Percepção de professores quanto ao impacto do ruído no ambiente escolar / Teachers' perception of the impact of noise in the school environment / Percepción del docente sobre el impacto del ruido en el entorno escolar

Introdução: a poluição sonora está presente na escola, sendo assim, é importante conhecer as fontes de ruído, o impacto na saúde do professor e no ensino. Objetivo: avaliar a percepção de professores do ensino fundamental I quanto ao impacto do ruído no ambiente escolar, bem como seus sintomas vocais. Método: estudo observacional, descritivo, analítico, transversal. Aplicou-se inventário, do qual participaram 26 professoras da rede municipal da cidade de Santo Amaro da Imperatriz, SC. Aplicou-se um questionário com questões referentes à idade, sexo, tempo de trabalho, carga horária diária, impacto e percepção do ruído no ambiente escolar. Utilizou-se o Índice de Triagem para Distúrbios da Voz, uma triagem para identificação de risco para distúrbio de voz em professores. Para a análise de associação dos resultados foi utilizado o teste de Qui Quadrado, com nível de significância de 5%. Resultados: 53,57% das professoras responderam que há excesso de ruído na escola e 57,14% consideram que o ruído dentro da sala prejudica as atividades. As fontes externas e internas de ruído que mais atrapalham são: pátio, corredor, conversas paralelas e ventilador. Quanto aos sintomas vocais referidos, destacaram-se: garganta seca, cansaço ao falar, pigarro e rouquidão. Professoras que lecionam em período integral apresentaram mais queixas para o pigarro. Conclusão: os sujeitos têm a percepção de que o ambiente escolar é excessivamente ruidoso e causa prejuízos no desenvolvimento das atividades. As participantes têm poucas queixas relacionadas à voz, sendo a mais frequente, garganta seca. Além disso, professoras que lecionam em período integral apresentaram, significativamente, mais queixas de pigarro. (AU)

Introducción: la contaminación acústica está presente en la escuela, entonces es importante conocer las fuentes del ruido, el impacto en la salud del docente y en la enseñanza. Propósito: evaluar la percepción de docentes sobre el impacto del ruido en el ambiente escolar, así como sus síntomas vocales. Método: estudio observacional, descriptivo, analítico, transversal. Se aplicó un inventario, en el que participaron 26 docentes de la red municipal de la ciudad de Santo Amaro da Imperatriz, (SC). con preguntas relacionadas con edad, género, tiempo de trabajo, carga diaria de trabajo, impacto y percepción del ruido en el ambiente escolar. Se utilizó el Índice de Detección de Trastornos de la Voz para identificar el riesgo de trastornos de la voz. Para el análisis de asociación se utilizó la prueba de chi-cuadrado, con un nivel de significación del 5%. Resultados: 53,57% respondió que en la escuela hay exceso de ruido y 57,14% consideram que el ruido dentro del salón perjudica las actividades. Las fuentes de ruido más molestas son: patio, pasillo, conversaciones paralelas y ventilador. En cuanto a los síntomas vocales reportados destacan sequedad de garganta, cansancio al hablar, carraspeo y ronquera. Los maestros de tiempo completo se quejaron más de carraspear. Conclusión: los sujetos tienen la percepción de que el ambiente escolar es excesivamente ruidoso y provoca perjuicios para el desarrollo de las actividades. Los participantes tienen pocas quejas relacionadas con la voz, siendo la garganta seca la más frecuente. Además, los maestros que enseñan a tiempo completo tenían muchas más quejas de carraspeo. (AU)

Introduction: noise pollution is present at school; therefore, it is important to know the sources of noise, the impact on the teacher's health and on teaching. Purpose: to evaluate the perception of elementary school teachers regarding the impact of noise in the school environment, as well as their vocal symptoms. Method: observational, descriptive, analytical, cross-sectional study. An inventory was applied, in which 26 teachers from the municipal network of the city of Santo Amaro da Imperatriz, (SC). participated. A questionnaire was applied with questions related to age, gender, working time, daily workload, impact and perception of noise in the school environment. The Voice Disorders Screening Index was used, a screening to identify risk for voice disorders in teachers. For the analysis of the association of results, the chi-square test was used, with a significance level of 5%. Results: 53.57% of the teachers answered that there is excessive noise in the school and 57.14% consider that the noise inside the room harms the activities. The most disturbing external and internal sources of noise are courtyard, corridor, parallel conversations and fan. As for the reported vocal symptoms, the following stand out: dry throat, tiredness when speaking, throat clearing and hoarseness. Full-time teachers complained more about throat clearing. Conclusion: the subjects have the perception that the school environment is excessively noisy and causes damage to the development of activities. The participants have few voice-related complaints, the most frequent being dry throat. In addition, teachers who teach full-time had significantly more complaints of throat clearing. (AU)

Research on early warning model of the hearing loss of workers exposed to noise / 中华劳动卫生职业病杂志

Objective: To explore the change of hearing threshold of workers exposed to noise, establish an individual-based hearing loss early warning model, accurately and differentiated the health of workers exposed to noise. Methods: In September 2019, all physical examination data of 561 workers exposed to noise from an enterprise were collected since their employment. Three indicators of average hearing threshold of the better ear, namely, at high frequency, 4000 Hz and speech frequency, were constructed. The generalized estimating equation (GEE) was used to adjust gender and age and establish the warning model of each indicator. Finally, sensitive indicators and warning models were screened according to AUC and Yoden index. Results: Among the 561 workers exposed to noise, 26 (4.6%) workers had hearing loss. The sensitivity indicators were the average hearing threshold at speech frequency ≥20 dB, high frequency ≥30 dB and 4000 Hz ≥25 dB. The AUC of each index was 0.602, 0.794 and 0.804, and the Youden indexes were 0.204, 0.588 and 0.608, respectively. In GEE of hearing loss warning models, high-frequency hearing threshold ≥20 dB and 4000 Hz hearing threshold ≥25 dB were the optimal models, with AUC of 0.862. Conclusion: Combined with the changes of individual hearing threshold over the years, can accurately assess the risk of individual hearing loss of workers exposed to noise.

