Enfrentamento da subnotificação da perda auditiva induzida por ruído relacionada ao trabalho: a experiência de uma oficina educativa em planejamento e programação local em saúde do trabalhador / Addressing underreported occupational noise-induced hearing loss: the experience of an educational workshop on local occupational health planning and program

Resumo Introdução: a subnotificação da Perda Auditiva Induzida por Ruído (Pair) relacionada ao trabalho é um problema que contribui para a invisibilidade e falta de prioridade deste agravo nos programas de Saúde do Trabalhador (ST). Logo, ações de educação permanente voltadas ao planejamento estratégico-situacional podem contribuir para o enfrentamento desta realidade. Objetivo: apresentar e discutir a experiência de uma intervenção educativa com técnicos da ST de uma macrorregião de saúde do estado da Bahia, Brasil, sobre o uso do Planejamento e Programação Local em Saúde (PPLS) como ferramenta para ampliação da notificação da Pair relacionada ao trabalho Métodos: a intervenção consistiu em uma oficina estruturada em cinco etapas, as quais proporcionaram discussão sobre a Pair, conhecimento do PPLS, prática do PPLS, socialização dos resultados e avaliação do evento. Resultados: a prática do PPLS, a partir de um problema real, viabilizou o delineamento de ações concretas de enfrentamento da subnotificação da Pair a serem implementadas nos Centros de Referência em Saúde do Trabalhador (Cerest) e no estado como um todo. Conclusão: a experiência mostrou-se bem-sucedida ao fomentar a tomada de consciência e mobilização dos técnicos para enfrentamento da subnotificação da Pair, ao tempo que propiciou qualificação em PPLS dos participantes.

Abstract Introduction: underreported occupational noise-induced hearing loss (ONIHL) is an issue that increases the invisibility and lack of priority of this condition in occupational health (OH) programs. Hence, permanent education actions focused on strategic-situational planning may help address the situation. Objective: to present and discuss the experience of an educational intervention in OH technicians of a larger health region in the state of Bahia, Brazil, approaching the use of the Local Health Planning and Program (PPLS, in Portuguese) as a toll to increase reports of ONIHL. Methods: the intervention had a workshop structured into five stages, which approached ONIHL discussions, PPLS knowledge, PPLS practice, result socialization, and event evaluation. Results: real-problem PPLS practice made it possible to outline concrete actions to address underreported ONIHL, which can be implemented in Occupational Health Reference Centers (Cerest) and other settings statewide. Conclusion: the experience proved to be positive, raising technicians' awareness of underreported ONIHL and mobilizing them to address the underreporting of ONIHL, while also effectively training participants to use PPLS.

Comparative transcriptome profiling reveals RNA splicing alterations and biological function in patients exposed to occupational noise.

Genetic factors play an important role in susceptibility to noise-induced hearing loss (NIHL). Alternative splicing (AS) is an essential mechanism affecting gene expression associated with disease pathogenesis at the post-transcriptional level, but has rarely been studied in NIHL. To explore the role of AS in the development of NIHL, we performed a comprehensive analysis of RNA splicing alterations by comparing the RNA-seq data from blood samples from NIHL patients and subjects with normal hearing who were exposed to the same noise environment. A total of 356 differentially expressed genes, including 23 transcription factors, were identified between the two groups. Of particular note was the identification of 56 aberrant alternative splicing events generated by 41 differentially expressed genes between the two groups, with exon skipping events accounting for 54% of all the differentially alternative splicing (DAS) events. The results of functional enrichment analysis showed that these intersecting DAS genes and differentially expressed genes were significantly enriched in autophagy and mitochondria-related pathways. Together, our findings provide insights into the role of AS events in susceptibility and pathogenesis of NIHL.

Impact of a hearing conservation programs on occupational noise-induced hearing loss

ABSTRACT Purpose: to analyze the impact of a Hearing Conservation Program on occupational noise-induced hearing loss in a metallurgical plant. Methods: a longitudinal case study (2003-2018) was carried out and a Hearing Conservation Program assessed with interviews and document verification. The assessment also included 2,350 audiometric examinations and occupational noise exposure of 152 Hearing Conservation Program - participating employees, collecting the data from the company's database. Results: high compliance indices regarding occupational noise -induced hearing loss - prevention Hearing Conservation Program practices were found between 2003 and 2018. The comparison between 2018 and 2003 showed a reduced number of workers exposed to noise at 85 dB(A) or above. The final prevalence of audiometric changes suggestive of occupational noise-induced hearing loss that remained in degree I differed from the initial one in the period. The high Hearing Conservation Program percentages and low occupational noise-induced hearing loss indicators point to an inverse relationship between them. Conclusion: the results suggest a positive impact of a Hearing Conservation Program on occupational noise-induced hearing loss in this metallurgical plant, in the period studied.

