Home Email this page Print this page Bookmark this page Decrease font size Default font size Increase font size
Noise & Health  
 CURRENT ISSUE    PAST ISSUES    AHEAD OF PRINT    SEARCH   GET E-ALERTS    
 
 
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
Email Alert *
Add to My List *
* Registration required (free)  
 


 
   Abstract
  Introduction
  Methods
  Results
  Discussion
  Acknowledgments
   References
   Article Figures
   Article Tables
 

 Article Access Statistics
    Viewed7448    
    Printed389    
    Emailed19    
    PDF Downloaded37    
    Comments [Add]    
    Cited by others 4    

Recommend this journal

 


 
  Table of Contents    
ARTICLE  
Year : 2012  |  Volume : 14  |  Issue : 56  |  Page : 39-44
The effect of a hearing conservation program on adolescents' attitudes towards noise

Department of Speech, Language, and Hearing Sciences at the University of Florida, Gainesville, USA

Click here for correspondence address and email
Date of Web Publication29-Feb-2012
 
  Abstract 

Crandell et al., reported that education programs such as hearing conservation programs (HCPs) represent the most common and well-recognized procedure in reducing the incidence of noise-induced hearing loss (NIHL). The purpose of this study was to assess the effectiveness of an HCP in changing knowledge and attitudes toward exposures to high intensity sounds or noise among adolescents aged 12-14 years. Local middle school students in physical education classes were recruited for participation. Sixty-four middle school students between the ages of 12 and 14 received pre- and post-test measures and participated in the HCP. The pre-test measure had 24 questions that included 5 demographic questions and 19 Likert-type questions [modified from the Youth Attitude to Noise Scale] that assess adolescents' attitudes towards noise; and a post-test measure included the identical 24 questions of the pre-test measure in addition to three subjective questions. A Wilcoxon signed rank test and a Two-Factor Analysis of Variance were completed to assess changes in knowledge and attitudes toward noise among the study population after receiving the HCP. A statistically significant reduction (P< 0.003) in pro-noise attitudes among the adolescents was present after the intervention. It was established that an HCP facilitated a change in pro-noise attitudes among adolescents. Further, the students thought this program facilitated learning of the auditory system and healthy hearing behaviors.

Keywords: Adolescents, attitudes, hearing conservation programs, noise

How to cite this article:
Dell SM, Holmes AE. The effect of a hearing conservation program on adolescents' attitudes towards noise. Noise Health 2012;14:39-44

How to cite this URL:
Dell SM, Holmes AE. The effect of a hearing conservation program on adolescents' attitudes towards noise. Noise Health [serial online] 2012 [cited 2020 Oct 20];14:39-44. Available from: https://www.noiseandhealth.org/text.asp?2012/14/56/39/93333

  Introduction Top


Individuals of all ages are at risk to the dangers of high intensity sounds (>85 dB A) that cause anatomical and physiological changes within the cochlea, which houses the auditory sensory cells or hair cells. [1],[2],[3] Specifically, the outer hair cells (OHCs) are sensitive to hazardous high intensity sounds. Noise exposure from high intensity sounds can cause the OHCs to die; and when these cells die they do not regenerate. Thus, repeated noise exposure results in the death of numerous OHCs that produce an irreversible and measurable permanent hearing loss. [4],[5],[6] This permanent sensorineural hearing loss is better known as noise-induced hearing loss (NIHL). [1],[3],[7],[8] Commonly, NIHL is associated with high intensity sounds caused by occupational and military sound sources; approximately 30 million American workers are exposed to hazardous noise at work. [9] However, these adults are afforded protection from mandatory regulation enforced by the Occupational Safety and Health Administration (OSHA). [7],[10] Workers exposed to loud sounds above the action level or 85 dB A are enrolled in mandatory hearing conservation programs (HCPs). These HCPs provide audiologic monitoring, hearing protection devices, noise control, noise surveys, education and motivation. [2],[7],[11]

Although high intensity sounds or noise are often defined as sounds that are undesired or annoying, [2],[8] sounds that are considered comfortable and enjoyable can also become a risk to hearing. Noise comes from other sources besides occupational exposures or by firing weapons. For instance, sounds from loud music, concerts, hunting, motor sports, and public sporting events [2],[7] can also contribute to hearing loss. Therefore, within this paper the term noise will be used interchangeably for high intensity sound(s). Hence, the dangers of noise exposure can affect all populations including children that are being exposed to loud sound environments. Consequently, approximately 12.5% or 5.2 million children have NIHL in one or both ears; [12] and unlike working adults, children that are exposed to noise do not have regulations to protect them from the effects of NIHL. In a recent study, the reported prevalence of hearing loss, especially high frequency hearing loss among adolescents, aged 12-19 years old increased by 31%. [13] Thus, children and adolescents are being exposed to noise every day in the form of MP3 players, toys, video games, and other recreational activities.

