Risk behaviour and noise exposure among adolescents

Adolescents in Western society often expose themselves to high levels of sound in gyms, rock concerts, discotheques etc. As these behaviours are as threatening to young people's health as more traditional risk behaviours are, our aim in the present study was to analyze the relationship between self-exposure to noise, risk behaviours and risk judgements among 310 Swedish adolescents aged 15-20 (167 men; 143 women). Adolescents' behaviour in different traditional risk situations correlated with behaviour in noisy environments, while judgements about traditional risks correlated with judgements regarding noise exposure. It is an interesting finding that although young women judge risk situations as generally more dangerous than young men do, they nevertheless behave in the same way. We suggest that this difference is a social and cultural phenomenon which underscores the importance of adopting a gender perspective in the analysis of risk factors. Adolescents reporting permanent tinnitus judged loud music as more risky than adolescents with no symptoms and they did not listen to loud music as often as those with occasional tinnitus. Research on hearing prevention for young people needs to acknowledge and make use of theories on risk behaviour, especially due to the existence of a relationship between adolescents' risk-taking in noisy environments and other types of risk-taking. Similarly, theories on risk behaviour should acknowledge noise as a risk factor.     

Attitudes toward noise,perceived hearing symptoms,and reported use of hearing protection among college students: Influence of youth culture

The purpose of this study was to assess the attitude toward noise, perceived hearing symptoms, noisy activities that were participated in, and factors associated with hearing protection use among college students. A 44-item online survey was completed by 2,151 college students (aged 17 years and above) to assess the attitudes toward noise, perceived hearing symptoms related to noise exposure, and use of hearing protection around noisy activities. Among the participants, 39.6% experienced at least one hearing symptom, with ear pain as the most frequently reported (22.5%). About 80% of the participants were involved in at least one noise activity, out of which 41% reported the use of hearing protection. A large majority of those with ear pain, hearing loss, permanent tinnitus, and noise sensitivity was involved in attending a sporting event, which was the most reported noisy activity. The highest reported hearing protection use was in the use of firearms, and the lowest in discos/ dances. The reported use of hearing protection is associated with having at least one hearing symptom but the relationship is stronger with tinnitus, hearing loss, and ear pain (χ² = 30.5-43.5, P < 0.01) as compared to noise sensitivity (χ² = 3.8, P = 0.03); it is also associated with anti-noise attitudes, particularly in youth social events. Universities and colleges have important roles in protecting young adults’ hearing by integrating hearing conservation topic in the college curriculum, promoting hearing health by student health services, involving student groups in noise-induced hearing loss (NIHL) awareness and prevention, and establishing noise level limitations for all on-campus events.     

Self-reported tinnitus and noise sensitivity among adolescents in Sweden

It seems to be a common opinion among researchers within the field of audiology that the prevalence of tinnitus will increase as a consequence of environmental factors, for example exposure to loud noise. Young people are exposed to loud sounds, more than any other age group, especially during leisure time activities, i.e. at pop concerts, discotheques and gyms. A crucial factor for the prevention of hearing impairments and hearing-related symptoms in the young population is the use of hearing protection. The focus of the present study is use of hearing protection and self-reported hearing-related symptoms, such as tinnitus and noise sensitivity in a young population of high-school students (N=1285), aged 13 to 19 years. The results show that the prevalence of permanent tinnitus and noise sensitivity, reported in the total group, was 8.7% and 17.1% respectively. Permanent tinnitus was not significantly related to level of socio-economic status, but age-related differences in the prevalence rates of experienced tinnitus and noise sensitivity were found to be significant. Older students reported such symptoms to a greater extent than younger students did. Those who reported tinnitus and other hearing-related symptoms protected their hearing to the highest extent and were the ones most worried.     