[Research progress on antioxidant therapy and prevention in noise- induced hearing loss].

Noise- induced hearing loss usually refers to auditory impairment which is caused by long-term exposure to noise. The occupational noise problem is serious and urgently needs to be addressed, along with the lack of effective treatments. Recent studies have shown that the imbalance between oxidation and antioxidation is the source of the disease. To correct the redox reaction imbalance and to maintain an equilibrium of the redox reaction have always been the research focus of the prevention and treatment in noise induced hearing loss. This article reviews antioxidant therapy and prevention in noise induced hearing loss, including antioxidants, antioxidant enzymes and herbal medicine.

Chilean dentists' knowledge of hearing loss generated by occupational noise exposure / Conocimiento de odontólogos chilenos sobre la pérdida auditiva generada por exposición ocupacional al ruido

Abstract Introduction: Dentists are a population at high risk of hearing loss due to their constant exposure to instruments that can generate noise of up to 100 dB during their practice. Objective: To determine the level of knowledge of dentists working in Chile regarding hearing loss caused by exposure to noise generated by dental instruments. Materials and methods: A cross-sectional study was conducted in 114 dentists, who completed a virtual survey of 22 questions regarding the perception and level of knowledge about hearing loss due to exposure to loud noises and about national regulations on occupational noise exposure. Differences between perception and knowledge levels were evaluated taking into account the years of professional practice and the average weekly workload in dental treatment rooms. Descriptive and inferential statistics (Chi-squared test) were used for data analysis. Results: Most participants were Chilean (99.1%); 58.8% were women, and 72.8% had less than 10 years of professional experience. In addition, 97.4% were unaware of national regulations on occupational noise exposure and 50% of the sample reported having experienced hearing loss; of these, 57.9% (n = 32) associated it with their practice. Conclusions: A very low percentage of participants knew that there are regulations regarding occupational noise exposure. For this reason, it is important that, both during their training and their professional practice, dentists in Chile have greater access to information about these regulations and hearing protection measures.

Resumen Introducción. Los odontólogos son una población con un alto riesgo de desarrollar pérdida auditiva debido a la constante exposición a instrumentales que deben usar en su práctica profesional y que pueden generar ruidos de hasta 100 dB. Objetivo. Determinar el nivel de conocimiento de odontólogos laboralmente activos en Chile respecto a la pérdida auditiva causada por la exposición al ruido generado por maquinarias dentales. Materiales y métodos. Estudio transversal realizado en 114 odontólogos, quienes diligenciaron una encuesta virtual de 22 preguntas relativas a la percepción y el nivel de conocimiento sobre pérdida auditiva por exposición a ruidos fuertes y sobre la normativa nacional respecto a exposición ocupacional al ruido. Se evaluaron las diferencias entre percepción y niveles de conocimiento según los años de ejercicio profesional y la carga promedio de trabajo semanal en boxes de atención. Para el análisis de los datos se utilizó estadística descriptiva e inferencial (prueba de chi-cuadrado). Resultados. La mayoría de participantes eran chilenos (99.1%); el 58.8% fueron mujeres, y el 72.8% tenía menos de 10 años de ejercicio profesional. Además, el 97.4% desconocía las regulaciones nacionales sobre exposición ocupacional al ruido y el 50% reportó haber experimentado pérdida auditiva; de estos, 57.9% (n=32) lo asoció a su profesión. Conclusiones. Un muy bajo porcentaje de los participantes sabe que hay disposiciones sobre exposición ocupacional al ruido, por lo que es importante que, tanto en su formación, como durante su ejercicio profesional, los odontólogos en Chile tengan un mayor acceso a información relativa a estas normativas y a medidas ocupacionales de protección auditiva.

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

Objective: To investigate factors associated with the notification of noise-induced hearing loss (NIHL) in Brazil's Notifiable Diseases Information System. Methods: Ecological study to estimate the proportion of municipalities that notified NIHL. Logistic regression models were conducted to identify associated factors. Results: Between 2013-2015, 277 (5.0%) municipalities notified NIHL. This notification was more common among municipalities with coverage by a Worker Health Referral Centre (CEREST) (OR=1.62 ­ 95%CI 1.02;2.59) or that hosted a CEREST in their territory (OR=4.37 ­ 95CI% 2.75;6.93), within a shorter distance to the state capital (OR=1.43 ­ 95%IC 1.06;1.92) and having a high human development index (OR=2.35 ­ 95%CI 1.16;4.75). Among the municipalities located in a Cerest coverage area, notification was more common when there was a Speech-Language-Hearing professional in the team (OR=1.96 ­ 95%CI ­ 1.47;2.63) and a low turnover of professionals (OR=1.88 ­ 95%CI 1.40;2.52). Conclusion: Contextual factors influence NIHL notification, particularly the existence and qualification of CEREST. 