Association between occupational noise exposure and the risk of cardiovascular diseases / 中华劳动卫生职业病杂志

Objective: To explore the association between occupational noise exposure and cardiovascular disease (CVD) risk in a large Chinese population. Methods: In December 2019, the study included 21412 retired participants from the Dongfeng-Tongji Cohort Study at baseline from September 2008 to June 2010, occupational noise exposure was evaluated through workplace noise level and/or the job titles. In a subsample of 8931 subjects, bilateral hearing loss was defined as a pure-tone mean of 25 dB or higher at 0.5, 1 , 2, and 4 kHz in both ears. Logistic regression models were used to explore the association of occupational noise exposure, bilateral hearing loss with 10-year CVD risk. Results: Compared with participants without occupational noise exposure, the 10-year CVD risk was significantly higher for noise exposure duration ≥20 years (OR=1.20, 95%CI:1.01-1.41 , P=0.001) after adjusting for potential confounders. In the sex-specific analysis, the association was only statistically significant in males (OR=2.34, 95%CI: 1.18-4.66, P<0.001) , but not in females (OR=1.15, 95%CI:0.97-1.37, P=0.153). In the subsample analyses, bilateral hearing loss, which was an indicator for exposure to loud noise, was also associated with a higher risk of 10-year CVD (OR= 1.17, 95% CI:1.05-1.44, P <0.001) , especially for participants who were males (OR =1.24, 95% CI:1.07-2.30, P<0.001) , aged equal and over 60 years old (OR=2.30, 95%CI: 1.84-2.88, P<0.001) , and exposed to occupational noise (OR=1.66, 95%CI: 1.02-2.70, P=0.001). Conclusion: Occupational noise exposure may be a risk factor for CVD.

Application of three risk assessment methods to noise risk assessment in an automobile foundry enterprise / 中华劳动卫生职业病杂志

Objective: To explore the applicability of three different kinds of noise occupational health risk assessment methods to the occupational health risk assessment of noise exposed positions in an automobile foundry enterprise. Methods: In July 2020, the occupational-health risk assessment of noise-exposed positions was conducted by using the Guidelines for risk management of occupational noise hazard (guideline method) , the International Commission on Mining and Metals Guidelines for Occupational Health Risk Assessment (ICMM) method and the Occupational-health risk index method (index method) respectively, and the results were analyzed and compared. Results: Through the occupational health field investigation, the noise exposure level of the enterprise's main workstations was between 80.3 and 94.8 dB (A) , among which the noise of the posts of shaking-sand, cleaning and modeling was greater than 85 dB (A) ; The noise risk of each position was evaluated by the three methods, and the adjustment risk level was between 2 and 5 assessed using the guideline method, between 2 and 3 assessed using the index method, and 5 evaluated using the ICMM model. Conclusion: Each of the three risk assessment methods has its own advantages and disadvantages. The ICMM model has a large difference in value assignment, and values in the results are larger than expected. The evaluation results of the guideline method and the index method are consistent in some positions, there is certain subjectivity in the evaluation using the index method, and the guideline method is more objective.

Literature analysis of hot topics on occupational noise-induced hearing loss / 中华劳动卫生职业病杂志

Objective: To analyze the literature of related research reports on occupational hearing loss (ONIHL) , study the characteristics of the subject and determine the research hotspots. Methods: In December 2020, PubMed database was searched by bibliometrics for ONIHL published in PubMed database from January 1971 to December 2020. Bicomb 2.03 software was used to extract the subject. The publication year, publication country, source magazine and subject words were summarized and analyzed. Results: A total of 1 473 papers were included in this study, and the number of papers was 66 from 1971 to 1980, and 628 from 2011 to 2020, an increase of nearly 10 times. The top three countries were the United States, China and Germany, with 31.5% (464/1473) , 11.5% (171/1473) and 6.2% (91/1473) ; The cross-sectional study was the most applied type; The top five words for 2011-2020: Mental Illness, polymorphism, cardiovascular disease, high frequency hearing impairment and standards and regulations. Conclusion: Susceptibility Genes, Psychological Disorders, Cardiovascular Diseases and Risk Assessment are hot areas in ONIHL at present. Researchers should focus on major fields and grasp future trends as a whole.

Noise exposure and its impact on health in an auto parts manufacturing enterprise / 中华劳动卫生职业病杂志

Objective: To learn about the noise exposure and health status of workers and analyze factors that may affect the health outcomes of workers in an auto manufacturing enterprise in Tianjin City. Methods: In September 2020, occupational hygiene survey, noise exposure level detection and occupational health examination data collection were carried out in an auto parts manufacturing enterprise. Chi square test and unconditional logistic regression analysis were used to analyze the health effects of noise exposure and hearing loss of 361 noise exposure workers. Results: The rates of over-standard noise exposure, hearing loss and hypertension were 69.39% (34/49) , 33.24% (120/361) and 11.36% (41/361) , respectively. There were upward trends on age and noise-working years for hearing loss and hypertension rates (χ(2)=-5.95, -6.16, -2.81, -2.74, P<0.05) . Unconditional logistic regression analysis showed that age>35 years old, noise exposure length of service >10 years and noise L(EX, 8 h)>85 dB (A) were risk factors for hearing loss (OR=3.57, 95%CI: 1.09, 11.75; OR=4.05, 95%CI: 1.97, 8.25; OR=1.75, 95%CI: 1.00, 3.05; P=0.036, 0.001, 0.047) . Conclusion: This company has a high rate of job noise exceeding the standard, and noise-exposed workers have more serious hearing loss. Age, noise exposure and high noise exposure are risk factors for hearing loss.

Evaluación del ambiente sonoro de la Empresa Productora y Comercializadora de Glucosas, Almidón y Derivados del Maíz. Cienfuegos, Cuba / Evaluation of sound environment in the Manufacturing and Marketing Company of glucose, starch and other corn byproducts. Cienfuegos, Cuba

