Awareness of Noise-Induced Hearing Loss and Use of Hearing Protection among Young Adults in Jordan

A Comprehensive Review of Auditory and Non-Auditory Effects of Noise on Human Health

OBJECTIVE

Excessive noise is unpleasant and induces several physiological and psychological effects. Noise pollution is a potential threat to humans, particularly those continuously exposed for extended periods throughout the day over many years. This review aims to examine the various auditory and non-auditory outcomes associated with prolonged exposure to noise pollution.

MATERIALS AND METHODS

The review utilized a combination of relevant keywords to search the electronic databases. After screening based on the applied selection criteria for title, abstract, and full text, 44 articles were finally selected for critical review.

RESULTS

We identified and analyzed research findings related to noise-induced hearing loss, tinnitus, and sleep disturbances along with non-auditory issues such as annoyance, cognitive impairments, and mental stress associated with cardiovascular disorders. Furthermore, the existing studies were compared and collated to highlight the unique challenges and significance of noise pollution as a distinctive environmental concern and to explore the ongoing efforts in its research and prevention, including the early detection and potential reversal of noise-induced hearing loss.

CONCLUSION

The fundamental health consequences of noise pollution underscore the need for extensive research encompassing emerging noise sources and technologies to establish a health management system tailored to address noise-related health concerns and reduce noise exposure risk among populations. Finally, further research is warranted to ensure improved measurement of noise exposure and related health outcomes, especially in the context of occupational noise.

B. A Survey of Knowledge and Attitude of College Students Toward Hearing Loss Prevention

BACKGROUND

College students risk hearing loss due to loud sound exposure during leisure activities. Hearing loss prevention is possible by reducing the noise from the source, using hearing protection devices and increasing their knowledge and awareness on the effects of loud sound exposure.

OBJECTIVE

The study aims to assess the knowledge and attitude of college students regarding hearing loss and its prevention.

STUDY DESIGN

A cross-sectional study design with a survey method was adopted. A total of 94 college students (mean age: 22 years; range: 18 to 26) who were pursuing an undergraduate and postgraduate degree (50 males and 44 females) formed the part of the study. The researcher administered a standardized self-reported Knowledge, Attitude and Behaviour questionnaire. The knowledge score in percentage and absolute scores for attitude were estimated.

RESULTS

The mean knowledge score was 35.8 (SD ± 12.18; range: 12.5-75), and the attitude score was + 9.8 (SD ± 7.1; range: - 4 to + 30). Chi square test revealed no significant association between knowledge and attitude to sociodemographic characteristics.

CONCLUSION

 The study indicated that though college students lack knowledge, they had a positive attitude regarding hearing health and its protection. These findings implicate the importance of creating awareness and encouraging hearing protection strategies for college students.

Salivary cortisone as potential predictor of occupational exposure to noise and related stress

Salivary cortisone strongly correlates with serum cortisol, and since it is less invasive to measure salivary cortisone than serum cortisol and easier than to measure cortisol in saliva, as its concentrations are much lower, we wanted to compare salivary cortisone and cortisol levels as markers of noise-induced stress reaction. The study included 104 participants aged 19-30 years, 50 of whom were exposed to occupational noise ≥85 dB(A) and 54 non-exposed, control students. All participants took samples of their saliva with Salivette® Cortisol synthetic swabs on three consecutive working days first thing in the morning. Salivary cortisone and cortisol levels were determined with high-performance liquid chromatography. In addition, they completed a 10-item Perceived Stress Scale (PSS-10) questionnaire, and occupationally noise-exposed participants also completed the Health and Safety Executive (HSE) questionnaire on occupational psychosocial risks. The exposed participants had significantly higher cortisone (P<0.001) and cortisol (P<0.001) levels than controls, and the correlation between cortisone and cortisol levels in the exposed participants was strong (ϱ =0.692, P<0.001), which suggests that salivary cortisone can replace cortisol measurements in saliva as a more reliable method than salivary cortisol and less invasive than serum cortisol. However, the level of perceived stress scored on PSS-10 in the exposed participants did not differ significantly from stress reported by controls, but correlated negatively with cortisone levels, which is contrary to our expectations and raises questions as to why.

