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He J, Smith LM, Shkembi A, Neitzel RL. Evaluating the impact of occupational noise exposure on workplace fatal and nonfatal injuries in the U.S. (2006-2020). Int J Hyg Environ Health 2024; 263:114468. [PMID: 39332352 DOI: 10.1016/j.ijheh.2024.114468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Revised: 09/05/2024] [Accepted: 09/20/2024] [Indexed: 09/29/2024]
Abstract
OBJECTIVES This study assessed the relationship between occupational noise exposure and the incidence of workplace fatal injury (FI) and nonfatal injury (NFI) in the United States from 2006 to 2020. It also examined whether distinct occupational and industrial clusters based on noise exposure characteristics demonstrated varying risks for FI and NFI. METHODS An ecological study design was utilized, employing data from the U.S. Bureau of Labor Statistics for FI and NFI and demographic data, the U.S. Census Bureau for occupation/industry classification code lists, and the U.S./Canada Occupational Noise Job Exposure Matrix for noise measurements. We examined four noise metrics as predictors of FI and NFI rates: mean Time-Weighted Average (TWA), maximum TWA, standard deviation of TWA, and percentage of work shifts exceeding 85 or 90 dBA for 619 occupation-years and 591 industry-years. K-means clustering was used to identify clusters of noise exposure characteristics. Mixed-effects negative binomial regression examined the relationship between the noise characteristics and FI/NFI rates separately for occupation and industry. RESULTS Among occupations, we found significant associations between increased FI rates and higher mean TWA (IRR: 1.06, 95% CI: 1.01-1.12) and maximum TWA (IRR: 1.10, 95% CI: 1.07-1.14), as well as TWA exceedance (IRR: 1.04, 95% CI: 1.01-1.07). Increased rates of NFI were found to be significantly associated with maximum TWA (IRR: 1.06, 95% CI: 1.04-1.09) and TWA exceedance (IRR: 1.03, 95% CI: 1.01-1.05). In addition, occupations with both higher exposure variability (IRR with FI rate: 1.49, 95% CI: 1.23-1.80; IRR with NFI rate: 1.40, 95% CI: 1.14-1.73) and higher level of sustained exposure (IRR with FI rate: 1.27, 95% CI: 1.12-1.44; IRR with NFI rate: 1.21, 95% CI: 1.05-1.39) were associated with higher rates of FI and NFI compared to occupations with low noise exposure. Among industries, significant associations between increased NFI rates and higher mean TWA (IRR: 1.05, 95% CI: 1.02-1.08) and maximum TWA (IRR: 1.06, 95% CI: 1.04-1.08) were observed. Unlike the occupation-specific analysis, industries with higher exposure variability and higher sustained exposures did not display significantly higher FI/NFI rates compared to industries with low exposure. CONCLUSIONS The results suggest that occupational noise exposure may be an independent risk factor for workplace FIs/NFIs, particularly for workplaces with highly variable noise exposures. The study highlights the importance of comprehensive occupational noise assessments.
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Affiliation(s)
- Jie He
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Abor, MI, 48109, USA
| | - Lauren M Smith
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Abor, MI, 48109, USA
| | - Abas Shkembi
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Abor, MI, 48109, USA
| | - Richard L Neitzel
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Abor, MI, 48109, USA.
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Masterson EA, Themann CL. Prevalence of Hearing Loss Among Noise-Exposed US Workers Within the Utilities Sector, 2010-2019. J Occup Environ Med 2024; 66:648-653. [PMID: 38664951 DOI: 10.1097/jom.0000000000003125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/06/2024]
Abstract
OBJECTIVE This study's objective was to estimate hearing loss prevalence for noise-exposed US Utilities workers. METHODS In this cross-sectional study of a retrospective cohort, audiograms were examined for 1.3 million workers (13,595 within utilities) from 2010-2019. Hearing loss prevalence and adjusted risk as compared with a reference industry were estimated. RESULTS The hearing loss prevalence for noise-exposed Utilities workers (25%) was higher than for noise-exposed workers in all industries combined (20%). Some subsectors surpassed the prevalence for all industries combined and/or had adjusted risks significantly higher than the reference industry. The highest prevalence subsectors were Hydroelectric Power Generation (37%) and steam and Air-Conditioning Supply (29%). CONCLUSIONS While often overlooked, noise-exposed workers in this sector have among the highest prevalences of hearing loss and significantly higher risks. Increased attention and better hearing conservation strategies are needed.
