Noise & Health
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Item Fatigue after work in noise - an epidemiological survey study and three quasi-experimental field studies.(1998-04-12) Kjellberg,; Muhr,; Sköldström,The contribution of noise exposure to fatigue at work was studied in a survey study and three field studies. The survey study was based on a questionnaire covering symptoms and work place exposure answered by 50 000 state employees. Noise exposure was also estimated from their type of job and self-rated noise exposure. Fatigue and headache were found to be more common among the noise exposed groups even after control for the effects of other critical variables. Study 2 compared reaction times before and after a week's work in high noise exposure and one in low exposure exposure in a group of aeroplane mechanics. Reaction times were prolonged after work in the noise week, whereas an opposite trend was seen in the control week. Study 3 showed a gradual increase of reaction times during a week of noise exposure in a group of aeroplane technicians. Study 4 compared reaction times and subjective fatigue among naval crews on a day with low and a day with high noise exposure. In one of the studied boat types the development of fatigue during the work day was accentuated on the day with high exposure.Item Distortion Product Otoacoustic Emissions in acute acoustic trauma.(1998-04-12) Oeken,Acute acoustic traumas are caused by exposure to extremely high noise levels ranging from milliseconds to several hours' duration. In pure tone audiometry they range from the C5 dip to basomediocochlear sensorineural hearing loss. Their pathogenesis is assumed to consist of micromechanical-traumatic and biochemical-metabolic damage to the outer hair cells. In order to establish the changes to the DPOAE (distortion products of otoacoustic emissions), 17 patients were examined after sustaining acute acoustic trauma. The causes included firework explosions, anti-tank rocket launchers, vehicle tyre bursting, rock concerts, hand-gun shots, sub-machine gun fire, hand grenade explosion, exploding car battery. The pure tone audiogram, tympanogram, tinnitus maskability and DPOAE (both DP-gram and growth rate in various frequencies) were determined in all patients. If the event had occurred some time ago, measurements were taken only once; in acute cases measurements were repeated at different times. In nine patients with persistent hearing impairment, clear DPs were found in the unaffected frequencies but were completely absent in the affected frequency range. Four of these patients were unilaterally and two patients were bilaterally affected; three patients had a different (not noise-induced) hearing loss on the opposite side. In eight patients with regressive hearing loss, DPs were by contrast detectable throughout the entire frequency range, their amplitudes only rising slightly as hearing recovered. Of these eight patients, three were unilaterally and five bilaterally affected. DPOAE seem to indicate the likelihood of recovery of hearing threshold after an acute acoustic trauma. In cases with DPs completely absent in the affected frequency range, the prognosis seems to be much worse than in cases with present DPs in the frequency range of hearing.Item The contribution of social noise to tinnitus in young people - a preliminary report.(1998-04-12) Davis,; Lovell,; Smith,; Ferguson,In our study of the Hearing in Young Adults (HIYA) aged 18-25 years, there appeared to be little effect of social noise on hearing thresholds (Smith et al. 1998). There was however, a threefold increase in the reports of tinnitus in those subjects with significant social noise exposure (>/=97 dB NIL). No other abnormality was found of hearing function for those who were exposed to the most social noise. In an attempt to investigate this further we invited a sub-sample of those tested in the earlier phase of the study, to conduct further examinations of their hearing function. The three groups eventually consisted of those in the most social noise group who reported tinnitus (n=15) and those who did not (n=15), plus a group of people who had no social noise exposure but who reported tinnitus (n=8). All the groups were retested for their hearing thresholds, using standard audiometry and also the Audioscan technique to look for notches in the audiogram. Speech tests were carried out using an adaptive FAAF test. Transient-evoked oto-acoustic emissions were measured and also suppressed with a contralateral broad-band noise. Some evidence has been found to suggest that those young people who reported tinnitus are affected by social noise exposure, in terms of pure tone thresholds, speech tests, oto-acoustic emissions and reported hearing problems. Lessons can be drawn from our attempt to follow up this interesting population. First, the population is highly mobile and follow-up is difficult. Second, the presumed noise exposure was often not appropriate because even after a year it was possible for several individuals with insignificant social noise to move into the group with significant social noise exposure. Third, there is a need for a larger multi-centre study to look at the effect of social noise in more detail using a common protocol. The results of our study will be very useful in calculating the numbers needed in such a multi-centre study.Item Personal Active Noise Reduction with integrated Speech Communication devices: development and assessment.