Relationship between Otological Symptoms and TMD.

BACKGROUND: Patients with any type of temporomandibular disorder (TMD) may have several symptoms in their temporomandibular joints, masticatory muscles and associated structures, and may have otological symptoms such as tinnitus, ear fullness, ear pain, hearing loss, hyperacusis, and vertigo, which may be due to the anatomical proximity between the temporomandibular joint, muscles innervated by the trigeminal nerve, and ear structures. Objective: This study found a prevalence of ear complaints described in the medical records of patients (n = 485) at the Center for Diagnosis and Treatment of the Temporomandibular Joint and Dental-Facial Functional Alterations at Tuiuti University of Paraná (CDATM/UTP), with TMD evaluated by the Research Diagnostic Criteria/Temporomandibular Disorders (RDC/ TMD). METHOD: After approval by the ethics committee were examined 485 medical records of patients of the CDATM/UTP, of both sexes a period of 2 years. The data analyzed were gender, age and the presence of reported otologic symptoms. The data were organized and subjected to statistical analysis using SPSS (IBM Statistic 20.0). RESULTS: The results showed a higher number of female patients between 41 and 50 years old. There was a prevalence of otological symptoms (tinnitus, deafness, dizziness, imbalance, and ear fullness) in 87% of TMD cases, regardless of sex and age. Tinnitus was the symptom with the highest prevalence (42%), followed by the ear fullness (39%). CONCLUSION: These data support the correlation between temporomandibular disorders and otological symptoms, even without being caused directly by the ear.

Amplified music with headphones and its implications on hearing health in teens.

OBJECTIVE: To analyze the habits and behavior of adolescents exposed to amplified music with headphones and its implications on their hearing health. METHODS: One hundred thirty-one high school students, aged 15 to 18 years were given a questionnaire containing closed questions regarding their habits and behavior related to personal stereos use. It is a descriptive cross-sectional study and used the Chi-square test. RESULTS: It was shown that 79% of young people make use of portable music devices, 61.83% have a habit of using them often, 34.35% have long periods of exposure, and 37.40% use them at high volume. In terms of symptoms, present were: difficulty concentrating 63.36%; the need to ask people to repeat what was said 64.12%; the need to increase the TV volume 43.51%; tinnitus 38.93%, excitability 38.93%; and 36.64% of teens say they are somewhat worried about losing their hearing through the use of personal stereos. For the preventive aspects, 90.84% believe that noise is part of society, 80.92% find it important to reduce noise pollution, 51.91% would like to know the influence of the noise/pollution, but 74.81% would not like to participate in projects with questions about hearing health. CONCLUSION: The youths in this study are making indiscriminate use of personal stereos with headphones, within a population at risk for hearing loss considering its habits. Hearing Health Promotion Programs are recommended for this population.

The impact of tinnitus on the quality of life in patients with temporomandibular dysfunction.

INTRODUCTION: The most common otological symptoms in patients with temporomandibular disorders (TMD) are ear fullness, tinnitus and ear pain. OBJECTIVE: To evaluate the impact of tinnitus on the quality of life for patients with TMD. METHOD: This is a quantitative, cross-sectional retrospective study. The sample consisted of 19 individuals with TMD, 17 (89.47%) females and 2 (10.53%) male, mean age 53.5 years. Data collection consisted of: anamnesis, pure tone audiometry, acuphenometry and application of the Portuguese version of the Tinnitus Handicap Inventory (Brazilian THI). RESULTS: 63.12% had had tinnitus for less than five years, and 15.79% had tinnitus that sounded like whistling, rain and/or a cricket. There was a predominance of laterality in the right ear (42.11%). 52.63% of the subjects reported that their tinnitus is continuous, while 31.58% stated that it lasts for days, and 47.37% report that it is common. The audiometry revealed mean audiometric thresholds above 25 dB HL in the high frequencies (3000, 4000, 6000 and 8000 Hz) bilaterally. In acuphenometry, the average loudness of the tinnitus was 21 dB SL the right ear and 17.85 dB SL in the left ear, and the average tinnitus pitch was 3775 Hz in the right ear and 3750 Hz in the left ear. The total THI score was 37.8 points. It appears that there is significant correlation between the THI scale, time of tinnitus duration and its occurrence. CONCLUSION: Tinnitus reported in patients with TMD caused moderate impact on quality of life and can be seen in the presence of background noise although daily activities can still be performed.