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Affiliation(s)
- Elizabeth A Masterson
- From the National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio
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3
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Morata TC, Gong W, Tikka C, Samelli AG, Verbeek JH. Hearing protection field attenuation estimation systems and associated training for reducing workers' exposure to noise. Cochrane Database Syst Rev 2024; 5:CD015066. [PMID: 38757544 PMCID: PMC11099959 DOI: 10.1002/14651858.cd015066.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
BACKGROUND Global Burden of Disease studies identify hearing loss as the third leading cause of years lived with a disability. Their estimates point to large societal and individual costs from unaddressed hearing difficulties. Workplace noise is an important modifiable risk factor; if addressed, it could significantly reduce the global burden of disease. In practice, providing hearing protection devices (HPDs) is the most common intervention to reduce noise exposure at work. However, lack of fit of HPDs, especially earplugs, can greatly limit their effectiveness. This may be the case for 40% of users. Testing the fit and providing instructions to improve noise attenuation might be effective. In the past two decades, hearing protection fit-test systems have been developed and evaluated in the field. They are called field attenuation estimation systems. They measure the noise attenuation obtained by individual workers using HPDs. If there is a lack of fit, instruction for better fit is provided, and may lead to better noise attenuation obtained by HPDs. OBJECTIVES To assess: (1) the effects of field attenuation estimation systems and associated training on the noise attenuation obtained by HPDs compared to no instruction or to less instruction in workers exposed to noise; and (2) whether these interventions promote adherence to HPD use. SEARCH METHODS We used CENTRAL, MEDLINE, five other databases, and two trial registers, together with reference checking, citation searching, and contact with study authors to identify studies. We imposed no language or date restrictions. The latest search date was February 2024. SELECTION CRITERIA We included randomised controlled trials (RCTs), cluster-RCTs, controlled before-after studies (CBAs), and interrupted time-series studies (ITSs) exploring HPD fit testing in workers exposed to noise levels of more than 80 A-weighted decibels (or dBA) who use hearing protection devices. The unit 'dBA' reports on the use of a frequency-weighting filter to adjust sound measurement results to better reflect how human ears process sound. The outcome noise attenuation had to be measured either as a personal attenuation rating (PAR), PAR pass rate, or both. PAR pass rate is the percentage of workers who passed a pre-established level of sufficient attenuation from their HPDs, identified on the basis of their individual noise exposure. DATA COLLECTION AND ANALYSIS Two review authors independently assessed study eligibility, risk of bias, and extracted data. We categorised interventions as fit testing of HPDs with instructions at different levels (no instructions, simple instructions, and extensive instructions). MAIN RESULTS We included three RCTs (756 participants). We did not find any studies that examined whether fit testing and training contributed to hearing protector use, nor any studies that examined whether age, gender, or HPD experience influenced attenuation. We would have included any adverse effects if mentioned by the trial authors, but none reported them. None of the included studies blinded participants; two studies blinded those who delivered the intervention. Effects of fit testing of HPDs with instructions (simple or extensive) versus fit testing of HPDs without instructions Testing the fit of foam and premoulded earplugs accompanied by simple instructions probably does not improve their noise attenuation in the short term after the test (1-month follow-up: mean difference (MD) 1.62 decibels (dB), 95% confidence interval (CI) -0.93 to 4.17; 1 study, 209 participants; 4-month follow-up: MD 0.40 dB, 95% CI -2.28 to 3.08; 1 study, 197 participants; both moderate-certainty evidence). The intervention probably does not improve noise attenuation in the long term (MD 0.15 dB, 95% CI -3.44 to 3.74; 1 study, 103 participants; moderate-certainty evidence). Fit testing of premoulded earplugs with extensive instructions on the fit of the earplugs may improve their noise attenuation at the immediate retest when compared to fit testing without instructions (MD 8.34 dB, 95% CI 7.32 to 9.36; 1 study, 100 participants; low-certainty evidence). Effects of fit testing of HPDs with extensive instructions versus fit testing of HPDs with simple instructions Fit testing of foam earplugs with extensive instructions probably improves their attenuation (MD 8.62 dB, 95% CI 6.31 to 10.93; 1 study, 321 participants; moderate-certainty evidence) and also the pass rate of sufficient attenuation (risk ratio (RR) 1.75, 95% CI 1.44 to 2.11; 1 study, 321 participants; moderate-certainty evidence) when compared to fit testing with simple instructions immediately after the test. This is significant because every 3 dB decrease in noise exposure level halves the sound energy entering the ear. No RCTs reported on the long-term effectiveness of the HPD fit testing with extensive instructions. AUTHORS' CONCLUSIONS HPD fit testing accompanied by simple instructions probably does not improve noise attenuation from foam and premoulded earplugs. Testing the fit of foam and premoulded earplugs with extensive instructions probably improves attenuation and PAR pass rate immediately after the test. The effects of fit testing associated with training to improve attenuation may vary with types of HPDs and training methods. Better-designed trials with larger sample sizes are required to increase the certainty of the evidence.
