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Ren Y, Wu K, He Y, Zhang H, Ma J, Li C, Ruan Y, Zhang J, Wen Y, Wu X, Chen S, Qiu H, Zhang Y, Zhou L, Ou Z, Liang J, Wang Z. The role of NLRP3 inflammasome-mediated neuroinflammation in chronic noise-induced impairment of learning and memory ability. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 286:117183. [PMID: 39437517 DOI: 10.1016/j.ecoenv.2024.117183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 10/09/2024] [Accepted: 10/10/2024] [Indexed: 10/25/2024]
Abstract
BACKGROUND Noise pollution pervades daily working and living environment, becoming a serious public health problem. In addition to causing auditory impairment, noise independently contributes to cognitive decline as a risk factor. Though neuroinflammation plays an important role in noise-induced cognitive deficits, the mechanisms underlying noise-induced neuroinflammation in the hippocampus are still poorly understood. Glial hyperactivation of the NLRP3 inflammasome contributes to various neurodegenerative diseases, including Alzheimer's disease (AD) and Parkinson's disease (PD). However, whether the NLRP3 inflammasome plays a role in noise-induced cognitive impairment remains to be further investigated. METHODS Adult male Wistar rats were exposed to 100 dB white noise (4 h/day) for 30 days with or without injection of the NLRP3 inhibitor MCC950 (10 mg/kg/day). The Morris water maze (MWM) test and the open field test (OFT) were performed to evaluate learning and memory ability of rats. HE staining was used to explore hippocampal pathological changes, while immunohistochemical staining was employed to evaluate the number and morphology of microglia and astrocytes. The mRNA levels of the NLRP3 inflammasome in the hippocampus were examined by Real-time PCR. The protein levels of NLRP3 inflammasome, inflammatory cytokines, p-Tau-S396, and amyloid-β (Aβ) 42 in the hippocampus were examined by Western blot. Immunofluorescence was used to observe the distribution of NLRP3 in glial cells and neurons, and the assembly of the NLRP3 inflammasome. RESULTS We found that noise exposure induced learning and memory impairment in rats, mainly related to the activation of microglia and astrocytes in hippocampus region. Noise exposure increased the protein levels of p-Tau-S396, Aβ42, ionized calcium binding adapter molecule 1 (Iba-1), glial fibrillary acidic protein (GFAP), interleukin (IL)-1β, IL-18, and tumor necrosis factor-α (TNF-α) in hippocampus. Furthermore, the hippocampus of noise-exposed rats showed elevated protein levels of NLRP3, ASC and cleaved caspase-1. The co-labeled immunofluorescence levels of Iba-1 or GFAP with NLRP3 significantly increased in the dentate gyrus (DG) region of the hippocampus. NLRP3 inhibitor MCC950 intervention reversed chronic noise-induced activation of NLRP3 inflammasome, AD-like pathologies and impairment of learning and memory in rats. CONCLUSIONS The NLRP3 inflammasome-mediated neuroinflammation played an essential role in chronic noise-induced cognitive dysfunction. These results provide novel strategies for the prevention and treatment of cognitive deficits caused by chronic noise.
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Affiliation(s)
- Yixian Ren
- Key Laboratory of Occupational Environment and Health, Guangzhou Occupational Disease Prevention and Treatment Hospital, Guangzhou, China; Institute of Occupational and Environmental Health, Guangzhou Medical University, Guangzhou, China
| | - Kangyong Wu
- Key Laboratory of Occupational Environment and Health, Guangzhou Occupational Disease Prevention and Treatment Hospital, Guangzhou, China; Institute of Occupational and Environmental Health, Guangzhou Medical University, Guangzhou, China
| | - Yongke He
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Hangqian Zhang
- School of Public Health, Southern Medical University, Guangzhou, China
| | - Jialao Ma
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Caixia Li
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Yanmei Ruan
- Key Laboratory of Occupational Environment and Health, Guangzhou Occupational Disease Prevention and Treatment Hospital, Guangzhou, China
| | - Jinwei Zhang
- Key Laboratory of Occupational Environment and Health, Guangzhou Occupational Disease Prevention and Treatment Hospital, Guangzhou, China
| | - Ying Wen
- Institute of Pediatrics, Guangzhou Women and Children's Medical Centre, Guangzhou Medical University, Guangzhou, China
| | - Xian Wu
- Health Management Center, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Siran Chen
- School of Basic Medicine and Public Health, Jinan University, Guangzhou, China
| | - Heng Qiu
- Department of Chemistry, The University of Hong Kong, Hong Kong
| | - Yifan Zhang
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Liping Zhou
- Key Laboratory of Occupational Environment and Health, Guangzhou Occupational Disease Prevention and Treatment Hospital, Guangzhou, China
| | - Zejin Ou
- Key Laboratory of Occupational Environment and Health, Guangzhou Occupational Disease Prevention and Treatment Hospital, Guangzhou, China; Institute of Occupational and Environmental Health, Guangzhou Medical University, Guangzhou, China
| | - Jiabin Liang
- Key Laboratory of Occupational Environment and Health, Guangzhou Occupational Disease Prevention and Treatment Hospital, Guangzhou, China; Institute of Occupational and Environmental Health, Guangzhou Medical University, Guangzhou, China
| | - Zhi Wang
- Key Laboratory of Occupational Environment and Health, Guangzhou Occupational Disease Prevention and Treatment Hospital, Guangzhou, China; Institute of Occupational and Environmental Health, Guangzhou Medical University, Guangzhou, China.