Occurrence of tinnitus and other auditory symptoms among musicians playing different instruments.

INTRODUCTION: Tinnitus is one of the most reported auditory symptoms among musicians and can negatively influence their ability to work, sometimes even more severely than hearing loss. OBJECTIVES: To analyze the occurrence of tinnitus and other auditory symptoms in musicians who play different instruments. METHODS: One hundred musicians participated by answering a questionnaire on instrument played, practice time with the instrument, occurrence of tinnitus, hearing difficulties, and intolerance to loud sounds. The symptoms were analyzed in relation to gender, musical instrument, and time of experience using statistical tests such as the Chi-squared test and Difference in Proportions test at a significance level of 0.05 as well as finding the Prevalence Ratio. RESULTS: Tinnitus was the most frequent symptom among musicians, especially among those who play amplified instruments. There was an association between tinnitus and hearing difficulty, and between instrument experience time and intolerance to loud sounds. The proportion of musicians with occasional tinnitus was high among those with less than 15 years of musical practice, and 4.53 times more prevalent in those with more than 15 years of experience. CONCLUSION: The presence of auditory symptoms, especially tinnitus, among musicians reinforces the need for implementation of hearing conservation programs for this profession.

Hearing Health at School: analysis of knowledge, behaviors and attitudes of Southern-Brazilian children and adolescents on noise.

PURPOSE: to analyze the knowledge, behaviors, and attitudes of students on noise. METHODS: We used an observational method study, in 32 Schools from Itajaí/Brazil, with a convenience sample, comprising 1,835 students, 45.7% females and 54.3% males, mean age of 11.53 ± 0.8 years, was conducted. The Portuguese version of Dangerous Decibels® questionnaire was applied. For the data analysis, descriptive and inferential statistics were used, significance level of 5%. RESULTS: A large part of the sample part of the sample had harmful hearing habits; 62.6% reported knowledge on the subject, but only 25.4% answered the questions on the theme correctly; 58.9% reported that they did not know how to protect hearing if necessary. Regarding sex and age: males have more hazardous hearing habits (p < 0.001) and tinnitus complaint (p<0.001) and females have more knowledge (p < 0.001) and the intent to wear hearing protection (p<0.001), greater intention to wear hearing protection among younger students (10 and 11 years old) (p < 0.001), and the older ones (12 to 16 years old) get more exposed to noise (p < 0.001), and there are more tinnitus complaints (p < 0.05) among them. CONCLUSION: A large part of the students in the study has hazardous noisy habits and scarce knowledge on the theme, with males and older subjects showing the worst attitudes and behaviors in face of the potential hearing risk caused by exposure to high noise levels.

Tinnitus in adolescents and its relation to the use of personal sound systems.

INTRODUCTION: References to recreational exposure to high sound pressure levels (SPL) and the risk of hearing loss and sensation of tinnitus has increased in the adolescent population. OBJECTIVE: To identify the occurrence of tinnitus in adolescents who use personal sound systems (PSS). MATERIAL AND METHODS: This was a descriptive cross-sectional study, using a sample of 153 normal-hearing adolescent students. Participants answered a self-adaministered questionnaire containing open and closed questions, addressing information regarding sound habits with the use of PSS and symptoms associated with this practice. RESULTS: The occurrence of a habit of using PSS was 93%. Comparing the exposed and unexposed groups, the incidence of tinnitus was 40% and 33% respectively, and 22% reported the occurrence of tinnitus induced by the use of PSS. There was no significant difference for the presence of tinnitus depending on the degree of exposure. CONCLUSION: Although no relation between the use of PSS with tinnitus has been observed, the prevalence of symptoms of up to 40%, including noise-induced episodes, reinforces the possibility of subclinical hearing loss induced by high NPS and, because of the irreversible nature of these losses, the urgency of educational and regulatory measures to reverse these habits and attitudes.

Audiological Tests Used in the Evaluation of the Effects of Solvents on the Human Auditory System: A Mixed Methods Review.