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Affiliation(s)
- Thais C Morata
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health (NIOSH), Cincinnati, OH, USA
| | - Wei Gong
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health (NIOSH), Cincinnati, OH, USA
| | - Christina Tikka
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Alessandra G Samelli
- Department of Physical Therapy, Speech-Language-Hearing Sciences, and Occupational Therapy, Universidade de São Paulo, São Paulo, Brazil
| | - Jos H Verbeek
- Cochrane Work, Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
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Jo H, Baek EM. Impacts of noise-induced hearing loss on sleep, health, and workplace: Multi-group analysis. Heliyon 2024; 10:e30861. [PMID: 38774066 PMCID: PMC11107223 DOI: 10.1016/j.heliyon.2024.e30861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 05/05/2024] [Accepted: 05/07/2024] [Indexed: 05/24/2024] Open
Abstract
Noise-induced hearing loss (NIHL) is a significant occupational health concern, particularly in industries with high levels of noise exposure. This study examines the effects of NIHL on sleep quality, daily life health conditions, and workplace health problems among workers. A total of 1285 workers participated in the study, and the data were analyzed using partial least squares structural equation modeling (PLS-SEM) to assess the impacts of NIHL. The analysis included a multi-group analysis to differentiate the effects between workers who wear noise protection and those who do not. Our findings indicate that NIHL significantly affects sleep quality, with a coefficient of 0.263 (t = 9.957, p<0.001), daily life health conditions with a coefficient of 0.296 (t = 10.793, p<0.001), and workplace health problems with a coefficient of 0.345 (t = 13.814, p<0.001). The multi-group analysis revealed more severe impacts on sleep and health in the non-wearing group compared to the noise-protection-wearing group, with statistically significant differences in path coefficients for sleep disorders (-0.033), health problems in daily life (-0.184), and health problems in the workplace (-0.190), all showing p-values of 0.000. These results underscore the detrimental effects of NIHL on multiple aspects of workers' health and emphasize the importance of wearing noise protection to mitigate these effects. This study provides vital insights for both researchers and practitioners in public health, suggesting that improved noise protection strategies are essential for protecting workers in noisy environments.
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Affiliation(s)
- Hyeon Jo
- Headquarters, HJ Institute of Technology and Management, 71 Jungdong-ro 39, Bucheon-si, Gyeonggi-do, 14721, Republic of Korea
| | - Eun-Mi Baek
- Department of Preventive Medicine, College of Medicine, Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
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Chand A, Manoharan A, Kumari LR. An Exploratory Study on Self-Reported Auditory Symptoms and Hearing Loss among Workers in a Small-Scale LPG Plant. Indian J Occup Environ Med 2024; 28:94-99. [PMID: 39114100 PMCID: PMC11302531 DOI: 10.4103/ijoem.ijoem_44_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/28/2023] [Accepted: 07/16/2023] [Indexed: 08/10/2024] Open
Abstract
Background Occupational noise is considered a factor contributing to acquired hearing loss (HL) in adults. Frequent noise exposure can cause cochlear damage, leading to sensorineural HL, tinnitus, vertigo, and other non auditory effects as well. Although it is well known that liquefied petroleum gas (LPG) plants in India have become a workplace source for occupational noise pollution exposure, there are not many studies that probe into the auditory effects of workplace noise in LPG plants. Aim The study aims to document HL and self reported otological symptoms in employees with occupational noise exposure at a typical LPG plant in a suburban location in India. 53 employees who reported workplace noise exposure were assessed for HL and self reported auditory symptoms. Method Self reported symptoms were collected using a custom made case history questionnaire, and auditory sensitivity was measured using air conduction audiometers. Results Among the 53 participants, 27 tested positive for HL. A mild degree of HL was frequently observed, followed by a moderate and severe degree of HL. In the self reported otological complaints reported by 31 participants, HL and aural fullness were the most commonly reported auditory symptoms. Additionally, the use of ear protection devices and hearing conservation practices among the participants were poor. Conclusion Hearing loss and self-reported auditory symptoms were present in the study group indicating the effect of occupational noise in the auditory system.
