirido para os demais familiares, amigos e colegas de trabalho. Os três princípios básicos do programa Dangerous Decibels®: afastar-se do ruído, abaixar o volume e proteger os ouvidos, foram adotados pelos participantes. Conclusão: o programa Dangerous Decibels® desenvolvido em um contexto intergeracional, foi bem recebido e aceito pelos trabalhadores e seus filhos. Como estratégia de intervenção educativa em saúde auditiva, ele mostrou-se viável, conveniente e com conteúdo adequado para ser usado simultaneamente em populações com faixas etárias diferentes.

Study on hearing loss and its relationship with work in pesticide-exposed tobacco growers / Estudo da perda auditiva e a sua relação com o trabalho em fumicultores expostos a agrotóxicos

ABSTRACT The Purpose of this case report is to present four cases of tobacco growers with hearing loss due to occupational exposure to pesticides. A qualitative case study comprising three cases of sensorineural hearing loss with causal nexus (Cases 1, 2 and 4), and one (Case 3) of sensorineural hearing loss compatible with ototoxicity by pesticides, with causal nexus mainly based on minor neuropsychiatric disorders. The sample was composed of rural workers with health problems, in working age, having started working early in life, exposed to various pesticides, including organophosphates. The auditory and neurovegetative symptoms reported were noise discomfort (n = 2), speech perception difficulty (n = 3), dizziness (n = 2), and imbalance (n = 2). The pure-tone audiometry revealed a sensorineural hearing loss in one or more high frequencies, and one of the cases presented alteration in the brainstem auditory evoked potentials. There is evidence, in this study, of an association between hearing loss and work in tobacco growers exposed to pesticides, with peripheral auditory damage in four cases, and central damage in one of them. Thus, the need for a complete audiological evaluation of pesticide-exposed populations is highlighted.

RESUMO O objetivo desse relato de casos clínicos é apresentar quatro casos de fumicultores com perda auditiva devida à exposição laboral a agrotóxicos. Trata-se de um estudo de caso qualitativo, incluindo 3 casos de perda auditiva sensório-neural com nexo causal (Casos 1, 2 e 4) e um caso (Caso 3) de perda auditiva sensório-neural compatível com ototoxidade por agrotóxicos, com nexo baseado, sobretudo, nos transtornos neuropsiquiátricos menores. A casuística foi constituída por trabalhadores rurais com problemas de saúde, em idade produtiva, com início de atividade laboral precoce, expostos a múltiplos agrotóxicos, incluindo os organofosforados. Os sintomas auditivos e neurovegetativos relatados foram: desconforto a sons (n=2), dificuldade de compreender a fala (n=3), tontura (n=2) e desequilíbrio (n=2). A audiometria tonal revelou perda auditiva sensório-neural em uma ou mais frequências altas e um dos casos apresentou alteração no Potencial Evocado Auditivo de Tronco Encefálico. Foi evidenciada associação entre perda auditiva e o trabalho nos fumicultores expostos a agrotóxicos, com danos auditivos periféricos nos quatro casos e dano central em um dos casos, demonstrando a necessidade da avaliação audiológica completa para populações expostas a agrotóxicos.

The Importance of Otoneurological Evaluation in Brazilian Workers Exposed to Pesticides: A Preliminary Study

Introduction: Agrochemicals, also known as pesticides, are widely used in agriculture and in public health. They are organic and inorganic chemical substances with a high level of toxicity not only for the environment, but also for human health. Objective: To verify findings on labyrinthine assessment in endemic disease control agents, and to recommend the inclusion of the vestibular exam in the set of tests for pesticide-exposed populations. Methods: Descriptive, prospective, cross-sectional study with a sample comprising 15 endemic disease control agents, males, mean age of 51.6 years old (standard deviation [SD] = 5.9). All of the participants were submitted to anamnesis, otorhinolaryngological screening, and vestibular assessment. Results: Regarding the most reported complaints, dizziness (73.4%), headache (60%), and tingling in the extremities (53.4%) were observed. The findings of the vestibular exams were normal in 53.3%, while 46.7% showed peripheral vestibular disorder, of which 26.7% were of deficitary type, and 20% of the irritative type. Conclusions: Alteration in the vestibular system was verified in 50% of the workers, with a greater prevalence in the caloric testing. Several disorders related to pesticides intoxication are scientifically known. Actions promoting knowledge and qualification of this population for the proper handling of chemicals are suggested, in addition to the elaboration and inclusion of protocols of vestibular assessment in hearing health programs for the prevention, diagnosis and treatment of vestibular disorders (AU)

The Importance of Otoneurological Evaluation in Brazilian Workers Exposed to Pesticides: A Preliminary Study.