This study aimed to scope the literature, identify knowledge gaps, appraise results, and synthesize the evidence on the audiological evaluation of workers exposed to solvents. We searched Medline, PubMed, Embase, CINAHL, and NIOSHTIC-2 up to March 22, 2021. Using Covidence, two authors independently assessed study eligibility, risk of bias, and extracted data. National Institute of Health Quality Assessment Tools was used in the quality evaluation of included studies; the Downs and Black checklist was used to assess the risk of bias. Of 454 located references, 37 were included. Twenty-five tests were studied: two tests to measure hearing thresholds, one test to measure word recognition in quiet, six electroacoustic procedures, four electrophysiological tests, and twelve behavioral tests to assess auditory processing skills. Two studies used the Amsterdam Inventory for Auditory Disability and Handicap. The quality of individual studies was mostly considered moderate, but the overall quality of evidence was considered low. The discrepancies between studies and differences in the methodologies/outcomes prevent recommending a specific test battery to assess the auditory effects of occupational solvents. Decisions on audiological tests for patients with a history of solvent exposures require the integration of the most current research evidence with clinical expertise and stakeholder perspectives.

Audiological findings of family farmers exposed to pesticides. / Achados audiológicos de agricultores familiares paranaenses expostos a agrotóxicos.

PURPOSE: To analyze the possible differences among the hearing of farmers and their families when compared to the population not exposed to pesticides. METHODS: Cross-sectional study with 70 smallholder family farmers (research group), with the mean age of 39.7 years, of both sexes and a mean of 23.7 years of exposure to pesticides. We included a control group with 71 participants of both sexes with the mean age of 39.5 years, not exposed to either noise or chemical substances, to compare the results. In stage 1, both groups were submitted to conventional and high-frequency audiometry, and acoustic immittance. In stage 2, only people with normal hearing were submitted to the evoked otoacoustic emissions and suppression effect on transient otoacoustic emissions. RESULTS: Significant differences were observed between the groups in the conventional pure-tone and in the high-frequency audiometry, as well as in the acoustic reflex. The most affected frequencies in the conventional pure-tone audiometry ranged from 3 to 6 kHz and, in the high-frequency audiometry, from 9000 to 11200 Hz. As for the transient otoacoustic emissions, the worse suppression effect results were found in the research group. CONCLUSION: There were differences among the hearing of family farmers and the control group. The conventional auditory thresholds are related to the group, age and sex. Farming is associated with impairments in the basal region of the cochlea, absence of acoustic reflex, reduced signal-to-noise ratio of the transient otoacoustic emissions, and dysfunction in the olivocochlear efferents of the auditory system.

OBJETIVO: Analisar as possíveis diferenças na audição de agricultores e suas famílias em comparação com população não exposta aos agrotóxicos. MÉTODO: Estudo transversal, com 70 participantes (grupo pesquisa), com média de idade de 39,7 anos, de ambos os sexos, proprietários de pequenos estabelecimentos agrícolas vinculados a agricultura familiar e tempo de exposição médio aos agrotóxicos de 23,7 anos. Um grupo controle com 71 participantes de ambos os sexos, sem exposição a ruído e agentes químicos, com idade média de 39,5 anos, foi incluído para a comparação dos resultados. Na etapa 1, ambos os grupos foram submetidos a audiometria convencional e de altas frequências e imitanciometria. Na etapa 2, somente os normoouvintes foram submetidos as emissões otoacústicas evocadas e efeito de supressão das emissões otoacústicas transientes. RESULTADOS: Observou-se diferenças significativas entre os grupos para audiometria tonal convencional e de altas frequências, e no reflexo acústico. As frequências mais afetadas na audiometria tonal convencional foram 3 a 6kHz e na audiometria de altas frequências foram as frequências de 9.000 e 11.200 Hz. Nas emissões otoacusticas transientes, observou-se no efeito de supressão piores resultados no grupo de pesquisa. CONCLUSÃO: Conclui-se que houve diferenças na audição dos agricultores familiares em comparação com o grupo controle. Os limiares auditivos convencionais estão relacionados em função do grupo, idade e gênero. O trabalho na agricultura está associado com o comprometimento na região basal da cóclea, à ausência de reflexo acústico, à redução da relação sinal/ruído das emissões otoacústicas transientes e à disfunção do sistema auditivo eferente olivococlear.

Perception of the Quality of Life of Tobacco Growers Exposed to Pesticides: Emphasis on Health, Hearing, and Working Conditions.

