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   2011| November-December  | Volume 13 | Issue 55  
    Online since November 28, 2011

 
 
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ARTICLES
High-frequency audiometry: A means for early diagnosis of noise-induced hearing loss
Amir H Mehrparvar, Seyyed J Mirmohammadi, Abbas Ghoreyshi, Abolfazl Mollasadeghi, Ziba Loukzadeh
November-December 2011, 13(55):402-406
DOI:10.4103/1463-1741.90295  PMID:22122956
Noise-induced hearing loss (NIHL), an irreversible disorder, is a common problem in industrial settings. Early diagnosis of NIHL can help prevent the progression of hearing loss, especially in speech frequencies. For early diagnosis of NIHL, audiometry is performed routinely in conventional frequencies. We designed this study to compare the effect of noise on high-frequency audiometry (HFA) and conventional audiometry. In a historical cohort study, we compared hearing threshold and prevalence of hearing loss in conventional and high frequencies of audiometry among textile workers divided into two groups: With and without exposure to noise more than 85 dB. The highest hearing threshold was observed at 4000 Hz, 6000 Hz and 16000 Hz in conventional right ear audiometry, conventional left ear audiometry and HFA in each ear, respectively. The hearing threshold was significantly higher at 16000 Hz compared to 4000. Hearing loss was more common in HFA than conventional audiometry. HFA is more sensitive to detect NIHL than conventional audiometry. It can be useful for early diagnosis of hearing sensitivity to noise, and thus preventing hearing loss in lower frequencies especially speech frequencies.
  11,841 46 8
Noise-induced tinnitus: A comparison between four clinical groups without apparent hearing loss
Ann-Cathrine Lindblad, Björn Hagerman, Ulf Rosenhall
November-December 2011, 13(55):423-431
DOI:10.4103/1463-1741.90310  PMID:22122959
The number of people with normal hearing thresholds seeking medical help for tinnitus and other hearing problems is increasing. For diagnostic purposes, existence/nonexistence of lesions or combinations of lesions in the inner ear not reflected in the audiogram was evaluated with advanced hearing tests applied to tinnitus patients with certain backgrounds, including noise exposure. For forty-six patients with pronounced tinnitus, and other symptoms, tentative diagnoses were established, including judgments of the influence of four causative factors: (1) acoustic trauma, (2) music, (3) suspected hereditary, and (4) nonauditory, for example, stress or muscular tension. They were analyzed with a test battery sensitive to lesions involving the outer hair cells, damage from impulse noise, and dysfunction of the efferent system. There were significant differences in test results between groups with individuals with the same most likely causative factor. Most patients claiming acoustic trauma had a specific type of result, 'hyper-PMTF' (psychoacoustical modulation transfer function), and abnormal test results of the efferent system. Everyone in the hereditary group had dysfunction of the efferent system. All patients working with music, except one, had some abnormality, but without specific pattern. The nonauditory group mostly had normal test results. The investigation shows that it is possible to diagnose minor cochlear lesions as well as dysfunction of the efferent system, which might be causing the tinnitus. Those abnormalities could not be detected with routine audiological tests. Malfunctioning caused by impulse noise is an obvious example of this. These findings facilitate choice of treatment, rehabilitation programs, and medicolegal decisions.
  9,197 40 4
The efficacy of N-acetylcysteine to protect the human cochlea from subclinical hearing loss caused by impulse noise: A controlled trial
Ann-Cathrine Lindblad, Ulf Rosenhall, Åke Olofsson, Björn Hagerman
November-December 2011, 13(55):392-401
DOI:10.4103/1463-1741.90293  PMID:22122955
In military outdoor shooting training, with safety measures enforced, the risk of a permanent, noise-induced hearing loss is very small. But urban warfare training performed indoors, with reflections from walls, might increase the risk. A question is whether antioxidants can reduce the negative effects of noise on human hearing as it does on research animals. Hearing tests were performed on a control group of 23 military officers before and after a shooting session in a bunker-like room. The experiments were repeated on another group of 11 officers with peroral adminstration of N-acetyl­cysteine (NAC), directly after the shooting. The measurements performed were tone thresholds; transient-evoked otoacoustic emissions, with and without contralateral noise; and psycho­acoustical modulation transfer function (PMTF), thresholds for brief tones in modulated noise. Effects from shooting on hearing thresholds were small, but threshold behavior supports use of NAC treatment. On the PMTF, shooting without NAC gave strong effects. Those effects were like those from continuous noise, which means that strict safety measures should be enforced. The most striking finding was that the non-linearity of the cochlea, that was strongly reduced in the group without NAC, as manifested by the PMTF-results, was practically unchanged in the NAC-group throughout the study. NAC treatment directly after shooting in a bunkerlike room seems to give some protection of the cochlea.
