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.     

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.     

Development and pilot test of hearing conservation training for construction workers

BACKGROUND: Hearing conservation efforts in construction frequently rely on use of hearing protection devices (HPDs): however, training on HPDs is often not provided, and usage rates remain low. In this study, a hearing conservation training program was developed and pilot tested. METHODS: A theoretical model was selected as the basis for the program, and program contents and delivery methods were selected to optimize the effectiveness and flexibility of the training. Two evaluation measures were selected to assess training-related changes in self-reported HPD use. The first was a validated method using concurrent work-shift noise dosimetry, and the second was a survey concerning workers beliefs and attitudes towards HPDs and HPD use. RESULTS: The training program was pilot tested on a single construction site. Complete assessment data were available for 23 workers. The percent of time when hearing protection was used during noise levels above 85 dBA nearly doubled post-training, and the change was statistically significant. CONCLUSIONS: Pre- and post-training data from participating workers demonstrated that HPD use can be increased significantly with basic model-based training, even in industries with complex noise exposures such as construction.     

A comparison of "Train-the-Trainer" and expert training modalities for hearing protection use in construction

BACKGROUND: Few assessments have been conducted on the impact of a "Train-the-Trainer" (T3) approach for training delivery. The present study compared the effectiveness of a noise induced hearing loss (NIHL) prevention training delivered using "Train-the-Trainer" and expert trainer modalities. METHODS: Participating construction companies were assigned to the Train-the-Trainer or expert trainer modalities. Workers were recruited from each company and then trained. The effectiveness of the modalities was assessed through the use of surveys. The accuracy of self-reported hearing protection device (HPD) use was also evaluated through on-site observation. RESULTS: Post-training scores for hearing conservation knowledge, perceived barriers, and current and intended future use of HPDs improved significantly for both training modalities. Subjects trained by T3 trainers significantly increased their beliefs regarding general susceptibility to NIHL, desire to prevent NIHL, and ability to recognize, and control hazardous noise exposures. The expert-trained groups significantly increased their beliefs regarding the benefits of HPD use and ability to ask for help with HPDs. The only changes that were significantly different between modalities were in general susceptibility to NIHL and effective use of HPDs. However, these beliefs differed significantly between subjects in the two-modality groups prior to training. Self-reported HPD use was poorly correlated with observed use, calling into question the validity of survey-based HPD use measures in this context. CONCLUSIONS: The training improved beliefs regarding HPD use, increased workers' hearing conservation knowledge, and increased self-reported HPD use. The effectiveness of the training was not found to be dependent on training modality.     

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.     

Shooting history and presence of high-frequency hearing impairment in Swedish hunters: A cross-sectional internet-based observational study

The aim of this cross-sectional study among Swedish hunters was to examine the association between shooting history and presence of high-frequency hearing impairment (HFHI). All hunters registered with an e-mail address in the membership roster of the Swedish Hunters’ Association were invited via e-mail to a secure website with a questionnaire and an Internet-based audiometry test. Associations, expressed as prevalence ratio (PR), were multivariately modelled using Poisson regression. The questionnaire was answered by 1771 hunters (age 11-91 years), and 202 of them also completed the audiometry test. Subjective severe hearing loss was reported by 195/1771 (11%), while 23/202 (11%) exhibited HFHI upon testing with Internet-based audiometry. As many as 328/1771 (19%) had never used hearing protection during hunting. In the preceding 5 years, 785/1771 (45%), had fired >6 unprotected gunshots with hunting rifle calibers. The adjusted PR of HFHI when reporting 1-6 such shots, relative to 0, was 1.5 [95% confidence interval (CI) 1.1-2.1; P = 0.02]. We could not verify any excessive HFHI prevalence among 89 hunters reporting unprotected exposure to such gunshot noise >6 times. Nor did the total number of reported rifle shots seem to matter. These findings support the notion of a wide variation in individual susceptibility to impulse noise; that significant sound energy, corresponding to unprotected noise from hunting rifle calibers, seems to be required; that susceptible individuals may sustain irreversible damage to the inner ear from just one or a few shots; and that use of hearing protection should be encouraged from the first shot with such weapons.     

Simultaneous effects of noise exposure and smoking on OAEs

Noise is one of the most pervasive hazardous factors in the workplace. Noise-induced hearing loss (NIHL) is the most common disorder related to noise exposure. Smoking is probably associated with hearing loss. The simultaneous effect of noise and smoking on hearing is a recent concern. In this study, we assessed the simultaneous effect of noise and smoking on standard pure tone audiometry (PTA) and distortion product otoacoustic emissions (DP-OAEs). This was an historical cohort study on 224 workers exposed to noise who were divided into two groups: Smokers and nonsmokers. DP-OAE response amplitudes were assessed. Data were analyzed by SPSS software (version 19) using Student''s t-test and Mann-Whitney U test. One hundred and five subjects were smokers (case group) and 119 individuals were nonsmokers (control group). All the subjects were exposed to 91.08 ± 2.29 dBA [time-weighted average (TWA) for an 8 h work shift]. Mean DP-OAE response amplitude at frequencies higher than 1,000 Hz was significantly higher in the smokers than the nonsmokers. This study showed that smoking can aggravate the effect of noise on hearing in DP-OAEs.     