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Berns MP, Nunez GM, Zhang X, Chavan A, Zemlianova K, Mowery TM, Yao JD. Auditory decision-making deficits after permanent noise-induced hearing loss. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.09.23.614535. [PMID: 39386692 PMCID: PMC11463679 DOI: 10.1101/2024.09.23.614535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/12/2024]
Abstract
Loud noise exposure is one of the leading causes of permanent hearing loss. Individuals with noise-induced hearing loss (NIHL) suffer from speech comprehension deficits and experience impairments to cognitive functions such as attention and decision-making. Here, we tested whether a specific sensory deficit, NIHL, can directly impair auditory cognitive function. Gerbils were trained to perform an auditory decision-making task that involves discriminating between slow and fast presentation rates of amplitude-modulated (AM) noise. Decision-making task performance was assessed across pre-versus post-NIHL sessions within the same gerbils. A single exposure session (2 hours) to loud broadband noise (120 dB SPL) produced permanent NIHL with elevated threshold shifts in auditory brainstem responses (ABRs). Following NIHL, decision-making task performance was tested at sensation levels comparable to those prior to noise exposure in all animals. Our findings demonstrate NIHL diminished perceptual acuity, reduced attentional focus, altered choice bias, and slowed down evidence accumulation speed. Finally, video-tracking analysis of motor behavior during task performance demonstrates that NIHL can impact sensory-guided decision-based motor execution. Together, these results suggest that NIHL impairs the sensory, cognitive, and motor factors that support auditory decision-making.
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Mousavi Kordmiri SH, Aliabadi M, Golmohammadi R, Farhadian M, Abbasi Balochkhaneh F. Effect of concurrent exposure to noise and hand-transmitted vibration on auditory and cognitive attention under simulated work with construction tools. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2024; 30:754-764. [PMID: 38628029 DOI: 10.1080/10803548.2024.2337545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2024]
Abstract
Objectives. This study aimed to investigate the effects of separate and concurrent exposure to occupational noise and hand-transmitted vibration (HTV) on auditory and cognitive attention. Methods. The experimental study was conducted with 40 construction workers who were exposed to noise (A-weighted equivalent sound pressure level of 90 dB) and to HTV (10 m/s2 at 31.5 Hz), and concurrent exposure to both for 30 min under simulated work with vibrating equipment used in construction. Cognitive performance aspects were then evaluated from each individual in two pre-exposure and post-exposure settings for each session. Results. The effect sizes of concurrent exposure (HTV + noise) and separate exposure to noise on auditory attention were very close (effect size = 0.648 and 0.626). The largest changes in the difference of response time in both types of attention (selective and divided attention) were related to the concurrent exposure scenario and then exposure to HTV, respectively. The highest effects for the correct response of selective and divided attention are related to concurrent exposure (HTV + noise) and then noise exposure, respectively. Conclusion. The HTV effect during concurrent exposure is hidden in auditory attention, and noise has the main effects. The divided attention was more affected than the selective attention in the different scenarios.
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Affiliation(s)
- Seyed Hojat Mousavi Kordmiri
- Student Research Committee, Hamadan University of Medical Sciences, Iran
- Department of Occupational Health and Safety Engineering, Esfarayen Faculty of Medical Sciences, Esfarayen, Iran
| | - Mohsen Aliabadi
- School of Public Health and Occupational Health & Safety Research Center, Hamadan University of Medical Sciences, Iran
| | - Rostam Golmohammadi
- School of Public Health and Research Center for Health Sciences, Hamadan University of Medical Sciences, Iran
| | - Maryam Farhadian
- School of Public Health and Research Center for Health Sciences, Hamadan University of Medical Sciences, Iran
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Zhao Y, Huang Y, Liu Z, Zhou Y. The architecture of functional brain network modulated by driving under train running noise exposure. PLoS One 2024; 19:e0306729. [PMID: 39146301 PMCID: PMC11326564 DOI: 10.1371/journal.pone.0306729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 06/22/2024] [Indexed: 08/17/2024] Open
Abstract
A noisy environment can considerably impact drivers' attention and fatigue, endangering driving safety. Consequently, this study designed a simulated driving experimental scenario to analyse the effects of noise generated during urban rail transit train operation on drivers' functional brain networks. The experiment recruited 16 participants, and the simulated driving scenario was conducted at noise levels of 50, 60, 70, and 80 dB. Functional connectivity between all electrode pairs across various frequency bands was evaluated using the weighted phase lag index (WPLI), and a brain network based on this was constructed. Graph theoretic analysis employed network global efficiency, degree, and clustering coefficient as metrics. Significant increases in the WPLI values of theta and alpha frequency bands were observed in high noise environments (70 dB, 80 dB), as well as enhanced brain synchronisation. Furthermore, concerning the topological metrics of brain networks, it was observed that the global efficiency of brain networks in theta and alpha frequency ranges, as well as the node degree and clustering coefficients, experienced substantial growth in high noise environments (70 dB, 80 dB) as opposed to 50 dB and 60 dB. This finding indicates that high-noise environments impact the reorganisation of functional brain networks, leading to a preference for network structures with improved global efficiency. Such findings may improve our understanding of the neural mechanisms of driving under noise exposure, and thus potentially reduce road accidents to some extent.