Introduction Tobacco farming exposes workers to various health risks due to the high application of pesticides needed to control pests, weeds and fungal diseases that prevent the tobacco plant growth. Objective To analyze the perception of the quality of life of tobacco growers exposed to pesticides, with emphasis on general health, hearing, and working conditions. Method This is a descriptive, cross-sectional study using a quantitative approach with farmers from southern Brazil. Data were collected from November of 2012 to November of 2014. For data collection, we opted for the 36-item short form health survey (SF-36) questionnaire, and a questionnaire with closed questions about health, hearing and working conditions. We evaluated a total of 78 subjects; the study group, made up of 40 tobacco farmers exposed to pesticides, and a control group of 38 participants without occupational exposure to pesticides. Both groups are residents of the same municipality, and users of the federal public health system. Results The results showed that tobacco growers had lower quality of life scores compared with the control group. Significant differences were observed in the areas of pain and general health. There were correlations between physical elements and chronic diseases; hearing complaints and a lack of personal protective equipment use, occupation and hearing complaints, as well as general health and hearing complaints. Conclusion Tobacco farming is a risky activity for general and hearing health, and it can impact the quality of life of those working in this field.

The Importance of Otoneurological Evaluation in Brazilian Workers Exposed to Pesticides: A Preliminary Study.

Introduction Agrochemicals, also known as pesticides, are widely used in agriculture and in public health. They are organic and inorganic chemical substances with a high level of toxicity not only for the environment, but also for human health. Objective To verify findings on labyrinthine assessment in endemic disease control agents, and to recommend the inclusion of the vestibular exam in the set of tests for pesticide-exposed populations. Methods Descriptive, prospective, cross-sectional study with a sample comprising 15 endemic disease control agents, males, mean age of 51.6 years old (standard deviation [SD] = 5.9). All of the participants were submitted to anamnesis, otorhinolaryngological screening, and vestibular assessment. Results Regarding the most reported complaints, dizziness (73.4%), headache (60%), and tingling in the extremities (53.4%) were observed. The findings of the vestibular exams were normal in 53.3%, while 46.7% showed peripheral vestibular disorder, of which 26.7% were of deficitary type, and 20% of the irritative type. Conclusions: Alteration in the vestibular system was verified in 50% of the workers, with a greater prevalence in the caloric testing. Several disorders related to pesticides intoxication are scientifically known. Actions promoting knowledge and qualification of this population for the proper handling of chemicals are suggested, in addition to the elaboration and inclusion of protocols of vestibular assessment in hearing health programs for the prevention, diagnosis and treatment of vestibular disorders.

Achados audiológicos de agricultores familiares paranaenses expostos a agrotóxicos / Audiological findings of family farmers exposed to pesticides

RESUMO Objetivo Analisar as possíveis diferenças na audição de agricultores e suas famílias em comparação com população não exposta aos agrotóxicos. Método Estudo transversal, com 70 participantes (grupo pesquisa), com média de idade de 39,7 anos, de ambos os sexos, proprietários de pequenos estabelecimentos agrícolas vinculados a agricultura familiar e tempo de exposição médio aos agrotóxicos de 23,7 anos. Um grupo controle com 71 participantes de ambos os sexos, sem exposição a ruído e agentes químicos, com idade média de 39,5 anos, foi incluído para a comparação dos resultados. Na etapa 1, ambos os grupos foram submetidos a audiometria convencional e de altas frequências e imitanciometria. Na etapa 2, somente os normoouvintes foram submetidos as emissões otoacústicas evocadas e efeito de supressão das emissões otoacústicas transientes. Resultados Observou-se diferenças significativas entre os grupos para audiometria tonal convencional e de altas frequências, e no reflexo acústico. As frequências mais afetadas na audiometria tonal convencional foram 3 a 6kHz e na audiometria de altas frequências foram as frequências de 9.000 e 11.200 Hz. Nas emissões otoacusticas transientes, observou-se no efeito de supressão piores resultados no grupo de pesquisa. Conclusão Conclui-se que houve diferenças na audição dos agricultores familiares em comparação com o grupo controle. Os limiares auditivos convencionais estão relacionados em função do grupo, idade e gênero. O trabalho na agricultura está associado com o comprometimento na região basal da cóclea, à ausência de reflexo acústico, à redução da relação sinal/ruído das emissões otoacústicas transientes e à disfunção do sistema auditivo eferente olivococlear.