RESUMEN Fundamento el ruido se incluye dentro de los cinco principales factores de riesgo de naturaleza física para la salud en el medio laboral. Objetivo determinar si la contaminación acústica de la Empresa Productora y Comercializadora de Glucosas, Almidón y Derivados del Maíz, de Cienfuegos sobrepasa los valores máximos admisibles establecidos en la NC 871/11 de Seguridad y Salud en el trabajo. Métodos se realizó un estudio descriptivo, transversal en la Empresa Productora y Comercializadora de Glucosas, Almidón y Derivados del Maíz de Cienfuegos, en el mes de febrero de 2018. En la empresa laboraban 287 trabajadores, de ellos 247 directos a la producción. Las mediciones del nivel sonoro en el área de trabajo se realizaron según la metodología que establece la Norma Cubana vigente NC 19-01-14/83. Se analizaron las variables: nivel sonoro equivalente continuo, expresado en decibeles (dB(A)) y el tiempo de exposición (en horas). Para medir el ruido se utilizó un sonómetro integrador clase 2. Las mediciones se realizaron durante la jornada laboral. Resultados en el generador de vapor, caldera de compresores, área de molinación y generación, recepción de maíz y limpieza, empaque fábrica de pienso, secadores y centrífugas los niveles de ruido sobrepasan los 90 db(a) de exposición. En los previos 2 y 3 del área molinación y generación, los niveles de ruido fueron superiores a los 100 db(a) de exposición. Conclusiones: los niveles de ruido encontrados sobrepasan el valor máximo admisible, lo que pudiera ocasionar consecuencias nocivas en la salud de los trabajadores por lo que se hace necesario intervenir en este medio laboral.

ABSTRACT Foundation: noise is included among the 5 risk factors of physical origin for health in the working environment. Objective: to determine if sound pollution at the Cienfuegos Manufacturing and Marketing Company of glucose, starch and other corn byproducts, exceeds maximum admissible values on NC 871/11 of Health Safety and Health at Work. Methods: a cross descriptive study at the Cienfuegos Manufacturing and Marketing Company of glucose, starch and other corn byproducts was conducted, on February 2018. A number of 287 persons were working, out of them 247 directly in production processes. Measurements of sound levels in the working areas were done according to the valid Cuban standard NC 19-01-14/83. Variables continues equivalent sound level, express in decibels (dB(A) and time of exposure in hours. To measure noise, it was used and integrative sonometer type 2. Measurements were done the during working hours. Results: in the steam generator, compressor boiler, grinding and generation areas, corn reception and cleaning, animal feed factory, dryers and centrifugal equipment noise levels exceed 90 db (a) of exposition. Conclusion: the levels of noise found exceed the admissible maximum which might produce harmful health consequences on workers therefore it is necessary to intervene this working environment

Research progress on non-steady state noise-induced hearing loss / 中华劳动卫生职业病杂志

Non-steady state noise has become the main type of workplace noise. Compared with steady state noise, non-steady state noise may cause more serious hearing loss. This paper reviews the new situation of occupational hearing loss caused by non-steady state noise exposure, the overview of international noise exposure assessment standards and new challenges, and the new evidence of non-steady state noise induced hearing loss, so as to provide the basis for the future research of non-steady state noise induced hearing loss.

Study on the association between occupational noise exposure and cardiovascular diseases / 中华劳动卫生职业病杂志

Occupational noise is one of the most common occupational hazards in the workplace. Long-term exposure to occupational noise could not only lead to the damage of the hearing system, but also may cause a certain impact on the cardiovascular system. Studies have shown that occupational noise exposure was positively associated with cardiovascular diseases, including hypertension, coronary heart disease and myocardial infarction. However, the results of studies on occupational noise exposure and stroke are still controversial. This paper reviews the relationship between occupational noise exposure and hypertension, coronary heart disease, stroke, myocardial infarction by summarizing the epidemiological data of domestic and foreign population in recent years. Our study could provide evidence for the design and implementation of well-designed epidemiological and mechanism studies, and the recognition of the role of occupational noise exposure in the occurrence and development of cardiovascular diseases, so as to better protect workers' health.

Dificuldade auditiva autorreferida e exposição ocupacional a agentes otoagressores: um estudo de base populacional / Self-reported hearing impairment and occupational exposure to hazardous noise and ototoxic agents: a population-based study / Dificultad auditiva autoinformada y exposición ocupacional a agentes otoagresores: un estudio de base poblacional

O objetivo deste estudo foi estimar a associação entre dificuldade auditiva autorreferida e exposição ocupacional a agentes otoagressores em trabalhadores brasileiros. Trata-se de um estudo transversal realizado com dados da Pesquisa Nacional de Saúde (PNS-2013). A variável dependente foi a dificuldade auditiva autorreferida, e foram analisadas três exposições principais: ruído, poeira industrial e substâncias químicas. Realizou-se análise de regressão logística, estimando-se as odds ratio (OR) brutas e ajustadas, com intervalos de 95% de confiança (IC95%). As variáveis principais de exposição foram ajustadas entre si e pelas covariáveis sexo, idade, ambiente de trabalho, tempo de trabalho e hipertensão arterial. Participaram deste estudo 36.442 trabalhadores. Maior prevalência de dificuldade auditiva foi observada em indivíduos expostos à poeira industrial (9,9%) (p < 0,001). Além disso, quanto maior a idade do trabalhador e tempo de trabalho, maior foi a prevalência do desfecho (p < 0,001). Na análise ajustada, trabalhadores expostos a ruído apresentaram 1,65 vez mais chance de referir dificuldade auditiva, quando comparados aos indivíduos não expostos (p < 0,001). O mesmo ocorreu com trabalhadores expostos à poeira industrial (OR = 1,36) (p = 0,012). Não foi observada associação entre o desfecho e a variável exposição a substâncias químicas (p = 0,120). Observou-se associação entre dificuldade auditiva e exposição ocupacional a ruído e à poeira industrial em trabalhadores brasileiros. Reforçam-se a importância do aprimoramento de políticas públicas em saúde auditiva e o desenvolvimento de ações voltadas à prevenção e ao monitoramento auditivo em ambiente ocupacional.

This study's objective was to estimate the association between self-reported hearing impairment and occupational exposure to hazardous noise and ototoxic agents in Brazilian workers. This was a cross-sectional study with data from the Brazilian National Health Survey (PNS-2013). The dependent variable was self-reported hearing impairment, and three principal exposures were analyzed: noise, industrial dust, and chemical substances. Logistic regression was performed, estimating crude and adjusted odds ratios (OR) with 95% confidence intervals (95%CI). The principal exposure variables were adjusted for each other and by covariables sex, age, workplace, time on the job, and hypertension. 36,442 workers participated in the study. Higher prevalence of hearing impairment was seen in workers exposed to industrial dust (9.9%) (p < 0.001). The older the worker and the longer the time on the job, the higher the prevalence of hearing impairment (p < 0.001). In the adjusted analysis, workers exposed to noise showed 1.65 higher odds of reporting difficulty hearing, when compared to unexposed individuals (p < 0.001). The same was true for workers exposed to industrial dust (OR = 1.36) (p = 0.012). No association was observed between the outcome and exposure to chemical substances (p = 0.120). There was an association between hearing impairment and occupational exposure to noise and industrial dust in Brazilian workers. This emphasizes the importance of strengthening public policies for hearing health and the development of measures for prevention and auditory monitoring in the workplace.