Introduction Agrochemicals, also known as pesticides, are widely used in agriculture and in public health. They are organic and inorganic chemical substances with a high level of toxicity not only for the environment, but also for human health. Objective To verify findings on labyrinthine assessment in endemic disease control agents, and to recommend the inclusion of the vestibular exam in the set of tests for pesticide-exposed populations. Methods Descriptive, prospective, cross-sectional study with a sample comprising 15 endemic disease control agents, males, mean age of 51.6 years old (standard deviation [SD] = 5.9). All of the participants were submitted to anamnesis, otorhinolaryngological screening, and vestibular assessment. Results Regarding the most reported complaints, dizziness (73.4%), headache (60%), and tingling in the extremities (53.4%) were observed. The findings of the vestibular exams were normal in 53.3%, while 46.7% showed peripheral vestibular disorder, of which 26.7% were of deficitary type, and 20% of the irritative type. Conclusions: Alteration in the vestibular system was verified in 50% of the workers, with a greater prevalence in the caloric testing. Several disorders related to pesticides intoxication are scientifically known. Actions promoting knowledge and qualification of this population for the proper handling of chemicals are suggested, in addition to the elaboration and inclusion of protocols of vestibular assessment in hearing health programs for the prevention, diagnosis and treatment of vestibular disorders.

Perception of the Quality of Life of Tobacco Growers Exposed to Pesticides: Emphasis on Health, Hearing, and Working Conditions

Abstract Introduction Tobacco farming exposes workers to various health risks due to the high application of pesticides needed to control pests, weeds and fungal diseases that prevent the tobacco plant growth. Objective To analyze the perception of the quality of life of tobacco growers exposed to pesticides, with emphasis on general health, hearing, and working conditions. Method This is a descriptive, cross-sectional study using a quantitative approach with farmers from southern Brazil. Data were collected from November of 2012 to November of 2014. For data collection, we opted for the 36-item short form health survey (SF-36) questionnaire, and a questionnaire with closed questions about health, hearing and working conditions. We evaluated a total of 78 subjects; the study group, made up of 40 tobacco farmers exposed to pesticides, and a control group of 38 participants without occupational exposure to pesticides. Both groups are residents of the same municipality, and users of the federal public health system. Results The results showed that tobacco growers had lower quality of life scores compared with the control group. Significant differences were observed in the areas of pain and general health. There were correlations between physical elements and chronic diseases; hearing complaints and a lack of personal protective equipment use, occupation and hearing complaints, as well as general health and hearing complaints. Conclusion Tobacco farming is a risky activity for general and hearing health, and it can impact the quality of life of those working in this field. (AU)

Perception of the Quality of Life of Tobacco Growers Exposed to Pesticides: Emphasis on Health, Hearing, and Working Conditions.

Introduction Tobacco farming exposes workers to various health risks due to the high application of pesticides needed to control pests, weeds and fungal diseases that prevent the tobacco plant growth. Objective To analyze the perception of the quality of life of tobacco growers exposed to pesticides, with emphasis on general health, hearing, and working conditions. Method This is a descriptive, cross-sectional study using a quantitative approach with farmers from southern Brazil. Data were collected from November of 2012 to November of 2014. For data collection, we opted for the 36-item short form health survey (SF-36) questionnaire, and a questionnaire with closed questions about health, hearing and working conditions. We evaluated a total of 78 subjects; the study group, made up of 40 tobacco farmers exposed to pesticides, and a control group of 38 participants without occupational exposure to pesticides. Both groups are residents of the same municipality, and users of the federal public health system. Results The results showed that tobacco growers had lower quality of life scores compared with the control group. Significant differences were observed in the areas of pain and general health. There were correlations between physical elements and chronic diseases; hearing complaints and a lack of personal protective equipment use, occupation and hearing complaints, as well as general health and hearing complaints. Conclusion Tobacco farming is a risky activity for general and hearing health, and it can impact the quality of life of those working in this field.