ABSTRACT Purpose To analyze the possible differences among the hearing of farmers and their families when compared to the population not exposed to pesticides. Methods Cross-sectional study with 70 smallholder family farmers (research group), with the mean age of 39.7 years, of both sexes and a mean of 23.7 years of exposure to pesticides. We included a control group with 71 participants of both sexes with the mean age of 39.5 years, not exposed to either noise or chemical substances, to compare the results. In stage 1, both groups were submitted to conventional and high-frequency audiometry, and acoustic immittance. In stage 2, only people with normal hearing were submitted to the evoked otoacoustic emissions and suppression effect on transient otoacoustic emissions. Results Significant differences were observed between the groups in the conventional pure-tone and in the high-frequency audiometry, as well as in the acoustic reflex. The most affected frequencies in the conventional pure-tone audiometry ranged from 3 to 6 kHz and, in the high-frequency audiometry, from 9000 to 11200 Hz. As for the transient otoacoustic emissions, the worse suppression effect results were found in the research group. Conclusion There were differences among the hearing of family farmers and the control group. The conventional auditory thresholds are related to the group, age and sex. Farming is associated with impairments in the basal region of the cochlea, absence of acoustic reflex, reduced signal-to-noise ratio of the transient otoacoustic emissions, and dysfunction in the olivocochlear efferents of the auditory system.

Hearing health educational interventions for school students / Intervenções educativas em saúde auditiva para escolares

ABSTRACT Purpose: to implement and assess hearing health interventions for school students, using Dangerous Decibels® Program activities in partnership with the Young Doctor Project, approaching noise-induced hearing loss prevention. Methods: the study encompassed 41 students, aged 12 to 14 years, from two schools in inland São Paulo and a social institution for public school students. Activities were based on the Young Doctor Project and the Dangerous Decibels® Brazil Program. The students answered a questionnaire administered in three situations: before the intervention (pre), right after the intervention (post), and 4 months after the intervention. The ANOVA, Friedman (p < 0.001), and Tukey´s (p < 0.05) statistical tests were used. Results: the 41 students who participated in the program were protagonists of knowledge, spreading the content they learned to another 954 students in the three schools through cultural workshops. The analysis of program effectiveness revealed improved results right after the intervention and 4 months afterward. Conclusion: combining these two programs encouraged the protagonism of young people to increase their involvement with the community. Moreover, the students changed their attitude toward potentially dangerous sounds.

RESUMO Objetivo: implementar e avaliar intervenções em saúde auditiva para escolares, utilizando as atividades do Programa Dangerous Decibels ®, em parceria com o Projeto Jovem Doutor, abordando aspectos preventivos da perda auditiva induzida por níveis de pressão sonora elevados. Métodos: participaram do estudo 41 escolares, com idade entre 12 e 14 anos, de duas escolas no interior de São Paulo e uma Instituição Social direcionada a estudantes de escolas públicas. As atividades foram baseadas no Projeto Jovem Doutor e no programa Dangerous Decibels ® Brasil. Os escolares responderam a um questionário aplicado em três situações, antes da intervenção (pré), logo após a intervenção (pós) e quatro meses após a intervenção. Foram utilizados os testes estatísticos ANOVA, FRIEDMAN; p<0,001 e TUKEY; p<0,05. Resultados: os 41 escolares que participaram do programa atuaram como protagonistas do conhecimento, multiplicando o conteúdo aprendido através das oficinas culturais, envolvendo 954 escolares das três escolas. Ao analisar a eficácia do programa, observou-se melhora nos resultados logo após a intervenção e, também, após 4 meses. Conclusão: a união desses dois programas incentivou o protagonismo juvenil, objetivando o maior envolvimento dos estudantes junto da comunidade. Foi possível observar a mudança de atitude dos escolares frente aos sons potencialmente perigosos.

Effects of COVID-19 on auditory and vestibular function in an adult patient: a longitudinal case study / Efeitos da COVID-19 na função auditiva e vestibular em paciente adulta: um estudo de caso longitudinal

ABSTRACT COVID-19 is a viral infection that mainly affects the lower respiratory tract and with the affinity of the Spike protein to the Angiotensin 2 converter enzyme, inducing a prothrombotic state which may lead to compromising of the cardiovascular, central nervous, auditory, and vestibular systems. Viral infections knowingly affect vestibular and auditory systems. This study aimed to present the auditory and vestibular findings of a woman without otoneurological complaints, before the infection with SARS-CoV-2. This is a longitudinal case report, presenting the evolution of the otoneurological clinical picture accompanied by the results of a battery of tests. The results evidenced a unilateral, permanent, cochlear sensorineural hearing loss through altered otoacoustic emissions albeit with normal tonal thresholds, accompanied by peripheral vestibular hypofunction which worsened with time, without any other factor that could justify these findings. This study shows the importance of the complete protocol of tests performed over time for a better understanding of long-time implications of the SARS-CoV-2 infection.