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Affiliation(s)
- Yashuai Zhao
- School of Urban Rail Transportation, Shanghai University of Engineering Science, Shanghai, P.R. China
| | - Yuanchun Huang
- School of Urban Rail Transportation, Shanghai University of Engineering Science, Shanghai, P.R. China
| | - Zhigang Liu
- School of Urban Rail Transportation, Shanghai University of Engineering Science, Shanghai, P.R. China
| | - Yifan Zhou
- School of Urban Rail Transportation, Shanghai University of Engineering Science, Shanghai, P.R. China
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Huang L, Ma J, Jiang F, Zhang S, Lan Y, Zhang Y. Relationship Between Work-Related Noise Exposure and Cognitive Impairment: A Cross-Sectional Study in China. J Alzheimers Dis 2024; 100:151-161. [PMID: 38848172 DOI: 10.3233/jad-240061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024]
Abstract
Background Noise exposure and the risk of cognitive impairment are currently major public health issues. Objective This study aimed to analyze the relationship between noise exposure and early impairment of cognitive function from the perspective of occupational epidemiology and to provide evidence for the long-term prevention and treatment of dementia in the context of aging. Methods This study was conducted in China between May and August 2021. The independent variables were the type of hazardous factors, duration of noise exposure, perceived noise intensity, and cumulative noise exposure (CNE). The dependent variable was cognitive function, which was measured using the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Multiple linear and logistic regression were used to analyze the relationship between noise exposure and cognitive function and to establish an effect curve. Results The detection rates of cognitive dysfunction using the MMSE and MoCA were 1.1% and 36.2%, respectively. The predicted MMSE and MoCA scores showed a downward trend within the CNE value ranging from 90-140 dB.time. Each unit increase in CNE decreased cognitive function scores by 0.025 (0.037, 0.013) and 0.020 (0.037, 0.003) points,respectively. Conclusions From the perspective of occupational epidemiology, these findings reveal a potential link between long-term noise exposure and early cognitive impairment.
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Affiliation(s)
- Lei Huang
- Department of Postgraduate Students, West China Hospital and West China School of Medicine, Sichuan University, Chengdu, China
| | - Jingxuan Ma
- Department of Environmental Health and Occupational Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Fugui Jiang
- Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China
| | - Shushan Zhang
- Department of Neurology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Yajia Lan
- Department of Environmental Health and Occupational Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yang Zhang
- Department of Periodical Press and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
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Balk SJ, Bochner RE, Ramdhanie MA, Reilly BK. Preventing Excessive Noise Exposure in Infants, Children, and Adolescents. Pediatrics 2023; 152:e2023063752. [PMID: 37864407 DOI: 10.1542/peds.2023-063752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/27/2023] [Indexed: 10/22/2023] Open
Abstract
Noise affects people of all ages. Noise-induced hearing loss, a major problem for adults, is also a problem for young people. Sensorineural hearing loss is usually irreversible. Environmental noise, such as traffic noise, can affect learning, physiologic parameters, sleep, and quality of life. Children and adolescents have unique vulnerabilities. Infants and young children must rely on adults to remove them from noisy situations; children may not recognize hazardous noise exposures; teenagers often do not understand consequences of high exposure to music from personal listening devices or attending concerts and dances. Personal listening devices are increasingly used, even by small children. Environmental noise has disproportionate effects on underserved communities. This statement and its accompanying technical report review common sources and effects of noise as well as specific pediatric exposures. Because noise exposure often starts in infancy and effects are cumulative, more attention to noise in everyday activities is needed starting early in life. Pediatricians can potentially lessen harms by raising awareness of children's specific vulnerabilities to noise. Safer listening is possible. Noise exposure is underrecognized as a serious public health issue in the United States. Greater awareness of noise hazards is needed at a societal level.
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Affiliation(s)
- Sophie J Balk
- Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York
| | - Risa E Bochner
- Department of Pediatrics, New York City Health and Hospitals Harlem, Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | | | - Brian K Reilly
- Otolaryngology and Pediatrics, George Washington University Medical School, Children's National Hospital, Washington, District of Columbia
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Balk SJ, Bochner RE, Ramdhanie MA, Reilly BK. Preventing Excessive Noise Exposure in Infants, Children, and Adolescents. Pediatrics 2023; 152:e2023063753. [PMID: 37864408 DOI: 10.1542/peds.2023-063753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/27/2023] [Indexed: 10/22/2023] Open
Abstract
Noise exposure is a major cause of hearing loss in adults. Yet, noise affects people of all ages, and noise-induced hearing loss is also a problem for young people. Sensorineural hearing loss caused by noise and other toxic exposures is usually irreversible. Environmental noise, such as traffic noise, can affect learning, physiologic parameters, and quality of life. Children and adolescents have unique vulnerabilities to noise. Children may be exposed beginning in NICUs and well-baby nurseries, at home, at school, in their neighborhoods, and in recreational settings. Personal listening devices are increasingly used, even by small children. Infants and young children cannot remove themselves from noisy situations and must rely on adults to do so, children may not recognize hazardous noise exposures, and teenagers generally do not understand the consequences of high exposure to music from personal listening devices or attending concerts and dances. Environmental noise exposure has disproportionate effects on underserved communities. In this report and the accompanying policy statement, common sources of noise and effects on hearing at different life stages are reviewed. Noise-abatement interventions in various settings are discussed. Because noise exposure often starts in infancy and its effects result mainly from cumulative exposure to loud noise over long periods of time, more attention is needed to its presence in everyday activities starting early in life. Listening to music and attending dances, concerts, and celebratory and other events are sources of joy, pleasure, and relaxation for many people. These situations, however, often result in potentially harmful noise exposures. Pediatricians can potentially lessen exposures, including promotion of safer listening, by raising awareness in parents, children, and teenagers. Noise exposure is underrecognized as a serious public health issue in the United States, with exposure limits enforceable only in workplaces and not for the general public, including children and adolescents. Greater awareness of noise hazards is needed at a societal level.
