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Couth S, Prendergast G, Guest H, Munro KJ, Moore DR, Plack CJ, Ginsborg J, Dawes P. A longitudinal study investigating the effects of noise exposure on behavioural, electrophysiological and self-report measures of hearing in musicians with normal audiometric thresholds. Hear Res 2024; 451:109077. [PMID: 39084132 DOI: 10.1016/j.heares.2024.109077] [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] [Received: 11/27/2023] [Revised: 06/07/2024] [Accepted: 07/08/2024] [Indexed: 08/02/2024]
Abstract
Musicians are at risk of hearing loss and tinnitus due to regular exposure to high levels of noise. This level of risk may have been underestimated previously since damage to the auditory system, such as cochlear synaptopathy, may not be easily detectable using standard clinical measures. Most previous research investigating hearing loss in musicians has involved cross-sectional study designs that may capture only a snapshot of hearing health in relation to noise exposure. The aim of this study was to investigate the effects of cumulative noise exposure on behavioural, electrophysiological, and self-report indices of hearing damage in early-career musicians and non-musicians with normal hearing over a 2-year period. Participants completed an annual test battery consisting of pure tone audiometry, extended high-frequency hearing thresholds, distortion product otoacoustic emissions (DPOAEs), speech perception in noise, auditory brainstem responses, and self-report measures of tinnitus, hyperacusis, and hearing in background noise. Participants also completed the Noise Exposure Structured Interview to estimate cumulative noise exposure across the study period. Linear mixed models assessed changes over time. The longitudinal analysis comprised 64 early-career musicians (female n = 34; age range at T0 = 18-26 years) and 30 non-musicians (female n = 20; age range at T0 = 18-27 years). There were few longitudinal changes as a result of musicianship. Small improvements over time in some measures may be attributable to a practice/test-retest effect. Some measures (e.g., DPOAE indices of outer hair cell function) were associated with noise exposure at each time point, but did not show a significant change over time. A small proportion of participants reported a worsening of their tinnitus symptoms, which participants attributed to noise exposure, or not using hearing protection. Future longitudinal studies should attempt to capture the effects of noise exposure over a longer period, taken at several time points, for a precise measure of how hearing changes over time. Hearing conservation programmes for "at risk" individuals should closely monitor DPOAEs to detect early signs of noise-induced hearing loss when audiometric thresholds are clinically normal.
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Affiliation(s)
- Samuel Couth
- Manchester Centre for Audiology and Deafness, University of Manchester, UK.
| | | | - Hannah Guest
- Manchester Centre for Audiology and Deafness, University of Manchester, UK
| | - Kevin J Munro
- Manchester Centre for Audiology and Deafness, University of Manchester, UK; Manchester Academic Health Science Centre, Manchester University Hospitals NHS Foundation Trust, UK
| | - David R Moore
- Manchester Centre for Audiology and Deafness, University of Manchester, UK; Communication Sciences Research Center, Cincinnati Children's Hospital Medical Centre, OH, USA
| | - Christopher J Plack
- Manchester Centre for Audiology and Deafness, University of Manchester, UK; Department of Psychology, Lancaster University, UK
| | | | - Piers Dawes
- Manchester Centre for Audiology and Deafness, University of Manchester, UK; Centre for Hearing Research, School of Health and Rehabilitation Sciences, University of Queensland, Australia
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Lin IF, Tsai PJ, Wu JL, Chin WS, Lin CY, Guo YL. The effect of cumulative noise exposure on distortion product otoacoustic emissions. Int J Audiol 2023; 62:886-892. [PMID: 35968641 DOI: 10.1080/14992027.2022.2106450] [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] [Received: 04/15/2021] [Revised: 07/12/2022] [Accepted: 07/21/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE This study aimed to identify the characteristics of distortion product otoacoustic emissions (DPOAEs) that can be used to differentiate noise-induced hearing loss (NIHL) from age-related hearing loss. A potential index to detect NIHL was defined in terms of its susceptibility to cumulative noise exposure but not to age. DESIGN In this cross-sectional cohort study, a job-exposure matrix was used to calculate the cumulative noise exposure. Multivariate linear regression models were used to examine how age and cumulative noise exposure associated with DPOAEs at individual frequencies after adjusting for hypertension, dyslipidaemia, tobacco use and alcohol consumption. STUDY SAMPLE The pure-tone audiometry and DPOAEs data collected from 239 male workers in a steel factory. RESULTS DPOAEs and DPOAE signal-to-noise ratios (SNRs) at all frequencies were found to be correlated with age, and those at 2, 3, 4 and 6 kHz were correlated with both age and noise exposure. The difference between DPOAE SNR at 1 and 3 kHz showed significant correlation with noise exposure but not with age. CONCLUSIONS The results showed that this DPOAE index, the DPOAE SNR at 1 kHz minus the DPOAE SNR at 3 kHz, could add values to audiometric evaluation of NIHL.
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Affiliation(s)
- I-Fan Lin
- Department of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Occupational Medicine, Shuang Ho Hospital, New Taipei City, Taiwan
| | - Perng-Jy Tsai
- Department of Environment and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jiunn-Liang Wu
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wei-Shan Chin
- Department of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Cheng-Yu Lin
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yue Leon Guo
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Anastasios G, Magioula G, Konstantinos K, Ioannis A. Noise and Health: Review. Indian J Otolaryngol Head Neck Surg 2022; 74:5482-5491. [PMID: 36742745 PMCID: PMC9895353 DOI: 10.1007/s12070-021-02797-1] [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: 06/04/2021] [Accepted: 08/01/2021] [Indexed: 02/07/2023] Open
Abstract
Noise in human societies is unavoidable, but it tends to become a modern epidemic that induces various detrimental effects to several organs and functions in humans. Increased cardiovascular danger, anxiety and sleep disturbance are just few of these effects. It is noteworthy that children, even neonates and their developing organism are especially vulnerable to noise-related health problems. Noise is measured with special noise-meters. These devices express results in decibels by transforming random noise to a continuous sound. This sound is characterized by equivalent acoustic energy to the random noise for a defined time interval. Human auditory apparatus is principally endangered by acute noises but also by chronic noise exposure, in the context of both occupational and recreational activities. Various mechanisms are implicated in the pathogenesis of noise-induced hearing loss that can cause either temporary or permanent damage. Among them, emphasis is given to the impairment by free radicals and inflammatory mediators, to the activation of apoptotic molecular pathways, but also to glutamate excitotoxicity. A hidden hearing loss, synaptopathy, is attributed to the latter. The irreversible nature of hearing loss, as well as the idiosyncratic sensitivity of individuals, imposes the necessity of early diagnosis of auditory impairment by noise. Super high frequency audiograms, otoacoustic emissions and electrophysiological examinations can address diagnosis. Thankfully, there is extensive research on acoustic trauma therapeutic approaches. However, until we succeed in regenerating the sensory organ of hearing, chronic noise-induced hearing loss cannot be treated. Thus, it is fundamental that society protects people from noise, by laws and regulations.
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Affiliation(s)
- Goulioumis Anastasios
- Department of Otorhinolaryngology, Pediatric Hospital “Karamandanio”, Patras, Greece
| | | | - Kourelis Konstantinos
- Department of Otorhinolaryngology, Pediatric Hospital “Karamandanio”, Patras, Greece
| | - Athanasopoulos Ioannis
- Department of Otorhinolaryngology, Pediatric Center of “Iatriko Athinon” Hospital, Athens, Greece
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Jahn KN. Clinical and investigational tools for monitoring noise-induced hyperacusis. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2022; 152:553. [PMID: 35931527 PMCID: PMC9448410 DOI: 10.1121/10.0012684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Hyperacusis is a recognized perceptual consequence of acoustic overexposure that can lead to debilitating psychosocial effects. Despite the profound impact of hyperacusis on quality of life, clinicians and researchers lack objective biomarkers and standardized protocols for its assessment. Outcomes of conventional audiologic tests are highly variable in the hyperacusis population and do not adequately capture the multifaceted nature of the condition on an individual level. This presents challenges for the differential diagnosis of hyperacusis, its clinical surveillance, and evaluation of new treatment options. Multiple behavioral and objective assays are emerging as contenders for inclusion in hyperacusis assessment protocols but most still await rigorous validation. There remains a pressing need to develop tools to quantify common nonauditory symptoms, including annoyance, fear, and pain. This review describes the current literature on clinical and investigational tools that have been used to diagnose and monitor hyperacusis, as well as those that hold promise for inclusion in future trials.