RESUMO A COVID-19 é uma infecção viral que afeta, principalmente, a via respiratória inferior e, com a afinidade da proteína Spike com a Enzima Conversora de Angiotensina 2, gerando estado protrombótico, pode haver comprometimento dos sistemas cardiovasculares, nervoso central e renal. As infecções virais são capazes, também, de causar alterações nos sistemas auditivo e vestibular. O presente estudo teve por finalidade apresentar os achados auditivos e vestibulares de uma mulher sem queixas otoneurológicas, previamente à infecção pela SARS-CoV-2. Trata-se de um relato de caso longitudinal, com apresentação da evolução do quadro clínico otoneurológico acompanhado de uma bateria de exames. Os resultados evidenciaram o aparecimento de uma perda auditiva neurossensorial unilateral prevista por emissões otoacústicas alteradas na presença limiares tonais normais. Com a sequência de exames, observou-se piora dos limiares auditivos e alteração da função vestibular, de maneira permanente, sem qualquer outro histórico que pudesse justificar a instalação do quadro. Em quadros infecciosos faz-se importante a longitudinalidade de avaliação com uso de protocolo completo de exames para melhor compreensão dos efeitos tardios.

Neonatal Hearing Screening in primary health care and family health care. / Rastreamento e monitoramento da Triagem Auditiva Neonatal em Unidade de Estratégia de Saúde da Família: estudo-piloto.

PURPOSE: The Universal Newborn Hearing Screening (UNHS) looks for early diagnosis and rehabilitation of newborns at risk or not of hearing impairment. The purpose is analyze the flow of Universal Newborn Hearing Screening in the family health care strategy unit through the tracking and monitoring of children. METHODS: This is a quantitative and retrospective study. The trace begins with the third copy of the Live Newborn Declaration, filled in at the maternity ward. An interview with parents and guardians was made by a community agent at the Health Unit or at the home of the newborn. Monitoring was conducted by live birth declaration and the information collected by the interviewer from maternal and child health booklet and the follow-up at high complexity services. RESULTS: The sample was made up of 50 neonates. 52% were between 30 and 89 days and 54% were male. 12% of newborns presented a risk factor for hearing loss and the neonatal screening was performed in 86% of cases. Hearing health measures show integrality in hearing impairment care at the basic health unit to high complexity hospital. CONCLUSION: The flow of care for newborn hearing screening is in agreement with the child health care guidelines in Curitiba, however, it is not yet universal. In conclusion, the participation of the family health strategy unit in the tracking and monitoring of children submitted to the Universal newborn hearing screening program is feasible and recommended.

Ambient Noise in Emergency Rooms and Its Health Hazards.

Introduction The occupational risk due to high levels of noise in the hospital environment has been recognized, and the National Agency of Sanitary Surveillance of the Ministry of Health recommends evaluation and control of noise in hospital areas. Objectives To assess the sound environment in the emergency ward of a general trauma reference hospital in the city of Curitiba, Parana State, Brazil. Methods In this descriptive study, noise levels were assessed on mornings, afternoons, and evenings using an integrating Bruel & Kjaer (Denmark) calibrated sound level meter, type 2230. Ten indoor points in the emergency ward were assessed; the helicopter as well as several available pieces of equipment in the ward were assessed individually. Results Noise levels in sound pressure level ambiance [dBA] ranged from 56.6 to 68.8. The afternoon period was the noisiest. The helicopter at 119 dBA and the cast saw at 90 dBA were the noisiest equipment, and the lowest noise level found was the activated oximeter at 61.0 dBA. Conclusion In all assessed points, noise levels were above the comfort levels recommended by the Brazilian Association of Technical Standards (1987), which may harm users' and professionals' health as well as influence professional performance in the emergency ward. Sound pressure levels of the helicopter and cast saw reach high hearing hazard levels, requiring professionals to use individual protection equipment, and point to the need for creation and implementation of effective control measures of noise levels in emergency wards.