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Affiliation(s)
- Sophie J Balk
- Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York
| | - Risa E Bochner
- Department of Pediatrics, New York City Health and Hospitals Harlem, Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | | | - Brian K Reilly
- Otolaryngology and Pediatrics, George Washington University Medical School, Children's National Hospital, Washington, District of Columbia
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Whitham MD, Casali JG, Smith GK, Allihien AL, Wright BW, Barter SM, Urban AR, Dudley DJ, Fuller RR. Noise in cesarean deliveries: a comprehensive analysis of noise environments in the Labor and Delivery operating room and evaluation of a visual alarm noise abatement program. Am J Obstet Gynecol MFM 2023; 5:100887. [PMID: 36781121 DOI: 10.1016/j.ajogmf.2023.100887] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 01/26/2023] [Accepted: 01/31/2023] [Indexed: 02/13/2023]
Abstract
BACKGROUND Cesarean delivery is the most common major surgery worldwide. Noise in healthcare settings leads to impaired communication and concentration, and stress among healthcare providers. Limited information is available about noise at cesarean delivery. OBJECTIVE This study aimed to achieve a comprehensive analysis of noise that occurs during cesarean deliveries. Sound level meters are used to determine baseline noise levels and to describe the frequency of acute noise generated during a cesarean delivery that will cause a human startle response. Secondarily, we aimed to evaluate the effectiveness of a visual alarm system in mitigating excessive noise. STUDY DESIGN We completed a preintervention/postintervention observational study of noise levels during cesarean deliveries before and after introduction of a visual alarm system for noise mitigation between February 15, 2021 and August 26, 2021. There were 156 cases included from each study period. Sound pressure levels were analyzed by overall case median decibel levels and by time epoch for relevant phases of the operation. Rapid increases in noise events capable of causing a human startle response, "startle events," were detected by retrospective analysis, with quantification for baselines and analysis of frequency by case type. Median noise levels with interquartile ranges are presented. Data are compared between epochs and case characteristics with nonparametric 2-tailed testing. RESULTS The median acoustic pressure for all cesarean deliveries was 61.8 (58.8-65.9) (median [interquartile range]) dBA (A-weighted decibels). The median dBA for the full case time period was significantly higher in cases with neonatal intensive care unit team presence (62.1 [60.5-63.9]), admission to the neonatal intensive care unit (62.0 [60.4-63.9]), 5-minute Apgar score <7 (62.2 [61.1-64.3]), multiple gestations (62.6 [62.0-64.2]), and intraoperative tubal sterilization (62.8 [61.5-65.1]). The use of visual alarms was associated with a statistically significant reduction of median noise level by 0.7 dBA, from 61.8 (60.6-63.5) to 61.1 (59.8-63.7) dBA (P<.001). CONCLUSION The noise intensities recorded during cesarean deliveries were commonly at levels that affect communication and concentration, and above the safe levels recommended by the World Health Organization. Although noise was reduced by 0.7 dBA, the reduction was not clinically significant in reaching a discernible amount (a 3-dB change) or in reducing "startle events." Isolated use of visual alarms during cesarean deliveries is unlikely to be a satisfactory noise mitigation strategy.
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Affiliation(s)
- Megan D Whitham
- Department of Obstetrics and Gynecology, University of Virginia School of Medicine, Charlottesville, VA (Drs Whitham, Smith, Allihien, and Wright, Ms Urban, and Drs Dudley and Fuller).