Attitudes towards hearing, hearing loss, and hearing protection in university students

OBJECTIVE

Young adults are at risk for hearing loss caused by exposure to loud music. Intervention at this stage provides opportunities to support lifelong hearing protection use. This study explores attitudes related to hearing, hearing loss, and hearing protection among university students.

DESIGN

Qualitative interview design, supplemented by quantitative questionnaire data.

STUDY SAMPLE

18 university students, aged 18-24 years.

RESULTS

Students were uncertain about mechanisms of noise-induced hearing loss, did not feel vulnerable to permanent hearing damage from loud music, were unconvinced of hearing protection efficacy, and reported barriers to hearing protection use. Students emphasised the positive effects of loud music and reported an increased likelihood of using hearing protection were it used by peers. Music students appeared more aware of the negative effects of loud music exposure. Students reported conflicting attitudes regarding government regulation of hearing protection use.

CONCLUSION

Young adults require education about hearing protection from multiple, credible sources and need to understand the mechanisms behind noise-induced hearing loss in a way that makes it of high personal relevance.

The public healthcare sector of Mauritius: knowledge of and attitudes toward hearing loss among community health workers

Mauritius does not have community health workers trained in identifying risk factors for hearing loss or in referring patients for diagnostic testing. It is crucial to gather information about the knowledge of and attitudes toward hearing loss among community health workers before involving them in the identification and intervention of hearing loss in Mauritius. To describe the knowledge of and attitudes toward hearing loss among community health workers in Mauritius. A descriptive survey design with quantitative analysis was used. Using non-probability purposive sampling, 125 community health workers which included 94 community health officers and 31 community-based rehabilitation officers were recruited from the five catchment areas of the public healthcare sector. Participants filled in a 15-item paper-based questionnaire on the knowledge of and attitudes toward hearing loss. The questionnaire was internally consistent, with Cronbach alpha scores of 0.759 and 0.863. The overall knowledge of community health workers regarding risk factors and the identification of hearing loss was poor (38.3%). 92.6% of community health workers reported positive attitudes toward hearing loss. General knowledge of hearing loss (P=0.015) and knowledge of risk factors and identification of hearing loss (P=0.005) were significant predictors of attitudes toward hearing loss. Knowledge of and attitudes toward hearing loss were significantly associated with working experience and practice setting (P=0.004). There remains a need to educate community health workers about the risk factors and identification of hearing loss to ensure timely diagnosis and management of hearing loss at the community level.

The Relationship Between Noise-Induced Hearing Loss Awareness and the Use of Personal Listening Devices in Makkah Region, Saudi Arabia

Introduction Noise-induced hearing loss (NIHL) is one of the most common avoidable reasons for hearing impairment worldwide. Work-related, genetic, infectious, and environmental factors all have a part in defining the level of hearing impairment. Nevertheless, the use of personal listening devices (PLDs) is popular nowadays, particularly among younger people. Healthy behaviors are needed to prevent them from developing hearing loss. Our objective is to evaluate the knowledge level of NIHL among the people of Makkah, Saudi Arabia, and understand its association with PLDs. Methods A cross-sectional survey was performed in December 2022 by sending an online survey on various social media applications. An electronic Arabic questionnaire with a total of 37 questions was designed to explore the participants' demographic data, history of hearing loss, risk factors, attitudes, and awareness of NIHL. Results Almost 22% of the study had mild-to-severe hearing impairment. Hearing issues were especially common among male individuals. A higher incidence of hearing impairments was seen in individuals who were utilizing a sound degree of more than 80%. The causes for NIHL comprised exposure to occupational noise, duration of the listening session per day, and the level to which the sound of the television or the broadcasting was raised. Approximately 77% of the participants preferred to reduce the sound of their personal audio devices (PADs) to prevent NIHL. Conclusion According to this study, there is a high prevalence of hearing problems in the Saudi population. Most of the respondents understood the risk factors linked to NIHL. There is a need for more NIHL awareness campaigns to educate the Saudi population and reinforce positive, healthy listening habits.

Hearing loss and its associated factors among metal workshop workers at Gondar city, Northwest Ethiopia

Introduction

Noise-induced hearing loss is a permanent sensorineural deficiency, which is caused by exposure to excessive noise sound. Although noise-induced hearing loss due to industrialization is a main public health problem in Ethiopia, studies on the prevalence and associated factors of hearing loss are scarce.