This exposure to noise can cause NIHL; and like any other type of hearing loss, NIHL is also known to cause detrimental effects, such as auditory problems (i.e. inability to discern speech), depression, anxiety, reduced cognition, and poor psycho-social function. [14],[15],[16],[17] In addition, noise that produces NIHL can generate various physiological ailments that poorly affect the quality of life of individuals of all ages, especially children. These non-auditory effects on health and well-being that are caused by noise include increased stress, inability to concentrate, lack of sleep, elevated blood pressure, and increased heart rate. [18],[19],[20],[21],[21] Noise can also cause impaired cognitive function among children. It has been shown that excessive exposure to noise has affects on central processing, language comprehension, and attention (i.e. being able or unable to multitask in the presence of background noise caused by multiple talkers). [18],[20],[22] Hearing loss at high frequencies can also affect children's speech comprehension of the fricative sounds (e.g. f or s), which can lead to decreased speech discrimination for differentiation of words and overall performance in school. Hence, with deficits in speech comprehension and other cognitive function, children with minimal hearing loss caused by noise have an obstacle to overcome when it comes to learning and attaining an education. Therefore, educationally significant hearing losses in the form of NIHL can affect children's potential to succeed and excel in school and ultimately in life. Many children with hearing loss experience reduced academic performance. [19],[20],[22],[23]

The literature has also shown gender differences among those individuals with NIHL. In the Third National Health and Nutrition Examination Survey (NHANES III), Niskar et al., found a higher prevalence of NIHL in males than females. Also, young males are more likely to engage in more hearing-related risk behaviors than young females. [24],[25] On the other hand, there is very little literature regarding racial/ethnic differences among African Americans and other groups regarding NIHL. However, from the limited research it can be gleaned that African Americans, adults and children, have a lower prevalence of NIHL. The NHANES III revealed that African American children had the lowest prevalence (11.7%) of high frequency hearing loss or NIHL compared to Caucasian children (12.3%) and Latino children (15.1%), [12] yet there are no statistical differences between these groups.

NIHL is slow and insidious, yet it is preventable. Within the occupational sector, various US laws from the Walsh Healey Act to the Hearing Conservation Amendment are enforced to protect the workforce from the hazards of NIHL. [3],[7],[26] These laws require the implementation of HCPs. However, unlike other countries, no regulations exist against NIHL caused by recreational noise within the US. [27] Thus, many Americans, especially children and adolescents, are being exposed to noise that has the potential to cause NIHL among various diverse groups without any protective regulation. There have been numerous calls of action to provide HCPs within the schools. A proponent of the importance of inclusion of HCPs within schools, Robert L. Folmer reported within his review that the need for hearing conservation addition within the education system has been stressed by numerous health policy agencies and experts in hearing science for more than 30 years. [28] Thus, with the numerous opportunities for children to be exposed to noise, many are unaware of the dangers of noise. Many children of all races believe that hearing loss is only a concern for old people. [29] Thus, the ultimate goal of preventing NIHL among children would be avoiding the initiation of several risky hearing behaviors, such as attending a loud sporting event without the use of hearing protection. [1],[2],[30] Following the Health Belief Model, an intrapersonal theory that predicts how knowledge, attitudes, and beliefs within the individual will affect health behaviors. [31],[32] Based on this theoretical framework, knowledge, attitudes, and beliefs regarding the dangers of noise will effect an individual's hearing health behaviors. Positive hearing health behaviors (i.e. using hearing protection) are dependent upon knowledge and attitudes toward noise. Therefore, one way to combat NIHL is through awareness and knowledge, which will hopefully change beliefs and attitudes and ultimately behaviors. Thus, the purpose of this pilot study was (1) to evaluate the effectiveness of an HCP in increasing knowledge and modifying positive attitudes towards noise among adolescents in a school setting and (2) to evaluate if gender and race have an effect on changes seen in children's attitudes.