| | - John G Casali
- Department of Industrial and Systems Engineering, Virginia Polytechnic Institute and State University, Blacksburg, VA (Drs Casali and Barter)
| | - Gabrielle K Smith
- Department of Obstetrics and Gynecology, University of Virginia School of Medicine, Charlottesville, VA (Drs Whitham, Smith, Allihien, and Wright, Ms Urban, and Drs Dudley and Fuller)
| | - Alexis L Allihien
- Department of Obstetrics and Gynecology, University of Virginia School of Medicine, Charlottesville, VA (Drs Whitham, Smith, Allihien, and Wright, Ms Urban, and Drs Dudley and Fuller)
| | - Brett W Wright
- Department of Obstetrics and Gynecology, University of Virginia School of Medicine, Charlottesville, VA (Drs Whitham, Smith, Allihien, and Wright, Ms Urban, and Drs Dudley and Fuller)
| | - Shannon M Barter
- Department of Industrial and Systems Engineering, Virginia Polytechnic Institute and State University, Blacksburg, VA (Drs Casali and Barter)
| | - Amanda R Urban
- Department of Obstetrics and Gynecology, University of Virginia School of Medicine, Charlottesville, VA (Drs Whitham, Smith, Allihien, and Wright, Ms Urban, and Drs Dudley and Fuller)
| | - Donald J Dudley
- Department of Obstetrics and Gynecology, University of Virginia School of Medicine, Charlottesville, VA (Drs Whitham, Smith, Allihien, and Wright, Ms Urban, and Drs Dudley and Fuller)
| | - Robert R Fuller
- Department of Obstetrics and Gynecology, University of Virginia School of Medicine, Charlottesville, VA (Drs Whitham, Smith, Allihien, and Wright, Ms Urban, and Drs Dudley and Fuller)
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Rahimian B, Jambarsang S, Mehrparvar AH. The relationship between noise-induced hearing loss and cognitive function. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2023:1-6. [PMID: 36744757 DOI: 10.1080/19338244.2023.2174927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
INTRODUCTION NIHL may affect some domains of cognitive function. This study was conducted to assess the relationship between NIHL and working memory, attention and response time. MATERIALS AND METHODS This was a cross-sectional study on 154 textile workers with exposure to noise higher than 85dBA in a textile factory. The participants were divided into two groups: with and without NIHL and some domains of cognitive function were compared between two groups. Wechsler working memory test and Stroop color-word test were used to measure working memory, selective attention and response time. Data were analyzed by SPSS (ver. 24) using student's T test, and multiple linear regression model. RESULTS Totally, 154 workers entered the study (77 with NIHL and 77 without NIHL). All participants were males. Working memory score and response time were higher and interference score was lower in NIHL group, although only the difference in working memory was significant. Due to the significant difference of age and work history between case and control groups, cognitive parameters were compared between two groups after adjusting for these two variables, but the significance was not changed. CONCLUSION This study showed that noised-exposed middle-aged males with NIHL had probably a lower working memory span than their counterparts without NIHL.
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Affiliation(s)
- Behnaz Rahimian
- International Campus, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sara Jambarsang
- Research Center of Prevention and Epidemiology of Non-Communicable Diseases, Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Vasudevamurthy S, Kumar U A. Effect of Occupational Noise Exposure on Cognition and Suprathreshold Auditory Skills in Normal-Hearing Individuals. Am J Audiol 2022; 31:1098-1115. [PMID: 35998292 DOI: 10.1044/2022_aja-22-00015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES Adverse effects of noise exposure on hearing and cognition are well documented in the literature. Recently, it has becoming increasingly evident that noise exposure deteriorates suprathreshold auditory skills, even though the hearing sensitivity is intact. This condition is termed as cochlear synaptopathy or hidden hearing loss, which is apparent in animal models. However, equivocal findings are reported in humans. This study aimed at assessing the working memory, attention abilities, and suprathreshold hearing abilities in normal-hearing individuals with and without occupational noise exposure. We also explored the relationship between cognitive measures and suprathreshold auditory measures. DESIGN The study participants were divided into two groups. All the participants had normal-hearing thresholds. The control group consisted of 25 individuals with no occupational noise exposure, whereas the noise exposure group had 25 individuals exposed to occupational noise of 85 dBA for a minimum period of 1 year. Working memory was assessed using auditory digit span (forward and backward), operation span, and reading span. The Erikson flanker test was used to evaluate attention abilities. The suprathreshold hearing was assessed in terms of gap detection thresholds and sentence identification in noise. RESULTS The results showed that the noise exposure group performed poorly compared to the control group on all auditory and cognitive tasks except the reading span. CONCLUSION The results of the study suggest that occupational noise exposure may hamper the cognitive skills and suprathreshold hearing abilities of the individual despite having normal peripheral hearing.
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Affiliation(s)
| | - Ajith Kumar U
- Department of Audiology, All India Institute of Speech and Hearing, Mysuru
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Khajehnasiri F, Samaei SE, Mehrzad S, Taban E, Ghalenoei M, Salimi F. The effect of traffic noise on cognitive performance with regard to personality traits: A laboratory experiment study. Work 2022; 72:697-706. [DOI: 10.3233/wor-210002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Exposure to traffic noise could play an important part in inducing psychological disorders which in turn can affect individuals’ cognitive and mental performance. OBJECTIVE: The aim of this study was to determine the effect of traffic noise exposure on the cognitive performance with regard to subjects’ personality traits. METHODS: Sixty students with normal hearing and vision took part in this experimental study. In order to simulate the traffic noise condition of Tehran, the noise from several busy streets was first carefully recorded. Later on, the subjects were exposed to this recorded noise in an anechoic chamber. Also, the NEO-five factor inventory questionnaire and the continuous performance test were used to assess personality traits and cognitive performance of participants respectively. RESULTS: The results showed that the cognitive features of the study, such as reaction time and the number of commission/omission errors in continuous performance testing increased significantly after exposure to the traffic noise (p < 0.05), and among the personality traits, only the neuroticism has a significant correlation with response time in the continuous performance tests (p < 0.05). CONCLUSIONS: Apart from the effect of traffic noise on cognitive function, the findings of this study confirmed that Neuroticism (one of the personality traits) also significantly affect the cognitive performance of individuals when they are exposed to traffic noise in laboratory conditions.