  8,810 24 4
Impact of wind turbine noise in The Netherlands
Edwin Verheijen, Jan Jabben, Eric Schreurs, Kevin B Smith
November-December 2011, 13(55):459-463
DOI:10.4103/1463-1741.90331  PMID:22122963
The Dutch government aims at an increase of wind energy up to 6 000 MW in 2020 by placing new wind turbines on land or offshore. At the same time, the existing noise legislation for wind turbines is being reconsidered. For the purpose of establishing a new noise reception limit value expressed in L den , the impact of wind turbine noise under the given policy targets needs to be explored. For this purpose, the consequences of different reception limit values for the new Dutch noise legislation have been studied, both in terms of effects on the population and regarding sustainable energy policy targets. On the basis of a nation-wide noise map containing all wind turbines in The Netherlands, it is calculated that 3% of the inhabitants of The Netherlands are currently exposed to noise from wind turbines above 28 dB(A) at the faηade. Newly established dose-response relationships indicate that about 1500 of these inhabitants are likely to be severely annoyed inside their dwellings. The available space for new wind turbines strongly depends on the noise limit value that will be chosen. This study suggests an outdoor A-weighted reception limit of L den = 45 dB as a trade-off between the need for protection against noise annoyance and the feasibility of national targets for renewable energy.
  7,310 64 1
Speech understanding in noise with integrated in-ear and muff-style hearing protection systems
Sharon M Abel, Ann Nakashima, Douglas Saunders
November-December 2011, 13(55):378-384
DOI:10.4103/1463-1741.90289  PMID:22122953
Integrated hearing protection systems are designed to enhance free field and radio communications during military operations while protecting against the damaging effects of high-level noise exposure. A study was conducted to compare the effect of increasing the radio volume on the intelligibility of speech over the radios of two candidate systems, in-ear and muff-style, in 85-dBA speech babble noise presented free field. Twenty normal-hearing, English-fluent subjects, half male and half female, were tested in same gender pairs. Alternating as talker and listener, their task was to discriminate consonant-vowel-consonant syllables that contrasted either the initial or final consonant. Percent correct consonant discrimination increased with increases in the radio volume. At the highest volume, subjects achieved 79% with the in-ear device but only 69% with the muff-style device, averaged across the gender of listener/talker pairs and consonant position. Although there was no main effect of gender, female listener/talkers showed a 10% advantage for the final consonant and male listener/talkers showed a 1% advantage for the initial consonant. These results indicate that normal hearing users can achieve reasonably high radio communication scores with integrated in-ear hearing protection in moderately high-level noise that provides both energetic and informational masking. The adequacy of the range of available radio volumes for users with hearing loss has yet to be determined.
  6,769 21 1
Risk of hypertension related to road traffic noise among reproductive-age women
Inga Bendokiene, Regina Grazuleviciene, Audrius Dedele
November-December 2011, 13(55):371-377
DOI:10.4103/1463-1741.90288  PMID:22122952
Chronic noise exposure is associated with adverse pathophysiological effects, which may contribute to the progression of hypertension. However, evidence supporting its effect on women is still inconsistent. The aim of the study was to examine the hypertension risk related to road traffic noise in residential settings in an urban community amongst reproductive-aged women. Cross-sectional study data including 3,121 pregnant women, 20-45 years old, and a geographic information system (GIS) to assess the average road noise (LAeq 24 hr) for every subject at the current residential address were used. Effects on physician-diagnosed hypertension were estimated by logistic regression with adjustments for age, social status, marital status, education, alcohol consumption, ethnic group, parity, body mass index, chronic disease, and exposure duration. The prevalence of hypertension amongst women aged 20-45 years in the lowest exposure category was 13.1% in comparison to 13.6% and 18.1% amongst those exposed to the medium and the highest exposure category, respectively. After making adjustments for the selected variables, no exposure effects [Odds ratio (OR) ≈ 1.0] were noted in the medium exposure category [51-60 dB(A)]. However, a slight increase was noted in the highest exposure category [≥61 dB(A)), OR 1.36; 95% CI 0.86-2.15]. The effect was more pronounced amongst women aged 30-45 years and a positive exposure-response relation was indicated for hypertension: An effect was seen at noise levels 51-60 dB(A) (OR = 1.03; 95% CI 0.72-1.49) and at >61 dB(A) (OR = 1.94, 95% CI 1.01-3.72). The present study shows some evidence for an association between the residential road traffic noise and hypertension amongst reproductive-aged women, and an exposure-response relationship.