Exposure to music and noise-induced hearing loss (NIHL) among professional pop/rock/jazz musicians

Noise-induced hearing loss (NIHL) has been extensively studied in industrial work environments. With the advent of new technologies, loud music has been increasingly affecting listeners outside of the industrial setting. Most research on the effects of music and hearing loss has focused on classical musicians. The purpose of the current study was to examine the relationship between the amount of experience a professional pop/rock/jazz musician has and objective and subjective variables of the musician''s hearing loss. This study also examined professional pop/rock/jazz musicians’ use of hearing protection devices in relation to the extent of their exposure to amplified music. Forty-four pop/rock/jazz musicians were interviewed using the Pop/Rock/Jazz Musician''s Questionnaire (PRJMQ) in order to obtain self-reported symptoms of tinnitus and hyperacusis. Forty-two of the subjects were also tested for air-conduction hearing thresholds in the frequency range of 1-8 kHz. Results show that the extent of professional pop/rock/jazz musicians’ exposure to amplified music was related to both objective and subjective variables of hearing loss: Greater musical experience was positively linked to higher hearing thresholds in the frequency range of 3-6 kHz and to the subjective symptom of tinnitus. Weekly hours playing were found to have a greater effect on hearing loss in comparison to years playing. Use of hearing protection was not linked to the extent of exposure to amplified music. It is recommended that further research be conducted with a larger sample, in order to gain a greater understanding of the detrimental effects of hours playing versus years playing.     

Hearing protection use in manufacturing workers: a qualitative study

Occupational noise is a significant contributor to disabling hearing loss worldwide. Noise-induced hearing loss (NIHL) has resulted in huge human and economic consequences costing New Zealand approximately $53M annually and rising. A high proportion of hearing loss claims are made by workers in the manufacturing sector. Hearing protection devices (HPDs) are used together with engineering and administrative controls to minimize noise exposure and to prevent hearing loss. Unfortunately, inconsistent and improper use of HPDs has hindered efforts to prevent NIHL. The purpose of this study was to understand the factors that influence the use of HPDs amongst a group of manufacturing workers in New Zealand. A purposive sample of twenty-five workers was recruited to take part in semi-structured interviews. The open-ended questions were aimed at exploring the participants' knowledge, attitude, beliefs, and behavior towards noise and HPDs. The data were analyzed using conventional content analysis and key themes emerged in relation to HPD use. Themes that emerged from the interviews either supported good hearing protection behavior or acted as barriers against it. Five major themes, (perception of noise, hearing preservation, reluctance to use HPDs, workplace interaction, and value of hearing) and sub-themes described various factors that influence hearing protection use. Both personal and environmental factors influence the use of HPDs. Based on this study, personal and environmental factors need to be targeted for further research using ecological models to develop interventions that promote HPD use amongst workers.     

The impact of hyperacusis and hearing loss on tinnitus perception in German teachers

Recent research indicates that a notable number of teachers are concerned with conditions of auditory impairment such as tinnitus, hyperacusis, and hearing loss. Studies focussing on characteristics and interdependencies of single hearing disorders (HD) are rare. This explorative study examines tinnitus, hyperacusis, hearing loss, and all possible combinations (tinnitus + hyperacusis; tinnitus + hearing loss; hyperacusis + hearing loss; tinnitus, hyperacusis + hearing loss) in German teachers. The impact of single HD on perceived distress, depending on the number and kind of comorbid HD, was of special interest. Information was collected via online survey and includes self-reported data as well as data from the Mini-Tinnitus Questionnaire (Mini-TQ). Results show that most of the 1468 participants (45%) suffered from two HD in different combinations, and the fewest (25%) were afflicted with only one HD. Considering the seven HD groups, most teachers (30%) suffered from all three HD. Across all groups, tinnitus was present in 1096, hyperacusis in 988, and hearing loss in 937 teachers. Multiple intergroup comparisons revealed that self-rated tinnitus-related distress rose significantly with the increasing number of HD. No significant differences were found for distress ratings of hyperacusis between the four groups including hyperacusis and between the four groups with hearing loss. In the Mini-TQ, groups including hyperacusis scored considerably higher than those excluding hyperacusis. The frequent prevalence of HD in German teachers points to a need of better noise prevention in German schools as one priority of occupational safety.     