(1998-04-12) Steeneken,Active noise reduction is a successful addition to passive eardefenders for improvement of the sound attenuation at low frequencies. Assessment methods are discussed, focused on subjective and objective attenuation measurements, stability, and on high noise level applications. Active noise reduction systems are suitable for integration with an intercom. For this purpose the intelligibility in combination with environmental noise is evaluated. Development of a system includes the acoustical design, the feedback amplifier, and the speech input facility. An example of such a development is discussed. Finally the performance of some commercial systems and a laboratory prototype are compared.Item The World Health Organisation and the prevention of deafness and hearing impairment caused by noise.(1998-04-12) Smith,The WHO Programme for Prevention of Deafness and Hearing Impairment (PDH) is especially targeted at developing countries where there is a serious lack of accurate population-based data on the prevalence and causes of deafness and hearing impairment, including noise-induced hearing loss. However, opportunities exist for prevention of noise-induced hearing loss by primary, secondary and tertiary means and it is necessary for countries to measure the size of the problem and adopt strategies for its prevention. The World Health Assembly has passed two resolutions in relation to PDH, in 1985 and 1995. They affirmed that much deafness and hearing impairment is avoidable or remediable and that the greatest needs for the problem are in developing countries. The 1995 resolution estimated that there are 120 million persons with disabling hearing difficulties worldwide and urged member states to set up National Programmes for the prevention of deafness and hearing impairment, with the technical assistance of WHO. WHO-PDH addresses problems in this field of major public health importance which are amenable to intervention, giving priority to the poorest developing countries. These problems include ototoxicity, chronic otitis media, noise damage to hearing, inherited and congenital causes, and the provision of appropriate affordable hearing aid services. A fundamental requirement for the development of a National Plan and choice of preventive strategy for a National Programme is accurate, population-based data on the prevalence and causes of the problem. The PDH programme has developed a standardised Ear Disease Assessment Protocol to enable countries to conduct national surveys rapidly. A National Programme will require a set of integrated strategies to prevent deafness and hearing impairment. The PDH programme has already addressed two such causes, ototoxic drugs and chronic otitis media and will shortly produce guidelines for implementation of these strategies within the context of primary health care. The most recent meeting organised by the PDH programme at WHO, in the series on strategies for prevention, was on the prevention of noise-induced hearing loss, held in Geneva in October 1997. The participants concluded that exposure to excessive noise is the major avoidable cause of permanent hearing impairment worldwide. Noise-induced hearing loss is the most prevalent irreversible industrial disease, and the biggest compensatable occupational hazard. In developing countries, occupational noise and urban, environmental noise are increasing risk factors for hearing impairment. The meeting recommended that all countries should implement National Programmes for the Prevention of noise-induced hearing loss, integrated with Primary Health Care, and including elements on health promotion, and measures to reduce noise sources and introduce legislation and effective hearing conservation. There is an urgent need to obtain more, accurate epidemiological data on the problem, especially in developing countries. More research is needed on basic mechanisms and means of prevention.Item Epidemiological Studies of the Cardiovascular effects of Occupational Noise - A Critical Appraisal.(1998-04-12) Babisch,Reviews of epidemiological studies of cardiovascular effects of occupational noise have been published regularly in the literature. The first part of this paper summarises the conclusions which have been drawn. The second part focuses in more detail on the results of studies in which noise exposure was not assessed by objective measurements, but on the basis of subjective ratings as given by the study subjects in a questionnaire. Finally, the paper addresses some issues of occupational noise studies which deserve special attention from the methodological and conceptual point of view. These are concerned with study design, statistical inference, selection and confounding bias, overcontrolling, effect modification and exposure misclassification.Item Birth of a new Journal.(1998-04-12) Prasher,Item Noise, the most ubiquitous pollutant.(1998-04-12) Alberti,Item Pharmacological strategies for preventing cochlear damage induced by noise trauma.(1998-04-12) Canlon,; Agerman,; Dauman,; Puel,Hearing loss induced by noise, as well as in combination with other environmental factors, is a significant health problem throughout the world. Although most structures in the inner ear can be harmed by excessive sound exposure, the sensory cells are the most vulnerable. Damage to the stereocilia bundle is often the first structural alteration noted. Once a large number of hair cells are lost, the nerve fibres to that region also degenerate resulting in an irreversible hearing loss. At present, the underlying mechanism for cochlear damage induced by noise is not fully understood. The failure of the adult peripheral auditory system to regenerate after injury is a major clinical problem. However, a number of experimental applications have recently become available and are effective in reducing the damaging effects of noise. Current experimental designs include strategies for protecting against injury and are primarily based on the fact that the metabolic state of the cochlea can determine the overall degree of hearing loss induced by noise. The purpose of the present article is to review the current literature dealing with strategies for protecting against noise trauma.Item Issue of Environmental Noise and Annoyance.