  6,096 49 5
Effect of vitamin E supplementation on carbogen-induced amelioration of noise induced hearing loss in man
Neeru Kapoor, Kumar Vyonkesh Mani, Radhey Shyam, Raj Kumar Sharma, Ambika Prasad Singh, William Selvamurthy
November-December 2011, 13(55):452-458
DOI:10.4103/1463-1741.90327  PMID:22122962
The study explores the effect of occupational noise on oxidative stress status and prophylactic effect of Vitamin E and carbogen (5% CO 2 +95%O 2 ) breathing in alleviating the oxidative damage and conserving the hearing in human volunteers exposed to intense occupational noise. Plasma total antioxidant status, blood glutathione (GSH), malondialdehyde (MDA), antioxidant enzyme activities of GSH peroxidase (EC 1.11.1.9, GPx), superoxide dismutase (EC 1.15.1.1; SOD) in erythrocytes, nitric oxide and nitric oxide synthase in plasma were assessed before and after 6 days of administration of Vitamin E and Carbogen. Results of the study indicate that the exposure to noise for 6 days increased blood concentration of MDA, decreased concentrations of reduced GSH, antioxidant enzyme activity of SOD and plasma total antioxidant status in control (noise) group. Vitamin E- supplemented group showed decline in oxidative stress reflected by significant decrease in blood concentration of MDA and increase in antioxidant enzyme activity of erythrocyte SOD. Results of audiometric studies revealed that breathing of carbogen prevented the development of temporary threshold shift; thereby reducing the risk of noise induced hearing loss.
  5,747 26 4
A four-part setting on examining the anxiety-provoking capacity of the sound of dental equipment
Hai Ming Wong, Cheuk Ming Mak, Ying Feng Xu
November-December 2011, 13(55):385-391
DOI:10.4103/1463-1741.90291  PMID:22122954
This paper reports the results of a four-part questionnaire survey to assess the effects of the sound of dental equipment on people's perceptions and dental anxiety levels. The convenience sample for the survey comprised 230 dental students and 230 gender and age matched non-dental university students. The subjects were requested to complete the questionnaires themselves. The results show that the sound of dental equipment has a great influence on dental anxiety. Dental students, who are more familiar with the operation of this equipment, are less prone to anxiety when they hear its sound than their non-dental counterparts.
  5,319 16 2
Increased vitamin plasma levels in Swedish military personnel treated with nutrients prior to automatic weapon training
CG Le Prell, AC Johnson, AC Lindblad, Å Skjönsberg, M Ulfendahl, K Guire, GE Green, K.C.M Campbell, JM Miller
November-December 2011, 13(55):432-443
PMID:22122960
Noise-induced hearing loss (NIHL) is a significant clinical, social, and economic issue. The development of novel therapeutic agents to reduce NIHL will potentially benefit multiple very large noise-exposed populations. Oxidative stress has been identified as a significant contributor to noise-induced sensory cell death and NIHL, and several antioxidant strategies have now been suggested for potential translation to human subjects. One such strategy is a combination of beta-carotene, vitamins C and E, and magnesium, which has shown promise for protection against NIHL in rodent models, and is being evaluated in a series of international human clinical trials using temporary (military gunfire, audio player use) and permanent (stamping factory, military airbase) threshold shift models (NCT00808470). The noise exposures used in the recently completed Swedish military gunfire study described in this report did not, on average, result in measurable changes in auditory function using conventional pure-tone thresholds and distortion product otoacoustic emission (DPOAE) amplitudes as metrics. However, analysis of the plasma samples confirmed significant elevations in the bloodstream 2 hours after oral consumption of active clinical supplies, indicating the dose is realistic. The plasma outcomes are encouraging, but clinical acceptance of any novel therapeutic critically depends on demonstration that the agent reduces noise-induced threshold shift in randomized, placebo-controlled, prospective human clinical trials. Although this noise insult did not induce hearing loss, the trial design and study protocol can be applied to other populations exposed to different noise insults.