El objetivo de este estudio fue estimar la asociación entre dificultad auditiva autoinformada y la exposición ocupacional a agentes otoagresores en trabajadores brasileños. Se trata de un estudio transversal, realizado con datos de la Encuesta Nacional de Salud (PNS-2013). La variable dependiente fue la dificultad auditiva autoinformada y se analizaron tres exposiciones principales: ruido, polvo industrial y substancias químicas. Se realizó un análisis de regresión logística, estimándose las odds ratio (OR) brutas y ajustadas, con intervalos de un 95% de confianza (IC95%). Las variables principales de exposición fueron ajustadas entre sí y por las covariables: sexo, edad, ambiente de trabajo, tiempo de trabajo e hipertensión arterial. Participaron en este estudio 36.442 trabajadores. La mayor prevalencia de dificultad auditiva se observó en individuos expuestos al polvo industrial (9,9%) (p < 0,001). Asimismo, cuanto mayor era la edad del trabajador y tiempo de trabajo, mayor fue la prevalencia del desenlace (p < 0,001). En el análisis ajustado, los trabajadores expuestos a ruido presentaron 1,65 veces más oportunidad de informar de dificultad auditiva, cuando se comparan con los individuos no expuestos (p < 0,001). Lo mismo sucedió con trabajadores expuestos a polvo industrial (OR = 1,36) (p = 0,012). No se observó una asociación entre el desenlace y la variable exposición a sustancias químicas (p = 0,120). Se observó una asociación entre dificultad auditiva y exposición ocupacional a ruido y polvo industrial en trabajadores brasileños. Se refuerza la importancia del perfeccionamiento de políticas públicas en salud auditiva y desarrollo de acciones dirigidas a la prevención y monitoreo auditivo en el entorno laboral.

Dysphonia, arterial hypertension, diabetes mellitus, thyroid diseases, and noise complaints as probable factors associated with hearing loss among teachers / Disfonia, hipertensão arterial, diabetes mellitus, doenças da tireoide e queixas de ruído como prováveis fatores associados a perda auditiva em professores

ABSTRACT Objective: to verify a possible association between hearing loss and dysphonia, arterial hypertension, diabetes mellitus, thyroid diseases, and noise complaints. Methods: a cross-sectional study involving 60 teachers, mean age 47.05 years. Pure-tone threshold audiometry was used to assess hearing, the voice questionnaire and voice acoustic evaluation were used for voice perception and quality, and the standardized questionnaire verified noise complaint and comorbidities. The statistical analysis was conducted with Mann-Whitney and Fisher's exact tests and multivariate linear regression. Results: there was a significant association between hearing loss and diabetes mellitus, hypertension, and thyroid disease (both p <0.0001), but there was no association between noise complaints and hearing loss in this population. The regression showed that dysphonia (p = 0.0311) and diabetes mellitus (p = 0.0302) are independent risk factors for hearing loss. A correlation was found between hearing loss and voice characteristics: roughness, breathiness, tension, and resonance. Conclusion: this study showed that hypertension and thyroid diseases are factors associated with hearing loss. In addition, dysphonia and diabetes mellitus are independent factors associated with hearing loss in teachers. These results show the need for policies aimed at promoting teachers' health.

RESUMO Objetivo: verificar possível associação da perda auditiva com disfonia, hipertensão arterial (HA), diabetes mellitus (DM), doenças da tireoide e queixas de ruído. Métodos: estudo transversal envolvendo 60 professores, média de idade de 47,05 anos. Foi avaliada a audição por meio da Audiometria tonal limiar, a percepção e qualidade vocal com o questionário vocal e a avaliação vocal acústica, enquanto a queixa de ruído e as comorbidades envolvidas foram investigadas com o questionário padronizado. A análise estatística utilizou os testes Ex-act de Mann Whitney, Fisher e regressão linear multivariada. Resultados: houve associação significante entre perda auditiva e DM, HA e doenças da tireoide (ambas p <0,0001), mas não foi encontrada associação entre queixa de ruído e perda auditiva nesta população. A regressão mostrou que as variáveis disfonia (p = 0,0311) e DM (p = 0,0302) são fatores de risco independentes para perda auditiva. Houve correlação entre perda auditiva e as características vocais rugosidade, soprosidade, tensão e ressonância. Conclusão: este estudo demostrou que HA e doenças da tireoide são fatores associados a perda auditiva, além disso a disfonia e DM se constituem em fatores associados independentes para a perda auditiva em professores. Estes resultados mostram a necessidade de políticas direcionadas a promoção da saúde do professor.

Fatores associados à notificação de perda auditiva induzida por ruído no Brasil, 2013-2015: estudo ecológico / Factores asociados a la notificación de pérdida auditiva inducida por ruido en Brasil, 2013-2015: estudio ecológico / Factors associated with notification of noise-induced hearing loss in Brazil, 2013-2015: an ecological study

Objetivo: Investigar fatores associados à notificação de perda auditiva induzida por ruído (Pair), no Sistema de Informação de Agravos de Notificação no Brasil. Métodos: Estudo ecológico para estimar a proporção de municípios notificantes de Pair. Foram empregados modelos de regressão logística para identificar fatores associados. Resultados: Entre 2013 e 2015, 277 (5,0%) municípios notificaram Pair. A notificação foi mais comum entre municípios com cobertura por Cerest (OR=1,62 - IC95% 1,02;2,59) ou que sediavam unidade de Cerest em seu território (OR=4,37 - IC95% 2,75;6,93), a menor distância da capital do estado (OR=1,43 - IC95% 1,06;1,92) e com alto índice de desenvolvimento humano (OR=2,35 - IC95% 1,16;4,75). Entre os municípios situados em área com cobertura de Cerest, a notificação foi mais comum quando na equipe havia fonoaudiólogo (OR=1,96 - IC95% 1,47;2,63) e era baixa a rotatividade de profissionais (OR=1,88 - IC95% 1,40;2,52). Conclusão: Fatores contextuais influenciam na notificação de Pair, notadamente a existência e qualificação dos Cerest.