Objectives

This study aimed to assess the prevalence and associated factors of hearing loss among workers at a metal workshop in Gondar city, Northwest Ethiopia.

Methods

A cross-sectional study was employed among 300 participants using a stratified sampling technique. Data were collected using an interviewer-administered questionnaire. Bivariable and multivariable logistic regressions were conducted. In the multivariable logistic regression model, adjusted odds ratios (AOR) with a 95% confidence interval (CI) and a p &lt; 0.05 were computed to determine the level of significance.

Results

The prevalence of hearing loss among metal workshop workers was 30.7% [95% CI: (25.7, 35.7)]. Age between 30 and 44 years [AOR = 2.9; 95% CI: 1.2, 7.1], age between 45 and 65 years [AOR = 3.8; 95% CI (1.5, 9.5)], cigarette smoking [AOR = 2.3; 95% CI: 1.2, 4.5], working area noise level &gt;85 dB [AOR = 2.2; 95% CI: 1.1, 6.5], working experience of 6–10 years [AOR = 1.8; 95% CI: 1.4, 6.0], working experience &gt;10 years [AOR = 3.5; 95% CI: 1.3, 4.3], and using ear protection devices [AOR = 0.3; 95% CI: 0.1, 0.6] were significantly associated with hearing loss.

Conclusion

The prevalence of hearing loss was considerably high. This study revealed that advanced age, cigarette smoking, increased working area noise level, and working experiences were found to increase the odds of having hearing loss. Therefore, it is important to emphasize metal workshop workers that are at high risk of hearing loss and develop preventive strategies to reduce the burden of this problem. Besides, minimizing working area noise levels, proper utilization of ear protection devices, and creating awareness about the impact of hearing loss are recommended.

Superoxide dismutase@zeolite Imidazolate Framework-8 Attenuates Noise-Induced Hearing Loss in Rats

Reactive oxygen species (ROS) and inflammation have been considered major contributors to noise-induced hearing loss (NIHL) that constituted a public health threat worldwide. Nanoantioxidants, with high antioxidant activity and good stability, have been extensively used in the study of ROS-related diseases. In this study, we constructed a superoxide dismutase (SOD)@zeolite imidazolate framework-8 (ZIF-8) nanoparticle based on biomimetic mineralization and applied it to a rat model of NIHL. Our results showed that SOD@ZIF-8 effectively protected the animals from hearing loss and hair cell loss caused by noise. ROS, oxidative damage, and inflammation of noise-damaged cochlea were attenuated considerably after SOD@ZIF-8 administration. Importantly, we found that SOD@ZIF-8 achieved nanotherapy for NIHL in rats via a primary effect on the Sirtuin-3 (SIRT3)/superoxide dismutase2 (SOD2) signaling pathway without obvious adverse side effects. Therefore, our study is expected to open up a new field for NIHL treatment, and lay a foundation for the application of nanomaterials in other ROS-related inner ear diseases.

Seafarers' Perception and Attitudes towards Noise Emission on Board Ships

Noise has long been neglected as an environmental pollutant and impairment health factor in maritime transport. Recently, acoustic pollution indicates the highest growth in transport external cost unit values. In 2020, questionnaires were submitted to seafarers to examine their noise exposure and perception on board and attitudes towards noise abatement measures. Responses of 189 participants were processed using descriptive statistics and Likert scale valuation, while their consistency was tested with indirect indicators using linear regression and correlation test. Results show that more than 40% of respondents do not consider noise as a significant environmental problem. The negative perception among respondents with ≥10 years of work experience was much lower (23.53%). Most are aware of the onboard noise harmful effects that can influence their health. Despite that, they use personal protection equipment only sometimes. A higher positive perception was recorded in groups of respondents with a university degree (90%), work experience longer than ten years (82.35%), and monthly income higher than 4000 € (70%). Respondents are not strongly motivated to participate in funding noise mitigation measures, and such a viewpoint is not related to their monthly incomes. The low awareness and motivation regarding acoustic pollution generally shown by the surveyed seafarers should be watched as a threat by the company managers. Better education and awareness are likely to be crucial to change the current state of affairs.