(1999-04-12) Prasher,Item A theoretical framework for environmental noise annoyance.(1999-04-12) Stallen,Noise annoyance is a phenomenon of 'mind and mood'. It is only partly determined by acoustic factors: typical noise metrics (LAeq and the like) allow only the prediction of aggregated annoyance scores (community levels) with moderate degree of precision. Many non-acoustic factors have been identified with varying degrees of association with annoyance. However, the proper identification and understanding of the role of non-acoustical factors can only be achieved on the basis of sound theories about rise and reduction of noise annoyance. This article discusses first the few systematic theories to understand the relative role of acoustic and non-acoustic factors. Then, it presents a theoretical perspective that places a major non-acoustic factor in the center: perceived control. It views noise annoyance as a form of psychological stress: disturbances may tax persons resources, and different people may use different ways of coping to deal with annoyance. The focus on perceived control also highlights that for residents exposed to environmental noise 'noise management at the source' often will be an equally important external stimulus to respond to as 'noise at the source'.Item Exposure to Nocturnal Road Traffic Noise: Sleep Disturbance and its After Effects.(1999-04-12) Ouis,In this paper the disturbances to sleep caused by road traffic noise are reviewed in the light of the latest published findings. First, a short presentation is made of what noise is in general. Then an exposition is made of the different characteristics of road traffic noise and how it may be measured and rated with various descriptors. In general terms, the continuous exposure of people to road traffic noise leads to suffering various kinds of discomfort, thereby reducing the number of well-being elements. However, this conclusion is made more complex to attain when non-acoustical factors such as socio-economic situation, age and gender are taken into account. In broad terms, nocturnal road traffic activity leads to difficulties in falling asleep for people and to a reduction of their sleep quality. This, however, depends strongly on physical measures of noise like for instance the intermittency of loud single noise events, their level relative to that of the background noise and the frequency and time of their occurrence. Several studies have also confirmed the fact that mood, too, is strongly affected after spending a night with significant noise exposure. Other psychological and physiological functions affected by night-time exposure to road traffic noise, such as performance the following day and cardiovascular reactivity are also reviewed.Item Coping with Stress: Neuroendocrine Reactions and Implications for Health.(1999-04-12) Lundberg,A new stress model, the Allostatic Load Model, refers to the ability to achieve stability through change. The various biological functions activated during stress serve an important role in the organism's adaptation to the environment by protecting and restoring the body but may, under certain conditions, also have health damaging consequences. Two different psychoneuroendocrine stress systems are of particular interest: (1) the sympathetic adrenal medullary (SAM) and (2) the hypothalamic pituitary adrenocortical (HPA) systems. Sustained activation of the SAM system with overexposure to epinephrine (adrenaline) and norepinephrine (noradrenaline) is considered to contribute to the development of cardiovascular disease (CVD). Chronic stress exposure influencing the HPA-axis is associated with metabolic changes which also increase the risk of CVD but, in addition, also contribute to impaired immune function, diabetes, depressive symptoms and cognitive disturbances. The present paper is focused on the possible biological pathways between environmental stress and somatic illness, including the role of environmental stress for the development of musculoskeletal disorders. It is concluded that the SAM and the HPA systems play an important role in linking environmental stress to various negative health outcomes and that knowledge about these psychobiological pathways is of considerable importance for the possibilities to prevent and treat environmentally induced ill health.Item Hearing Protection in the Military Environment.(1999-04-12) Dancer,; Buck,; Hamery,; Parmentier,The present state of passive (linear and non-linear) and active techniques for hearing protection in the military environment is reviewed. Solutions which allow to protect the ear from large continuous and high-level impulse noises while preserving the operational abilities of the personnel (detection, localisation, communication.) are emphasised.Item Industrial Noise Exposure and Risk Factors for Cardiovascular Disease: Findings from the CORDIS Study.(1999-04-12) Melamed,; Kristal-Boneh,; Froom,Previous studies of the association between occupational noise exposure and cardiovascular disease (CVD) or risk factors for CVD are primarily either cross-sectional or retrospective, whereas the design of the CORDIS study was both cross-sectional and longitudinal. It had three phases: Phase I was conducted during 1985-87 among 6,016 employees from 21 factories. Recorded were medical, ergonomic, environmental (including noise levels at the various work stations) and psychological data. Phase II was conducted during 1988-90, at 18 of the 21 original factories and included similar data collected from 3,509 subjects. Phase III was conducted during the years 1995-96 and 4,995 workers who participated in Phases I and II completed questionnaires pertaining to medical, occupational and life style variables. Mortality and cancer morbidity