Objetivo: Investigar factores asociados con la notificación de pérdida auditiva inducida por ruido (Pair) en el Sistema de Información de Agravamientos de Notificación Obligatoria en Brasil. Métodos: Estudio ecológico para estimar la proporción de municipios notificantes de Pair. Se utilizaron modelos de regresión logística para identificar factores asociados. Resultados: Entre 2013-2015, 277 (5,0%) municipios notificaron Pair. La notificación fue más común entre los municipios con cobertura de los Centros de Referencia en Salud Ocupacional (Cerest) (OR=1,62 - IC95% 1,02; 2,59), o que albergaron Cerest (OR=4,37 - IC95% 2,75; 6,93), cercanos a la capital (OR=1,43 - IC95% 1,06; 1,92) y con alto índice de desarrollo humano (OR=2,35 - IC95% 1,16; 4,75). Entre los municipios en área de cobertura de Cerest, la notificación fue más alta cuando había fonoaudiólogo en el equipo (OR=1,96 - IC95% 1,47; 2,63) y baja rotación de profesionales (OR=1,88 - IC95% 1,40; 2,52). Conclusión: Factores contextuales influyen en la notificación de Pair, en particular, la existencia y cualificación de los Cerest.

Objective: To investigate factors associated with the notification of noise-induced hearing loss (NIHL), on the Notifiable Health Conditions Information System (SINAN) in Brazil. Methods: This was an ecological study to estimate the proportion of municipalities that had notified NIHL. Logistic regression models were used to identify associated factors. Results: Between 2013-2015, 277 (5.0%) municipalities notified NIHL. Notification was more prevalent among municipalities in an Occupational Health Referral Center (CEREST) coverage area (OR=1.62 - 95%CI 1.02;2.59) or those that had a CEREST in their territory (OR=4.37 - 95CI% 2.75;6.93), those that were closer to the state capital (OR=1.43 - 95%CI 1.06;1.92) and those with a high human development index (OR=2.35 - 95%CI 1.16;4.75). Among the municipalities located in a CEREST coverage area, notification was more frequent when there was a speech-language-hearing professional in the team (OR=1.96 - 95%CI - 1.47;2.63) and when employee turnover was low (OR=1.88 - 95%CI 1.40;2.52). Conclusion: Contextual factors influence NIHL notification, particularly the presence of CERESTs and their qualification.

Polymorphism in GRHL2 gene may contribute to noise-induced hearing loss susceptibility: a meta-analysis / Polimorfismo no gene GRHL2 pode contribuir para a suscetibilidade à perda auditivainduzida por ruído: uma metanálise

Abstract Instruction: Noise-induced hearing loss is a leading occupational disease caused by gene-environment interaction. The Grainy Like 2, GRHL2, is a candidate gene. In this regard, many studies have evaluated the association between GRHL2 and noise-induced hearing loss, although the results are ambiguous and conflicting. Objective: The purpose of this study was to identify a precise estimation of the association between rs3735715 polymorphism in GRHL2 gene and susceptibility of noise-induced hearing loss. Methods: A comprehensive search was performed to collect data up to July 8, 2018. Finally, 4 eligible articles were included in this meta-analysis comprising 2410 subjects. The pooled odds ratios with 95% confidence intervals were used to evaluate the strength of the association. Results: Significant association was found in the overall population in the dominant model (GA/AA vs. GG, odds ratio = 0.707, 95% confidence interval = 0.594-0.841) and allele model (G allele vs. A allele, odds ratio = 1.189, 95% confidence interval = 1.062-1.333). When stratified by source of the subjects, we also found association between rs3735715 and noise-induced hearing loss risk in the dominant model (GA/AA vs. GG, odds ratio = 0.634, 95% confidence interval = 0.514-0.783) and allele model (G allele vs. A allele, odds ratio = 1.206, 95% confidence interval = 1.054-1.379). Conclusion: Rs3735715 polymorphism in GRHL2 gene may influence the susceptibility of noise-induced hearing loss. Additional large, well-designed and functional studies are needed to confirm this association in different populations.

Resumo Introdução: Perda auditiva induzida por ruído é uma das principais doenças ocupacionais causadas pela interação gene-ambiente. O Grainy Like 2, ou GRHL2 é um gene que tem sido considerado como candidato. Nesse sentido, muitos estudos avaliaram a associação entre o GRHL2 e perda auditiva induzida por ruído, embora os resultados sejam ambíguos e conflitantes. Objetivo: Identificar uma estimativa precisa da associação entre o polimorfismo rs3735715 no gene GRHL2 e a suscetibilidade à perda auditiva induzida por ruído. Método: Uma pesquisa abrangente foi feita para coletar dados até 8 de julho de 2018. No fim, quatro artigos elegíveis foram incluídos nesta metanálise, abrangeram 2.410 indivíduos. As odds ratios agrupadas com intervalos de confiança de 95% foram usadas para avaliar a força da associação. Resultados: Uma associação significante foi encontrada na população geral no modelo de dominância (GA/AA vs. GG, odds ratio = 0,707, intervalo de confiança 95% = 0,594-0,841) e modelo de alelo (alelo G vs. alelo A; odds ratio = 1,189, intervalo de confiança 95% = 1,062 a 1,333). Quando estratificados pelo local de trabalho dos indivíduos, também encontramos associação entre rs3735715 e risco de perda auditiva induzida por ruído no modelo de dominância (GA/AA vs. GG, odds ratio = 0,634, intervalo de confiança 95% = 0,514 ± 0,783) e modelo de alelo (alelo G vs. alelo A; odds ratio = 1,206, intervalo de confiança 95% = 1,054- 1,379). Conclusão: O polimorfismo Rs3735715 no gene GRHL2 pode influenciar a suscetibilidade à perda auditiva induzida por ruído. Estudos adicionais, amplos, bem desenhados e funcionais são necessários para confirmar essa associação em diferentes populações.