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Affiliation(s)
- Kelly N Jahn
- Department of Speech, Language, and Hearing, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas 75080, USA
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Meng ZL, Chen F, Zhao F, Gu HL, Zheng Y. Early detection of noise-induced hearing loss. World J Clin Cases 2022; 10:1815-1825. [PMID: 35317152 PMCID: PMC8891767 DOI: 10.12998/wjcc.v10.i6.1815] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 10/28/2021] [Accepted: 01/20/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Noise-induced hearing loss (NIHL) is the second most common acquired hearing loss following presbycusis. Exposure to recreational noise and minimal use of hearing protection increase the prevalence of NIHL in young females. NIHL is irreversible. Identifying minor hearing pathologies before they progress to hearing problems that affect daily life is crucial.
AIM To compare the advantages and disadvantages of extended high frequency (EHF) and otoacoustic emission and determine an indicator of hearing pathologies at the early sub-clinical stage.
METHODS This cross-sectional study was implemented in West China Hospital of Sichuan University from May to September 2019. A total of 86 participants, aged 18-22 years, were recruited to establish normative thresholds for EHF. Another 159 adults, aged 18-25 years with normal hearing (0.25-8 kHz ≤ 25 dBHL), were allocated to low noise and noise exposure groups. Distortion otoacoustic emission (DPOAE), transient evoked otoacoustic emissions (TEOAE), and EHF were assessed in the two groups to determine the superior technique for detecting early-stage noise-induced pathologies. The chi-square test was used to assess the noise and low noise exposure groups with respect to extended high-frequency audiometry (EHFA), DPOAE, and TEOAE. P ≤ 0.05 was considered statistically significant.
RESULTS A total of 86 participants (66 females and 20 males) aged between 18 and 22 (average: 20.58 ± 1.13) years were recruited to establish normative thresholds for EHF. The normative thresholds for 9, 10, 11.2, 12.5, 14, 16, 18, and 20 kHz were 15, 10, 20, 15, 15, 20, 28, and 0 dBHL, respectively. A total of 201 participants were recruited and examined for eligibility. Among them, 159 adults aged between 18 and 25 years were eligible in this study. No statistical difference was detected between the noise exposure and the low noise exposure groups using EHFA, DPOAE, and TEOAE (P > 0.05) except in the right ear at 4 kHz using TEOAE (abnormal rate 20.4% vs 5.2%, respectively; P = 0.05).
CONCLUSION These results showed TEOAE as the earliest indicator of minor pathology compared to DPOAE and EHFA. However, a multicenter controlled study or prospective study is essential to verify these results.
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Affiliation(s)
- Zhao-Li Meng
- Department of Otorhinolaryngology-Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Fei Chen
- Department of Otorhinolaryngology-Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Fei Zhao
- Cardiff School of Health Science, Cardiff Metropolitan University, Cardiff CF3 0UJ, United Kingdom
- Department of Hearing and Speech Science, Xinhua College, Sun Yat-Sen University, Guangzhou 510000, Guangdong Province, China
| | - Hai-Ling Gu
- Department of Hearing, Speech and Language Rehabilitation, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yun Zheng
- Department of Otorhinolaryngology-Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
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Kuo CY, Hung CL, Chen HC, Shih CP, Lu RH, Chen CW, Hung LW, Lin YC, Chen HK, Chu DM, Lin YY, Chen YC, Wang CH. The Immediate and Long-Term Impact of Military Aircraft Noise on Hearing: A Cross-Sectional Comparison of Fighter Pilots and Ground Staff. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18062982. [PMID: 33799421 PMCID: PMC7999744 DOI: 10.3390/ijerph18062982] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/03/2021] [Accepted: 03/09/2021] [Indexed: 11/16/2022]
Abstract
We examined the immediate and long-term impacts of military aircraft noise exposure on noise-induced hearing loss (NIHL) in fighter pilots and ground staff. We recruited 40 pilots, 40 ground staff, and 136 age-matched controls; all participants underwent hearing tests, including conventional pure-tone audiometry (PTA) (0.25–8.0 kHz), extended high-frequency (EHF) audiometry (9.0–18.0 kHz), and distortion-product otoacoustic emission (DPOAE) as a recent reference. A subsequent hearing test immediately after flight-mission noise exposure was requested. The results revealed higher recent hearing thresholds in pilots and ground staff than in controls. Threshold shifts at many octave band frequencies were also significantly elevated in ground staff. The grouped frequency threshold was significantly elevated in the 4–8 kHz high-frequency range. After a single flight-mission noise exposure, both ground staff and pilots showed decreased signal-to-noise ratios for DPOAE (1–8 kHz), whereas only ground staff showed significantly elevated left-ear hearing thresholds at 3, 11.2, and 12.5 kHz by conventional and EHF PTA. Fighter pilots and ground staff serve in hazardous noise-exposed environments that cause hearing damage and subsequent NIHL, but ground staff may be more vulnerable. A comprehensive hearing conservation program should be implemented to protect high-risk service members, and especially ground staff, from high-intensity noise exposure.
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Affiliation(s)
- Chao-Yin Kuo
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (C.-Y.K.); (H.-C.C.); (C.-P.S.); (R.-H.L.); (L.-W.H.); (H.-K.C.); (Y.-Y.L.)
- Institute of Cognitive Neuroscience, National Central University, Taoyuan 32001, Taiwan
| | - Chia-Lien Hung
- Taichung Armed Forces General Hospital, Taichung 41168, Taiwan;
| | - Hsin-Chien Chen
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (C.-Y.K.); (H.-C.C.); (C.-P.S.); (R.-H.L.); (L.-W.H.); (H.-K.C.); (Y.-Y.L.)
| | - Cheng-Ping Shih
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (C.-Y.K.); (H.-C.C.); (C.-P.S.); (R.-H.L.); (L.-W.H.); (H.-K.C.); (Y.-Y.L.)
| | - Rou-Huei Lu
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (C.-Y.K.); (H.-C.C.); (C.-P.S.); (R.-H.L.); (L.-W.H.); (H.-K.C.); (Y.-Y.L.)
| | - Chen-Wai Chen
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan; (C.-W.C.); (D.-M.C.)
| | - Li-Wen Hung
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (C.-Y.K.); (H.-C.C.); (C.-P.S.); (R.-H.L.); (L.-W.H.); (H.-K.C.); (Y.-Y.L.)
| | - Yi-Chun Lin
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Hang-Kang Chen
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (C.-Y.K.); (H.-C.C.); (C.-P.S.); (R.-H.L.); (L.-W.H.); (H.-K.C.); (Y.-Y.L.)
- Taichung Armed Forces General Hospital, Taichung 41168, Taiwan;
| | - Da-Ming Chu
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan; (C.-W.C.); (D.-M.C.)
| | - Yuan-Yung Lin
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (C.-Y.K.); (H.-C.C.); (C.-P.S.); (R.-H.L.); (L.-W.H.); (H.-K.C.); (Y.-Y.L.)
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Yueh-Chun Chen
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan; (C.-W.C.); (D.-M.C.)
- Correspondence: (Y.-C.C.); (C.-H.W.); Tel.: +886-2-27303742 (Y.-C.C.); +886-2-87927192 (C.-H.W.); Fax: +886-2-27303742 (Y.-C.C.); +886-2-87927193 (C.-H.W.)
| | - Chih-Hung Wang
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (C.-Y.K.); (H.-C.C.); (C.-P.S.); (R.-H.L.); (L.-W.H.); (H.-K.C.); (Y.-Y.L.)
- Taichung Armed Forces General Hospital, Taichung 41168, Taiwan;
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 11490, Taiwan;
- Correspondence: (Y.-C.C.); (C.-H.W.); Tel.: +886-2-27303742 (Y.-C.C.); +886-2-87927192 (C.-H.W.); Fax: +886-2-27303742 (Y.-C.C.); +886-2-87927193 (C.-H.W.)