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Affiliation(s)
- Arya Chand
- Department of Audiology and Speech Language Pathology, National Institute of Speech and Hearing, Trivandrum, Kerala, India
| | - Asha Manoharan
- Department of Audiology and Speech Language Pathology, National Institute of Speech and Hearing, Trivandrum, Kerala, India
| | - L Rejitha Kumari
- Department of Social Work, National Institute of Speech and Hearing, Trivandrum, Kerala, India
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Rincon Sabatino S, Rivero A, Sangaletti R, Dietrich WD, Hoffer ME, King CS, Rajguru SM. Targeted therapeutic hypothermia protects against noise induced hearing loss. Front Neurosci 2024; 17:1296458. [PMID: 38292902 PMCID: PMC10826421 DOI: 10.3389/fnins.2023.1296458] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 12/14/2023] [Indexed: 02/01/2024] Open
Abstract
Introduction Exposure to occupational or recreational loud noise activates multiple biological regulatory circuits and damages the cochlea, causing permanent changes in hearing sensitivity. Currently, no effective clinical therapy is available for the treatment or mitigation of noise-induced hearing loss (NIHL). Here, we describe an application of localized and non-invasive therapeutic hypothermia and targeted temperature management of the inner ear to prevent NIHL. Methods We developed a custom-designed cooling neck collar to reduce the temperature of the inner ear by 3-4°C post-injury to deliver mild therapeutic hypothermia. Results This localized and non-invasive therapeutic hypothermia successfully mitigated NIHL in rats. Our results show that mild hypothermia can be applied quickly and safely to the inner ear following noise exposure. We show that localized hypothermia after NIHL preserves residual hearing and rescues noise-induced synaptopathy over a period of months. Discussion This study establishes a minimally-invasive therapeutic paradigm with a high potential for rapid translation to the clinic for long-term preservation of hearing health.
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Affiliation(s)
| | - Andrea Rivero
- Department of Biomedical Engineering, University of Miami, Coral Gables, FL, United States
| | - Rachele Sangaletti
- The Miami Project to Cure Paralysis, University of Miami, Coral Gables, FL, United States
| | - W. Dalton Dietrich
- Department of Otolaryngology, University of Miami, Coral Gables, FL, United States
| | - Michael E. Hoffer
- The Miami Project to Cure Paralysis, University of Miami, Coral Gables, FL, United States
| | | | - Suhrud M. Rajguru
- Department of Biomedical Engineering, University of Miami, Coral Gables, FL, United States
- The Miami Project to Cure Paralysis, University of Miami, Coral Gables, FL, United States
- RestorEar Devices LLC, Bozeman, MT, United States
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Masterson EA, Wurzelbacher SJ, Bushnell PT, Tseng CY. Workers' Compensation Costs for Occupational Hearing Loss Claims in the United States, 2009-2013. Semin Hear 2023; 44:412-436. [PMID: 37818144 PMCID: PMC10562048 DOI: 10.1055/s-0043-1769587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/12/2023] Open
Abstract
This study estimated the average annual number of U.S. workers' compensation (WC) claims for occupational hearing loss (OHL) and their associated cost and identified the industry/occupation classifications with the highest numbers of OHL claims. The most recent U.S. cost estimate ($242 million) was based on data from one state in 1 year (1991). WC data from the National Council on Compensation Insurance, Inc. (35 states) and two additional individual states were examined, incorporating data from 37 states and the District of Columbia. Costs and numbers of claims were estimated for the 13 missing states to develop estimates for the United States. Sensitivity analyses were also performed to develop ranges for the point estimates. The estimated U.S. average annual OHL claim cost fell within the range of $49 to $67 million during 2009-2013, with a point estimate of $60 million (2013 dollars). The estimated average annual number of OHL claims ranged from 4,114 to 5,986, with a point estimate of 4,965 claims. Based on data available from 36 states and DC, 18 of the 40 industry/occupation classifications with ≥50 OHL claims were in the manufacturing sector. WC data underestimate the true burden of OHL. Most OHL cases are not compensated. WC laws, industry composition and other factors vary widely by state, so estimates must employ data for many states. This study incorporated data from most states and utilized sensitivity and comparative analyses to obtain estimates. Workers in a wide range of industry/occupation classifications need special attention to prevent OHL.