  Methods Top


Participants

The University of Florida Institutional Review Board (IRB) gave approval (approval # 2009-U-0275) for this study. All participants were instructed that they could withdraw from the study at anytime. The student participants were middle school students (grades six to eight) enrolled in physical education (P.E.) classes from the University of Florida's Developmental Research School. The P.E. teacher was randomly selected and his classes were selected for the study. The students were selected from three P.E. classes that varied by grade and class size due to block scheduling. The first class was made up of 27 sixth graders, the second class had 36 students in the sixth and seventh grades, and the final class included 13 eighth graders for a total study population of n = 76. However, due to absences or failure to give assent, the final study population size was n = 64. Student participants were between the ages of 12 and 14 years (mean age was 13 years). There was an equal distribution of male and female student participants. The racial/ethnic composition of participates were as follows: White non-Hispanic (n = 28, 47.5%), Black non-Hispanic/Latino (n = 21, 35.6%), Hispanic/Latino (n = 7, 11.9%), Asian (n = 1, 1.7%), and Other (n = 2, 3.4%).

Procedures

All student participants received a pre-test and post-test measure and participated in the HCP. All student participants received a pre-test measure before the HCP and a post-test measure one week after the HCP. The pre-test measure included a total of 24 questions, 5 demographic and 19 Likert-type questions modified from the Youth Attitude to Noise Scale or YANS. [33] Word choice modifications were made to make the YANS compatible for an American population (i.e. substituting the word discos with dances). The YANS contains 19 questions that measure adolescents' attitudes toward noise. These questions can be broken into four factors or categories which include: (1) Youth Culture or sounds related to leisure time, sound levels at concerts etc. (includes 8 items), (2) Daily Noise or daily sounds, such as sounds from traffic, computers, etc. (includes 3 items), (3) Concentration in Noise or the relationship between noise and concentration (includes 4 items), and (4) Intent to Influence or the wish to influence the environmental sound level (includes 4 items). During the development of the YANS, the four categories had a four factors solution performed and the alpha values are alpha 0.78 for attitudes towards noise associated with youth culture, alpha 0.72 for attitude towards daily noises, alpha 0.53 for intention to influence sound environment, and alpha. 66 for attitudes towards the ability to concentrate in noisy environments. [34] Sample items are shown in [Table 1]. The post-test measure that was given one week after the HCP included a total of 27 questions, 24 question were identical questions from the pre-test measure in addition to three subjective questions, such as "What were the things you liked from the program?" or "What have you learned?"
Table 1: Sample questions from each factor of the YANS

Click here to view


The first author, a licensed audiologist with an Au.D. degree, implemented the Dangerous Decibels® educational HCP. Dangerous Decibels® is a highly interactive and evidence-based program targeted to children in grades K-12. [28],[35] The HCP included information about the anatomy and physiology of the auditory system, the causes of NIHL using NIOSH exposure levels, proper use and care of hearing protection, and ear hygiene. This program stresses three simple ways of protecting one's hearing that include: 1. Turn it Down, 2. Walk Away, and 3. Protect Your Ears. Materials from the Dangerous Decibels Educator Kit was used for the hour long presentation of HCP, which included the Dangerous Decibels DVD, stereocilia model, "physics of sound" demonstration, "sound is vibration" demonstration, "how loud is too loud!" game, and the use of a sound level meter facilitated learning of the functions of the auditory system and the dangers of noise. For instance, the sound level meter activity stressed the effectiveness of walking away when loud music from a radio was played. At the completion of the study, student participants received hearing education materials and free ear protection. Student participants were further instructed on proper insertion and fit of ear plugs within the external ear canal and how to calculate how much hearing protection one could achieve by reviewing the noise reduction rating (NRR) listed on the hearing protection packaging.