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Orru H, Luha A, Pindus M, Jõgeva R, Vahisalu M, Lekk U, Indermitte E, Merisalu E. Hearing loss among military personnel in relation to occupational and leisure noise exposure and usage of personal protective equipment. Noise Health 2021; 22:90-98. [PMID: 33402609 PMCID: PMC8000139 DOI: 10.4103/nah.nah_12_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Context: Hearing loss (HL) is a major health concern among military personnel due to noise from shooting, blasts, military vehicles, and noisy training environments. Nevertheless, one’s exposure can be partially reduced by using personal protective equipment (PPE). The aim of this study is to estimate the prevalence of HL among military personnel, to analyse associations between HL and self-reported occupational and leisure noise exposure, and use of PPEs. Materials and Methods: A cross-sectional study was conducted among 150 military personnel during their routine medical examinations. First, all participants filled in a questionnaire about their exposure to noise and later the respondents went through an audiometric test. The diagnostic criteria for slight, moderate, and severe HL was HL of 25–40, 41–60, and >60 dB at 4 and 6 kHz, respectively. The associations between noise exposure and HL were studied with multinomial logistic regression analysis. Results: The prevalence of slight to severe HL in high frequencies (4 and 6 kHz) among study participants was 62.7%. Nevertheless, the majority of it was slight, as the prevalence of severe HL was 9.3%. The prevalence of any kind of HL was highest in the Navy and the prevalence of severe HL was highest in the Central Command Units. The relative risk ratios (RRRs) for HL were higher among those who had been working for a long time in a noisy environment, working with noise-producing equipment, driving in a PASI or a Bandvagn or had been shooting with blanks at least once per week. It also appeared that military personnel who had HL, reported tinnitus more often. Respondents’ previous health problems, music-listening habits, and amount of exposure to loud noise in non-military environments were not independently associated with HL, but in several cases it increased the RRRs together with military exposure. We also found significantly more frequent HL among those never using PPEs. Conclusion: HL loss was more prevalent among personnel who are more often exposed to military noise, especially among those who never use PPEs. The effect was enhanced by leisure time noise, but it was not independently associated to HL.
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Affiliation(s)
- Hans Orru
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Assar Luha
- Institute of Technology, Estonian University of Life Sciences, Tartu, Estonia
| | - Mihkel Pindus
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | | | | | - Urve Lekk
- The North Medical Centre, Tallinn, Estonia
| | - Ene Indermitte
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Eda Merisalu
- Institute of Technology, n University of Life Sciences, Tartu, Estonia
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Couth S, Prendergast G, Guest H, Munro KJ, Moore DR, Plack CJ, Ginsborg J, Dawes P. Investigating the effects of noise exposure on self-report, behavioral and electrophysiological indices of hearing damage in musicians with normal audiometric thresholds. Hear Res 2020; 395:108021. [PMID: 32631495 DOI: 10.1016/j.heares.2020.108021] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/02/2020] [Accepted: 06/11/2020] [Indexed: 01/11/2023]
Abstract
Musicians are at risk of hearing loss due to prolonged noise exposure, but they may also be at risk of early sub-clinical hearing damage, such as cochlear synaptopathy. In the current study, we investigated the effects of noise exposure on electrophysiological, behavioral and self-report correlates of hearing damage in young adult (age range = 18-27 years) musicians and non-musicians with normal audiometric thresholds. Early-career musicians (n = 76) and non-musicians (n = 47) completed a test battery including the Noise Exposure Structured Interview, pure-tone audiometry (PTA; 0.25-8 kHz), extended high-frequency (EHF; 12 and 16 kHz) thresholds, otoacoustic emissions (OAEs), auditory brainstem responses (ABRs), speech perception in noise (SPiN), and self-reported tinnitus, hyperacusis and hearing in noise difficulties. Total lifetime noise exposure was similar between musicians and non-musicians, the majority of which could be accounted for by recreational activities. Musicians showed significantly greater ABR wave I/V ratios than non-musicians and were also more likely to report experience of - and/or more severe - tinnitus, hyperacusis and hearing in noise difficulties, irrespective of noise exposure. A secondary analysis revealed that individuals with the highest levels of noise exposure had reduced outer hair cell function compared to individuals with the lowest levels of noise exposure, as measured by OAEs. OAE level was also related to PTA and EHF thresholds. High levels of noise exposure were also associated with a significant increase in ABR wave V latency, but only for males, and a higher prevalence and severity of hyperacusis. These findings suggest that there may be sub-clinical effects of noise exposure on various hearing metrics even at a relatively young age, but do not support a link between lifetime noise exposure and proxy measures of cochlear synaptopathy such as ABR wave amplitudes and SPiN. Closely monitoring OAEs, PTA and EHF thresholds when conventional PTA is within the clinically 'normal' range could provide a useful early metric of noise-induced hearing damage. This may be particularly relevant to early-career musicians as they progress through a period of intensive musical training, and thus interventions to protect hearing longevity may be vital.
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Affiliation(s)
- Samuel Couth
- Manchester Centre for Audiology and Deafness, University of Manchester, UK.
| | | | - Hannah Guest
- Manchester Centre for Audiology and Deafness, University of Manchester, UK
| | - Kevin J Munro
- Manchester Centre for Audiology and Deafness, University of Manchester, UK; Manchester Academic Health Science Centre, Manchester University Hospitals NHS Foundation Trust, UK
| | - David R Moore
- Manchester Centre for Audiology and Deafness, University of Manchester, UK; Communication Sciences Research Center, Cincinnati Children's Hospital Medical Centre, OH, USA
| | - Christopher J Plack
- Manchester Centre for Audiology and Deafness, University of Manchester, UK; Department of Psychology, Lancaster University, UK
| | | | - Piers Dawes
- Manchester Centre for Audiology and Deafness, University of Manchester, UK; Department of Linguistics, Macquarie University, Sydney, Australia
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9
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Miaskowski C, Paul SM, Mastick J, Abrams G, Topp K, Smoot B, Kober KM, Chesney M, Mazor M, Mausisa G, Schumacher M, Conley YP, Sabes JH, Cheung S, Wallhagen M, Levine JD. Associations Between Perceived Stress and Chemotherapy-Induced Peripheral Neuropathy and Otoxicity in Adult Cancer Survivors. J Pain Symptom Manage 2018; 56:88-97. [PMID: 29524582 PMCID: PMC6015523 DOI: 10.1016/j.jpainsymman.2018.02.021] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 02/27/2018] [Accepted: 02/27/2018] [Indexed: 11/22/2022]
Abstract
CONTEXT The most common adverse effects from neurotoxic chemotherapy are chemotherapy-induced neuropathy (CIPN), hearing loss, and tinnitus. Although associations between perceived stress and persistent pain, hearing loss, and tinnitus are documented, no studies have examined these associations in cancer survivors who received neurotoxic chemotherapy. OBJECTIVES In this cross-sectional study, we evaluated for associations between perceived stress and the occurrence of CIPN, hearing loss, and tinnitus, in 623 adult cancer survivors who received platinum and/or taxane compounds. METHODS Survivors completed self-report measures of hearing loss, tinnitus, and perceived stress (i.e., Impact of Events Scale-Revised [IES-R]). Separate logistic regression analyses were done for each neurotoxicity to evaluate whether each of the IES-R subscale (i.e., intrusion, avoidance, hyperarousal) and total scores made a significant independent contribution to neurotoxicity group membership. RESULTS Of the 623 survivors in this study, 68.4% had CIPN, 34.5% reported hearing loss, and 31.0% reported tinnitus. Older age, higher body mass index, poorer functional status, being born prematurely, cancer diagnosis, and higher intrusion (P = 0.013), hyperarousal (P = 0.014), and total (P = 0.047) IES-R scores were associated with CIPN. Older age, being male, poorer functional status, a worse comorbidity profile, and a higher IES-R hyperarousal (P = 0.007) score were associated with hearing loss. Being male, having less education, a worse comorbidity profile, and a higher IES-R hyperarousal (P = 0.029) score were associated with tinnitus. CONCLUSION These findings suggest that increased levels of perceived stress are associated with the most common chemotherapy-induced neurotoxicities.