The use of the Dangerous Decibels® program for refrigeration company workers and their children: an intergenerational pilot study / Uso do programa Dangerous Decibels® para trabalhadores de empresa frigorífica e seus filhos: estudo piloto intergeracional

ABSTRACT Objective: to report the use of the Dangerous Decibels® program for workers of a refrigeration company and their children as an intervention strategy for hearing health. Methods: an intervention study conducted in the city of Chapecó, SC, Brazil. Eight workers from a refrigeration company and their children participated in the study. The strategies adopted were those proposed by the Dangerous Decibels® program. Results: the Dangerous Decibels® program strategies contributed to the reflection on noise and favored interaction among participants. Workers and their children mutually committed to protecting and preserving hearing by passing on the knowledge gained to other family members, friends, and co-workers. The three basic principles of the Dangerous Decibels® program adopted by the participants were: Move away from noise, turn down the volume and protect the ears. Conclusion: the Dangerous Decibels® program developed in an intergenerational context was well received and accepted by workers and their children. As an educational intervention strategy for hearing health, it proved to be viable, convenient and with adequate content to be used simultaneously in populations of different age groups.

RESUMO Objetivo: relatar o uso do programa Dangerous Decibels® para trabalhadores de uma empresa frigorífica e seus filhos como estratégia de intervenção em saúde auditiva. Métodos: o estudo caracteriza-se como um estudo de intervenção, realizado na cidade de Chapecó, no estado de Santa Catarina. Participaram do estudo, oito trabalhadores de uma empresa frigorífica e seus filhos. Foram utilizadas as estratégias propostas pelo Programa Dangerous Decibels®. Resultados: as estratégias do programa Dangerous Decibels®, contribuíram para a reflexão sobre o ruído e favoreceram a interação entre os participantes. Os trabalhadores e seus filhos assumiram o compromisso mútuo de proteger e preservar a audição, levando adiante o conhecimento adquirido para os demais familiares, amigos e colegas de trabalho. Os três princípios básicos do programa Dangerous Decibels®: afastar-se do ruído, abaixar o volume e proteger os ouvidos, foram adotados pelos participantes. Conclusão: o programa Dangerous Decibels® desenvolvido em um contexto intergeracional, foi bem recebido e aceito pelos trabalhadores e seus filhos. Como estratégia de intervenção educativa em saúde auditiva, ele mostrou-se viável, conveniente e com conteúdo adequado para ser usado simultaneamente em populações com faixas etárias diferentes.

Newborn physiological responses to noise in the neonatal unit.

INTRODUCTION: The incorporation of technologies in the care of infants has contributed to increased survival; however, this has turned neonatal unit into a noisy environment. OBJECTIVE: To evaluate the physiological and functional effects resulting from the exposure to noise on low-weight newborns in incubators in a neonatal unit. METHODS: Prospective, observational, quantitative, exploratory, descriptive study. The adopted statistical method included tables of frequency, descriptive statistics, and Student's t-test, with a 0.05 level of significance. As data collection tools, the environmental noise and the noise inside of the incubator were evaluated, and the Assessment of Preterm Infant Behavior scale was used to assess premature newborn behavior and projected specifically to document the neurobehavioral functioning of preterm infants. The data collection occurred from September of 2012 to April of 2013; 61 low-weight newborns admitted in the neonatal unit and in incubators were observed. RESULTS: Significant differences in the variables heart rate and oxygen saturation were noted when newborns were exposed to noise. CONCLUSION: Low-weight neonates in incubators present physiological alterations when facing discomfort caused by environmental noise in neonatal units.

Study on hearing loss and its relationship with work in pesticide-exposed tobacco growers / Estudo da perda auditiva e a sua relação com o trabalho em fumicultores expostos a agrotóxicos

ABSTRACT The Purpose of this case report is to present four cases of tobacco growers with hearing loss due to occupational exposure to pesticides. A qualitative case study comprising three cases of sensorineural hearing loss with causal nexus (Cases 1, 2 and 4), and one (Case 3) of sensorineural hearing loss compatible with ototoxicity by pesticides, with causal nexus mainly based on minor neuropsychiatric disorders. The sample was composed of rural workers with health problems, in working age, having started working early in life, exposed to various pesticides, including organophosphates. The auditory and neurovegetative symptoms reported were noise discomfort (n = 2), speech perception difficulty (n = 3), dizziness (n = 2), and imbalance (n = 2). The pure-tone audiometry revealed a sensorineural hearing loss in one or more high frequencies, and one of the cases presented alteration in the brainstem auditory evoked potentials. There is evidence, in this study, of an association between hearing loss and work in tobacco growers exposed to pesticides, with peripheral auditory damage in four cases, and central damage in one of them. Thus, the need for a complete audiological evaluation of pesticide-exposed populations is highlighted.

