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   2016| September-October  | Volume 18 | Issue 84  
    Online since October 18, 2016

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Disorders induced by direct occupational exposure to noise: Systematic review
Andrea Domingo-Pueyo, Javier Sanz-Valero, Carmina Wanden-Berghe
September-October 2016, 18(84):229-239
DOI:10.4103/1463-1741.192479  PMID:27762251
Background: To review the available scientific literature about the effects on health by occupational exposure to noise. Materials and Methods: A systematic review of the retrieved scientific literature from the databases MEDLINE (via PubMed), ISI-Web of Knowledge (Institute for Scientific Information), Cochrane Library Plus, SCOPUS, and SciELO (collection of scientific journals) was conducted. The following terms were used as descriptors and were searched in free text: “Noise, Occupational,” “Occupational Exposure,” and “Occupational Disease.” The following limits were considered: “Humans,” “Adult (more than 18 years),” and “Comparative Studies.” Results: A total of 281 references were retrieved, and after applying inclusion/exclusion criteria, 25 articles were selected. Of these selected articles, 19 studies provided information about hearing disturbance, four on cardiovascular disorders, one regarding respiratory alteration, and one on other disorders. Conclusions: It can be interpreted that the exposure to noise causes alterations in humans with different relevant outcomes, and therefore appropriate security measures in the work environment must be employed to minimize such an exposure and thereby to reduce the number of associated disorders.
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The effect of room acoustics on the sleep quality of healthy sleepers
Ingo Fietze, Charlotte Barthe, Matthias Hölzl, Martin Glos, Sandra Zimmermann, Ralf Bauer-Diefenbach, Thomas Penzel
September-October 2016, 18(84):240-246
DOI:10.4103/1463-1741.192480  PMID:27762252
Introduction: Noise is one of the factors that can seriously disturb sleep, and sound volume is an important factor in this context. One strategy involves avoiding exposure to sounds in the night, while entail the minimization of background noise in a bedroom. The goal of this study was to investigate the effect of systematic sound attenuation on nocturnal sleep by influencing sound volume and reverberation within the context of room acoustics. Materials and Methods: On this basis, we designed a randomized, controlled crossover trial investigating 24 healthy sleepers (15 men and 9 women, aged 24.9 ± 4.1 years) with a body mass index (BMI) of 21.9 ± 1.6 kg/m2. Each participant slept for three consecutive nights at three different locations: (a) at our sleep lab, (b) at the participant’s home, and (c) at an acoustically isolated room. In addition to conduct of polysomnography (PSG), subjective sleep quality and nocturnal noise level were measured at each location. We likewise measured room temperature and relative humidity. Results: Under conditions of equal sleep efficiency, a significant increase in deep sleep, by 16–34 min, was determined in an acoustically isolated room in comparison to the two other sleep locations. Fewer arousal events and an increase in rapid eye movement (REM) latency became evident in an acoustically isolated environment. Sleep in a domestic environment was subjectively better than sleep under the two test conditions. Discussion: For healthy sleepers, room acoustics influence the microstructure of sleep, without subjective morning benefit. Reduction of noise level and of reverberation leads to an increase in the amount of deep sleep and to reduction of nocturnal arousal events, which is especially important for poor sleepers.