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Affiliation(s)
| | - Steven M Paul
- School of Nursing, University of California, San Francisco, California, USA
| | - Judy Mastick
- School of Nursing, University of California, San Francisco, California, USA
| | - Gary Abrams
- School of Medicine, University of California, San Francisco, California, USA
| | - Kimberly Topp
- School of Medicine, University of California, San Francisco, California, USA
| | - Betty Smoot
- School of Medicine, University of California, San Francisco, California, USA
| | - Kord M Kober
- School of Nursing, University of California, San Francisco, California, USA
| | - Margaret Chesney
- School of Medicine, University of California, San Francisco, California, USA
| | - Melissa Mazor
- School of Nursing, University of California, San Francisco, California, USA
| | - Grace Mausisa
- School of Nursing, University of California, San Francisco, California, USA
| | - Mark Schumacher
- School of Medicine, University of California, San Francisco, California, USA
| | - Yvette P Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - Steven Cheung
- School of Medicine, University of California, San Francisco, California, USA
| | - Margaret Wallhagen
- School of Nursing, University of California, San Francisco, California, USA
| | - Jon D Levine
- School of Medicine, University of California, San Francisco, California, USA; School of Dentistry, University of California, San Francisco, California, USA
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Blioskas S, Tsalighopoulos M, Psillas G, Markou K. Utility of otoacoustic emissions and olivocochlear reflex in predicting vulnerability to noise-induced inner ear damage. Noise Health 2018; 20:101-111. [PMID: 29785975 PMCID: PMC5965001 DOI: 10.4103/nah.nah_61_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim: The aim of the present study was to explore the possible utility of otoacoustic emissions (OAEs) and efferent system strength to determine vulnerability to noise exposure in a clinical setting. Materials and Methods: The study group comprised 344 volunteers who had just begun mandatory basic training as Hellenic Corps Officers Military Academy cadets. Pure-tone audiograms were obtained on both ears. Participants were also subjected to diagnostic transient-evoked otoacoustic emissions (TEOAEs). Finally, they were all tested for efferent function through the suppression of TEOAEs with contralateral noise. Following baseline evaluation, all cadets fired 10 rounds using a 7.62 mm Heckler & Koch G3A3 assault rifle while lying down in prone position. Immediately after exposure to gunfire noise and no later than 10 h, all participants completed an identical protocol for a second time, which was then repeated a third time, 30 days later. Results: The data showed that after the firing drill, 280 participants suffered a temporary threshold shift (TTS) (468 ears), while in the third evaluation conducted 30 days after exposure, 142 of these ears still presented a threshold shift compared to the baseline evaluation [permanent threshold shift (PTS) ears]. A receiver operating characteristics curve analysis showed that OAEs amplitude is predictive of future TTS and PTS. The results were slightly different for the suppression of OAEs showing only a slight trend toward significance. The curves were used to determine cut points to evaluate the likelihood of TTS/PTS for OAEs amplitude in the baseline evaluation. Decision limits yielding 71.6% sensitivity were 12.45 dB SPL with 63.8% specificity for PTS, and 50% sensitivity were 12.35 dB SPL with 68.2% specificity for TTS. Conclusions: Interestingly, the above data yielded tentative evidence to suggest that OAEs amplitude is both sensitive and specific enough to efficiently identify participants who are particularly susceptible to hearing loss caused by impulse noise generated by firearms. Hearing conservation programs may therefore want to consider including such tests in their routine. As far as efferent strength is concerned, we feel that further research is due, before implementing the suppression of OAEs in hearing conservations programs in a similar manner.
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Affiliation(s)
- Sarantis Blioskas
- Department of Otorhinolaryngology - Head and Neck Surgery, 424 Military Hospital of Thessaloniki, Perifereiaki Odos Efkarpias, Greece
| | - Miltiadis Tsalighopoulos
- 1st Department of Otorhinolaryngology - Head and Neck Surgery, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - George Psillas
- 1st Department of Otorhinolaryngology - Head and Neck Surgery, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Konstantinos Markou
- 1st Department of Otorhinolaryngology - Head and Neck Surgery, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
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Ohgami N, Li X, Yajima I, Oshino R, Ohgami K, Kato Y, Ahsan N, Akhand AA, Kato M. Manganese in toenails is associated with hearing loss at high frequencies in humans. Biomarkers 2018; 23:533-539. [PMID: 29619852 DOI: 10.1080/1354750x.2018.1458153] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE Elevated hearing thresholds from high frequencies are known to be one of the hallmarks of age-related hearing loss. Our recent study showed accumulation of manganese (Mn) in inner ears resulting in acceleration of age-related hearing loss in mice orally exposed to Mn. However, there is no evidence showing an association between Mn in non-invasive biological samples and hearing loss in humans evaluated by pure tone audiometry (PTA). In this study, we evaluated Mn in non-invasive biological samples as a possible biomarker for hearing loss in humans. MATERIALS AND METHODS We determined hearing levels by PTA and Mn levels in toenails, hair and urine with an inductively coupled plasma mass spectrometer (ICP-MS) in 145 healthy subjects in Bangladesh. RESULTS Multivariable analyses showed that Mn levels in toenails, but not in hair and urine samples, were significantly associated with hearing loss at 8 kHz and 12 kHz. Moreover, our experimental study showed a significant correlation between Mn levels in inner ears and nails, but not hair, in mice orally exposed to Mn. CONCLUSIONS The results provide novel evidence that Mn in toenails is a possible biomarker for hearing loss at high frequencies in humans.
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Affiliation(s)
- Nobutaka Ohgami
- a Department of Occupational and Environmental Health , Nagoya University Graduate School of Medicine , Nagoya , Japan.,b Voluntary Body for International Health Care in Universities , Nagoya , Japan
| | - Xiang Li
- a Department of Occupational and Environmental Health , Nagoya University Graduate School of Medicine , Nagoya , Japan
| | - Ichiro Yajima
- a Department of Occupational and Environmental Health , Nagoya University Graduate School of Medicine , Nagoya , Japan.,b Voluntary Body for International Health Care in Universities , Nagoya , Japan
| | - Reina Oshino
- a Department of Occupational and Environmental Health , Nagoya University Graduate School of Medicine , Nagoya , Japan.,b Voluntary Body for International Health Care in Universities , Nagoya , Japan
| | - Kyoko Ohgami
- a Department of Occupational and Environmental Health , Nagoya University Graduate School of Medicine , Nagoya , Japan.,b Voluntary Body for International Health Care in Universities , Nagoya , Japan
| | - Yoko Kato
- a Department of Occupational and Environmental Health , Nagoya University Graduate School of Medicine , Nagoya , Japan.,b Voluntary Body for International Health Care in Universities , Nagoya , Japan
| | - Nazmul Ahsan
- b Voluntary Body for International Health Care in Universities , Nagoya , Japan.,c Department of Genetic Engineering and Biotechnology , University of Dhaka , Dhaka , Bangladesh
| | - Anwarul Azim Akhand
- b Voluntary Body for International Health Care in Universities , Nagoya , Japan.,c Department of Genetic Engineering and Biotechnology , University of Dhaka , Dhaka , Bangladesh
| | - Masashi Kato
- a Department of Occupational and Environmental Health , Nagoya University Graduate School of Medicine , Nagoya , Japan.,b Voluntary Body for International Health Care in Universities , Nagoya , Japan
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12
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Colon DC, Verdugo-Raab U, Alvarez CP, Steffens T, Marcrum SC, Kolb S, Herr C, Twardella D. Early indication of noise-induced hearing loss from PMP use in adolescents: A cross-sectional analysis. Noise Health 2017; 18:288-296. [PMID: 27991459 PMCID: PMC5227008 DOI: 10.4103/1463-1741.195798] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Context: Distortion product otoacoustic emissions (DPOAEs) may indicate preclinical noise-induced hearing loss (NIHL) in adolescents from unsafe personal music player (PMP) use. Aims: The objective, therefore, was to observe preclinical signs of NIHL in 9th grade adolescents with clinically normal hearing by comparing DPOAE signals between different levels of A-weighted equivalent PMP exposure. Settings and Design: Subjects were recruited from all secondary-level schools located in the city of Regensburg, Germany during two academic years 2009/2010 and 2010/2011. Subjects and Methods: A-weighted equivalent sound pressure levels (SPLs) for a 40-hour work week (LAeq,40h) were estimated from questionnaire responses on output and duration of PMP use of the previous week. Subjects were then categorized into four levels of exposure: <80, 80–85, >85 to <90, and ≥90 A-weighted Decibel [dB(A)]. DPOAE signals were collected by trained audiological staff, applying a standard optimized protocol, at the Department of Otorhinolaryngology of the University Hospital Regensburg. Statistical Analysis Used: Mean DPOAE signals were compared between levels by unpaired t test. Novel linear regression models adjusting for other leisure noise exposures and with outcome variables DPoutcome and 4 kilo Hertz (kHz) DPOAEs estimated effects between levels. Results: A total of 1468 subjects (56% female, mostly aged 15 or 16 years) were available for analysis. Comparison of DPOAE means by PMP exposure typically showed no greater than 1 dB difference between groups. In fact, comparisons between ≥90 dB(A) and <80 dB(A) presented the least differences in magnitude. Both DPoutcome and 4 kHz linear regression models presented a weak association with the 4-level PMP exposure variable. An expected dose-response to PMP exposure was not observed in any analyses. Conclusions: DPOAE signal strength alone cannot indicate preclinical NIHL in adolescents.