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

Revisão sistemática de intervenções para prevenção da perda auditiva induzida por ruído ocupacional - uma atualização / Systematic Review of Interventions to Prevent Occupational Noise-Induced Hearing Loss - A Follow-up

Resumo Objetivo realizar uma revisão sistemática sobre a efetividade de intervenções para prevenção da perda auditiva induzida por ruído ocupacional, atualizando os achados da mais recente versão da revisão sistemática Cochrane do mesmo tema. Estratégia de pesquisa As buscas ocorreram nas bases PubMed, Web of Science e Scopus. Critérios de seleção Como intervenções, foram considerados: controles de engenharia/administrativos; dispositivos de proteção auditiva (DPA); vigilância auditiva e monitoramento audiológico. Análise dos dados Para a análise de risco de viés, cada estudo foi avaliado de acordo com a adoção de randomização, alocação, cegamento, desfecho, outras fontes de viés. Resultados Foram obtidas 475 referências no total. Destas, 17 estudos cumpriram os critérios de inclusão: um randomizado, um de série temporal interrompida e 15 de antes e depois. A maioria dos estudos foi realizada em indústrias; três em ambiente militar e/ou de treinamento de tiro; um em orquestra e outro em construção civil. A maioria dos estudos mostrou alto risco de viés. Seis estudos verificaram redução da exposição ao ruído a curto prazo por meio de controles de engenharia/administrativos; um verificou impacto positivo decorrente de mudança na legislação; cinco verificaram efeitos positivos dos DPA na diminuição da exposição ao ruído e dos treinamentos educacionais no uso do DPA; e dois encontraram redução dos níveis de ruído e aumento no uso do DPA decorrentes da implementação de programas de conservação auditiva. Conclusão Todos os estudos analisados concluíram que as intervenções utilizadas resultaram em efeitos positivos sobre a audição e/ou sobre a exposição ao ruído. Em relação aos efeitos de longo termo, a grande maioria dos estudos limitou-se a avaliar efeitos imediatos ou de curto termo, reforçando que estudos incluindo follow-up de longo termo devem ser desenvolvidos.

Abstract Purpose To conduct a systematic review of the effectiveness of interventions to prevent occupational hearing loss, following up on the findings of the most recent version of Cochrane systematic review on the same topic. Research strategy Searches were carried out in PubMed, Web of Science and Scopus databases. Selection criteria The following interventions were considered: engineering/administrative controls; hearing protection devices (HPD); and audiological monitoring. Data analysis For bias risk analysis, each study was assessed according to randomization, allocation, blinding, outcomes, other sources of bias. Results 475 references were obtained. Of these, 17 studies met the inclusion criteria: one randomized, one interrupted time series, and 15 before and after studies. Most studies were conducted in industries; three in military and/or shooting training environments; one in an orchestra, and one in construction. Most studies showed a high risk of bias. Six studies found a reduction in short-term exposure to noise through engineering/administrative controls; one found a positive impact due to changes in legislation; five studies have found positive effects of HPD in reducing exposure to noise and of educational trainings in the use of HPD; lastly, two studies found a reduction in noise levels and an increase in the using of HPD due to the implementation of hearing conservation programs. Conclusão Todos os estudos analisados concluíram que as intervenções utilizadas resultaram em efeitos positivos sobre a audição e/ou sobre a exposição ao ruído. Em relação aos efeitos de longo termo, a grande maioria dos estudos limitou-se a avaliar efeitos imediatos ou de curto termo, reforçando que estudos incluindo follow-up de longo termo devem ser desenvolvidos.