Gender perspectives in psychometrics related to leisure time noise exposure and use of hearing protection

The purpose of the present study was to investigate possible gender differences regarding psychometric scales measuring risk perception in noisy situations, attitudes towards loud music, perceived susceptibility to noise, and individual norms and ideals related to activities where loud music is played. In addition the purpose was to analyze whether these variables are associated with protective behavior such as the use of hearing protection. A questionnaire was administered to a Swedish sample including 543 adolescents aged 16 to 20. The result revealed significant gender differences for all the psychometric scales. In addition, all psychometric measures were associated with hearing protection use in musical settings. Contrary to previous studies, gender did not contribute to any explanation of protective behavior by itself in the analysis. One conclusion is that although gender does not contribute by itself for the explanation of protective behavior, gender may affect psychological variables such as risk perception, attitudes and perceived susceptibility and that these variables may in turn be valuable for decision-making and protective behavior in noisy situations. Although women tend to be more 'careful' psychologically, they nevertheless tend to behave in the same way as men as regards actual noise-related risk taking.     

High Frequency Hearing Sensitivity in Adolescent Females of a Lower Socioeconomic Status Over a Period of 24 Years (1985–2008)

PurposeTo examine annually over a period of 24 years, the high frequency hearing sensitivity in different groups of urban female adolescents with a low socioeconomic status (SES) and residential foster care.MethodsHearing screening (15 decibel [dB] hearing level ranging from 1,000 to 8,000 Hertz [Hz]) and threshold (>15 dB hearing level) records were obtained from 8,710 female adolescents (mean age, 15.8 years [range, 12–20 years]), predominantly Hispanic and African American from households with a low SES. Data related to the use of personal listening devices (PLDs), daily hours of usage, occurrence of tinnitus, and hearing thresholds between 1,000 and 8,000 Hz over an 8-year period (2001–2008) were obtained from the adolescents.ResultsHigh frequency hearing loss (HFHL) doubled over the 24-year period from 10.1% in 1985 to 19.2% in 2008. In comparison with the general adolescent population, this group of female adolescents presented with a higher percentage of bilateral mild or greater degrees of HFHL at two or more frequencies including 3,000, 4,000, and 6,000 Hz. Use of PLDs increased four-fold, from 18.3% (n = 68) in 2001 to 76.4% (n = 227) in 2008. Of the total number reporting tinnitus (n = 286), 99.7% (n = 285) also reported regular PLD use. A significant relationship was found between PLD use and reported tinnitus and HFHL irrespective of time of use of PLD.ConclusionsIncreased incidence of HFHL, reported tinnitus, PLD use, and hours of daily use in at-risk female adolescents of a low SES was found. A frequency interval of 3,000–6,000 Hz should be included in hearing screening protocols to identify potentially disabling hearing loss. Hearing conservation strategies need to be developed and/or modified that target and reach at-risk children and adolescents.     

Auditory lifestyles and beliefs related to hearing loss among college students in the USA

The purpose of this study was to evaluate the auditory life styles and beliefs of college students with reference to exposure to loud sounds in the context of the health belief model. A survey was administered to 238 (40 men, 198 women) students in the USA. Results suggest that 44% of the students use noisy equipment without ear protection and 29% (69/238) of the students work in noisy environments. Of the 69 who worked in noisy surroundings, only ten reported wearing hearing protection devices although 50 (72.46%) reported tinnitus. The use of hearing protection devices (HPDs) was associated with previous experience with hearing loss and tinnitus. Although 75% of the students were aware that exposure to loud sounds could cause hearing loss, 50% of the students appeared to be exposing themselves to potentially harmful loud music. Furthermore, 46% of the students reported not using HPDs during loud musical activities because they felt that the music was difficult to hear with HPDs. Most students in this study considered hearing loss to be serious but 76% of the students believed that they would not lose their hearing until a greater age. Although 66% of the students had experienced tinnitus, 58% of these students reported not being concerned about it. These results suggest a critical need for promoting healthy hearing behavior among college students. Possible strategies could include improved education, experience with simulated hearing loss for extended periods and availability of cosmetically appealing or invisible HPDs with uniform attenuation across the frequency range.     