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Affiliation(s)
- Diana C Colon
- Department of Occupational and Environmental Medicine and Epidemiology, Bavarian Health and Food Safety Authority, Munich; Pettenkofer School of Public Health, Ludwig-Maximilians-University, Munich, Germany
| | - Ulla Verdugo-Raab
- Department of Occupational and Environmental Medicine and Epidemiology, Bavarian Health and Food Safety Authority, Munich, Germany
| | - Carmelo P Alvarez
- Department of Otorhinolaryngology, University Hospital Regensburg, Regensburg, Germany
| | - Thomas Steffens
- Department of Otorhinolaryngology, University Hospital Regensburg, Regensburg, Germany
| | - Steven C Marcrum
- Department of Otorhinolaryngology, University Hospital Regensburg, Regensburg, Germany
| | - Stefanie Kolb
- Department of Occupational and Environmental Medicine and Epidemiology, Bavarian Health and Food Safety Authority, Munich; Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Clinical Centre of the Ludwig-Maximilians-University, Munich, Germany
| | - Caroline Herr
- Department of Occupational and Environmental Medicine and Epidemiology, Bavarian Health and Food Safety Authority, Munich; Pettenkofer School of Public Health, Ludwig-Maximilians-University, Munich, Germany
| | - Dorothee Twardella
- Department of Occupational and Environmental Medicine and Epidemiology, Bavarian Health and Food Safety Authority, Munich, Germany
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Le TN, Straatman LV, Lea J, Westerberg B. Current insights in noise-induced hearing loss: a literature review of the underlying mechanism, pathophysiology, asymmetry, and management options. J Otolaryngol Head Neck Surg 2017; 46:41. [PMID: 28535812 PMCID: PMC5442866 DOI: 10.1186/s40463-017-0219-x] [Citation(s) in RCA: 201] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 05/15/2017] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Noise-induced hearing loss is one of the most common forms of sensorineural hearing loss, is a major health problem, is largely preventable and is probably more widespread than revealed by conventional pure tone threshold testing. Noise-induced damage to the cochlea is traditionally considered to be associated with symmetrical mild to moderate hearing loss with associated tinnitus; however, there is a significant number of patients with asymmetrical thresholds and, depending on the exposure, severe to profound hearing loss as well. MAIN BODY Recent epidemiology and animal studies have provided further insight into the pathophysiology, clinical findings, social and economic impacts of noise-induced hearing loss. Furthermore, it is recently shown that acoustic trauma is associated with vestibular dysfunction, with associated dizziness that is not always measurable with current techniques. Deliberation of the prevalence, treatment and prevention of noise-induced hearing loss is important and timely. Currently, prevention and protection are the first lines of defence, although promising protective effects are emerging from multiple different pharmaceutical agents, such as steroids, antioxidants and neurotrophins. CONCLUSION This review provides a comprehensive update on the pathophysiology, investigations, prevalence of asymmetry, associated symptoms, and current strategies on the prevention and treatment of noise-induced hearing loss.
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Affiliation(s)
- Trung N. Le
- Division of Otolaryngology - Head & Neck Surgery, Department of Surgery, University of British Columbia, Vancouver, BC Canada
| | - Louise V. Straatman
- Division of Otolaryngology - Head & Neck Surgery, Department of Surgery, University of British Columbia, Vancouver, BC Canada
| | - Jane Lea
- Division of Otolaryngology - Head & Neck Surgery, Department of Surgery, University of British Columbia, Vancouver, BC Canada
| | - Brian Westerberg
- Division of Otolaryngology - Head & Neck Surgery, Department of Surgery, University of British Columbia, Vancouver, BC Canada
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14
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Ohgami N, Mitsumatsu Y, Ahsan N, Akhand AA, Li X, Iida M, Yajima I, Naito M, Wakai K, Ohnuma S, Kato M. Epidemiological analysis of the association between hearing and barium in humans. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2016; 26:488-493. [PMID: 26464097 DOI: 10.1038/jes.2015.62] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 08/10/2015] [Accepted: 08/21/2015] [Indexed: 06/05/2023]
Abstract
Our previous study experimentally showed barium (Ba)-mediated hearing loss in mice. To our knowledge, however, it remains unknown whether Ba affects hearing in humans. This epidemiological study aimed at investigating ototoxicity of Ba in humans. Associations of Ba levels in hair, toenails and urine with hearing levels (1, 4, 8 and 12 kHz) were analyzed in 145 Bangladeshi subjects. Binary logistic regression analysis with adjustment for age, sex, body mass index (BMI) and smoking showed that Ba levels in hair had significant associations with hearing loss at 8 kHz (OR=4.75; 95% CI: 1.44, 17.68) and 12 kHz (OR=15.48; 95% CI: 4.04, 79.45). Ba levels in toenails were also associated with hearing loss at 8 kHz (OR=3.20; 95% CI: 1.35, 7.85) and 12 kHz (OR=3.63; 95% CI: 1.58, 8.55), whereas there was no correlation between Ba level in urinary samples and hearing. There was a significant correlation between hearing loss and Ba levels in hair and toenails in the model adjusted with arsenic levels as the confounder. In conclusion, this study suggested that Ba levels could be a new risk factor for hearing loss, especially at high frequencies of 8 and 12 kHz, in humans.