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Affiliation(s)
- Farahnaz Khajehnasiri
- Department of Community Medicine, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Ehsan Samaei
- Department of Occupational Health Engineering, School of Health, Mazandaran University of Medical Sciences, Mazandaran, Iran
| | - Sharzad Mehrzad
- Department of Occupational Health Engineering, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Ebrahim Taban
- Social Determinants of Health Research Center, Department of Occupational Health Engineering, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehran Ghalenoei
- Department of Occupational Health Engineering, School of Public Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Fatemeh Salimi
- Department of Occupational Health Engineering, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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Bhatt IS, Washnik N, Torkamani A. Suprathreshold Auditory Measures for Detecting Early-Stage Noise-Induced Hearing Loss in Young Adults. J Am Acad Audiol 2022; 33:185-195. [PMID: 36195294 PMCID: PMC10858682 DOI: 10.1055/s-0041-1740362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2022]
Abstract
BACKGROUND Over 1 billion young adults are at risk for developing noise-induced hearing loss (NIHL) due to their habit of listening to music at loud levels. The gold standard for detecting NIHL is the audiometric notch around 3,000 to 6,000 Hz observed in pure tone audiogram. However, recent studies suggested that suprathreshold auditory measures might be more sensitive to detect early-stage NIHL in young adults. PURPOSE The present study compared suprathreshold measures in individuals with high and low noise exposure backgrounds (NEBs). We hypothesized that individuals with high NEB would exhibit reduced performance on suprathreshold measures than those with low NEB. STUDY SAMPLE An initial sample of 100 English-speaking healthy adults (18-35 years; females = 70) was obtained from five university classes. We identified 15 participants with the lowest NEB scores (10 females) and 15 participants with the highest NEB scores (10 females). We selected a sample of healthy young adults with no history of middle ear infection, and those in the low NEB group were selected with no history of impulse noise exposure. DATA COLLECTION AND ANALYSIS The study included conventional audiometry, extended high-frequency audiometry, middle ear muscle reflex (MEMR) thresholds, distortion-product otoacoustic emissions (DPOAEs), QuickSIN, and suprathreshold auditory brainstem response (ABR) measures. We used independent sample t-tests, correlation coefficients, and linear mixed model analysis to compare the audiometric measures between the NEB groups. RESULTS The prevalence of audiometric notch was low in the study sample, even for individuals with high NEB. We found that: (1) individuals with high NEB revealed significantly reduced QuickSIN performance than those with low NEB; (2) music exposure via earphone revealed a significant association with QuickSIN; (3) individuals with high NEB revealed significantly reduced DPOAEs and ABR wave I amplitude compared with individuals with low NEB; (4) MEMR and ABR latency measures showed a modest association with NEB; and (5) audiometric thresholds across the frequency range did not show statistically significant association with NEB. CONCLUSION Our results suggest that young adults with high NEB might exhibit impaired peripheral neural coding deficits leading to reduced speech-in-noise (SIN) performance despite clinically normal hearing thresholds. SIN measures might be more sensitive than audiometric notch for detecting early-stage NIHL in young adults.
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Affiliation(s)
- Ishan S Bhatt
- Department of Communication Sciences and Disorders, The University of Iowa, Iowa City, Iowa
| | - Nilesh Washnik
- Department of Communication Sciences & Disorders, Ohio University, Athens, Ohio
| | - Ali Torkamani
- Department of Integrative Structural and Computational Biology, Scripps Translational Science Institute, La Jolla, California
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Thompson R, Smith RB, Bou Karim Y, Shen C, Drummond K, Teng C, Toledano MB. Noise pollution and human cognition: An updated systematic review and meta-analysis of recent evidence. ENVIRONMENT INTERNATIONAL 2022; 158:106905. [PMID: 34649047 DOI: 10.1016/j.envint.2021.106905] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 09/21/2021] [Accepted: 09/23/2021] [Indexed: 05/08/2023]
Abstract
BACKGROUND This systematic review provides a comprehensive synthesis of recent epidemiological evidence that environmental noise negatively impacts human cognition. METHODS We update a prior review with recent publications (PROSPERO CRD42019151923). The strength of evidence for associations was assessed using the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) framework. We also conducted random-effects meta-analyses where suitable. RESULTS 16 studies were identified and reviewed in tandem with 32 studies previously reviewed by Clark & Paunovic (2018). A meta-analysis from 3 studies found that reading comprehension scores in quiet classrooms were 0.80 (95% confidence interval: 0.40; 1.20) points higher than children in noisier classrooms. Meta-analysis of the impact of 1 dB (dB) increase in environmental noise on reading and language abilities gave a pooled beta coefficient of -0.11(95% confidence interval: -0.32; 0.10). A meta-analysis of Odds Ratios (OR) from 3 studies found higher odds of cognitive impairment in people aged 45 + with higher residential noise exposure (OR 1.40, 95% CI: 1.18;1.61). After qualitative synthesis of remaining studies, there was high quality evidence for an association between environmental noise and cognitive impairment in middle-to-older adults, moderate quality evidence for an association between aircraft noise and reading and language in children, and moderate quality evidence against an association between aircraft noise and executive functioning in children. Generally the literature was supportive for other cognitive outcomes, but with low or very low-quality evidence. DISCUSSION The evidence so far suggests that noise exposure is associated with cognition, but more good quality research using standardised methodology is required to corroborate these results and to allow for precise risk estimation by larger meta-analyses. There is also a need for more research with older teenagers and young-to-middle aged adults, on the synergistic effects of noise and air pollution, and in Africa, Central and South America, South Asia and Australasia.