Efficacy of an intervention to promote use of hearing protection devices by firefighters

Numerous cases of hearing loss consistent with noise-induced damage were noted among firefighters in the city of Columbia, MO. A survey of firefighting vehicles in operation showed that the firefighters were exposed to excessive noise levels and put at risk for noise-induced hearing loss (NIHL). Audiologic evaluation showed that 36 percent of the firefighters had moderate or severe hearing loss (a threshold of 40 decibels (dB) or more at 3,000, 4,000, or 6,000 hertz (Hz) in either ear). An educational program on NIHL was then carried out to increase the use of hearing protection devices (HPDs) by firefighters, followed by an evaluation of the intervention. The educational intervention successfully increased knowledge of NIHL, positive attitudes toward HPDs, and resulted in more frequent use of HPDs. After the intervention, 85 percent of firefighters regularly used HPDs compared with 20 percent before the intervention. Recommendations are made for fire departments to reduce the risk of NIHL.     

Predictors of hearing loss in New York farmers.

BACKGROUND: Data from the telephone interview portion of the New York Farm Family Health and Hazard Surveillance were used to study self-reported hearing loss in New York farmers. METHODS: One thousand six hundred and twenty-two persons completed the hearing loss and noise exposure interview. Hearing loss was defined as at least some trouble hearing in one or both ears. Predictors of hearing loss were determined using logistic regression. RESULTS: Twenty-two percent of participants reported hearing loss. From the logistic regression, significant confounders are age (P = 0.0001), gender (P = 0.0001), being from a livestock farm (P = 0.012), and loss of consciousness due to head trauma (P = 0.04). Significant noise exposures are more hours of lifetime exposure to noisy farm equipment (P = 0.001) and having had a noisy non-farm job (with some hearing protection P = 0.002, without any hearing protection P = 0.0001). CONCLUSIONS: Farm noise exposure is a serious risk to the hearing of this population. Although use of hearing protection should be encouraged, replacing and modifying farm equipment to decrease noise at the source should be the first priority.     

Musician earplugs: Appreciation and protection

Recreational music exposure is a potential risk factor for noise-induced hearing loss (NIHL). Augmented hearing protectors have been designed with modified attenuation characteristics to combine hearing protection and listening comfort. However, to date, only a few independent studies have assessed the performance of those augmented protectors in realistic exposure conditions. This study compares the listening experience and temporary effects on cochlear status with different types of earplugs after exposure to contemporary club music. Five different types of commercially available hearing protectors were worn, all commonly used during leisure-time music exposure. Four of them were augmented premolded earplugs and the fifth type was an inexpensive, standard earplug frequently distributed for free at music events. During five different test sessions of 30 min each, participants not professionally involved in music wore one particular type of protector. Contemporary club music was played at sound pressure levels (SPLs) representative of concerts and bars. After each listening session, a questionnaire on sound quality and general appreciation was completed. In addition, otoacoustic emissions (OAEs) were measured directly before and after music exposure. The reported appreciation clearly differed depending on the addressed characteristics and the specific earplug type. In this test group, the reported appreciation mainly depended on comfort and looks, while differences in sound quality were less noticeable. The changes in OAE amplitude before and after noise exposure were small in terms of clinical standards. Nevertheless, the observed temporary shifts differed systematically for the different types of hearing protectors, with two types of musician earplug showing a more systematic decline than the others. Further research with respect to actual use and achieved protection for real, unsupervised music exposure is warranted.     

The effect of drill-generated noise in the contralateral healthy ear following mastoid surgery: The emphasis on hearing threshold recovery time

In mastoid surgeries, contralateral ear noise exposure is a known, identified factor leading to high-frequency hearing loss due to the wide variety of surgical devices that may be used during the surgery. However, the hearing threshold recovery time after this trauma was uncertain. The present study aimed to assess this time. In this prospective survival analysis study, 28 consecutive patients with chronic otitis media who were undergoing tympanomastoidectomy were assessed. Standard pure-tone audiometry (PTA) and distortion-product otoacoustic emission (DPOAE) were measured in all contralateral ears before and 6 h, 24 h, 48 h, 72 h, and 96 h after the surgery. Based on the PTA postoperative hearing loss, survival rates at frequencies of 3000 Hz, 4000 Hz, 6000 Hz, and 8000 Hz were 44.4%, 36.4%, 51.7%, and 47.4%, 24 h after surgery; 11.1%, 9.1%, 10.3%, and 13.2%, 48 h after surgery; and 0%, 0%, 3.4%, and 2.6%, 72 h after surgery, respectively. Based on the PTA and DPOAE, survival rates at all frequencies were 0%, 96 h after the surgery. According to the PTA, mean hearing recovery times were 61.98 ± 26.76 h (3000 Hz), 62.73 ± 26.50 h (4000 Hz), 67.08 ± 25.90 h (6000 Hz), 70.70 ± 24.13 h (8000 Hz), and with regard to DPOAE the recovery times were 58.58 ± 28.39 h (2000 Hz), 63.32 ± 28.83 h (4000 Hz), 65.22 ± 29.13 h (6000 Hz), and 75.14 ± 22.70 h (8000 Hz), respectively. To conclude, high-frequency hearing loss usually occurs following mastoid surgeries that is mainly temporary and reversible after 72 h.     