Factors affecting the use of hearing protectors among classical music players

Classical musicians are often exposed to sound levels that exceed the Finnish national action limit value of 85 dB(A). Still, the use of hearing protectors is uncommon among musicians. The purpose of this study was to find out musician's attitudes towards hearing protectors, and under which conditions hearing protectors are used. The study group consisted of five major classical orchestras in the Helsinki region. The players were asked to fill out a questionnaire with questions on hearing protection, ear symptoms, including tinnitus, hearing loss, pain in the ears, and temporary ringing in the ears. Also, questions concerning stress and working environments were asked. Of those who responded, 94% were concerned about their hearing to some degree. Only 6% of the musicians always used hearing protector devices (HPDs). Self-reported hearing loss was quite common, with 31% of the musicians reporting some hearing loss. Temporary tinnitus was even more common at 37%. There were 15% of women, and 18% of men reporting permanent tinnitus. Hyper-acousis was reported by 43% of the musicians. The ear symptoms affected the usage rate. Hearing protectors were used more often among musicians having ear symptoms (20%) than those reporting no symptoms (6%). Further, the 43% of the musicians found their work to be interesting and meaningful. Stress was experienced to some extent by 60%, and musicians with ear symptoms had three to nine times more stress and felt their working environment noisier. The study shows that musicians seldom use hearing protectors before symptoms begin. Symptoms increased usage rate, but the usage levels are still far from ideal. Motivation and training is needed to improve hearing protector use among musicians.     

The effects of a hearing education program on recreational noise exposure,attitudes and beliefs toward noise,hearing loss,and hearing protector devices in young adults

Excessive recreational noise exposure in young adults might result in noise-induced hearing loss (NIHL) and tinnitus. Inducing behavioral change in young adults is one of the aims of a hearing conservation program (HCP). The goal of the current study was to evaluate the effect of a hearing education program after 6 months in young adults in relation to knowledge regarding their individual hearing status. The results of a questionnaire regarding the weekly equivalent recreational noise exposure, attitudes and beliefs toward noise, and hearing loss and hearing protector devices (HPDs) were compared between both sessions. Seventy-eight young adults completed the questionnaire concerning recreational noise exposure, youth attitude to noise scale (YANS), and beliefs about hearing protection and hearing loss (BAHPHL). Their hearing status was evaluated based on admittance measures, audiometry, transient-evoked otoacoustic emissions (TEOAEs), and distortion-product otoacoustic emissions (DPOAEs). The main analysis consisted of a mixed model analysis of variance with dependent variables of either the noise exposure or the scores on (subscales of) YANS and BAHPHL. The independent variables were hearing status and session one versus session two. There was a significant decrease in recreational noise exposure and several (sub) scales of YANS and BAHPHL between both the sessions. This behavioral change resulted in a more frequent use of HPDs in 12% of the participants. However, the behavioral change was not completely related to the knowledge of young adults’ individual hearing status. To prevent hearing damage in young people, investing in HCPs is necessary, apart from regulating sound levels and its compliance at various leisure-time activities. Also, the long-term effect of HCPs and their most cost-efficient repetition rates should be further investigated.     

Noise exposure and hearing loss among sand and gravel miners

The objectives of this study were to describe workplace noise exposures, risk factors for hearing loss, and hearing levels among sand and gravel miners, and to determine whether full shift noise exposures resulted in changes in hearing thresholds from baseline values. Sand and gravel miners (n = 317) were interviewed regarding medical history, leisure-time and occupational noise exposure, other occupational exposures, and use of hearing protection. Audiometric tests were performed both before the work shift (following a 12-hour noise-free interval) and immediately following the work shift. Full shift noise dosimetry was conducted. Miners' noise exposures exceeded the Recommended Exposure Limit (REL) of the National Institute for Occupational Safety and Health (NIOSH) for 69% of workers, and exceeded the Mine Safety and Health Administration's action level for enrollment in a hearing conservation program for 41% of workers. Significantly higher noise exposures occurred among employees of small companies, among workers with a job classification of truck driver, among males, and among black workers. Hearing protection usage was low, with 48% of subjects reporting that they never used hearing protection. Hearing impairment, as defined by NIOSH, was present among 37% of 275 subjects with valid audiograms. Black male workers and white male workers had higher hearing thresholds than males from a comparison North Carolina population unexposed to industrial noise. Small but statistically significant changes in hearing thresholds occurred following full shift noise exposure among subjects who had good hearing sensitivity at baseline. In a logistic regression model, age and history of a past noisy job were significant predictors of hearing impairment. Overall, sand and gravel workers have excessive noise exposures and significant hearing loss, and demonstrate inadequate use of hearing protection. Well-designed hearing conservation programs, with reduction of noise exposure, are clearly needed.     