Achados audiológicos em pacientes portadores de disfunção temporomandibular / Audiological findings in patients with temporomandibular dysfunction

RESUMO Objetivo Analisar os achados audiológicos em indivíduos com desordem temporomadibular e comparar esses achados com indivíduos sem desordem temporomanbibular. Métodos A amostra foi composta por 39 participantes adultos, de ambos os gêneros, com diagnóstico prévio de desordem temporomandibular (grupo de estudo) e 39 participantes adultos, sem desordem temporomandibular (grupo controle). Todos os participantes foram submetidos à audiometria tonal limiar em altas frequências, imitanciometria e pesquisa das emissões otoacústicas evocadas por produto de distorção. Resultados Observou-se prevalência de desordem temporomandibular no gênero feminino e a média de idade ficou acima da quarta década de vida. Na audiometria tonal limiar, foi observada ocorrência de perda auditiva do tipo neurossensorial e condutiva, no grupo de estudo, além de piores limiares auditivos em altas frequências. Em ambos os grupos, houve maior ocorrência de curva timpanométrica do tipo A, bem como diferenças entre os grupos na pesquisa do reflexo acústico ipsilateral e contralateral e no registro das emissões otoacústicas evocadas por produto de distorção. Conclusão Indivíduos com desordem temporomandibular apresentam piores resultados nos limiares auditivos, na timpanometria, nos reflexos acústicos ipsilaterais e contralaterais e nas emissões otoacústicas evocadas, quando comparados com o grupo controle.

ABSTRACT Purpose To analyze the audiological findings in individuals with temporomandibular disorder and compare these findings with individuals without temporomandibular disorder. Methods The sample was composed by 39 adult participants, both genders, with previous diagnosis of temporomandibular disorder (study group) and 39 adult participants, without temporomandibular disorder (control group). All the participants were submitted to audiometry including high frequencies, Immittance acoustic (Tympanometry and contralateral acoustic reflexes) and distortion product evoked otoacoustic emissions. Results The prevalence of temporomandibular disorder on female gender was observed, average age was over forty years old. In the audiometry, it was observed the incidence of hearing loss of a sensorineural and conductive type in the Study Group, besides worst hearing thresholds in high frequencies. In both groups, there was a bigger incidence of a type A tympanometric curve, as well as there were differences between the groups in the research of the ipsilateral and contralateral acoustic reflex and in the recording of distortion product evoked otoacoustic emissions. Conclusion It's possible to conclude that individuals with temporomandibular disorder show worst results in the hearing thresholds, in the tympanometry, in the ipsilateral and contralateral acoustic reflexes, in the evoked otoacoustic emissions, when compared to the control group.

Percepção de idosos sobre a restrição da participação relacionada à perda auditiva / Perception of elderly people about the restriction of participation related to hearing loss / Restrición de la participación en idosos relacionada a la pérdida auditiva