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The Protective effect of the endoplasmic reticulum stress-related factors BiP/GRP78 and CHOP/Gadd153 on noise-induced hearing loss in guinea pigs
Qiuhong Xue, Caihong Li, Jia Chen, Hongmei Guo, Dongqing Li, Xianglei Wu
September-October 2016, 18(84):247-255
DOI:10.4103/1463-1741.192481  PMID:27762253
Context: The audiological features and cochlear morphology of individuals with noise-induced hearing loss (NIHL) are well characterized. However, the molecular processes in the cochlea are not well understood. Aims: To explore the role of the endoplasmic reticulum stress (ERS) response in the guinea pig model of cochlear damage induced by exposure to intense noise. Settings and Design: A pilot case–control study. Subjects and Methods: Forty-eight guinea pigs were divided into four equal groups. At 1, 4, or 14 days (d) post-exposure, the auditory brainstem responses (ABRs) were tested before sacrificing the subjects. The expression levels of the binding immunoglobulin protein/glucose-regulated protein 78 (BiP/GRP78) and C/EBP-homologous protein/growth arrest and DNA damage-inducible gene 153 (CHOP/Gadd153) proteins were evaluated using immunohistochemistry and Western blotting. The number of cochlear hair cells with altered nuclei was counted using confocal fluorescence microscopy. Statistical analysis used: One-way analysis of variance (ANOVA) and the least squares difference (LSD) test. Results: The outer hair cells (OHCs) showed changes of apoptosis, necrosis, and loss after noise exposure. In the 1- and 4-d groups, more apoptotic cells were found than necrotic cells (P < 0.01). The level of BiP/GRP78 was significantly higher in all three experimental groups compared to the control group (P < 0.01). The level of CHOP/Gadd153 was increased at 1 d post-exposure, achieving a peak that was maintained until 4 d, after which it returned to baseline levels by 14 d post-exposure. Conclusions: ERS response was activated by inducing the expression of BiP/GRP78 to lessen the extent of the resulting cellular damage and activating the CHOP/Gadd153 pathway to eliminate the most severely damaged cells.
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Auditory brainstem responses for click and CE-chirp stimuli in individuals with and without occupational noise exposure
Zeena Venkatacheluvaiah Pushpalatha, Sreeraj Konadath
September-October 2016, 18(84):260-265
DOI:10.4103/1463-1741.192477  PMID:27762255
Introduction: Encoding of CE-chirp and click stimuli in auditory system was studied using auditory brainstem responses (ABRs) among individuals with and without noise exposure. Materials and Methods: The study consisted of two groups. Group 1 (experimental group) consisted of 20 (40 ears) individuals exposed to occupational noise with hearing thresholds within 25 dB HL. They were further divided into three subgroups based on duration of noise exposure (0–5 years of exposure-T1, 5–10 years of exposure-T2, and >10 years of exposure-T3). Group 2 (control group) consisted of 20 individuals (40 ears). Absolute latency and amplitude of waves I, III, and V were compared between the two groups for both click and CE-chirp stimuli. T1, T2, and T3 groups were compared for the same parameters to see the effect of noise exposure duration on CE-chirp and click ABR. Result: In Click ABR, while both the parameters for wave III were significantly poorer for the experimental group, wave V showed a significant decline in terms of amplitude only. There was no significant difference obtained for any of the parameters for wave I. In CE-Chirp ABR, the latencies for all three waves were significantly prolonged in the experimental group. However, there was a significant decrease in terms of amplitude in only wave V for the same group. Discussion: Compared to click evoked ABR, CE-Chirp ABR was found to be more sensitive in comparison of latency parameters in individuals with occupational noise exposure. Monitoring of early pathological changes at the brainstem level can be studied effectively by using CE-Chirp stimulus in comparison to click stimulus. Conclusion: This study indicates that ABR’s obtained with CE-chirp stimuli serves as an effective tool to identify the early pathological changes due to occupational noise exposure when compared to click evoked ABR.