Hearing loss and perceptions of noise in the workplace among rural Australians

OBJECTIVE: To compare measured hearing levels of individuals regularly exposed to noise in their workplace to self-reported and family-reported hearing loss. To compare the attitudes and preventative actions adopted by individuals who are more aware of the potential for hearing loss to less aware individuals. DESIGN: The project examined the perceptions of rural workers concerning noise, noise exposure and hearing. The subjects completed a 'Noise at Work' questionnaire and some demographic data at the time of audiometric testing. SETTING: The subjects were recruited when attending their rural health clinic for audiometric testing. PARTICIPANTS: Participants comprised 113 men and 23 women (20-65 years, mean = 39.6, SD = 11.4) working across a range of activities at different levels in their workplaces. The range in current employment was from 0.5 to 45 years (mean = 13.8, SD = 10.7). RESULTS: Hearing tests were compared with perceptions of noise annoyance, hearing damage risk and preventative action. Self- and family-reported hearing loss and conversational difficulties in noise correlated well with measured audiograms. Perceptions of workplace noise tended to be more positive if people felt they had hearing problems. There was no difference in preventative action between those who did and did not feel they had hearing problems. Both groups rated barriers to action and lack of self-efficacy in a similar negative way. CONCLUSIONS: There is a need for specific training to ensure that rural workers have skills to take more positive action in reducing noise exposure at work.     

Occupational noise exposure and hearing loss: A study of knowledge,attitude and practice among Tanzanian iron and steel workers

Abstract

We assessed Knowledge Attitude and Practice (KAP) regarding occupational noise exposure, Noise-induced hearing loss, audiometry and use of hearing protection devices among iron and steel factory workers exposed to high noise level. A modified, validated, structured questionnaire was used to collect information from 253 male workers randomly selected from the four factories. The sum scores for each domain of KAP were computed. Scores above 75% were defined as good knowledge and positive attitude. For practice, scores of >50% were defined as good. Independent samples t-test and Chi-squared test were used to analyze association between KAP and continuous/categorical variables respectively. Majority of workers displayed poor knowledge and poor practice (94%), but 76% displayed a positive attitude. Most of the workers (86%) had never been provided with hearing protection devices. The mean scores for attitude and practice differed significantly between the four factories (one-way ANOVA, p?<?0.001). Implementation of hearing conservation program with provision of hearing protection devices are suggested.     

Using the extended parallel process model to prevent noise-induced hearing loss among coal miners in Appalachia.

Occupational noise-induced hearing loss is the second most self-reported occupational illness or injury in the United States. Among coal miners, more than 90% of the population reports a hearing deficit by age 55. In this formative evaluation, focus groups were conducted with coal miners in Appalachia to ascertain whether miners perceive hearing loss as a major health risk and if so, what would motivate the consistent wearing of hearing protection devices (HPDs). The theoretical framework of the Extended Parallel Process Model was used to identify the miners' knowledge, attitudes, beliefs, and current behaviors regarding hearing protection. Focus group participants had strong perceived severity and varying levels of perceived susceptibility to hearing loss. Various barriers significantly reduced the self-efficacy and the response efficacy of using hearing protection.     

Noise and hearing loss: a review

BACKGROUND: Noise-induced hearing loss is a major cause of deafness and hearing impairment in the United States. Though genetics and advanced age are major risk factors, temporary and permanent hearing impairments are becoming more common among young adults and children especially with the increased exposure to portable music players. Though treatment options are limited for most people with noise-related hearing loss, several modifiable health behaviors that should begin in childhood might prevent or delay the onset of hearing impairment. The purpose of this article is to review modifiable and non-modifiable risk factors, comorbidity, and the role of health education in the prevention of noise-induced hearing loss. METHODS: Review of current literature in the etiology, prevention, and treatment of noise-induced hearing loss as well as the role of health education. RESULTS: Non-modifiable risk factors related to noise-related hearing loss include increasing age, genetics, male gender, and race. Modifiable risk factors are voluntary exposure to loud noise, nonuse of hearing protection, smoking, lack of exercise, poor diet, tooth loss, and the presence of diabetes and cardiovascular disease. CONCLUSIONS: As hearing impairment among children and teenagers rises due to mostly voluntary exposure to loud noise, there are many implications for health education. Health educators need to address barriers to the use of hearing protection, deliberate exposure to loud music, and other modifiable risk factors, which cause and exacerbate hearing loss among those exposed to loud noise.