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

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

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

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

Fatores de risco para perda auditiva em militares da Marinha: uma revisão / Risk factors for hearing loss in naval military personnel: a review

Resumo Introdução: militares estão expostos ao ruído em grande parte de suas atividades profissionais. Objetivo: identificar os fatores de risco e descrever os danos à audição relacionados à exposição ao ruído em atividades militares navais. Métodos: revisão de literatura nas bases bibliográficas Scopus, Web of Science e SciELO. Buscou-se artigos originais publicados de 2007 a 2017. A qualidade metodológica dos estudos foi classificada segundo critérios da Cochrane Collaboration. Resultados: de 47 estudos encontrados, sete atenderam aos critérios de inclusão. Os artigos selecionados evidenciaram que as atividades militares apresentam riscos para a saúde auditiva do pessoal militar naval. Os estudos confirmaram que os casos de perda auditiva aumentam com o tempo de serviço em atividade militar e pós-atividades operativas, tanto de combate quanto a bordo de navios. A prevalência de perda auditiva aumenta junto à idade e ao tempo de exposição dos indivíduos e se apresenta de acordo com o tipo de ruído. É mais frequente entre homens brancos e atinge predominantemente as altas frequências da audição, sendo de tipo sensório-neural. Conclusão: a vulnerabilidade desse grupo reforça a necessidade de inserção de programa de conservação auditiva nas organizações militares a fim de monitorar e desenvolver ações preventivas voltadas a essa categoria profissional.

Abstract Introduction: military personnel are exposed to noise in most of their professional activities. Objective: to identify risk factors and describe hearing damage related to noise exposure in naval military activities. Methods: literature review in Scopus, Web of Science and SciELO bibliographic bases. We searched original articles published from 2007 to 2017. The studies were classified according to the methodological quality Cochrane Collaboration criteria. Results: out of 47 studies, seven met the inclusion criteria. The selected articles showed that the naval military personnel's hearing health can be affected by military activities. The studies confirmed that hearing loss cases increase according to the length of time spent in military and post-operative activities, both in combat and on board of ships. The hearing loss prevalence increases with age and time of exposure, and is featured according to the type of noise. It is more frequent among white men and reaches predominantly the hearing high frequencies, being of sensorial-neural type. Conclusion: the vulnerability of this group reinforces the need for implementing hearing conservation programs within military organizations in order to monitor and develop preventive actions aimed at this professional category.

Intensidade de ruídos e conscientização da equipe de enfermagem no centro de materiais e esterilização / Noise intensity and raising awareness of the nursing team at the Materials and Sterilization Center / Intensidad de ruido y conciencia del personal de enfermería del Centro de Materiales y Esterilización

Objetivo: Identificar a intensidade sonora, por meio de decibéis (dB), no Centro de Material e Esterilização (CME) e orientar os colaboradores quanto à importância dos protetores auriculares como equipamento de proteção individual (EPI). Método: Trata-se de um estudo descritivo, do tipo relato de experiência. Utilizou-se o aplicativo Sound Meter para medir a intensidade de ruído no CME. A pesquisa foi realizada em hospital de grande porte de São Paulo, no período de uma semana, em 2018. Resultados: Os ruídos mais intensos foram mensurados no expurgo (93,0 dB), na área de preparo (92,3 dB), nas áreas de esterilização a baixa temperatura (91,6 dB) e a vapor (87,9 dB), diferentemente da percepção dos colaboradores. A conscientização da equipe deu-se por exposição dos resultados mensurados e discussão sobre importância do EPI. Conclusão: Verificaram-se ruídos mais intensos nas áreas de trabalho com maior número de maquinários, e houve divergência entre a intensidade do ruído mensurado e o percebido pelo profissional. Medidas educativas reflexivas são necessárias para a conscientização sobre a importância e adesão ao uso do EPI.

Objective: To identify the sound intensity, through decibels (dB), in the Materials and Sterilization Center (MSC) and to guide employees on the importance of ear protectors as personal protective equipment (PPE). Method: This is a descriptive and case report study. Sound Meter application was used to measure noise intensity in the MSC. Research was carried out in a large hospital in São Paulo City, for one week, in 2018. Results: The most intense noises were measured in the purge (93.0 dB), in the preparation area (92.3 dB), in sterilization areas at low temperature (91.6 dB), and steam sterilization (87.9 dB) different from the perception of collaborators. The team's awareness was based on the exposure of the measured results and discussion about the importance of PPE. Conclusion: There were more intense noises in the work areas with a higher number of machinery, and there was a divergence between the intensity of noise measured and that perceived by the professional. Reflective educational measures are needed to raise awareness about the importance of adhering to PPE.