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Affiliation(s)
- Elizabeth A. Masterson
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health (NIOSH), Cincinnati, Ohio
| | - Steven J. Wurzelbacher
- Center for Workers' Compensation Studies, Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Cincinnati, Ohio
| | - P. Timothy Bushnell
- Economic Research and Support Office, Office of the Director, National Institute for Occupational Safety and Health, Cincinnati, Ohio
| | - Chih-Yu Tseng
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health (NIOSH), Cincinnati, Ohio
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Themann CL, Masterson EA, Peterson JS, Murphy WJ. Preventing Occupational Hearing Loss: 50 Years of Research and Recommendations from the National Institute for Occupational Safety and Health. Semin Hear 2023; 44:351-393. [PMID: 37818146 PMCID: PMC10562059 DOI: 10.1055/s-0043-1769499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/12/2023] Open
Abstract
For more than 50 years, the National Institute for Occupational Safety and Health (NIOSH), part of the United States (U.S.) Centers for Disease Control and Prevention (CDC), has been actively working to reduce the effects of noise and ototoxic chemicals on worker hearing. NIOSH has pioneered basic and applied research on occupational hearing risks and preventive measures. The Institute has issued recommendations and promoted effective interventions through mechanisms ranging from formal criteria documents to blogs and social media. NIOSH has conducted surveillance and published statistics to guide policy and target prevention efforts. Over the past five decades, substantial progress has been made in raising awareness of noise as a hazard, reducing the risk of occupational hearing loss, improving the use of hearing protection, and advancing measurement and control technologies. Nevertheless, noise remains a prevalent workplace hazard and occupational hearing loss is still one of the most common work-related conditions. NIOSH continues to work toward preventing the effects of noise and ototoxicants at work and has many resources to assist audiologists in their hearing loss prevention efforts.
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Affiliation(s)
- Christa L. Themann
- Noise and Bioacoustics Team, National Institute for Occupational Safety and Health, Cincinnati, Ohio
| | - Elizabeth A. Masterson
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Cincinnati, Ohio
| | - Jeffrey Shawn Peterson
- Pittsburgh Mining Research Division, National Institute for Occupational Safety and Health, Pittsburgh, Pennsylvania
| | - William J. Murphy
- Noise and Bioacoustics Team, National Institute for Occupational Safety and Health, Cincinnati, Ohio
- Stephenson and Stephenson Research and Consulting, LLC, Batavia, Ohio
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Stroh O, Thomas G, Peters TM, Tatum M. Design and testing of a personalized noise monitoring system. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2023; 20:120-128. [PMID: 36445186 DOI: 10.1080/15459624.2022.2152036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Agricultural workers are more prone to noise-induced hearing loss than are many other workers. Hearing protection device use among agricultural workers is low, but training can increase hearing protection device use. This work proposes a system designed to automatically inform agricultural workers when they were exposed to noises that exceed the National Institute for Occupational Safety and Health (NIOSH) recommended exposure level. The smartphone-based system worn on the arm uses a noise dosimeter to measure noise exposures throughout the day to within ±2 A-weighted decibels of a Class 2 sound level meter. The device collects location and audio data, which are transferred to a server and presented to the worker on a locally hosted website. The website details noise exposure and helps the worker identify where exposure occurred and what specific tasks exceed NIOSH's recommended exposure limit, putting them at higher risk of noise-induced hearing loss. With this understanding, the worker is expected to adopt behavior changes and better hearing protection use at critical places and times. This pilot study evaluates the accuracy of the noise dosimeter and GPS relative to gold-standard instruments. The system was tested on a farm with outputs compared with gold-standard instruments. A-weighted, 1-sec averaged sound pressure levels and position data were collected while users were performing a variety of tasks indoors and outdoors. The smartphone's external noise dosimeter read within ±2 A-weighted decibels of the Class 2 reference dosimeter 59% of the time. The positioning devices had an average error of sub-4 m. While not perfectly matching gold-standard instruments, the device is capable of identifying and collecting information relative to loud noise events that promote noise-induced hearing loss.