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Affiliation(s)
- Nobutaka Ohgami
- Department of Occupational and Environmental Health, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Nutritional Health Science Research Center, Chubu University, Matsumoto, Kasugai, Aichi, Japan
- Voluntary Body for International Health Care in Universities, Nagoya, Japan
| | - Yuji Mitsumatsu
- Department of Occupational and Environmental Health, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nazmul Ahsan
- Department of Genetic Engineering and Biotechnology, University of Dhaka, Dhaka, Bangladesh
| | - Anwarul Azim Akhand
- Department of Genetic Engineering and Biotechnology, University of Dhaka, Dhaka, Bangladesh
| | - Xiang Li
- Department of Occupational and Environmental Health, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Machiko Iida
- Department of Occupational and Environmental Health, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Nutritional Health Science Research Center, Chubu University, Matsumoto, Kasugai, Aichi, Japan
- Voluntary Body for International Health Care in Universities, Nagoya, Japan
| | - Ichiro Yajima
- Department of Occupational and Environmental Health, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Voluntary Body for International Health Care in Universities, Nagoya, Japan
| | - Mariko Naito
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shoko Ohnuma
- Voluntary Body for International Health Care in Universities, Nagoya, Japan
| | - Masashi Kato
- Department of Occupational and Environmental Health, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Voluntary Body for International Health Care in Universities, Nagoya, Japan
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Tremblay KL, Pinto A, Fischer ME, Klein BEK, Klein R, Levy S, Tweed TS, Cruickshanks KJ. Self-Reported Hearing Difficulties Among Adults With Normal Audiograms: The Beaver Dam Offspring Study. Ear Hear 2015; 36:e290-9. [PMID: 26164105 PMCID: PMC4824300 DOI: 10.1097/aud.0000000000000195] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Clinicians encounter patients who report experiencing hearing difficulty (HD) even when audiometric thresholds fall within normal limits. When there is no evidence of audiometric hearing loss, it generates debate over possible biomedical and psychosocial etiologies. It is possible that self-reported HDs relate to variables within and/or outside the scope of audiology. The purpose of this study is to identify how often, on a population basis, people with normal audiometric thresholds self-report HD and to identify factors associated with such HDs. DESIGN This was a cross-sectional investigation of participants in the Beaver Dam Offspring Study. HD was defined as a self-reported HD on a four-item scale despite having pure-tone audiometric thresholds within normal limits (<20 dB HL0.5, 1, 2, 3, 4, 6, 8 kHz bilaterally, at each frequency). Distortion product otoacoustic emissions and word-recognition performance in quiet and with competing messages were also analyzed. In addition to hearing assessments, relevant factors such as sociodemographic and lifestyle factors, environmental exposures, medical history, health-related quality of life, and symptoms of neurological disorders were also examined as possible risk factors. The Center for Epidemiological Studies-Depression was used to probe symptoms associated with depression, and the Medical Outcomes Study Short-Form 36 mental score was used to quantify psychological stress and social and role disability due to emotional problems. The Visual Function Questionnaire-25 and contrast sensitivity test were used to query vision difficulties. RESULTS Of the 2783 participants, 686 participants had normal audiometric thresholds. An additional grouping variable was created based on the available scores of HD (four self-report questions), which reduced the total dataset to n = 682 (age range, 21-67 years). The percentage of individuals with normal audiometric thresholds who self-reported HD was 12.0% (82 of 682). The prevalence in the entire cohort was therefore 2.9% (82 of 2783). Performance on audiological tests (distortion product otoacoustic emissions and word-recognition tests) did not differ between the group self-reporting HD and the group reporting no HD. A multivariable model controlling for age and sex identified the following risk factors for HD: lower incomes (odds ratio [OR] $50,000+ = 0.55, 95% confidence interval [CI] = 0.30-1.00), noise exposure through loud hobbies (OR = 1.48, 95% CI = 1.15-1.90), or firearms (OR = 2.07, 95% CI = 1.04-4.16). People reporting HD were more likely to have seen a doctor for hearing loss (OR = 12.93, 95% CI = 3.86-43.33) and report symptoms associated with depression (Center for Epidemiological Studies-Depression [OR = 2.39, 95% CI = 1.03-5.54]), vision difficulties (Visual Function Questionnaire-25 [OR = 0.93, 95% CI = 0.89-0.97]), and neuropathy (e.g., numbness, tingling, and loss of sensation [OR = 1.98, 95% CI = 1.14-3.44]). CONCLUSIONS The authors used a population approach to identify the prevalence and risk factors associated with self-reported HD among people who perform within normal limits on common clinical tests of auditory function. The percentage of individuals with normal audiometric thresholds who self-reported HD was 12.0%, resulting in an overall prevalence of 2.9%. Auditory and nonauditory risk factors were identified, therefore suggesting that future directions aimed at assessing, preventing, and managing these types of HDs might benefit from information outside the traditional scope of audiology.
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Affiliation(s)
- Kelly L. Tremblay
- Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington, USA
| | - Alex Pinto
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin, USA
| | - Mary E. Fischer
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin, USA
| | - Barbara E. K. Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin, USA
| | - Ronald Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin, USA
| | - Sarah Levy
- Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington, USA
| | - Ted S. Tweed
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin, USA
| | - Karen J. Cruickshanks
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin, USA
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, USA
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16
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Kabe I, Koga Y, Kochi T, Miyauchi H, Minozoe A, Kuwata D, Tsustumi I, Nakagawa M, Tanaka S. [A survey of the otoacoustic emissions (OAEs) of workers exposed to noise in manufacturing factories]. SANGYO EISEIGAKU ZASSHI = JOURNAL OF OCCUPATIONAL HEALTH 2015; 57:306-313. [PMID: 26346131 DOI: 10.1539/sangyoeisei.e15002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVES Otoacoustic emission (OAE) testing is not widespread in Japanese industrial health. This study examined the association between hearing thresholds (HTs) and OAEs among workers exposed to noise in actual workplaces. METHODS In two metal products manufacturing factories, 34 workers with noise exposure in the workplace (exposure group, mean age 40.6 ± 9.4 years), and 9 workers with no noise exposure (control group, 49.0 ± 14.3 years) were surveyed. The time-weighted average (LAeq) and maximum (LAMAX) of environmental noise monitoring (ENM), and the time-weighted average (LTWA) and sound exposure level (LAE) of personal noise monitoring (PNM) were measured for each subject at the same time. As hearing effect indicators of noise exposure levels, HTs (0.5, 1, 2, 4 and 8 kHz) and distortion product OAEs (DPOAEs) (2, 3 and 4 kHz) were performed before and after 5 days of work. The results of the ENM, PNM, HTs and OAEs were compared between the groups using Student's t test, and their correlations were investigated using Pearson correlation coefficients. RESULTS Noise exposure levels of the exposure group were significantly higher than those of the control group. In the exposure group, LAeq, LAMAX, LTWA and LAE were respectively 84.5 ± 4.1 dB(A),89.5 ± 6.3 dB(A), 83.4 ± 4.7 dB(A) and 153.1 ± 15.7 dB(A), and in the control group, they were 53.2 ± 2.6 dB(A), 56.4 ± 2.4 dB(A), 67.8 ± 5.6 dB(A) and 119.5 ± 5.6 dB(A). There was no difference between hearing effect indicators (HTs and OAEs) before and after work in either group. There was no correlation between the noise exposure level (LAeq, LTWA, LTWA and LAE) and HTs or OAEs, but there was a significant correlation between the HTs and OAEs at most of frequencies. The HTs and OAEs of subjects with noise-induced hearing loss (NIHL) were significantly lower than those of subjects without NIHL. CONCLUSIONS This study revealed there is a significant correlation of the HTs and OAEs before and after 5 days of work. In the future, OAE is expected to be used as a screening test of hearing management of noise-exposed workers in Japan.
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Affiliation(s)
- Isamu Kabe
- Health Administration Department, Furukawa Electric Corporation, 2-2-3 Marunouchi, Chiyoda-ku, Tokyo 100-8322, Japan
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Job A, Hamery P, De Mezzo S, Fialaire JC, Roux A, Untereiner M, Cardinale F, Michel H, Klein C, Belcourt B. Rifle impulse noise affects middle-ear compliance in soldiers wearing protective earplugs. Int J Audiol 2015; 55:30-7. [DOI: 10.3109/14992027.2015.1070967] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Occupational noise exposure and hearing: a systematic review. Int Arch Occup Environ Health 2015; 89:351-72. [PMID: 26249711 PMCID: PMC4786595 DOI: 10.1007/s00420-015-1083-5] [Citation(s) in RCA: 196] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 07/30/2015] [Indexed: 12/20/2022]
Abstract
Purpose To give a systematic review of the development of noise-induced hearing loss (NIHL) in working life. Methods A literature search in MEDLINE, Embase, Web of Science, Scopus, and Health and Safety Abstracts, with appropriate keywords on noise in the workplace and health, revealed 22,413 articles which were screened by six researchers. A total of 698 articles were reviewed in full text and scored with a checklist, and 187 articles were found to be relevant and of sufficient quality for further analysis. Results Occupational noise exposure causes between 7 and 21 % of the hearing loss among workers, lowest in the industrialized countries, where the incidence is going down, and highest in the developing countries. It is difficult to distinguish between NIHL and age-related hearing loss at an individual level. Most of the hearing loss is age related. Men lose hearing more than women do. Heredity also plays a part. Socioeconomic position, ethnicity and other factors, such as smoking, high blood pressure, diabetes, vibration and chemical substances, may also affect hearing. The use of firearms may be harmful to hearing, whereas most other sources of leisure-time noise seem to be less important. Impulse noise seems to be more deleterious to hearing than continuous noise. Occupational groups at high risk of NIHL are the military, construction workers, agriculture and others with high noise exposure. Conclusion The prevalence of NIHL is declining in most industrialized countries, probably due to preventive measures. Hearing loss is mainly related to increasing age. Electronic supplementary material The online version of this article (doi:10.1007/s00420-015-1083-5) contains supplementary material, which is available to authorized users.