Objetivo: Identificar la intensidad sonora, mediante decibeles (dB), en el Centro de Material y Esterilización (CME) y orientar a los empleados sobre la importancia de los protectores auditivos como equipo de protección personal (EPP). Método: Se trata de un estudio descriptivo, del tipo informe de caso, La aplicación Sound Meter fue utilizada para medir la intensidad del ruido en el CME. La investigación se llevó a cabo en un gran hospital de São Paulo, durante una semana, en 2018. Resultados: Los ruidos más fuertes se midieron en la purga (93,0 dB), em el área de preparación (92,3 dB), en las áreas de esterilización a baja temperatura (91,6 dB) y vapor (87,9 dB), diferente a la percepción de los empleados. El equipo tomó conciencia al exponer los resultados medidos y discutir la importancia del EPI. Conclusión: Hubo ruido más intenso en las áreas de trabajo con mayor número de máquinas y hubo divergencia entre la intensidad del ruido medido y el percibido por el profesional. Las medidas educativas reflexivas son necesarias para sensibilizar sobre la importancia y adherencia al uso del EPI.

Acoustic shock: an update review.

BACKGROUND: This paper discusses the concept of acoustic shock based on a literature review and the results of our own research into cases seen in both clinical and medicolegal practice. With the demise of traditional 'metal bashing' and 'smoke stack' heavy industries, there has been a decline in the incidence of noise-induced hearing loss and tinnitus in this form of employment. However, with the increasing establishment of call centre work, the emergence of acoustic shock has been noted. Acoustic shock is recognised as a clinical entity distinct from noise-induced hearing loss and acoustic trauma. OBJECTIVE: This article discusses clinical implications, medicolegal considerations in light of a recent high-profile court case and proposed criteria for diagnosis.

[Noise-induced blood-labyrinth-barrier trauma of guinea pig and the protective effect of matrix metalloproteinase inhibitors].

Objective: The research is to study the expression and distribution of matrix metalloproteinase (MMPs)-2 and -9 in the guinea pig cochlea after noise exposure, and to explore the role of MMPs in the blood-labyrinth-barrier (BLB). In addition, the role of MMPs inhibitor doxycycline in noise-induced BLB trauma was studied as well, which provides the basis for further studies and prophylaxis of noise-induced hearing loss. Methods: A total of 45 healthy adult guinea pigs were randomly divided into the control group (15 received intraperitoneal injection of 0.9% saline for 4 consecutive days), the noise-exposure group (15 exposed by 120 dB SPL white noise for 4 h per day for continuous 2 d, intraperitoneal injection of normal saline for 4 consecutive days) and the noise-exposure + doxycycline group (15 exposed by 120 dB SPL white noise exposure for 4 h per day for 2 consecutive days, and intraperitoneal injection of doxycycline 50 mg/kg/d for 4 consecutive days), respectively. Immunofluorescence staining, western blot, and real-time quantitative PCR were used to analyze the distribution and differential expression of MMP-2 and -9 in the stria vascularis of guinea pigs in comparison with the normal control group, noise only group, and noise & doxycycline treatment group. Immunofluorescence staining was used to observe the changes in tight junction (TJ) protein ZO-1 in stria vascularis in three groups and to investigate the effect of acoustic injury on TJs. And ABR tests were utilized to detect the hearing function of guinea pigs in the three groups. Intravenous Evans blue was administrated intravenously as an indicator of vascular leakage among three groups to study the changes in BLB permeability in context of acoustic injury. SPSS 22.0 was used for statistical analysis. Results: There was no significant difference in hearing function between the noise-exposure group and the noise & doxycycline group two hours after noise exposure. After seven, 14 and 28 days noise exposure, the hearing recovery of the noise & doxycycline treatment group was significantly greater than that of the noise-exposure group (P<0.05) . Immunofluorescence staining showed that there was only a small amount of MMP-2 and -9 in the stria vascular in the normal control group, and ZO-1 showed dense linear expression. While, in the noise-explore group, MMP-2 and -9 in the stria vascular was significantly elevated (P<0.05), and the configuration of ZO-1 became loose and discontinuous. However, the MMP-2 and -9 in the noise & doxycycline treatment group were not significantly different from the normal control group (P>0.05), which were significantly less than that in the noise-exposure group, and just a little break of ZO-1 was observed, however, the overall structure remained dense. The leakage of Evans blue from stria vascular capillary in the noise-exposure group was significantly increased, and the difference between the other two groups did not show any statistical significance (P>0.05). Conclusions: The damage of tight junction structure induced by MMP-2 and -9 may play an important role in BLB destruction. In addition, doxycycline can inhibit MMPs secretion, thereby, to some extent, protecting the integrity of BLB from acoustic injury, and contributing to the long-term hearing recovery.

Comparison of oral steroid regimens for acute acoustic trauma caused by gunshot noise exposure.