  Results Top


A Wilcoxon signed rank test was used to compare the pre- and post-test measures means of the entire YANS and the 4 sub-factors (youth culture, concentration in noise, daily noise, and intent to influence). The pre-test YANS mean and the post-test YANS mean were 3.64 and 3.49, respectively, and the higher the YANS score (1-5) the more pro-noise views an individual holds. Therefore, when comparing pre- and post-test means of the entire YANS, there was a statistically significant reduction (P<</i>0.003) in pro-noise attitudes among the student participants. Factor One: Youth culture responses also showed a statistically significant (P<</i>0.001) change in adolescents' positive noise attitudes. However, Factor Two Concentration in Noise, Factor Three Daily Noise, and Factor Four Intent to Influence showed no statistically significant differences in the pre- and post-test responses [Table 2]. However, the negative Z-scores show that there was at least a reduction in the positive attitudes in post-test measure responses.
Table 2: Pre- and post-test means and standard deviations, Z-test scores between pre- and post-scores and the level of significance for each factor

Click here to view


To evaluate the effects of gender, race and/or ethnicity, and gender and race interaction on the differences between pre- and post-measures, a two-Factor Analysis of Variance (ANOVA) was completed. To increase statistical power when analyzing race/ethnicity, student participants that self identified as Hispanic, Asian, and Other were grouped into one group due to the few number of participants classified in the previously mentioned groups. Therefore, the three racial group categories were Caucasian, African American and Other. When examining the entire YANS, gender had no effect on the changes seen in the post-test measures with a significance level of P=0.639. Further, when looking at race alone and the interaction of race and gender on the changes seen in the post-test measures, there was no effect (P=0.15 and P=0.16). Factor One: Youth culture measure was not affected by gender (P=0.14), race (P=0.059), or gender and race interaction (P=0.16). However, the effect of race influenced the change from positive attitudes to more negative ones (i.e. noise is being viewed as a problem) seen in Factor One: Youth culture responses almost reached a statistically significant level (P=0.059), in that the HCP had a more positive effect in changing their views on noise [Figure 1]. Factor Two: Concentration in Noise measure was not affected by gender (P=0.57), race (P=0.97), or gender and race interaction (P=0.08), yet the interaction between gender and race also showed a trend of influence that was close to a significant level on the responses or attitudes towards concentration in noise. Factor Three: Daily Noise measure was not affected by gender (P=0.86), race (P=0.81), or gender and race interaction (P=0.87). Factor Four: Intent to Influence measure was not affected by gender (P=0.23), race (P=0.68), or gender and race interaction (P=0.75).
Figure 1: Youth culture factor and race

Click here to view


The post-test measure also included three subjective questions: "What were the things you liked from the program?" "What have you learned?" and "Would you recommend this program to be taught in other schools?" The majority of the students (approximately 89%) reported that they enjoyed the program and felt that they learned from the program. Review of the responses revealed student participants' consensus that HCPs should be implemented in the school setting, so that other students can become aware of the dangers of noise exposure. For instance, one participant stated "I think that you should do this at other schools all grades. I think that it will have a big impact on teen's lives."


  Discussion Top


Noise is a great danger that can hide in innoxious forms like music and other pleasurable activities. With the increased popularity of MP3 players, such as IPods, children and adolescents have introduced a new potential form of harm towards their auditory systems. Keppler et al. [36] reported that young adults exposed to music from MP3 players had greater odds of developing a decrease in hearing acuity compared to those that do not expose themselves to MP3 players. Thus, children and adolescents are exposing themselves to the dangers of noise, yet they may not know it. As a society we must intercede to reduce the poor hearing health outcomes that may affect this population. Recently, Shargorodsky et al. [13] reported an increase in the prevalence of hearing loss, especially high frequency hearing loss, among adolescents aged 12-19 years old in which there was a reported 31% increase in hearing loss among this population. One way to combat this may be through the use of HCPs, which can increase the knowledge and awareness of NIHL among children. [18],[28],[37],[38],[39] Based on the results in this study, the use of the Dangerous Decibels program facilitated a change in pro-noise attitudes, which is supported by the literature. The majority of student participants realized that noise can cause harm to their hearing health. Thus, information from a simple hour-long HCP was retained and made a significant influence in changing positive attitudes towards noise. However, a limitation of this pilot study is that the post testing was done relatively quickly (one week) after the presentation of the HCP. Thus, a future aim would be to look at long-term effects of HCPs by having assessments at longer intervals such as three months to access the amount of retained message and information. Another future aim would be to obtain a larger study population to further examine the differences among males and females and racially diverse populations. The standard deviations for all the factors (i.e. concentration in noise among the sexes) were quite large, so a larger population may help lower the standard deviations. The literature reports a clear gender difference with regards to NIHL, yet none was found within this project.