data were obtained over an 8 year follow-up period for all subjects. Results from Phase I, revealed no association between noise exposure and resting blood pressure. Positive association was found for serum lipids in women and in young men. Noise annoyance had an additive effect on this outcome. In addition, recurrent daily noise exposure was found to be associated with elevated acute resting heart rate. Results of Phase II showed that chronic exposure to high noise levels during the 2-4 years of the follow-up resulted in changes of 3.9 mmHg in SBP and 3.3 mmHg in DBP, among workers performing complex jobs. In workers performing simple jobs these changes were 0.3 and 0.4 mmHg. Thus the type of work performed appears to be a significant factor. Results of Phase III revealed that there was a trend for positive association between past noise exposure measured at Phase I and 8 years incidence of cardiovascular morbidity, mortality and total mortality. This trend was statistically significant for total mortality (hazard ratio = 1.97, 95% CI 1.28-4.54) even after controlling for possible confounders. In summary, tests for association between noise exposure and cardiovascular risk factors, or cardiovascular morbidity and mortality, and total mortality have yielded mixed results. Reasons for this are discussed, as well as suggestions for further research.Item Hearing ability in Danish symphony orchestra musicians.(1999-04-12) Obeling,; Poulsen,The audiograms of fifty-seven musicians from four Danish symphony orchestras were determined in connection with an interview about their working experience. Measurements of sound levels and noise dose were performed during rehearsal and during concerts in the four orchestras with the measurement equipment placed in various instrument groups. The average audiogram showed a decrease at higher frequencies similar to an age-related hearing loss. Each audiogram was corrected for the age of the person by means of the median from ISO 7029 and the average audiogram from these age-corrected individual audiograms showed no signs of hearing loss. The audiograms were also compared to the expected audiograms from ISO 1999, which takes account of the number of years at work, the number of playing hours per week, and the average sound level in the orchestra for the instrument group. In almost all cases the measured audiograms looked better than the predictions from ISO 1999. It may be concluded from this investigation that musicians cannot be expected to get pronounced audiometric hearing losses from playing in a symphony orchestra. It should be noted, though, that the data material is limited, and that the subjects have not been selected in a systematically or representative way.Item Noise and Drug Induced Cochlear Damage Leads to Functional Reorganisation in the Central Auditory System.(1999-04-12) Salvi,; Wang,; Lockwood,; Burkard,; Ding,Item Noise sensitivity as a factor influencing human reaction to noise.(1999-04-12) Job,Reaction (annoyance, dissatisfaction) to noise is itself an important health effect, as well as possibly contributing to other putative health effects of noise. Thus, factors such as noise sensitivity, which influence reaction, are of considerable importance. However, noise sensitivity is rarely clearly defined. This paper offers a formal definition of noise sensitivity, and reviews evidence relating to it. Noise sensitivity has been measured in various ways, but may be measured most directly by assessing reaction to many noise situations (other than those involving the noise source(s) which are the focus of the particular study). When noise sensitivity is measured in this way, factor analysis consistently reveals that noise sensitivity is not a unitary concept. Rather, two distinct factors appear: one related to loud noises (road traffic, lawn mower), and the other related to quieter noise situations which are nonetheless distracting (rustling papers at the movies, people talking while watching television). More research is needed to address the relationships between these factors, reaction and other health effects.Item A new look at noise.(1999-04-12) Maynard,Item Is there a gender difference in coping, perceived disability and handicap in patients with noise-induced hearing loss?(1999-04-12) Hallberg,Gender differences in coping strategies and self-rated disability and handicap were explored in individuals with noise-induced hearing loss. The study group consisted of 60 male and 33 female patients, consecutively presenting at the hearing clinics in two hospitals in the western part of Sweden. The females were older and had worse average hearing thresholds over the low frequencies (0.5, 1 and 2 kHz) in the better ear than the males. However, all subjects rated their hearing loss as "moderate" to "severe". The patients responded to the Communication Strategies Scale, CSS, measuring "maladaptive behaviour", "verbal strategies" and "non-verbal strategies" and the Hearing Disability and Handicaps Scale, HDHS, which is composed of four factorially derived subscales: "speech perception", "non-speech sounds", "interpersonal distress" and "threat to the self-image". Pure-tone audiometry and sociodemographic data was also assessed. Despite differences in pure-tone audiometry, there were no significant differences between gender in perceived disability or handicap. Significant gender differences in coping were found. The women used "maladaptive behaviour" and "verbal strategies" significantly more often than the men. This is in agreement with results of an interview-study of women with NIHL, showing that the perceived emotional temperature in a specific situation guided the choice of coping strategy. The gender difference in coping could also be related to, and explained by, the conversational goal (transactional or interactional).