BACKGROUND: There are no definite guidelines regarding the most adequate steroid regimens for acute acoustic trauma. OBJECTIVE: To elucidate the dose-dependent differing benefits of oral steroids on hearing improvement following acute acoustic trauma. METHODS: Twenty-nine patients treated with oral steroids following a diagnosis of unilateral acute acoustic trauma were retrospectively reviewed. Patients were sorted into two groups with an oral steroid regimen. Group 1 received a 14-day course of treatment: 60 mg prednisolone daily for 10 days, tapering off over days 11-14. Group 2 received prednisolone for a total of 10 days: 60 mg for 5 days, tapering down each day for the remainder. Multivariable linear regression analysis was performed to evaluate the factors associated with the hearing gain. RESULTS: In the multivariable regression (R2 = 0.51, p < 0.001), patients in group 1 showed more significant improvement in the degree of hearing gain compared to group 2 (p = 0.03). CONCLUSION: After comparing the differing benefits of oral steroids on hearing improvement by dosage, we recommend a high dose of prednisolone (60 mg per day) for 10 days, tapering over the remaining 4 days, for better hearing recovery following acute acoustic trauma.

Cochlear Damage Caused by the Striking Noise of Titanium Head Golf Driver.

OBJECTIVES: To investigate how mouse cochleae are affected by the striking noise of titanium head golf driver. METHODS: Thirty-two BALB/c mice (20-22 g) with normal hearing were used. The impact acoustic stimulus generated by the striking of titanium golf driver head was centered around 4.5 kHz with 120.5 dB sound pressure level. The recorded impact noise was provided to mice in two ways with the same exposure time of 288 seconds: 1,440 repetitions and an impact duration of 0.2 seconds for 2 hours (repetitive noise) or serially connected impact noise for 288 seconds (continuous noise). Auditory brainstem responses were measured at baseline, day 7, and day 14 after exposure. The mice were then sacrificed for histology. RESULTS: Both groups showed statistically significant threshold shifts immediately after noise exposure. Mice in the continuous exposure group, except for those exposed to 32 kHz noise, recovered from threshold shifts 1-2 weeks after noise exposure. However, in the repetitive exposure group, threshold shifts remained for 2 weeks after exposure. The repetitive exposure group had greater hair cell damage than did the continuous exposure group. Structural changes in the stria vascularis were observed in the repetitive exposure group. CONCLUSION: Overexposure to impact noise caused by hitting of titanium head golf driver may be hazardous to the cochlea, and repetitive exposure may induce greater damage than continuous exposure.

The effect of earplug training on noise protection.

BACKGROUND: Noise-induced hearing loss is an occupational disease, and workplace noise exposure is a major hazard in Korea. Although hearing protectors effectively reduce a worker's exposure to noise, their success is compromised by the wearer's inability to fit the protectors correctly, and there are no proper training methods for using hearing protectors in small-scale industries. This study aims to evaluate the effect of earplug training on hearing protection using field microphone-in-real-ear (F-MIRE) and prevent noise-induced hearing loss. METHODS: The study population comprised 172 noise-exposed manufacturing workers who visited occupational health facilities in Daegu, South Korea, between July 2014 and September 2017. Personal attenuation ratings (PARs) were calculated with F-MIRE. Paired t-tests were used to compare the differences in PAR (dB) before and after training, and generalized estimating equations (GEEs) were used to compare the differences in PAR according to the number of trainings. RESULTS: Mean PARs increased after the first and second training, and the differences were statistically significant. Among the 30 participants who received all 4 trainings, PARs were significantly higher after each training than before the training. As the number of training increased, the differences in PARs significantly increased. When comparing pretraining PARs for each training session, we found statistically significant differences between the first and second training and between the second and third training, but not between the third and fourth training. CONCLUSION: In this study, the short- and long-term effects of earplug training were statistically significant. In particular, the PAR before and after the fourth training showed the greatest increase, and the PARs continued to increase during each training.

[Correlation between FOXO3 gene polymorphisms and susceptibility to occupational noise-induced deafness].