When comparing prevalence of NIHL and hearing-related risk behaviors among racially/ethnically diverse populations the literature is quite limited. One study by Crandell et al. [40] examined differences in knowledge, behaviors, and attitudes of African American students compared to Caucasian students. The data revealed that African American students were consistently less likely to correctly identify symptoms of excessive noise and the risk of hearing damage compared to their Caucasian counterparts. This is not surprising and would be expected because different racial and ethnic groups hold different beliefs and attitudes, so these differences in beliefs would also be seen in attitudes towards noise. Our results suggest that these attitudes can be changes with HCPs. In the current study, no significant differences were found among the three racially distinctive groups. However, there was a trend towards significance within the African-American group being more positively influenced by the HCP in the area of Youth Culture.

Through awareness and knowledge, attitudes can be influenced and modified from pro-noise to awareness of the dangers that noise may bring. According to the Health Belief Model, [41] this change in knowledge and attitude will eventually positively influence hearing-related health behaviors. Thus, the issue of hearing conservation should receive the same resources that other education programs like anti-smoking, anti-drug use, and sexually transmitted infection education programs receive from the school systems and other venues. [42] There are several effective comprehensive HCPs available that can be implemented in numerous venues. Nevertheless, not many audiologists, teachers, and other health educators are utilizing them. There are several HCPs that can be combined with supplemental educational resources to create programs that accomplish the goals of the presenters or are specifically targeted to a particular adolescent group (i.e. minority students that live in urban environments). As a result, a specific program created for a particular group may be more effective in changing attitudes, beliefs, and behaviors.

In addition, all HCPs should be coupled with audiometric testing to assess the hearing acuity of the participants and to identify and monitor hearing losses, especially educationally significant hearing losses among children and adolescents. The American Speech Language and Hearing Association (ASHA) recommends that children have their hearing screened annually, starting in kindergarten through 3 rd grade and again in 7 th and 11 th grades; however, each state has their own guidelines. [43] In conclusion, audiologists and other healthcare professionals should advocate for those populations vulnerable to NIHL, so they may live happier, healthier lives. Thus, to combat positive noise attitudes we must provide honest information and empower adolescents so that they have control of their hearing health. One way this can be accomplished is by implementing the use of HCPs among adolescents, parents, teachers, and the community. This investigation provides statistically significant results showing the efficacy of an HCP given in a limited time span in changing adolescents' attitudes toward noise; therefore, making them more aware of the hazards of noise within their cultural environments which is the first step to prevention of NIHL.


  Acknowledgments Top


The authors would like to thank P.K. Yonge Developmental Research School and the students that participated in the study. In addition, the authors thank Dr. Russ Froman and Coach Willie Powers for all their help and support.

 
  References Top

1.Dobie RA. Prevention of noise-induced hearing loss. Arch Otolaryngol Head Neck Surg 1995;121:385-91.  Back to cited text no. 1
    
2.Rogers B, Meyer D, Summey C, Scheessele D, Atwell T, Ostendorf J, et al. What makes a successful hearing conservation program? AAOHN J 2009;57:321-35; quiz 336-7.  Back to cited text no. 2
    
3.Lusk SL. Noise exposures. Effects on hearing and prevention of noise induced hearing loss. AAOHN J 1997;45:397-408; quiz 409-10.  Back to cited text no. 3
    
4.Hu BH, Henderson D, Yang WP. The impact of mitochondrial energetic dysfunction on apoptosis in outer hair cells of the cochlea following exposure to intense noise. Hear Res 2008;236:11-21.  Back to cited text no. 4
    
5.Kopke R, Allen KA, Henderson D, Hoffer M, Frenz D, Van der Water T. A radical demise: Toxins and trauma share common pathways in hair cell death. Ann N Y Acad Sci 1999;884:171-91.  Back to cited text no. 5
    
6.Jahn AF, Santos-Sacchi J. Physiology of the Ear. 2 nd ed. Canada: Singular- Thomson Learning; 2001.  Back to cited text no. 6
    
7.Berger EH, Royster LH, Royster JD, Driscoll DP, Layne M, editors. The noise manual. 5 th ed. Fairfax, VA: American Industrial Hygiene Association; 2003.  Back to cited text no. 7
    