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Strategies for Evaluating Antioxidant Efficacy in Clinical Trials Assessing Prevention of Noise-Induced Hearing Loss. FREE RADICALS IN ENT PATHOLOGY 2015. [DOI: 10.1007/978-3-319-13473-4_9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Marshall L, Lapsley Miller JA, Guinan JJ, Shera CA, Reed CM, Perez ZD, Delhorne LA, Boege P. Otoacoustic-emission-based medial-olivocochlear reflex assays for humans. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2014; 136:2697-713. [PMID: 25373970 PMCID: PMC5392105 DOI: 10.1121/1.4896745] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2013] [Revised: 09/15/2014] [Accepted: 09/18/2014] [Indexed: 05/20/2023]
Abstract
Otoacoustic emission (OAE) tests of the medial-olivocochlear reflex (MOCR) in humans were assessed for viability as clinical assays. Two reflection-source OAEs [TEOAEs: transient-evoked otoacoustic emissions evoked by a 47 dB sound pressure level (SPL) chirp; and discrete-tone SFOAEs: stimulus-frequency otoacoustic emissions evoked by 40 dB SPL tones, and assessed with a 60 dB SPL suppressor] were compared in 27 normal-hearing adults. The MOCR elicitor was a 60 dB SPL contralateral broadband noise. An estimate of MOCR strength, MOCR%, was defined as the vector difference between OAEs measured with and without the elicitor, normalized by OAE magnitude (without elicitor). An MOCR was reliably detected in most ears. Within subjects, MOCR strength was correlated across frequency bands and across OAE type. The ratio of across-subject variability to within-subject variability ranged from 2 to 15, with wideband TEOAEs and averaged SFOAEs giving the highest ratios. MOCR strength in individual ears was reliably classified into low, normal, and high groups. SFOAEs using 1.5 to 2 kHz tones and TEOAEs in the 0.5 to 2.5 kHz band gave the best statistical results. TEOAEs had more clinical advantages. Both assays could be made faster for clinical applications, such as screening for individual susceptibility to acoustic trauma in a hearing-conservation program.
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Affiliation(s)
- Lynne Marshall
- Naval Submarine Medical Research Laboratory, Box 900, Subase NLON, Box 900, Groton, Connecticut 06349-5900
| | - Judi A Lapsley Miller
- Naval Submarine Medical Research Laboratory, Box 900, Subase NLON, Box 900, Groton, Connecticut 06349-5900
| | - John J Guinan
- Eaton-Peabody Laboratory of Auditory Physiology, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, Massachusetts 02114
| | - Christopher A Shera
- Eaton-Peabody Laboratory of Auditory Physiology, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, Massachusetts 02114
| | - Charlotte M Reed
- Research Laboratory of Electronics, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139-4307
| | - Zachary D Perez
- Research Laboratory of Electronics, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139-4307
| | - Lorraine A Delhorne
- Research Laboratory of Electronics, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139-4307
| | - Paul Boege
- Consultant, Hirschanger 17, D-82319, Starnberg, Germany
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Iizuka LY, Gil D. Avaliação audiológica em funcionários de um hospital público expostos a ruído. REVISTA CEFAC 2014. [DOI: 10.1590/1982-021620140713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objetivo caracterizar e comparar a audição de funcionários de um hospital público expostos a níveis de ruído ocupacional máximos superiores e inferiores a 85dB(A). Métodos trata-se de um estudo clínico, com 39 funcionários de um hospital público, divididos de acordo com o nível de exposição ao ruído: 20 indivíduos sob exposição máxima superior a 85dB(A) (Grupo 1) e 19 indivíduos sob exposição máxima inferior a 85dB(A) (Grupo 2). Foi realizada avaliação audiológica básica e emissões otoacústicas evocadas por estímulo transiente e produto de distorção. Resultados ambos os grupos apresentaram limiares de audibilidade normais. Contudo, observou-se ausência de respostas em 87,5% no Grupo 1 e 60,5% no Grupo 2 no teste de emissões otoacústicas evocadas por estímulo transiente, com diferença estatística. O Grupo 1 mostrou menor amplitude de respostas também às emissões otoacústicas produto de distorção, sendo a frequência de 6kHz a única alterada em ambos os grupos. Conclusão os níveis de pressão sonora e o tempo de exposição não influenciam os limiares auditivos tonais. As emissões otoacústicas mostraram-se mais alteradas quanto maior o nível de pressão sonora e tempo de exposição.
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Venet T, Campo P, Rumeau C, Thomas A, Parietti-Winkler C. One-day measurement to assess the auditory risks encountered by noise-exposed workers. Int J Audiol 2014; 53:737-44. [DOI: 10.3109/14992027.2014.913210] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Lee GJC, Lim MY, Kuan AYW, Teo JHW, Tan HG, Low WK. Relationship between leisure noise exposure and otoacoustic emissions in a young Asian population. Int J Audiol 2014; 53:462-8. [DOI: 10.3109/14992027.2014.893376] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Mehrparvar AH, Mirmohammadi SJ, Davari MH, Mostaghaci M, Mollasadeghi A, Bahaloo M, Hashemi SH. Conventional Audiometry, Extended High-Frequency Audiometry, and DPOAE for Early Diagnosis of NIHL. IRANIAN RED CRESCENT MEDICAL JOURNAL 2014; 16:e9628. [PMID: 24719719 PMCID: PMC3964437 DOI: 10.5812/ircmj.9628] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 11/19/2013] [Accepted: 05/13/2013] [Indexed: 12/11/2022]
Abstract
Background: Noise most frequently affects hearing system, as it may typically cause a bilateral, progressive sensorineural hearing loss at high frequencies. Objectives: This study was designed to compare three different methods to evaluate noise-induced hearing loss (conventional audiometry, high-frequency audiometry, and distortion product otoacoustic emission). Material and Methods: This was a cross-sectional study. Data was analyzed by SPSS (ver. 19) using chi square, T test and repeated measures analysis. Study samples were workers from tile and ceramic industry. Results: We found that conventional audiometry, extended high-frequency audiometry, low-tone distortion product otoacoustic emission and high-tone distortion product otoacoustic emission had abnormal findings in 29 %, 69 %, 22 %, and 52 % of participants. Most frequently affected frequencies were 4000 and 6000Hz in conventional audiometry, and 14000 and 16000 in extended high-frequency audiometry. Conclusions: Extended high-frequency audiometry was the most sensitive test for detection of hearing loss in workers exposed to hazardous noise compared with conventional audiometry and distortion product otoacoustic.
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Affiliation(s)
- Amir Houshang Mehrparvar
- Department of Occupational Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran
| | | | - Mohammad Hossein Davari
- Department of Occupational Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran
- Corresponding Author: Mohammad Hossein Davari, Shahid Rahnamoun Hospital, Farrokhi Ave, Yazd, IR Iran. Tel: +98-3516629193, Fax: +98-3156629194, E-mail:
| | - Mehrdad Mostaghaci
- Department of Occupational Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran
| | - Abolfazl Mollasadeghi
- Industrial Diseases Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran
| | - Maryam Bahaloo
- Industrial Diseases Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran
| | - Seyyed Hesam Hashemi
- Department of Occupational Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran
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Canlon B, Theorell T, Hasson D. Associations between stress and hearing problems in humans. Hear Res 2013; 295:9-15. [DOI: 10.1016/j.heares.2012.08.015] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2012] [Revised: 08/24/2012] [Accepted: 08/27/2012] [Indexed: 12/20/2022]
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Helleman HW, Dreschler WA. Overall versus individual changes for otoacoustic emissions and audiometry in a noise-exposed cohort. Int J Audiol 2012; 51:362-72. [DOI: 10.3109/14992027.2011.653447] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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27
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Sinicrope FA, Broaddus R, Joshi N, Gerner E, Half E, Kirsch I, Lewin J, Morlan B, Hong WK. Evaluation of difluoromethylornithine for the chemoprevention of Barrett's esophagus and mucosal dysplasia. Cancer Prev Res (Phila) 2011; 4:829-39. [PMID: 21636549 DOI: 10.1158/1940-6207.capr-10-0243] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Patients with Barrett's esophagus (BE) and dysplasia are candidates for chemopreventive strategies to reduce cancer risk. We determined the effects of difluoromethylornithine (DMFO) on mucosal polyamines, gene expression, and histopathology in BE. Ten patients with BE and low-grade dysplasia participated in a single-arm study of DFMO (0.5 g/m(2)/d) given continuously for 6 months. Esophagoscopy with biopsies was conducted at baseline, 3, 6, and 12 months. Dysplasia was graded by a gastrointestinal pathologist. Audiology was assessed (at baseline and at 6 months). Mucosal polyamines were measured by high-performance liquid chromatography. Microarray-based gene expression was analyzed using a cDNA two-color chip. DFMO suppressed levels of the polyamines putrescine (P = 0.02) and spermidine (P = 0.02) and the spermidine/spermine ratio (P < 0.01) in dysplastic BE (6 months vs. baseline) that persisted at 6 months following drug cessation. Among the top 25 modulated genes, we found those regulating p53-mediated cell signaling (RPL11), cell-cycle regulation (cyclin E2), and cell adhesion and invasion (Plexin1). DFMO downregulated Krüppel-like factor 5 (KLF5), a transcription factor promoting cell proliferation, and suppressed RFC5 whose protein interacts with proliferating cell nuclear antigen. Histopathology showed regression of dysplasia (n = 1), stable disease (n = 8), and progression to high-grade dysplasia (n = 1). Polyamines were suppressed in the responder to a greater extent than in stable cases. DFMO was well tolerated, and one patient had subclinical, unilateral ototoxicity. DFMO suppressed mucosal polyamines and modulated genes that may be mechanistically related to its chemopreventive effect. Further study of DFMO for the chemoprevention of esophageal cancer in BE patients is warranted.