Objective: To investigate the association between the single nucleotide polymorphisms of rs12212067 in FOXO3 gene and the susceptibility to occupational noise-induced deafness in a Chinese Han population. Methods: A total of 1 066 cases of noise exposure workers from a large chemical fiber factory in Jiangsu Province were selected as the study subjects. All subjects' basic data and field exposure data were collected through questionnaires and occupational health surveys. The subjects were divided into case group (531 persons, double ear high frequency average hearing threshold>25 dB) and control group (535 persons, double ear high frequency average hearing threshold≤25 dB) according to their results of pure tone hearing test .2ml fasting venous blood was collected for DNA extraction and genotyping was performed by TaqMan-PCR technique. Results: Genotyping results suggested that the GT+GG genotype is a risk factor for occupational noise-induced deafness, with an adjusted OR 95% confidence interval of 2.044 (1.51-2.78) . After the noise exposure intensity was stratified, the adjusted OR values and the 95% confidence intervals of noise intensity ≤85, 85-92 and>92 dB respectively 2.43 (1.52-3.90) , 2.17 (1.03-4.59) and 1.74 (1.07-2.83) . Conclusion: GT-GG genotype in rs12212067 of FOXO3 gene may be a risk factor for occupational noise-induced deafness.

Perfil audiométrico de músicos profissionais: revisão sistemática / Audiometric profile of professional musicians: systematic review / Perfil audiometrico de músicos profesionales: revisión integrativa

Objetivo: Conhecer o perfil audiológico de músicos com dedicação profissional. Métodos: Conduziu-se uma revisão sistemática da literatura nas bases eletrônicas Periódicos CAPES e Biblioteca Virtual em Saúde (BVS) utilizando os descritores "música", "perda auditiva induzida pelo ruído", "zumbido" e "audiometria". Na base PubMed, utilizaram-se os termos MESH: "music", "audiometry" e "hearing loss", utilizando os operadores booleanos "e" e "and". Incluíram-se estudos observacionais, em inglês, espanhol e português, que avaliaram a ocorrência e os fatores relacionados à perda auditiva em músicos profissionais, datados de 2006 a 2016. A seleção dos artigos aconteceu por pares. Resultados: A estratégia de busca resultou em 819 estudos, dos quais apenas 13 preencheram os critérios de elegibilidade. Dos músicos avaliados pelos treze estudos incluídos, 31,24% apresentaram perda auditiva induzida pelo ruído. Conclusão: Por meio dessa revisão foi possível identificar que os achados da literatura são consensuais quanto à detecção de que músicos apresentam perda auditiva induzida por ruído, sendo o zumbido o sintoma auditivo mais frequente, o que é indicativo que existe alteração na audição desses profissionais.

Objective: To know professional musicians' audiometric profile. Methods: A systematic review of the literature was carried out in the online databases of CAPES Journals and Virtual Health Library (VHL) using the descriptors "music", "noise-induced hearing loss", "tinnitus" and "audiometry". In the PubMed database, we used the MESH headings: "music", "audiometry" and "hearing loss", using Boolean term "and". We included observational studies in English, Spanish and Portuguese that assessed the occurrence and factors related to hearing loss in professional musicians dating from 2006 to 2016. The articles were peer-selcted. Results: The searching strategy resulted in 819 studies, of which only 13 met the eligibility criteria. Of all the musicians analyzed by the thirteen studies included in this review, 31,24% presented noise-induced hearing loss. Conclusion: The present review verified a consensus among the findings of the studies analyzed regarding the fact that musicians present noise-induced hearing loss, with tinnitus being the most frequent symptom, which indicates the existence of hearing alterations among these professionals.

Objetivo: Conocer el perfil audiológico de músicos con dedicación profesional. Métodos: Se realizó una revisión sistemática de la literatura en las bases de datos electrónicas Periódicos CAPES y Biblioteca Virtual en Salud (BVS) utilizando los descriptores "música", "pérdida auditiva provocada por el ruido", "zumbido" y "audiometría". En la base PubMed se utilizaron los términos MESH: "music", "audiometry" y "hearing loss" con los operadores booleanos "e" y "and". Se incluyeron los estudios observacionales, en inglés, español y portugués que evaluaron la ocurrencia y los factores relacionados con la pérdida auditiva de músicos profesionales entre 2006 y 2016. La selección de los artículos se dio por pares. Resultados: La estrategia de búsqueda resultó en 819 estudios de los cuales solamente 13 cumplieron los criterios de elegibilidad. De entre los músicos evaluados en los trece estudios incluidos, el 31,24% presentaron pérdida auditiva provocada por el ruido. Conclusión: A partir de esa revisión ha sido posible identificar que los hallazgos de la literatura presentan un consenso respecto la detección de que los músicos presentan pérdida auditiva provocada por el ruido siendo el zumbido el síntoma auditivo más frecuente lo que es una indicación de que hay alteración de la audición de estos profesionales.