Hearing function of gold miners with and without a history of tuberculosis treatment: a retrospective data review / Função auditiva de garimpeiros com e sem história de tratamento de tuberculose: uma revisão retrospectiva dos dados

Abstract Introduction: South Africa has a high prevalence of co-existing tuberculosis and HIV. As ototoxicity linked to the treatments for these conditions occurs with concomitant exposure to other ear toxins such as hazardous noise exposure, it is important to investigate the combination impact of these toxins. Limited published evidence exists on the co-occurrence of these conditions within this population. Objectives: The objective of this study was to compare the hearing function of gold miners with (treatment group) and without (non-treatment group) the history of tuberculosis treatment, in order to determine which group had increased risk of noise induced hearing loss. Furthermore, possible influence of age and HIV in these two groups was examined. Methods: A retrospective record review of 102 miners' audiological records, divided into two groups, was conducted, with data analyzed both qualitatively and quantitatively. Results: Findings suggest that gold miners with a history of tuberculosis treatment have worse hearing thresholds in the high frequencies when compared to those without this history; with evidence of a noise induced hearing loss notch at 6000 Hz in both groups. Pearson's correlations showed values between 0 and 0.3 (0 and −0.3) which are indicative of a weak positive (negative) correlation between HIV and hearing loss, as well as between hearing loss and age in this population. Conclusions: Current findings highlight the importance of strategic hearing conservation programs, including ototoxicity monitoring, and the possible use of oto-protective/chemo-protective agents in this population.

Resumo Introdução: A África do Sul apresenta uma alta prevalência de coinfecção de tuberculose e HIV. Como a ototoxicidade associada aos tratamentos para essas condições é observada na exposição concomitante a outros agentes ototóxicos, como a exposição a ruídos perigosos, é importante investigar o impacto da combinação desses agentes. São poucas as evidências publicadas sobre a co-ocorrência dessas condições nessa população. Objetivo: Comparar a função auditiva de garimpeiros com (grupo tratamento) e sem (grupo sem tratamento) história de tratamento de tuberculose, a fim de determinar que grupo apresentava maior risco de perda auditiva induzida por ruído. Além disso, avaliou-se a possível influência da idade e do HIV nesses dois grupos. Método: Os registros audiológicos de 102 garimpeiros, divididos em dois grupos, foram revisados de forma retrospectiva; os dados foram qualitativa e quantitativamente analisados. Resultados: Os achados indicam os garimpeiros com histórico de tratamento de tuberculose apresentam piores limiares auditivos nas altas frequências quando comparados àqueles sem esse histórico; em ambos os grupos, observou-se perda auditiva induzida por ruído com entalhe audiométrico a 6.000 Hz. As correlações de Pearson mostraram valores entre 0 e 0,3 (0 e -0,3), que são indicativos de uma fraca correlação positiva (negativa) entre o HIV e a perda auditiva, bem como entre a perda auditiva e a idade nessa população. Conclusões: Os resultados atuais destacam a importância de programas estratégicos de conservação auditiva, inclusive monitoramento de ototoxicidade, e o possível uso de agentes oto-/quimioprotetores nessa população.

Cochrane method for systematic review and meta-analysis of interventions to prevent occupational noise-induced hearing loss - abridged / Revisão sistemática e metanálise Cochrane de intervenções para prevenção de perda auditiva ocupacional induzida por ruído - abreviada

ABSTRACT Purpose Assess the effect of non-pharmaceutical interventions at work on noise exposure or occupational hearing loss compared to no or alternative interventions. Research strategies Pubmed, Embase, Web of Science, OSHupdate, Cochrane Central and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched. Selection criteria Randomized Controlled Trials (RCT), Controlled Before-After studies (CBA) and Interrupted Time-Series studies (ITS) evaluating engineering controls, administrative controls, personal hearing protection devices, and hearing surveillance were included. Case studies of engineering controls were collected. Data analysis Cochrane methods for systematic reviews, including meta-analysis, were followed. Results 29 studies were included. Stricter legislation can reduce noise levels by 4.5 dB(A) (very low-quality evidence). Engineering controls can immediately reduce noise (107 cases). Eleven RCTs and CBA studies (3725 participants) were evaluated through Hearing Protection Devices (HPDs). Training of earplug insertion reduces noise exposure at short term follow-up (moderate quality evidence). Earmuffs might perform better than earplugs in high noise levels but worse in low noise levels (very low-quality evidence). HPDs might reduce hearing loss at very long-term follow-up (very low-quality evidence). Seventeen studies (84028 participants) evaluated hearing loss prevention programs. Better use of HPDs might reduce hearing loss but other components not (very low-quality evidence). Conclusion Hearing loss prevention and interventions modestly reduce noise exposure and hearing loss. Better quality studies and better implementation of noise control measures and HPDs is needed.

RESUMO Objetivo Avaliar o efeito de intervenções no trabalho sobre a exposição ao ruído ou a perda auditiva em comparação com ausência ou intervenções alternativas. Estratégia de pesquisa Buscas em Pubmed, Embase, Web of Science, OSHupdate, Cochrane Central e CINAHL. Critérios de seleção Incluídos ensaios clínicos randomizados (ECR), estudos controlados pré/pós-intervenção (ECPPI) e estudos de séries temporais interrompidas (SIT) avaliando controles de engenharia, administrativos, equipamentos de proteção auditiva (EPAs) e vigilância auditiva. Coletados estudos de caso de engenharia. Análise dos dados Cochrane para revisões sistemáticas, incluindo metanálise. Resultados Foram incluídos 29 estudos. Legislação mais rigorosa pode reduzir níveis de ruído em 4,5 dB(A) (evidência de qualidade muito baixa). Controles de engenharia podem reduzir imediatamente o ruído (107 casos). Onze ECR e ECPPI (3.725 participantes) avaliaram EPAs. Treinamento para inserção do EPA reduz a exposição ao ruído no acompanhamento de curto prazo (evidência de qualidade moderada). Protetores tipo concha podem ter desempenho melhor do que protetores de inserção em níveis altos de ruído, mas piores em níveis mais baixos (evidência de qualidade muito baixa). EPAs podem reduzir a perda auditiva no acompanhamento de muito longo prazo (evidência de qualidade muito baixa). Dezessete estudos (84.028 participantes) avaliaram programas de prevenção de perdas auditivas. Um melhor uso do EPA pode reduzir a perda auditiva, mas outros componentes não (evidência de qualidade muito baixa). Conclusão As intervenções para prevenção da perda auditiva reduzem modestamente a exposição ao ruído e a perda auditiva. Estudos de melhor qualidade e melhor implementação de medidas de controle de ruído e EPA são necessários.