Introdução: Dentre as alterações fisiológicas do processo de envelhecimento humano, a perda auditiva relacionada à idade é uma das mais frequentes e incapacitantes, pois diminui o contato social do idoso, podendo afetar suas condições de saúde. Objetivo: Verificar a percepção de idosos sobre a restrição da participação relacionada à perda auditiva. Método: Estudo transversal e quantitativo com idosos maiores de 60 anos que têm perda auditiva, usuários ou não de aparelho de amplificação sonora. Analisou-se a audiometria tonal convencional e aplicou-se o questionário Hearing Handicap Inventory for the Elderly. Resultado: A amostra foi composta por 46 indivíduos, sendo 43,48% (n=20) do sexo feminino e 56,52% (n=26) do sexo masculino. A idade média foi 74,78 anos, com desvio padrão de 7,96 anos. A perda auditiva de maior ocorrência, em 73,91% (n=34) da amostra, foi do tipo neurossensorial bilateral e de configuração descendente, sendo que 50% (n=23) não usava aparelho de amplificação sonora individual, 45,65% (n=21) afirmou usá-lo e 4,35 (n=2) não respondeu essa questão. Quanto à participação, 82,6% dos idosos relatou restrições para participar de atividades sociais, sendo 50% da amostra (n=23) com percepção significativa. No geral, tal restrição foi maior no gênero masculino, na perda auditiva neurossensorial de grau moderado e configuração descendente, com idade até 79 anos e que não utilizavam o referido aparelho. Conclusão: Os idosos com perda auditiva apresentaram percepção significativa da restrição da participação, principalmente os que não utilizam aparelho de amplificação sonora individual, impactando negativamente sua qualidade de vida.

Introduction: Among the physiological alterations of the human aging process, age-related hearing loss is one of the most frequent and disabling, since it reduces the social contact of the elderly, and can generate impact on health conditions. Objective: to verify the perception of the elderly about the restriction of participation related to hearing loss. Method: A cross-sectional and quantitative study with elderly individuals over 60 years of age, all with hearing loss, users of hearing aids or not. The Hearing Handicap Inventory for the Elderly (HHIE) questionnaire was applied. Results: The sample consisted of 46 individuals, 43.48% (n = 20) of the female sex and 56.52% (n = 26) of the male sex. The average age was 74.78 years, with a standard deviation of 7.96 years. The most frequent hearing loss, in 73.91% (n = 34) of the sample, was bilateral sensorineural type with a descending configuration, with 50% (n = 23) not using hearing aids, 45.65% (n = 21) stated using it and 4.35% (n = 2) did not answer that question. The results showed that 82.6% of the elderly reported restrictions to participate in social activities, being 50% of the sample (n = 23) with significant perception. In general, such a restriction was higher in males, sensorineural hearing loss of moderate degree and descending configuration, ages up to 79 years, who did not use hearing aids, although the differences between the variables were not significant. Conclusion: Elderly people with hearing loss had a significant perception of the restriction of participation, especially among those who did not use PSAPI, which could negatively impact quality of life.

Introducción: Entre las alteraciones fisiológicas del proceso de envejecimiento humano, la pérdida auditiva relacionada a la edad es una de las más frecuentes e incapacitantes, pues disminuye la participación social del anciano, pudiendo generar impacto en las condiciones de salud. Objetivo: verificar la percepción de los ancianos, sobre la restricción de la participación relacionada a la pérdida auditiva. Método: Estudio transversal y cuantitativo con ancianos mayores de 60 años, con pérdida auditiva, usuarios o no de audífonos. Se analizó la audiometría tonal convencional y se aplicó el cuestionario Hearing Handicap Inventory for the Elderly. Resultado: La muestra fue compuesta por 46 individuos, siendo 43,48% (n = 20) del sexo femenino y 56,52% (n = 26) del sexo masculino. La edad media fue 74,78 años, con desviación estándar de 7,96 años. La pérdida auditiva de mayor ocurrencia, el 73,91% (n = 34) de la muestra, fue del tipo neurosensorial bilateral y de configuración descendente, siendo que el 50% (n = 23) no usaba audífonos, 45,65 % (n = 21) afirmó usarlo y 4,35 (n = 2) no respondió esta cuestión. Los resultados mostraron que el 82,6% de los ancianos relató restricciones para participar en actividades sociales, siendo el 50% de la muestra (n = 23) con percepción significativa. En general, tal restricción fue mayor en el género masculino, en la pérdida auditiva neurosensorial, de grado moderado y configuración descendente, con edad de hasta 79 años y que no utilizaban audífonos, aunque las diferencias entre las variables no fueron significativas. Conclusión: Los ancianos con pérdida auditiva presentaron percepción significativa de la restricción de la participación, principalmente aquellos que no utilizan audífonos, pudiendo así impactar negativamente en la calidad de vida.