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Hasson D, Theorell T, Wallén MB, Leineweber C, Canlon B. Stress and prevalence of hearing problems in the Swedish working population. BMC Public Health 2011; 11:130. [PMID: 21345187 PMCID: PMC3056746 DOI: 10.1186/1471-2458-11-130] [Citation(s) in RCA: 109] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2010] [Accepted: 02/23/2011] [Indexed: 01/15/2023] Open
Abstract
Background Current human and experimental studies are indicating an association between stress and hearing problems; however potential risk factors have not been established. Hearing problems are projected to become among the top ten disabilities according to the WHO in the near future. Therefore a better understanding of the relationships between stress and hearing is warranted. Here we describe the prevalence of two common hearing problems, i.e. hearing complaints and tinnitus, in relation to different work-and health-related stressors. Methods A total of 18,734 individuals were invited to participate in the study, out of which 9,756 (52%) enrolled. Results The results demonstrate a clear and mostly linear relationship between higher prevalence of hearing problems (tinnitus or hearing loss or both) and different stressors, e.g. occupational, poorer self-rated health, long-term illness, poorer sleep quality, and higher burnout scores. Conclusions The present study unambiguously demonstrates associations between hearing problems and various stressors that have not been previously described for the auditory system. These findings will open new avenues for future investigations.
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Affiliation(s)
- Dan Hasson
- Karolinska Institutet, Department of Physiology and Pharmacology, Stockholm, Sweden.
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Prediction of soman-induced cerebral damage by distortion product otoacoustic emissions. Toxicology 2010; 277:38-48. [DOI: 10.1016/j.tox.2010.08.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2010] [Accepted: 08/24/2010] [Indexed: 11/19/2022]
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Müller J, Dietrich S, Janssen T. Impact of three hours of discotheque music on pure-tone thresholds and distortion product otoacoustic emissions. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2010; 128:1853-1869. [PMID: 20968358 DOI: 10.1121/1.3479535] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The aim of this study was to investigate whether distortion product otoacoustic emissions (DPOAEs) are a suitable means for detecting changes in outer hair cell (OHC) functionality due to exposure to three hours of discotheque music and whether efferent reflex strength of the medial olivocochlear bundle is able to predict the ear's susceptibility to high-level noise. High-resolution DPOAEs (Δf(2)=47 Hz) were recorded between 3.5 and 4.5 kHz at close-to-threshold primary tone levels. For comparison, high-resolution pure-tone audiometry was conducted in the same frequency range. Efferent reflex strength was measured by means of DPOAEs at a specific frequency with and without contralateral acoustic stimulation. A significant deterioration of more than 10 dB was found for pure-tone thresholds and DPOAE levels indicating that three hours of high-level noise exert a considerable influence on hearing capability and OHC functionality. A significant correlation between shifts in pure-tone threshold and shifts in DPOAE level occurred when removing data with differing calibration across measurements. There was no clear correlation between efferent reflex strength and shifts in pure-tone threshold or shifts in DPOAE level suggesting that the applied measures of efferent reflex strength may not be suitable for quantifying individual vulnerability to noise.
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Affiliation(s)
- Jörg Müller
- Hals-Nasen-Ohrenklinik, Technische Universität München, Ismaningerstraße 22, 81675 Munich, Germany
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Marler JA, Sitcovsky JL, Mervis CB, Kistler DJ, Wightman FL. Auditory function and hearing loss in children and adults with Williams syndrome: cochlear impairment in individuals with otherwise normal hearing. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2010; 154C:249-65. [PMID: 20425785 DOI: 10.1002/ajmg.c.30262] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Hearing loss is common in school-age individuals with Williams syndrome (WS) and extensive in adults. Prior studies with relatively small sample sizes suggest that hearing loss in WS has an early onset and may be progressive, yet the auditory phenotype and the scope of the hearing loss have not been adequately characterized. We used standard audiometric tools: Otoscopy, tympanometry, air-conduction (bone conduction when available) behavioral testing, and distortion product otoacoustic emissions (DPOAEs) to measure hearing sensitivity and outer hair cell function. We tested 81 individuals with WS aged 5.33-59.50 years. Sixty-three percent of the school-age and 92% of the adult participants had mild to moderately-severe hearing loss. The hearing loss in at least 50% was sensorineural. DPOAE testing corroborated behavioral results. Strikingly, 12 of 14 participants with hearing within normal limits bilaterally had 4,000-Hz DPOAE input/output (DPOAE IO) functions indicative of outer hair cell damage and impaired cochlear compression. Our results indicate that hearing loss is very common in WS. Furthermore, individuals with WS who have "normal" hearing as defined by behavioral thresholds may actually have sub-clinical impairments or undetected cochlear pathology. Our findings suggest outer hair cell dysfunction in otherwise normal hearing individuals. The DPOAE IO in this same group revealed growth functions typically seen in groups with noise-induced damage. Given this pattern of findings, individuals with WS may be at increased risk of noise-induced hearing loss. Recommendations regarding audiological testing for individuals with WS and accommodations for these individuals in both academic and nonacademic settings are provided.
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Helleman HW, Jansen EJM, Dreschler WA. Otoacoustic emissions in a hearing conservation program: general applicability in longitudinal monitoring and the relation to changes in pure-tone thresholds. Int J Audiol 2010; 49:410-9. [PMID: 20192875 DOI: 10.3109/14992020903527616] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The hearing status of workers (N = 233) in a printing office was assessed twice within seventeen months by pure-tone audiometry and otoacoustic emissions (OAEs). One of the questions was how a quality criterion of OAE-measurements based on a minimum signal-to-noise-ratio (SNR) would affect the applicability on the entire population. Secondly, effects of noise exposure were investigated in overall changes in audiogram and OAE-measurements. For TEOAEs (transient evoked OAEs) in the frequency band of 4 kHz, only 55% of the data points meet the SNR-inclusion criterion. For DPOAEs (distortion product OAEs) around 6 kHz approximately 80% of the data points satisfy the criterion. Thus OAEs have a limited applicability for monitoring the hearing status of this entire population. Audiometry shows significant deteriorations at 6 and 8 kHz. TEOAEs show a significant decline at all frequency bands (1-4 kHz), DPOAEs between 4 and 8 kHz and less pronounced between 1 and 2 kHz. On group level, OAEs show a decline in a larger frequency region than the audiogram, suggesting an increased sensitivity of OAEs compared to audiometry.
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Affiliation(s)
- Hiske W Helleman
- Clinical and Experimental Audiology, ENT Department, Academic Medical Centre, Amsterdam, The Netherlands.
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