Asociaciones entre clase social e hipoacusia laboral / Associations between social class and labor hipoacusia

Introducción: la exposición a ruidos forma parte de nuestros hábitos cotidianos, culturales y de ocio. En el entorno de trabajo aparecen diferentes sonidos que puedenser perjudiciales para los oídos. El presente escrito trata de identificar la influencia que existe entre clase social e hipoacusia laboral en trabajadores de la ciudad de Cú-cuta, en edades comprendidas entre los 17 y los 70 años. Métodos: observacional, analítico y transversal; la población estudiada incluyó tra-bajadores del sector público y privado del municipio de Cúcuta, a quienes se les reali-zó un examen audiométrico ocupacional por parte del programa de Fonoaudiología. Resultados: se encontró que la mayoría de los trabajadores, un 54.05%, pertenece a una clase social baja; el 65% se expone a ruido en el trabajo, el 60% no utiliza ele-mentos de protección personal y el 30% presenta hipoacusia.Análisis y discusión: hay una asociación significativa entre la actividad laboral y la actividad extra laboral del grupo etario. Predomina el sexo masculino con una representación del 63%. Esto puede explicarse dado el contexto cultural en el que se realizó el estudio.Conclusiones: en Colombia, existe escasa información sobre la relación entre clase social e hipoacusia laboral. Se debe realizar un análisis de segregación socio-espacial tanto de los hogares como de la enfermedad, para así determinar qué enfermedades se asocian con la actividad laboral

Introduction: exposure to noise is part of our daily, cultural and leisure habits. In the work environment different sounds can be harmful to the ears. The present text tries to identify the influence that exists between social class and work-related hearing loss in the city of Cúcuta, aged between 17 and 70 years Methods: It is observational, analytical and cross-sectional. The studied population consisted of individuals working in the public and private sector of the municipality of Cúcuta. They underwent an occupational audiometric examination by the Speech-Audiology program.Results: It was determined that most of the workers, 54.05%, are members of a low social class; 65% of workers are exposed to noise at work, 60% of workers do not use personal protection elements and 30% of evaluated workers have hearing loss. Analysis and discussion: there is a significant association between work activity and non-work activity of the age group, predominant in males with a representation of 63%, this can be explained given the cultural context in which the study was conducted. Conclusions: in Colombia, there is little information on social class and work-related hearing loss. An analysis of socio-spatial segregation of both households and the disease must be carried out in order to determine which diseases are associated to work activity

Ruido en el ambiente laboral y efectos en sistema cardiovascular en operadores de transporte público / Workplace noise and cardiovascular effects in public transportation drivers

La exposición a ruido tiene un potencial importante para causar daños a la salud de los trabajadores con efectos auditivos y extra auditivos. El objetivo de la presente investigación fue determinar los niveles de ruido a los que se encuentran expuestos los trabajadores del transporte público de la ciudad de Chihuahua, México, durante la jornada laboral y su asociación con los posibles efectos en la presión arterial. Para ello, se realizaron mediciones de ruido en el ambiente laboral con un dosímetro. Para la medición de presión arterial se utilizó el monitor ambulatorio, el cual mide la presión arterial durante el desarrollo de las actividades laborales. Los parámetros bioquímicos que se midieron fueron colesterol y triglicéridos en ayunas. Con base en los resultados y al análisis de datos se encontró elevada la presión arterial (hipertensión), ruido inestable con variaciones de hasta 106.7 decibeles A (dB A) y un aumento en los lípidos en sangre (triglicéridos). Los resultados nos permiten proponer que la constante exposición al ruido de los choferes de transporte público, es un factor de riesgo importante para el desarrollo de alta presión arterial y un incremento en los niveles de triglicéridos, lo que aumenta el riesgo de sufrir enfermedades cardiovasculares(AU)

Occupational noise exposure can lead to both hearing and non-hearing effects on workers' health. The objective of this study was to measure ambient noise levels that public transportation workers in Chihuahua, Mexico are exposed to, and their association with blood pressure, using a standard noise level dosimeter. We used ambulatory monitors to measure blood pressure over the work shift, and also measured serum cholesterol and triglycerides. Noise levels varied widely, with peaks up to 106.7 decibels (A-scale); we also found elevated blood pressure and triglycerides. Our results suggest that, among public transportation drivers, continuous exposure to noise is a risk factor for elevated blood pressure and triglycerides which, in turn, are risk factors for cardiovascular disease(AU)

Níveis de pressão sonora em salas de aula de uma Universidade e seus efeitos em alunos e professores / Sound pressure levels in classrooms of a University and its effects on students and professors

RESUMO Objetivo Mensurar os níveis de pressão sonora em salas de aula de uma Universidade, bem como verificar a autopercepção do ruído e sua influência nas atividades desempenhadas por alunos e professores universitários. Método Trata-se de um estudo realizado em dez salas de aula do Instituto de Ciências Biológicas e da Saúde da Pontifícia Universidade Católica de Minas Gerais. Participaram do estudo 279 alunos e 20 professores. Alunos e professores responderam a um questionário destinado ao levantamento de informações sobre a autopercepção do ruído nas salas de aula, seus impactos nas atividades acadêmicas e presença de sintomas associados à exposição ao ruído. Foi realizada também medição dos níveis de pressão sonora nas salas de aula, em pontos selecionados de acordo com o recomendado pela literatura e conforme consta na legislação. Resultados As salas de aula do turno da manhã apresentaram o maior nível de ruído. O primeiro andar apresenta maior nível de ruído mensurado, sendo classificado como o andar mais ruidoso. O ruído é percebido tanto por alunos quanto pelos professores como fator interferente nas atividades desempenhadas dentro das salas de aula, entretanto professores apresentam maior percepção da interferência do ruído em suas atividades que os alunos. Não foi observada ocorrência significativa de sintomas associados à exposição ao ruído. Conclusão O ruído está presente em todas as salas de aula com valores superiores ao preconizado pela legislação nacional. Este ruído é percebido por alunos e professores e interfere negativamente nas atividades de ensino-aprendizagem.