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Soft tissue conduction as a possible contributor to the limited attenuation provided by hearing protection devices
Shai Chordekar, Cahtia Adelman, Haim Sohmer, Liat Kishon-Rabin
September-October 2016, 18(84):274-279
DOI:10.4103/1463-1741.192476  PMID:27762257
Context: Damage to the auditory system by loud sounds can be avoided by hearing protection devices (HPDs) such as earmuffs, earplugs, or both for maximum attenuation. However, the attenuation can be limited by air conduction (AC) leakage around the earplugs and earmuffs by the occlusion effect (OE) and by skull vibrations initiating bone conduction (BC). Aims: To assess maximum attenuation by HPDs and possible flanking pathways to the inner ear. Subjects and Methods: AC attenuation and resulting thresholds were assessed using the real ear attenuation at threshold (REAT) procedure on 15 normal-hearing participants in four free-field conditions: (a) unprotected ears, (b) ears covered with earmuffs, (c) ears blocked with deeply inserted customized earplugs, and (d) ears blocked with both earplugs and earmuffs. BC thresholds were assessed with and without earplugs to assess the OE. Results: Addition of earmuffs to earplugs did not cause significantly greater attenuation than earplugs alone, confirming minimal AC leakage through the external meatus and the absence of the OE. Maximum REATs ranged between 40 and 46 dB, leading to thresholds of 46–54 dB HL. Furthermore, calculation of the acoustic impedance mismatch between air and bone predicted at least 60 dB attenuation of BC. Conclusion: Results do not support the notion that skull vibrations (BC) contributed to the limited attenuation provided by traditional HPDs. An alternative explanation, supported by experimental evidence, suggests transmission of sound to inner ear via non-osseous pathways such as skin, soft tissues, and fluid. Because the acoustic impedance mismatch between air and soft tissues is smaller than that between air and bone, air-borne sounds would be transmitted to soft tissues more effectively than to bone, and therefore less attenuation is expected through soft tissue sound conduction. This can contribute to the limited attenuation provided by traditional HPDs. The present study has practical implications for hearing conservation protocols.
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Occupational noise exposure on a Royal Navy warship during weapon fire
Gurmail Singh Paddan
September-October 2016, 18(84):266-273
DOI:10.4103/1463-1741.192474  PMID:27762256
Introduction: Measurements were made of the sound pressure levels on a military ship HMS Grimsby during firing of a Heavy Machine Gun (HMG) mounted on the starboard bridge wing. The measurement positions comprised three locations on the ship’s bridge (the wheelhouse) and one location on the starboard bridge wing. Equipment and Procedure: The three locations on the bridge were the starboard door, centre and port door. A total of 255 burst firings were measured during the survey comprising 850 rounds with each burst encompassing from 1 to 10 rounds. Analysis: The data have been assessed and interpreted in accordance with the Control of Noise at Work Regulations 2005. Results: The highest peak sound pressure levels measured on the bridge wing and on the bridge were 160.7 dB(C) (2170 Pa) and 122.7 dB(C) (27.3 Pa), respectively. The highest sound exposure levels measured on the bridge wing and on the bridge corresponding to one round being fired were 127.8 dB(A) and 88.9 dB(A), respectively. The ship’s structure provided about 40 dB attenuation in the transmitted noise. Discussion: The operator of the weapon would be required to wear some form of hearing protection. On the basis of the measured peak noise levels, there would be no requirement for bridge crew to wear any hearing protection during firing of a HMG. However, crew exposure to noise on the bridge is likely to exceed the upper exposure action value corresponding to 85 dB(A) after about 11,750 rounds. Conclusions: Measurements made on the bridge wings are likely to be affected by reflections from the ship’s structure.
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Determination of the level of noise in nurseries and pre-schools and the teachers' level of annoyance
Ozan Gokdogan, Cagil Gokdogan
September-October 2016, 18(84):256-259
DOI:10.4103/1463-1741.192475  PMID:27762254
Objective: The aim of this article is to determine the level of noise in nurseries and pre-schools and also to compare measured levels with standard levels and evaluate the teachers’ level of annoyance. Materials and Methods: The level of noise was measured in three different schools. A total of 162 students, whose ages were between 3 and 6 years, and 12 teachers were included the study. Every age groups’ level of noise was measured during sleeping, gaming, and eating activity. In addition, teachers’ annoyance was assessed in different age groups. Results: The 4- to 6-year-old groups were found to have higher level of sounds than 3-year-old group. Eating period was found to be the highest level of sound whereas sleeping was found the lowest. Furthermore, teachers’ annoyance was found higher as the age decreased. Conclusion: Nurseries and pre-schools have noisy environment both for the students and the teachers. High level of noise, which has bad effects on health, is a public health problem. Both the students’ families and teachers must be aware of this annoying situation.
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Supporting the global initiative of preventing childhood hearing loss: Act now, here's how!
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy
September-October 2016, 18(84):280-281
DOI:10.4103/1463-1741.192478  PMID:27762258
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