Hearing and Exposure to Music in Adolescents From Four Schools of Córdoba, Argentina

Purposes The aims of this study are (a) to characterize the hearing of adolescents from four schools of Córdoba, Argentina, through the analysis of conventional and extended high-frequency audiometric thresholds and otoacoustic emissions (OAEs) and (b) to analyze the association between the mentioned hearing tests and exposure to music. Method It was a cross-sectional correlational descriptive study. Hearing thresholds (250-16000 Hz), transient evoked OAEs, and distortion product OAEs were evaluated in 225 adolescents (450 ears) aged 14 and 15 years. The ears were split into two groups: Group 1 had thresholds ≤ 21 dB HL in all frequencies, and Group 2 had thresholds > 21 dB HL in at least one. Exposure to music was evaluated through a questionnaire. Results Statistically significant differences were found in both ears between Groups 1 and 2. A notch at 3000-6000 Hz was noted in both groups. Group 2 showed a progressive threshold increase from 9000 Hz. Amplitude decrease, negative values, absent distortion product OAEs, and transient evoked OAEs were noted even in Group 1. A statistically significant association between Groups 1 and 2 and the presence/absence of OAEs was observed in most frequencies. Ears with moderate or high exposure to music had greater hearing thresholds compared to ears with low exposure at most frequencies; this was more evident in Group 1. Regarding exposure to music and OAEs, no significant differences were found between the exposure categories. Conclusions The findings highlight the value of implementing hearing conservation programs in Argentina, analyzing hearing tests correlated with questionnaires about recreational noise exposure in order to detect vulnerable ears early.

Associations between adolescents' earphone usage in noisy environments, hearing loss, and self-reported hearing problems in a nationally representative sample of South Korean middle and high school students

Few epidemiological studies have examined the relationship between earphone usage and hearing loss in adolescents. This study identified the prevalence of hearing loss in South Korean adolescents using representative national survey data and evaluated the relationship between earphone usage in a noisy environment and hearing loss. This study analyzed 532 subjects (12-19 years) who participated in a 2012 national survey and completed health and noise environment exposure questionnaires and pure tone audiometry (PTA) test. Hearing loss was defined as an average hearing threshold of 26 Decibel-A (dBA) or higher in PTA. The relationship between earphone usage and hearing loss was analyzed using a hierarchical logistic regression model. Adolescents who were exposed to high noise levels via headphones in a noisy environment had a hearing loss prevalence of 22.6% and adolescents who used earphones 80 minutes or more per day on average had the hearing loss prevalence of 22.3%. The results of the logistic regression analysis revealed that adolescents who used earphones in a noisy environment had a 4.5-fold higher risk of hearing loss and an 8.4 times higher risk of having a subjective hearing problem than those who did not use earphones (prevalence odds ratio (pOR) = 4.54, 95% confidence interval (CI): 1.35-15.24; pOR = 8.39, 95% CI: 1.12-62.83, respectively). Additionally, adolescents who used earphones more than 80 minutes per day in a noisy environment had a 4.7 times higher risk of hearing loss than those who used them less than 80 minutes per day (pOR = 4.68, 95% CI: 1.08-20.22). Longitudinal studies are needed to provide evidence of causality between earphone usage and hearing loss.

Investigation of the Acoustical Environment in A Shopping Mall and Its Correlation to the Acoustic Comfort of the Workers

Noise in shopping centers and restaurants can reduce intelligibility and affect the comfort of the employees working for long periods in such environments. In this study, the interior acoustics of a shopping mall are studied by measuring the reverberation time (RT), with no occupation, and the equivalent sound pressure levels (LAeq), with occupations at different times of the day, over a period of one week. The measurements were done at different locations, chosen based on their usage (shopping areas, entrances, food courts, and playing area). The values are correlated to the subjective acoustic comfort and the experience of loudness of the staff working at these locations, as measured through a questionnaire. The average RT values that were measured ranged between 0.9 s in the food court and 1.4 s for the main entrance. The LAeq was measured with a minimum of 58 dB in the shopping area in the early morning and a maximum of 83 dB in the playing area in the evening. The results showed an increase in the LAeq for the afternoon and evening in comparison with the early morning and midday time (p < 0.05); similarly, the sound levels for the weekends were higher than the weekdays (p < 0.05). The questionnaire results showed that headaches and difficulties in communicating with others (speech intelligibility) are the most important problems induced by the noise in shopping malls, occurring for 47.1% and 38.2% of respondents, respectively.