Correlation between FOXO3 gene polymorphisms and susceptibility to occupational noise-induced deafness / 中华劳动卫生职业病杂志

Objective@#To investigate the association between the single nucleotide polymorphisms of rs12212067 in FOXO3 gene and the susceptibility to occupational noise-induced deafness in a Chinese Han population.@*Methods@#A total of 1 066 cases of noise exposure workers from a large chemical fiber factory in Jiangsu Province were selected as the study subjects. All subjects’ basic data and field exposure data were collected through questionnaires and occupational health surveys. The subjects were divided into case group (531 persons, double ear high frequency average hearing threshold>25 dB) and control group (535 persons, double ear high frequency average hearing threshold≤25 dB) according to their results of pure tone hearing test .2ml fasting venous blood was collected for DNA extraction and genotyping was performed by TaqMan-PCR technique.@*Results@#Genotyping results suggested that the GT+GG genotype is a risk factor for occupational noise-induced deafness, with an adjusted OR 95% confidence interval of 2.044 (1.51-2.78) . After the noise exposure intensity was stratified, the adjusted OR values and the 95% confidence intervals of noise intensity ≤85, 85-92 and>92 dB respectively 2.43 (1.52-3.90) , 2.17 (1.03-4.59) and 1.74 (1.07-2.83) .@*Conclusion@#GT-GG genotype in rs12212067 of FOXO3 gene may be a risk factor for occupational noise-induced deafness.

Quality of life, perception and knowledge of dentists on noise / Qualidade de vida, percepção e conhecimento de dentistas sobre o ruído

ABSTRACT Purpose: to analyze the perception and knowledge of dentists on occupational noise, its prevention, and effects on their health and quality of life. Methods: a cross-sectional study carried out with 54 dentists of both genders. Two questionnaires were applied: one addressing issues of perception and knowledge on noise and its effects, and another on Quality of Life (SF 36). Results: the workplace noise was considered within medium intensity, and a health risk. Some professionals (59.2%) reported knowing noise prevention methods, although they do not use them. Complaints and the most frequently reported symptoms were irritability, difficulty in understanding speech and tinnitus. The perception of the Quality of Life was worse among men. There was association between pain and perception of noise intensity. Conclusion: noise was considered, regardless of gender, harmful to health and associated with perception of musculoskeletal pain. Symptoms and complaints caused by noise have been reported to negatively impact the professional activity of dentists, however, most of them do not adopt preventive measures.

RESUMO Objetivo: analisar a percepção e conhecimento de odontólogos sobre o ruído, sua prevenção e efeitos na saúde e qualidade de vida. Métodos: estudo transversal, realizado com 54 dentistas de ambos os gêneros. Aplicou-se dois questionários: um abordando a percepção e conhecimento sobre exposição a ruído e seus efeitos e outro sobre Qualidade de Vida (SF-36). Resultados: no ambiente de trabalho odontológico, o ruído foi percebido em média intensidade e considerado um risco à saúde. Alguns profissionais (59,2%) relataram conhecer métodos de prevenção dos efeitos do ruído, porém não os utilizam. As principais queixas e sintomas foram irritabilidade, dificuldade na compreensão da fala e zumbido. A percepção sobre a Qualidade de Vida foi pior entre os homens. Houve associação entre o domínio Dor com a percepção da intensidade do ruído. Conclusão: o ruído foi considerado, independente do gênero, como nocivo à saúde e se relacionou com a percepção de dor musculoesquelética. Foram relatados sintomas e queixas associados ao ruído que podem impactar negativamente a atividade profissional dos odontólogos, mas a maioria não adota medidas preventivas.

Blood Pressure of Jordanian Workers Chronically Exposed to Noise in Industrial Plants.

BACKGROUND: Occupational studies investigating the association between blood pressure and noise exposure are almost lacking in the Eastern Mediterranean Region countries. OBJECTIVE: To determine the association between occupational exposure to high level of noise and blood pressure among a group of workers in Jordan. METHODS: All workers who had been exposing to noise for at least 3 years in 3 plants in Madaba governorate in Jordan were included in this cross-sectional study. A structured questionnaire was used to collect data. The occupational noise level was measured with a portable calibrated sound meter. RESULTS: We studied 191 male workers, of whom 145 (75.9%) were exposed to a noise level higher than the permissible limit of 85 dBA. The mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) and the prevalence of hypertension were significantly higher among those exposed to higher noise level. In multivariate analysis, workers exposed to high level of noise had a significantly higher odds of hypertension compared to those exposed to noise level lower than the permissible limit (OR 4.7, 95% CI 1.6 to 13.8). The odds of hypertension increased by 17% (95% CI 10% to 30%) for each dB increase in noise intensity. CONCLUSION: Exposure to high level of noise is associated with elevated blood pressure.