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Affiliation(s)
- Oliver Stroh
- Industrial and Systems Engineering, College of Engineering, University of Iowa, Iowa City, Iowa
| | - Geb Thomas
- Industrial and Systems Engineering, College of Engineering, University of Iowa, Iowa City, Iowa
| | - Thomas M Peters
- Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Marcus Tatum
- Industrial and Systems Engineering, College of Engineering, University of Iowa, Iowa City, Iowa
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Trevino M, Zang A, Lobarinas E. The middle ear muscle reflex: Current and future role in assessing noise-induced cochlear damage. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2023; 153:436. [PMID: 36732247 PMCID: PMC9867568 DOI: 10.1121/10.0016853] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 12/21/2022] [Accepted: 12/23/2022] [Indexed: 06/18/2023]
Abstract
The middle ear muscle reflex (MEMR) in humans is a bilateral contraction of the middle ear stapedial muscle in response to moderate-to-high intensity acoustic stimuli. Clinically, MEMR thresholds have been used for differential diagnosis of otopathologies for decades. More recently, changes in MEMR amplitude or threshold have been proposed as an assessment for noise-induced synaptopathy, a subclinical form of cochlear damage characterized by suprathreshold hearing problems that occur as a function of inner hair cell (IHC) synaptic loss, including hearing-in-noise deficits, tinnitus, and hyperacusis. In animal models, changes in wideband MEMR immittance have been correlated with noise-induced synaptopathy; however, studies in humans have shown more varied results. The discrepancies observed across studies could reflect the heterogeneity of synaptopathy in humans more than the effects of parametric differences or relative sensitivity of the measurement. Whereas the etiology and degree of synaptopathy can be carefully controlled in animal models, synaptopathy in humans likely stems from multiple etiologies and thus can vary greatly across the population. Here, we explore the evolving research evidence of the MEMR response in relation to subclinical noise-induced cochlear damage and the MEMR as an early correlate of suprathreshold deficits.
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Affiliation(s)
- Monica Trevino
- School of Behavioral and Brain Sciences, Department of Speech, Language and Hearing, The University of Texas at Dallas, Richardson, Texas 75080, USA
| | - Andie Zang
- School of Behavioral and Brain Sciences, Department of Speech, Language and Hearing, The University of Texas at Dallas, Richardson, Texas 75080, USA
| | - Edward Lobarinas
- School of Behavioral and Brain Sciences, Department of Speech, Language and Hearing, The University of Texas at Dallas, Richardson, Texas 75080, USA
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Craner J. Audiometric data analysis for prevention of noise-induced hearing loss: A new approach. Am J Ind Med 2022; 65:409-424. [PMID: 35289946 DOI: 10.1002/ajim.23343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 02/03/2022] [Accepted: 02/23/2022] [Indexed: 11/11/2022]
Abstract
Compliance with noise regulations in the past three decades has significantly reduced workplace noise exposures, particularly in the loudest industries and occupations. However, the overall effectiveness of hearing conservation programs in preventing occupational noise-induced hearing loss remains uncertain and unquantified, while the incidence and cost of occupational hearing loss remain inexplicably high. This review/commentary critically explores this paradox by examining why the billions of annual audiograms conducted worldwide have not been aggregately utilized or applied to predict early NIHL in groups of workers or to measure the efficacy of exposure controls. Principal contributory reasons include regulation of noise as a safety standard rather than as a health standard, the inherent complexity of audiometric data, and the lack of a standardized method of interpretation for audiograms. The unsuccessful history of efforts to develop and adopt methods and tools to analyze aggregate audiometric data is described. Consequently, the Standard Threshold Shift-a regulatorily defined, lagging indicator of individual, irreversible hearing loss that is not an effective preventive metric-remains the de facto standard of care. A population-based Best Practices approach is proposed to leverage the raw audiometric data already available and turn it into actionable data for effective secondary prevention to strategically manage and reduce occupational hearing loss risk. This approach entails statistical methods and information management tools necessary to transform audiometry from a compliance-driven, individual screening test with limited preventive capability into a medical surveillance process directly linked to aggregate corrective and prevention actions.
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Affiliation(s)
- James Craner
- Verdi Technology, Inc. Reno Nevada USA
- Department of Medicine, Division of Occupational & Environmental Medicine University of California, San Francisco (UCSF) School of Medicine San Francisco California USA
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