ABSTRACT Purpose Measure the sound pressure levels in classrooms of a university as well to verify the self-perception of noise in the educational environment and its influence on the activities carried out by students and professors. Methods The study was carried out with students and professors who answered a questionnaire regarding self-perception of noise in the classroom, as well as the presence of auditory and non-auditory complaints. Measurement of sound pressure levels was performed in ten classrooms of Pontifical Catholic University of Minas Gerais. The points for measuring the sound pressure level inside the classrooms were selected according to the literature and legislation: three distinct points, totaling nine measurements in each room. Results Participated in this study students and professors from the Institute of Biological and Health Sciences. The classrooms of the morning shift had the highest noise measurement. Classrooms at lunch time had the lowest average noise. The first floor has the highest average noise, being classified as the noisiest floor. Noise is perceived by both students and professors as an interfering factor in the activities performed inside the classrooms, however, professors have a greater perception of noise interference in their activities than students. Conclusion Noise is present in all classrooms with values higher than those recommended by national legislation. This noise is perceived by students and professors and negatively interferes in the teaching-learning activities.

Ações para a melhoria do conforto acústico em instituições de educação infantil / Noise in early childhood education institutions

Resumo Elevados níveis de pressão sonora têm sido observados em escolas e, por sua interferência na saúde das crianças e professores, teve-se por objetivo analisar esses níveis em centros de educação infantil que atendem crianças com idades entre zero e seis anos, investigar a percepção dos funcionários quanto à exposição ao ruído e identificar a audição desses trabalhadores. O estudo foi realizado em dez instituições que empregam 320 trabalhadores. Os níveis de pressão sonora foram medidos segundo as normas técnicas, os funcionários preencheram questionário sobre a percepção do ruído e passaram por avaliação auditiva. Observou-se elevado nível de pressão sonora e diferenças entre as instituições, situações e locais. A maioria dos funcionários se considerou exposta ao ruído com dificuldades de atenção e concentração, ansiedade e dor de cabeça. Cerca de 30% dos funcionários apresentaram perda auditiva neurossensorial bilateral em frequências específicas. Os níveis de pressão sonora encontrados podem comprometer a aprendizagem das crianças e a saúde de todos. Os funcionários percebem o ruído e indicam prejuízos em sua rotina de trabalho. Ações para melhorar o conforto acústico nessas instituições foram discutidas e estão sendo implementadas.

Abstract High sound pressure levels have been observed in schools, and its interference in the health of children and teachers it was taken to analyze these levels in childhood education centers serving children aged zero to six years, investigate the staff's perceptions concerning noise exposure and identify the auditory conditions of these workers and the occurrence of diseases. The study was conducted in ten institutions employing 320 workers. Sound pressure levels were measured according to the technical norms; employees completed a questionnaire on the perception of noise and underwent auditory evaluation. There was high sound pressure level and differences between institutions, situations and places. Most employees are considered exposed to noise with attention and concentration difficulties, anxiety and headache. About 30% of employees had bilateral sensorineural hearing loss in specific frequency. The sound pressure levels found can affect children's learning and the health of all. The employees also perceived elevated levels of noise and indicated some possible negative aspects in their work routine. Actions to improve the acoustic comfort in these institutions will be discussed with the management teams.

Analysis of possible factors of vocal interference during the teaching activity / Análise de possíveis fatores de interferência no uso da voz durante atividade docente

ABSTRACT OBJECTIVE To measure the risk of dysphonia in teachers, as well as investigate whether the perceptual-auditory and acoustic aspects of the voice of teachers in situations of silence and noise, the signal-to-noise ratio, and the noise levels in the classroom are associated with the presence of dysphonia. METHODS This is an observational cross-sectional research with 23 primary and secondary school teachers from a private school in the municipality of São Paulo, Brazil, divided into the groups without dysphonia and with dysphonia. We performed the following procedures: general Dysphonia Risk Screening Protocol (General-DRSP) and complementary to speaking voice - teacher (Specific-DRSP), voice recording during class and in an individual situation in a silent room, and measurement of the signal-to-noise ratio and noise levels of classrooms. RESULTS We have found differences between groups regarding physical activity (General-DRSP) and particularities of the profession (Specific-DRSP), as well as in all aspects of the perceptual-auditory vocal analysis. We have found signs of voice wear in the group without dysphonia. Regarding the vocal resources in the situations of noise and silence, we have identified a difference for the production of abrupt vocal attack and the tendency of a more precise speech in the situation of noise. Both the signal-to-noise ratio and the room noise levels during class were high in both groups. CONCLUSIONS Teachers in both groups are at high risk for developing dysphonia and have negative vocal signals to a greater or lesser extent. Signal-to-noise ratio was inadequate in most classrooms, considering the standards for both children with normal hearing and with hearing loss, as well as equivalent noise levels.

RESUMO OBJETIVO Mensurar o risco de disfonia em professores, bem como investigar se os aspectos vocais perceptivo-auditivos e acústicos em situação de ruído, a relação sinal-ruído e os níveis de ruído em sala de aula estão associados à presença de disfonia. MÉTODOS Pesquisa transversal observacional com 23 professores da educação infantil e ensino fundamental de uma escola particular do município de São Paulo divididos nos grupos sem disfonia e com disfonia. Foram realizados os seguintes procedimentos: protocolo de rastreio de risco de disfonia geral (PRRD-Geral) e complementar para voz falada - professor (PRRD-Específico), gravação da voz durante aula e em situação individual em sala silenciosa, medição da relação sinal-ruído e dos níveis de ruído das salas de aula. RESULTADOS Foram encontradas diferenças entre os grupos quanto à atividade física (PRRD-Geral) e particularidades da profissão (PRRD-Específico), bem como em todos os aspectos da análise vocal perceptivo-auditiva. No grupo sem disfonia, foram encontrados sinais de desgaste da voz. Quanto aos recursos vocais nas situações de ruído e silêncio, identificamos diferença para produção de ataque vocal brusco e tendência de uma fala mais precisa na situação-ruído. Tanto a relação sinal-ruído quanto os níveis de ruído das salas durante a aula foram elevados nos dois grupos. CONCLUSÕES Os professores dos dois grupos estão expostos a riscos elevados para o desenvolvimento de disfonias e apresentam sinais vocais negativos em maior ou menor grau. A relação sinal-ruído apresentou-se inadequada em grande parte das salas de aula, considerando-se as normas tanto para crianças com audição normal quanto para aquelas com perda auditiva, assim como os níveis de ruído equivalentes.