8.Roeser RJ, Coleman T, Adams RM. Implementing an industrial hearing conservation program in the schools. J Sch Health 1983;53:408-11.  Back to cited text no. 8
    
9.National Institute of Occupational Safety and Health. Noise and Hearing Loss Prevention. Washington, DC: National Institute of Occupational Safety and Health; 2009.  Back to cited text no. 9
    
10.Occupational Safety and Health Administration. Occupational noise exposure (29 CRF 1910.95), Washington, D.C: Occupational Safety and Health Administration; 1983.  Back to cited text no. 10
    
11.Reynolds JL, Royster LH, Pearson RG. Hearing conservation programs (HCPs): the effectiveness of one company's HCP in a 12-hr work shift environment. Am Ind Hyg Assoc J 1990;51:437-46.  Back to cited text no. 11
    
12.Niskar AS, Kieszak SM, Holmes AE, Esteban E, Rubin C, Brody DJ. Estimated prevalence of noise-induced hearing threshold shifts among children 6 to 19 years of age: the Third National Health and Nutrition Examination Survey, 1988-1994, United States. Pediatrics 2001;108:40-3.  Back to cited text no. 12
    
13.Shargorodsky J, Curhan SG, Curhan GC, Eavey R. Change in Prevalence of Hearing Loss in US Adolescents. JAMA 2010;304:772-8.  Back to cited text no. 13
    
14.Bess FH, Dodd-Murphy J, Parker RA. Children with minimal sensorineural hearing loss: Prevalence, educational performance, and functional status. Ear Hear 1998;19:339-54.  Back to cited text no. 14
    
15.Davis JM, Shepard NT, Stelmachowicz PG, Gorga MP. Characteristics of hearing-impaired children in the public schools: part II-psychoeducational data. J Speech Hear Disord 1981;46:130-7.  Back to cited text no. 15
    
16.Bloom S. New hearing conservation initiatives: small steps with great potential. Hear J 2006;59:23.  Back to cited text no. 16
    
17.Coll KM, Cutler MM, Thobro P, Haas R, Powell S. An exploratory study of psychosocial risk behaviors of adolescents who are deaf or hard of hearing: comparisons and recommendations. Am Ann Deaf 2009;154:30-5.  Back to cited text no. 17
    
18.Daniel E. Noise and hearing loss: a review. J Sch Health 2007;77:225-31.  Back to cited text no. 18
    
19.Kawada T. The effect of noise on the health of children. J Nihon Med Sch 2004;71:5-10.  Back to cited text no. 19
    
20.Stansfeld SA, Matheson MP. Noise pollution: non-auditory effects on health. Br Med Bull 2003;68:243-57.  Back to cited text no. 20
    
21.Erlandsson SI, Holmes AE, Widen SE, Bohlin M. Cultural and social perspectives on attitudes, noise, and risk behavior in children and young adults. Semin Hear 2008;29:29-41.  Back to cited text no. 21
    
22.McFadden B, Pittman. Effect of minimal hearing on children's ability to multitask in quiet and noise. Lang Speech Hear Serv Sch 2008;39:342-51.  Back to cited text no. 22
    
23.Tharpe AM. Unilateral and bilateral hearing loss in children: Past and Current Perspectives. Trends Amplif 2008;12:7-15.  Back to cited text no. 23
    
24.Vogel I, Brug J, van der Ploeg CP, Raat H. Young people's exposure to loud music: a summary of the literature. Am J Prev Med 2007;33:124-33.  Back to cited text no. 24
    
25.Vogel I, Verschuure H, van der Ploeg CP, Brug J, Raat H. Adolescents and MP3 players: too many risks, too few precautions. Pediatrics 2009;123: e953-8.  Back to cited text no. 25
    
26.Suter AH. The hearing conservation amendment: 25 years later. Noise Health 2009;11:2-7.  Back to cited text no. 26
[PUBMED]  Medknow Journal  
27.Ryberg JB. A national project to evaluate and reduce high sound pressure levels from music. Noise Health 2009;11:124-8.  Back to cited text no. 27
[PUBMED]  Medknow Journal  
28.Folmer RL. Hearing-loss prevention practices should be taught in schools. Semin Hear 2008;29:67-80.  Back to cited text no. 28
    