RESUMO O objetivo desse relato de casos clínicos é apresentar quatro casos de fumicultores com perda auditiva devida à exposição laboral a agrotóxicos. Trata-se de um estudo de caso qualitativo, incluindo 3 casos de perda auditiva sensório-neural com nexo causal (Casos 1, 2 e 4) e um caso (Caso 3) de perda auditiva sensório-neural compatível com ototoxidade por agrotóxicos, com nexo baseado, sobretudo, nos transtornos neuropsiquiátricos menores. A casuística foi constituída por trabalhadores rurais com problemas de saúde, em idade produtiva, com início de atividade laboral precoce, expostos a múltiplos agrotóxicos, incluindo os organofosforados. Os sintomas auditivos e neurovegetativos relatados foram: desconforto a sons (n=2), dificuldade de compreender a fala (n=3), tontura (n=2) e desequilíbrio (n=2). A audiometria tonal revelou perda auditiva sensório-neural em uma ou mais frequências altas e um dos casos apresentou alteração no Potencial Evocado Auditivo de Tronco Encefálico. Foi evidenciada associação entre perda auditiva e o trabalho nos fumicultores expostos a agrotóxicos, com danos auditivos periféricos nos quatro casos e dano central em um dos casos, demonstrando a necessidade da avaliação audiológica completa para populações expostas a agrotóxicos.

Auditory effects of exposure to noise and solvents: a comparative study.

Introduction Industry workers are exposed to different environmental risk agents that, when combined, may potentiate risks to hearing. Objective To evaluate the effects of the combined exposure to noise and solvents on hearing in workers. Methods A transversal retrospective cohort study was performed through documentary analysis of an industry. The sample (n = 198) was divided into four groups: the noise group (NG), exposed only to noise; the noise and solvents group (NSG), exposed to noise and solvents; the noise control group and noise and solvents control group (CNS), no exposure. Results The NG showed 16.66% of cases suggestive of bilateral noise-induced hearing loss and NSG showed 5.26%. The NG and NSG had worse thresholds than their respective control groups. Females were less susceptible to noise than males; however, when simultaneously exposed to solvents, hearing was affected in a similar way, resulting in significant differences (p < 0.05). The 40- to 49-year-old age group was significantly worse (p < 0.05) in the auditory thresholds in the NSG compared with the CNS. Conclusion The results observed in this study indicate that simultaneous exposure to noise and solvents can damage the peripheral auditory system.

Perception of the Quality of Life of Tobacco Growers Exposed to Pesticides: Emphasis on Health, Hearing, and Working Conditions

Abstract Introduction Tobacco farming exposes workers to various health risks due to the high application of pesticides needed to control pests, weeds and fungal diseases that prevent the tobacco plant growth. Objective To analyze the perception of the quality of life of tobacco growers exposed to pesticides, with emphasis on general health, hearing, and working conditions. Method This is a descriptive, cross-sectional study using a quantitative approach with farmers from southern Brazil. Data were collected from November of 2012 to November of 2014. For data collection, we opted for the 36-item short form health survey (SF-36) questionnaire, and a questionnaire with closed questions about health, hearing and working conditions. We evaluated a total of 78 subjects; the study group, made up of 40 tobacco farmers exposed to pesticides, and a control group of 38 participants without occupational exposure to pesticides. Both groups are residents of the same municipality, and users of the federal public health system. Results The results showed that tobacco growers had lower quality of life scores compared with the control group. Significant differences were observed in the areas of pain and general health. There were correlations between physical elements and chronic diseases; hearing complaints and a lack of personal protective equipment use, occupation and hearing complaints, as well as general health and hearing complaints. Conclusion Tobacco farming is a risky activity for general and hearing health, and it can impact the quality of life of those working in this field. (AU)