Predictive factors of occupational noise-induced hearing loss in Spanish workers: A prospective study

The purpose of our study was to identify the main factors associated with objective noise-induced hearing loss (NIHL), as indicated by abnormal audiometric testing, in Spanish workers exposed to occupational noise in the construction industry. We carried out a prospective study in Tenerife, Spain, using 150 employees exposed to occupational noise and 150 age-matched controls who were not working in noisy environments. The variables analyzed included sociodemographic data, noise-related factors, types of hearing protection, self-report hearing loss, and auditory-related symptoms (e.g., tinnitus, vertigo). Workers with pathological audiograms had significantly longer noise-exposure duration (16.2 ± 11.4 years) relative to those with normal audiograms (10.2 ± 7.0 years; t = 3.99, P < 0.001). The vast majority of those who never used hearing protection measures had audiometric abnormalities (94.1%). Additionally, workers using at least one of the protection devices (earplugs or earmuffs) had significantly more audiometric abnormalities than those using both protection measures simultaneously (Chi square = 16.07; P < 0.001). The logistic regression analysis indicates that the use of hearing protection measures [odds ratio (OR) = 12.30, confidence interval (CI) = 4.36-13.81, P < 0.001], and noise-exposure duration (OR = 1.35, CI = 1.08-1.99, P = 0.040) are significant predictors of NIHL. This regression model correctly predicted 78.2% of individuals with pathological audiograms. The combined use of hearing protection measures, in particular earplugs and earmuffs, associates with a lower rate of audiometric abnormalities in subjects with high occupational noise exposure. The use of hearing protection measures at work and noise-exposure duration are best predictive factors of NIHL. Auditory-related symptoms and self-report hearing loss do not represent good indicators of objective NIHL. Routine monitoring of noise levels and hearing status are of great importance as part of effective hearing conservation programs.     

The effectiveness of hearing protection among construction workers

Effective hearing conservation programs in the construction industry are rare. Where programs are present, they often rely on workers' use of hearing protection devices (HPDs) rather than on exposure controls to reduce noise exposure levels. Dependence on HPDs for protection from high noise is problematic, as the protection provided by the HPD depends on both the HPD's attenuation level and the time the HPD is used. This article presents an analysis of data on noise exposure and hearing protection among construction workers drawn from several large datasets covering nine construction trades. A unique combination of 1-min dosimetry noise exposure levels and simultaneous self-reported use of HPDs was evaluated, as were occupational and nonoccupational HPD use data collected by questionnaire as part of a longitudinal study of noise exposure and hearing loss among apprentices. Direct measurements of HPD attenuation were also made on workers at their work site. The workers assessed in this study were found to use hearing protection less than one-quarter of the time that they were exposed above 85 dBA. Workers who reported always using HPDs in high noise on questionnaires were found to wear them only one-third of the time their exposures exceeded 85 dBA. Workers' self-reported use of HPDs during most noisy nonoccupational activities was also found to be low. Direct attenuation measurements found that workers were able to achieve more than 50% of the rated attenuation of their HPD on average, but that the variability in achieved attenuation was large. When the measured HPD attenuation levels and use time data were combined, the effective protection afforded by HPDs was less than 3 dB, a negligible amount given the high exposure levels associated with construction work. However, there was substantial variation in effective protection among the different trades assessed. These results demonstrate the need for better hearing conservation programs and expanded noise control efforts in the construction industry.     