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Affiliation(s)
- Rhiannon Thompson
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK; MRC Centre for Environment and Health, School of Public Health, Imperial College London, UK
| | - Rachel B Smith
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK; MRC Centre for Environment and Health, School of Public Health, Imperial College London, UK; Mohn Centre for Children's Health and Wellbeing, School of Public Health, Imperial College London, UK
| | - Yasmin Bou Karim
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK; MRC Centre for Environment and Health, School of Public Health, Imperial College London, UK
| | - Chen Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK; MRC Centre for Environment and Health, School of Public Health, Imperial College London, UK
| | - Kayleigh Drummond
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK; MRC Centre for Environment and Health, School of Public Health, Imperial College London, UK
| | - Chloe Teng
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK; MRC Centre for Environment and Health, School of Public Health, Imperial College London, UK
| | - Mireille B Toledano
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK; MRC Centre for Environment and Health, School of Public Health, Imperial College London, UK; Mohn Centre for Children's Health and Wellbeing, School of Public Health, Imperial College London, UK; National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Environmental Exposures and Health, School of Public Health, Imperial College London, UK; National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Chemical and Radiation Threats and Hazards, School of Public Health, Imperial College London, UK.
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Psychological profile in noise-induced hearing loss patients: a pilot study. ACTA BIOMEDICA SCIENTIFICA 2021. [DOI: 10.29413/abs.2021-6.5.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Introduction. Noise-induced hearing loss is a rather prevalent condition and can be distressing for a substantial proportion of patients, although researches describing psychological characteristics in noise-induced occupational hearing loss patients are not numerous.The study aims to find the effects of occupational noise on the psychological status among noise-induced hearing loss (NIHL) patients.Methods. Two groups, cross-sectional design. Study sample: 44 occupational noiseinduced male forming NIHL patients group (n = 21) and a control group (n = 23). Both groups were tested using the Russian versions of psychological questionnaires.Results. Almost one third of NIHL patients are the highly anxiety individuals as compared with the healthy participants (p < 0.01). Mixed type of response to the surrounding reality combined a high need for self-actualization with high self-control, tendency to inhibit and restrain behavioral reactions, in this case it is possible to “overlap” both neurotic and behavioral responses, which can affect the general overstrain and manifest by the somatization of the internal conflict. In general, NIHL patients use constructive cognitive, emotional and behavioral coping strategies. Patients use both constructive and tense defense mechanisms. Conclusion. It has been established that in patients with NIHL, in comparison with practically healthy persons, tension accumulates, and a tendency to psychotraumatization appears. However, it is currently difficult to determine whether NIHL is a predisposing factor for these psychological characteristics, so further research is needed to determine how significant this relationship is. Key words: noise-induced hearing loss, occupational noise, psychological profile>˂ 0.01). Mixed type of response to the surrounding reality combined a high need for self-actualization with high self-control, tendency to inhibit and restrain behavioral reactions, in this case it is possible to “overlap” both neurotic and behavioral responses, which can affect the general overstrain and manifest by the somatization of the internal conflict. In general, NIHL patients use constructive cognitive, emotional and behavioral coping strategies. Patients use both constructive and tense defense mechanisms.Conclusion. It has been established that in patients with NIHL, in comparison with practically healthy persons, tension accumulates, and a tendency to psychotraumatization appears. However, it is currently difficult to determine whether NIHL is a predisposing factor for these psychological characteristics, so further research is needed to determine how significant this relationship is.
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Farooqi ZUR, Ahmad I, Zeeshan N, Ilić P, Imran M, Saeed MF. Urban noise assessment and its nonauditory health effects on the residents of Chiniot and Jhang, Punjab, Pakistan. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:54909-54921. [PMID: 34018118 DOI: 10.1007/s11356-021-14340-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 05/04/2021] [Indexed: 06/12/2023]
Abstract
Elevated noise level is an emerging global problem. Therefore, the present work is conducted that can improve, increase, and integrate the already known issue in literature with new information coming from an emerging country such as Pakistan. The objectives of this study were (i) to assess the urban noise levels and traffic density of Chiniot and Jhang and (ii) to determine nonauditory health effects of noise levels on the residents of both cities. Noise levels were examined from 181 locations (103 from Jhang and 78 from Chiniot) and categorized into hospitals, educational, religious and recreational, residential, industrial areas, and traffic intersections. A-weighted noise level measurements were taken using an integrated sound level meter which recorded short-term road traffic noise continuously for 15 min at each location (LAeq15). The urban noise data showed 82% of the sites in Jhang (LAmax = 103 dB) and 95% in Chiniot (LAmax = 120 dB) exceeded the noise limits set by the National Environment Quality Standard of Pakistan (NEQS-Pak) and World Health Organization (WHO). Moreover, higher intensity of noise levels (LAeq15 ≥ 100 dB) was recorded in Chiniot (17 sites) than in Jhang (1 site). Regression analysis showed a relatively strong relationship of traffic density with noise at Chiniot (R2 = 0.48) compared to Jhang (R2 = 0.31). However, spatial variability of noise with traffic density was observed in both cities. Survey study revealed that all the respondents in Jhang and Chiniot suffered from many noise-related health problems such as annoyance (53 and 51%), depression (45 and 47%), dizziness (61 and 65%), headache (67 and 64%), hypertension (71 and 56%), hearing loss (53 and 56%), physiological stress (65 and 65%), sleeplessness (81 and 84%), and tinnitus (70 and 62%) due to noise, respectively. We conclude that noise levels are higher in Chiniot primarily due to high road traffic and secondarily due to high population density. It is recommended that vehicle maintenance and family and urban planning could be effective measures to reduce urban noise levels.