  5,219 30 1
Ambient noise levels in the chemotherapy clinic
Dana K Gladd, Gabrielle H Saunders
November-December 2011, 13(55):444-451
DOI:10.4103/1463-1741.90322  PMID:22122961
Many of the drugs used for chemotherapy treatments are known to be ototoxic, and can result in permanent hearing threshold shifts. The degree of ototoxic damage can be influenced by many factors including dosage, duration of exposure, genetics, and coadministration with other ototoxic agents. Cisplatin is known for its ototoxic effects on hearing thresholds, particularly in the high frequencies. Recent studies have indicated a synergistic relationship between Cisplatin administration and moderate to high noise level exposure starting between 70-85 dB SPL. This study measured the noise levels in the Portland Veteran's Affairs Medical Center's outpatient chemotherapy clinic. Average (LAeq) and peak (LCpeak) noise measures were recorded every minute from 7 am until 6 pm on the two busiest clinic days. Patients, visitors, and staff members filled out anonymous surveys regarding their reactions to noise levels. Cumulative noise levels were not at levels known to interact with Cisplatin for a significant period of time. Noise measurement analysis indicated that levels were at or above 70 dB SPL for less than ten minutes during the 11-hour recording window. The patient and visitor surveys indicated that both groups were unbothered by noise in the clinic. However, most staff members were bothered by or concerned about noise levels, and many felt that it caused stress and difficulty communicating on the phone.
  5,058 23 1
Vuvuzela media coverage during the 2010 FIFA soccer world cup tournament: Impact on raising awareness of noise-induced hearing loss
Lebogang Ramma
November-December 2011, 13(55):415-422
DOI:10.4103/1463-1741.90302  PMID:22122958
Hearing loss, most specifically noise-induced hearing loss (NIHL) due to exposure to vuvuzela noise, received extended media coverage before and during the 2010 Federation Internationale de Football Association (FIFA) soccer world cup tournament. This study aimed to evaluate the impact that this media coverage had on raising awareness about NIHL due to exposure to vuvuzela noise at soccer matches among South African soccer spectators. A descriptive survey study, using a 24-item, self-administered questionnaire was used for this study. One hundred and forty seven (147) soccer spectators were surveyed before (N1 =73) and after (N2 =74) the tournament. Systematic sampling strategy was used to select the participants. Participants completed the questionnaire before the start of matches. Sixteen percent of the participants surveyed reported having had some media exposure about NIHL due to exposure to vuvuzela noise during soccer matches before the tournament in comparison to 26% of the participants after the tournament. This increase in the level of awareness was not statistically significant. Further, most participants were still not aware of the risk of NIHL to them from exposure to excessive noise during matches and did not consider hearing loss from noise exposure during soccer matches a serious concern both before and after the tournament. The results of this study therefore seem to suggest that vuvuzela media coverage during the 2010 FIFA soccer world cup tournament did not significantly raise the level of awareness about NIHL due to exposure to excessive noise during matches among the spectators surveyed.
  4,976 18 1
Gender perspectives in psychometrics related to leisure time noise exposure and use of hearing protection
Stephen Widén, Margareta Bohlin, Ingemar Johansson
November-December 2011, 13(55):407-414
DOI:10.4103/1463-1741.90299  PMID:22122957
The purpose of the present study was to investigate possible gender differences regarding psychometric scales measuring risk perception in noisy situations, attitudes towards loud music, perceived susceptibility to noise, and individual norms and ideals related to activities where loud music is played. In addition the purpose was to analyze whether these variables are associated with protective behavior such as the use of hearing protection. A questionnaire was administered to a Swedish sample including 543 adolescents aged 16 to 20. The result revealed significant gender differences for all the psychometric scales. In addition, all psychometric measures were associated with hearing protection use in musical settings. Contrary to previous studies, gender did not contribute to any explanation of protective behavior by itself in the analysis. One conclusion is that although gender does not contribute by itself for the explanation of protective behavior, gender may affect psychological variables such as risk perception, attitudes and perceived susceptibility and that these variables may in turn be valuable for decision-making and protective behavior in noisy situations. Although women tend to be more 'careful' psychologically, they nevertheless tend to behave in the same way as men as regards actual noise-related risk taking.
  2,493 5 3