The effectiveness of school-based smoking prevention interventions among low- and high-SES European teenagers

Preventing smoking initiation among adolescents of lower socio-economic groups is crucial for the reduction of socio-economic inequalities in health. The aim of the present study was to examine whether effective smoking prevention interventions in Europe are equally effective among adolescents of low- and high-socio-economic status (SES). As part of the European Union-funded TEENAGE project, three school-based smoking prevention intervention studies in Europe were selected for secondary analyses: (i) a Dutch class competition intervention, (ii) the European Smoking Prevention Framework (ESFA) study and (iii) the A Stop Smoking in Schools Trial (ASSIST) intervention. All three studies differed in effectiveness by SES. The Dutch class competition study only had a significant effect among higher SES adolescents. The results for the ESFA study and ASSIST study were mixed and depended on which SES indicator was used. The conclusion of the study is that stratified analyses provide important insights in differential intervention effects for higher and lower socio-economic groups. Although findings from the different studies were mixed, interventions that use a social network approach in which youngsters are allowed to deliver the intervention themselves may be a successful strategy in targeting adolescents from lower socio-economic groups.     

The use of hearing protection devices by older adults during recreational noise exposure

A population-based study to assess the use of hearing protection devices by older adults during noisy recreational activities was performed. The population-based Epidemiology of Hearing Loss Study was designed to measure the prevalence of hearing loss in adults residing in Beaver Dam, Wisconsin. The use of hearing protection devices during noisy recreational activities was assessed by performing three examinations over a period of 10 years (1993-1995, no. of participants (n)=3753, aged 48-92 years; 1998-2000, n=2800, aged 53-97 years; 2003-2005, n=2395, aged 58-100 years). The recreational activities included hunting, target shooting, woodworking/carpentry, metalworking, driving loud recreational vehicles, and performing yard work using either power tools or a chain saw. The prevalence of using hearing protection devices during any of these activities increased with time (9.5%, 15.0%, and 19.9% at baseline, 5 years, and 10 years, respectively). However, the use of hearing protection devices remained low for most activities. Those under the age of 65 were twice as likely to use hearing protection devices during noisy activities than were older adults. Men, those with a hearing handicap, and those with significant tinnitus were more likely to use hearing protection devices. Smokers and the less educated were less likely to use hearing protection devices. The results demonstrated that many adults expose themselves to potentially damaging recreational noise, leaving them at risk for hearing loss.     

Noise exposure, awareness, attitudes and use of hearing protection in a steel rolling mill in Nigeria

OBJECTIVES: To study exposure to noise, the attitudes and knowledge towards noise-induced hearing loss and the actual use of hearing protection in a steel rolling mill in Nigeria. METHODS: A structured questionnaire was administered to 116 randomly selected workers to collect information relating to their knowledge and attitudes towards hazardous occupational noise and preventative measures. Noise mapping of the factory was also carried out. RESULTS: Time weighted average noise levels were: administrative area 49 dBA, mechanic/maintenance workshop 72 dBA, mill floor 86 dBA and finishing stage 93 dBA. There was high awareness of the hazard of noise to hearing (93%) and of methods of prevention (92%) but only 27% possessed hearing protectors and only 28% of these stated that they used them all the time. CONCLUSION: While noise is recognized as a hazard, initiatives are required to increase use of effective preventative measures.     

The effect of a hearing conservation program on adolescents' attitudes towards noise

Crandell et al., reported that education programs such as hearing conservation programs (HCPs) represent the most common and well-recognized procedure in reducing the incidence of noise-induced hearing loss (NIHL). The purpose of this study was to assess the effectiveness of an HCP in changing knowledge and attitudes toward exposures to high intensity sounds or noise among adolescents aged 12-14 years. Local middle school students in physical education classes were recruited for participation. Sixty-four middle school students between the ages of 12 and 14 received pre- and post-test measures and participated in the HCP. The pre-test measure had 24 questions that included 5 demographic questions and 19 Likert-type questions [modified from the Youth Attitude to Noise Scale] that assess adolescents' attitudes towards noise; and a post-test measure included the identical 24 questions of the pre-test measure in addition to three subjective questions. A Wilcoxon signed rank test and a Two-Factor Analysis of Variance were completed to assess changes in knowledge and attitudes toward noise among the study population after receiving the HCP. A statistically significant reduction (P< 0.003) in pro-noise attitudes among the adolescents was present after the intervention. It was established that an HCP facilitated a change in pro-noise attitudes among adolescents. Further, the students thought this program facilitated learning of the auditory system and healthy hearing behaviors.     