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Affiliation(s)
- Zia Ur Rahman Farooqi
- Institute of Soil and Environmental Sciences, University of Agriculture, Faisalabad, Pakistan
| | - Iftikhar Ahmad
- Department of Environmental Sciences, COMSATS University Islamabad, Vehari Campus, Vehari, 61100, Pakistan.
| | - Nukshab Zeeshan
- Institute of Soil and Environmental Sciences, University of Agriculture, Faisalabad, Pakistan
| | - Predrag Ilić
- PSRI Institute for Protection and Ecology of the Republic of Srpska, Banja Luka, Vidovdanska 43, 78000, Banja Luka, Bosnia and Herzegovina
| | - Muhammad Imran
- Department of Environmental Sciences, COMSATS University Islamabad, Vehari Campus, Vehari, 61100, Pakistan
| | - Muhammad Farhan Saeed
- Department of Environmental Sciences, COMSATS University Islamabad, Vehari Campus, Vehari, 61100, Pakistan
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16
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Huang L, Zhang Y, Wang Y, Lan Y. Relationship Between Chronic Noise Exposure, Cognitive Impairment, and Degenerative Dementia: Update on the Experimental and Epidemiological Evidence and Prospects for Further Research. J Alzheimers Dis 2021; 79:1409-1427. [PMID: 33459723 DOI: 10.3233/jad-201037] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Degenerative dementia, of which Alzheimer's disease is the most common form, is characterized by the gradual deterioration of cognitive function. The events that trigger and promote degenerative dementia are not clear, and treatment options are limited. Experimental and epidemiological studies have revealed chronic noise exposure (CNE) as a potential risk factor for cognitive impairment and degenerative dementia. Experimental studies have indicated that long-term exposure to noise might accelerate cognitive dysfunction, amyloid-β deposition, and tau hyperphosphorylation in different brain regions such as the hippocampus and cortex. Epidemiological studies are increasingly examining the possible association between external noise exposure and dementia. In this review, we sought to construct a comprehensive summary of the relationship between CNE, cognitive dysfunction, and degenerative dementia. We also present the limitations of existing evidence as a guide regarding important prospects for future research.
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Affiliation(s)
- Lei Huang
- Department of Environmental Health and Occupational Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, P.R. China.,Department of Occupational Hazard Assessment, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Yang Zhang
- Department of Periodical Press and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China.,Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Yongwei Wang
- Department of Occupational Hazard Assessment, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Yajia Lan
- Department of Environmental Health and Occupational Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, P.R. China
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Esmaily A, Jambarsang S, Mohammadian F, Mehrparvar AH. Effect of shift work on working memory, attention and response time in nurses. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2021; 28:1085-1090. [PMID: 33308103 DOI: 10.1080/10803548.2020.1863656] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objective. The present study aimed to investigate the relationship between shift work and cognitive performance in nurses. Methods. The present before-after study included 35 female nurses 25-40 years old with similar mental and physical workload. Working memory, response time and attention were assessed using Wechsler and Stroop tests. The variables were measured at the beginning and the end of three working shifts (morning, afternoon and night). An interval of 3 days was considered for performing an after-shift test to eliminate the learning effect. Data were analyzed using repeated-measures analysis of variance (ANOVA). Results. At the end of all three shifts, nurses' working memory (p = 0.039) and interference score (p = 0.04) were significantly decreased, but their response time was not significantly affected during a shift. The decrease in working memory after the night shift was significantly higher than after the morning and evening shifts (p < 0.001). Conclusion. The results of this study showed that shift work can affect some aspects of cognitive function (working memory and attention) in nurses, and this effect was more prominent after a night shift.
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Affiliation(s)
- Azam Esmaily
- School of Public Health, Shahid Sadoughi University of Medical Sciences, Iran
| | - Sara Jambarsang
- School of Public Health, Shahid Sadoughi University of Medical Sciences, Iran
| | - Farough Mohammadian
- Research Institute for Health Development, Kurdistan University of Medical Sciences, Iran
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Palacios-García I, Luarte N, Herrmann-Lunecke MG, Grasso-Cladera A, Parada FJ. Environmental noise is differently associated with negative and positive urban experience: an exploratory first-person pedestrian mobile study in Santiago de Chile ( El ruido medioambiental se asocia de una manera diferente a la experiencia urbana negativa y positiva: un estudio exploratorio en movimiento de peatones en primera persona realizado en Santiago de Chile). STUDIES IN PSYCHOLOGY 2020. [DOI: 10.1080/02109395.2020.1795376] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
| | - Nicolas Luarte
- Laboratorio de Neurociencia Cognitiva y Social, Universidad Diego Portales
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Ghasemi F, Aghaei H, Askaripoor T, Ghamari F. Analysis of occupational accidents among nurses working in hospitals based on safety climate and safety performance: a Bayesian network analysis. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2020; 28:440-446. [DOI: 10.1080/10803548.2020.1768759] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Fakhradin Ghasemi
- Department of Ergonomics and Occupational Health and Safety Research Center, Hamadan University of Medical Sciences, Iran
| | - Hamed Aghaei
- Department of Occupational Health Engineering, School of Health, Arak University of Medical Sciences, Iran
| | - Taleb Askaripoor
- Research Center for Health Sciences and Technologies, Semnan University of Medical Sciences, Iran
| | - Farhad Ghamari
- Research Center for Health Sciences and Technologies, Semnan University of Medical Sciences, Iran
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