29.Kochkin S. Hearing loss: The prevalence of hearing loss. Better Hearing Institute. Available from: http://www. Betterhearing.org/hearing_loss/prevalence.cfm. [Last retrieved on 2009 Apr 8].  Back to cited text no. 29
    
30.Caitlin FI. Noise-induced hearing loss. Am J Otol 1986;7:141-9.  Back to cited text no. 30
    
31.Sobel J, Meikle M. Applying health behavior theory to hearing-conservation interventions. Semin Hear 2008;29:81-9.  Back to cited text no. 31
    
32.Edberg M. Essentials of health behavior: Social and behavioral theory in public health. Boston: Jones and Barlett Publishers; 2007.  Back to cited text no. 32
    
33.Widén SE, Erlandsson SI. Self-reported tinnitus and noise sensitivity among adolescents in Sweden. Noise Health 2004;7:29-40.  Back to cited text no. 33
    
34.Widen SE, Erlandsson SI. The influence of socio-economic status on adolescent attitude to social noise and hearing protection. Noise Health 2004;7:59-70.  Back to cited text no. 34
    
35.Martin WH. Dangerous decibels: Partnership for preventing noise-induced hearing loss and tinnitus in children. Semin Hear 2008;29:102-10.  Back to cited text no. 35
    
36.Keppler H, Dhooge I, Maes L, D'haenens W, Bockstael A, Philips B, et al. Short-term auditory effects of listening to an MP3 Player. Arch Otolaryngol Head Neck Surg 2010;136:538-48.  Back to cited text no. 36
    
37.Weichbold V, Zorowka P. Can a hearing education campaign for adolescents change their music listening behavior? Int J Audiol 2007;46:128-33.  Back to cited text no. 37
    
38.Chermak GD, Curtis L, Seikel JA. The effectiveness of an interactive hearing conservation program for elementary school children. Lang Speech Hear Serv Sch 1996;27:29-39.  Back to cited text no. 38
    
39.Borchgrevink HM. Does health promotion work in relation to noise? Noise Health 2003;5:25-30.  Back to cited text no. 39
[PUBMED]  Medknow Journal  
40.Crandell C, Mills TL, Gauthier R. Knowledge, behaviors, and attitudes about hearing loss and hearing protection among racial/ethnically diverse young adults. J Natl Med Assoc 2004;96:176-86.  Back to cited text no. 40
    
41.Rosenstock IM, Strecher VJ, Becker MH. Social learning theory and the Health Belief Model. Health Educ Q 1988;15:175-83.  Back to cited text no. 41
    
42.Folmer RL, Griest SE, Martin WH. Hearing conservation education programs for children: a review. J Sch Health 2002;72:51-7.  Back to cited text no. 42
    
43.American Speech Language and Hearing Association, A. 1997. Guidelines for audiologic screenings. Available from: http://www.asha.org/policy. [Last retrieved on 2009 Feb 6].  Back to cited text no. 43
    

Top
Correspondence Address:
Shawna M Dell
PO Box 117420, University of Florida, Gainesville, Fl 32611
USA
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1463-1741.93333

Rights and Permissions


    Figures

  [Figure 1]
 
 
    Tables

  [Table 1], [Table 2]

This article has been cited by
1 Effectiveness of a preventive campaign for noise-induced hearing damage in adolescents
Annick Gilles,Van de Heyning Paul
International Journal of Pediatric Otorhinolaryngology. 2014; 78(4): 604
[Pubmed] | [DOI]
2 National research agenda for the prevention of occupational hearing loss-part 2
Themann, C., Suter, A., Stephenson, M.R.
Source of the Document Seminars in Hearing. 2013;
[Pubmed]
3 Infant hearing loss: From diagnosis to therapy official report of xxi conference of italian society of pediatric otorhinolaryngology [Ipoacusie infantili: Dalla diagnosi alla terapia Estratto dalla Relazione Ufficiale del XXI Congresso Nazionale della Societá Italiana di Otorinolaringoiatria Pediatrica]
Paludetti, G. and Conti, G. and Di Nardo, D. and de Corso, E. and Rolesi, R. and Picciotti, P.M. and Fetoni, A.R.
Acta Otorhinolaryngologica Italica. 2012; 32(6): 347-370
[Pubmed]
4 Non-organic hearing loss
Nelson, S.C.
Journal of the Royal Army Medical Corps. 2012; 158(4): 329-330
[Pubmed]



 

Top