Risks of developing noise-induced hearing loss in employees of urban music clubs

Noise-induced hearing loss has previously been reported among rock musicians. This study sought to determine whether a hazard of noise-induced hearing loss exists for music club employees other than musicians themselves. Sound levels at eight live-music clubs were measured and symptoms of noise exposure in 31 music club employees were assessed by questionnaire. The average sound level at the various clubs during performances ranged from 94.9 to 106.7 dBA. The overall sound level average, including both performance and ambient levels, ranged from 91.9 to 99.8 dBA. Symptoms of noise exposure, such as tinnitus and subjective hearing loss, correlated with sound intensity. Only 16% reported regular use of hearing protection. We conclude that employees of music clubs are at substantial risk of developing Noise-Induced Hearing Loss, due to chronic noise exposure which consistently exceeded safe levels. Hearing protection is used much too infrequently. The development of hearing conservation programs for this large group of workers is essential. Am. J. Ind. Med. 31:75–79 © 1997 Wiley-Liss, Inc.     

Socio-economic inequalities in physical activity practice among Italian children and adolescents: a cross-sectional study

Aim  

The aim of the study was to evaluate whether socio-economic inequalities in the practice of physical activity existed among children and adolescents, using different indicators of socio-economic status (SES).     

宁夏71家企业8 325名噪声作业人员双耳高频平均听阈分析

目的 通过对宁夏2015年噪声环境作业的工人职业卫生基本情况和职业健康体检结果分析,预防与发现职业禁忌症和职业病,为卫生部门制定相关策略提供依据。方法 根据GBZ-2007《职业健康监护技术规范》的要求,对全省2015年7家企业8 325名噪声环境作业工人的职业卫生基本情况和职业性岗中健康结果资料进行综合分析和评价。结果 7家企业8 325名噪声环境下工作的工人,以男性为主,年龄在18~69岁,双耳高频平均听阈异常检出率在50岁组最高,不同年龄、不同行业、不同企业规模双耳高频平均听阈异常检出率之间差异具有统计学意义(χ2=83.782,P<0.001;χ2=499.830,P<0.001;χ2=363.152,P<0.001)。结论 职业噪声可造成双耳高频平均听阈异常检出率提高,应该加强职业卫生监督管理,做好职业卫生防护。     

Hearing in young adults. Part I: The effects of attitudes and beliefs toward noise,hearing loss,and hearing protector devices

There is great concern regarding the development of noise-induced hearing loss (NIHL) in youth caused by high sound levels during various leisure activities. Health-orientated behavior of young adults might be linked to the beliefs and attitudes toward noise, hearing loss, and hearing protector devices (HPDs). The objective of the current study was to evaluate the effects of attitudes and beliefs toward noise, hearing loss, and HPDs on young adults’ hearing status. A questionnaire and an audiological test battery were completed by 163 subjects (aged 18-30 years). The questionnaire contained the Youth Attitude to Noise Scale (YANS) and Beliefs about Hearing Protection and Hearing Loss (BAHPHL). A more positive attitude or belief represented an attitude where noise or hearing loss is seen as unproblematic and attitudes and beliefs regarding HPDs is worse. Hearing was evaluated using (high frequency) pure tone audiometry (PTA), transient evoked and distortion product otoacoustic emissions. First, mean differences in hearing between the groups with different attitudes and beliefs were evaluated using one-way analysis of variance (ANOVA). Second, a χ² test was used to examine the usage of HPDs by the different groups with different attitudes and beliefs. Young adults with a positive attitude had significantly more deteriorated hearing and used HPDs less than the other subjects. Hearing conservation programs (HCPs) for young adults should provide information and knowledge regarding noise, hearing loss, and HPDs. Barriers wearing HPDs should especially be discussed. Further, those campaigns should focus on self-experienced hearing related symptoms that might serve as triggers for attitudinal and behavioral changes.