A multicenter study on the audiometric findings of styrene-exposed workers.

OBJECTIVE: The objective of this study was to evaluate hearing loss among workers exposed to styrene, alone or with noise. DESIGN: This cross-sectional study was conducted as part of NoiseChem, a European Commission 5th Framework Programme research project, by occupational health institutes in Finland, Sweden, and Poland. STUDY SAMPLE: Participants' ages ranged from 18-72 years (n = 1620 workers). Participants exposed to styrene, alone or with noise, were from reinforced fiberglass products manufacturing plants (n = 862). Comparison groups were comprised of workers noise-exposed (n = 400) or controls (n = 358). Current styrene exposures ranged from 0 to 309 mg/m(3), while mean current noise levels ranged from 70-84 dB(A). Hearing thresholds of styrene-exposed participants were compared with Annexes A and B from ANSI S3.44, 1996. RESULTS: The audiometric thresholds of styrene exposed workers were significantly poorer than those in published standards. Age, gender, and styrene exposure met the significance level criterion in the multiple logistic regression for the binary outcome 'hearing loss' (P = 0.0000). Exposure to noise (<85 dBA p = 0.0001; ≥85 dB(A) p = 0.0192) interacted significantly with styrene exposure. CONCLUSIONS: Occupational exposure to styrene is a risk factor for hearing loss, and styrene-exposed workers should be included in hearing loss prevention programs.

Quantitative test for sensory hand symptoms based on mechanoreceptor-specific vibrotactile thresholds.

A vibrotactile test for assessing the presence or absence of sensory symptoms in the hand has been developed from thresholds believed mediated by Merkel disks and Meissner corpuscles at the fingertips. It is constructed from the summed differences between the thresholds recorded at the fingertip of an individual and the mean values of the threshold for healthy persons at the same stimulation frequencies. The summed normalized threshold shift, TS(Sum(SD)), is shown to be related to reports by subjects of numbness and pain using three statistical tests for evaluating the significance of associations in 2x2 contingency tables. The small number of subjects (15) restricts direct calculation of a fence value for TS(Sum(SD)), t, between the presence and absence of symptoms: accordingly, interpolation between calculated t values has been performed graphically. A common range of t values can be identified that is judged significantly by each statistical test (3.3

Ototoxicity of organic solvents - from scientific evidence to health policy.

The scientific workshop, organized under the 6th European Framework Programme, the Marie Curie Host Fellowship for the Transfer of Knowledge "NoiseHear" Project, by the Nofer Institute of Occupational Medicine (Lódz, Poland, 15-16 November 2006), gathered world specialists in noise, chemicals, and ototoxicity, including hearing researchers, toxicologists, otolaryngologists, audiologists and occupational health physicians.The workshop examined the evidence and the links between isolated exposure to organic solvents, combined exposure to noise and solvents, and effects on the auditory system. Its main purpose was to review the key scientific evidence to gather the necessary knowledge for developing adequate occupational health policies. This paper summarizes the workshop sessions and subsequent discussions.

Virtual reality in posturography.

Balance dysfunctions are common, especially among elderly people. Present methods for the diagnosis and evaluation of severity of dysfuntion have limited value. We present a system that makes it easy to implement different visual and mechanical perturbations for clinical investigations of balance and visual-vestibular interaction. The system combines virtual reality visual stimulation with force platform posturography on a moving platform. We evaluate our contruction's utility in a classification task between 33 healthy controls and 77 patients with Ménière's disease, using a series of tests with different visual and mechanical stimuli. Responses of patients and controls differ significantly in parameters computed from stabilograms. We also show that the series of tests achieves a classification accuracy slightly over 80% between controls and patients.

Hand-arm vibration syndrome with use of anti-vibration chain saws: 19-year follow-up study of forestry workers.

OBJECTIVES: Hand-arm vibration syndrome (HAVS) consists of vascular and neurological component. Musculoskeletal component has not been delineated yet. In the present follow-up study, we evaluated the prevalence of HAVS and the cumulative exposure to vibration among a cohort of forestry workers. Special interest was given to numbness and musculoskeletal disorders of upper extremity and neck in forestry workers. METHODS: A follow-up study starting from 1976 was conducted among forestry workers in Suomussalmi in Finland. Total exposure of hand-arm vibration was recorded during 11 cross-sectional surveys. The last study was carried out in 1995. The lifetime dose of vibration energy was calculated. A cohort of 52 forest workers participated to all 11 cross-sectional surveys 1976-1995. HAVS and musculoskeletal disorders were evaluated. RESULTS: The prevalence of active vibration white finger (VWF) decreased from 13 to 4% in the cross-sectional study. In the cohort VWF decreased from 17 to 8% and numbness increased from 23 to 40%. Rotator cuff syndrome (P=0.034) and epicondylitis (P=0.004) associated with numbness. Regional neck pain was diagnosed in 38% of workers and associated with low back pain. In modeling VWF, the lifelong vibration energy (OR 1.03, CI 1.01-1.05), and smoking (OR 7.36, CI 1.07-50.76) were significant. Numbness was modeled by pain in upper extremities (OR 12.43, CI 2.42-63.80) and neck pain (5.97, CI 1.25-28.39), not by lifelong vibration energy. Right rotator cuff syndrome was modeled by age (OR 2.58, CI 1.04-6.41) and lifelong vibration energy (OR 1.04, CI 1.00-1.07). CONCLUSIONS: The prevalence of VWF constantly decreased. Numbness did not follow the vibration exposure profile. Numbness also associated with upper extremity musculoskeletal disorders. Hand-arm vibration associated with the right rotator cuff syndrome in forestry workers.

Effect of styrene on postural stability among reinforced plastic boat plant workers in Finland.

OBJECTIVE: Many drugs are vestibulotoxic and may impair balance. Styrene is both ototoxic and neurotoxic, but its effect on balance has been little studied. We evaluate the effect of low concentrations of styrene on balance among Finnish fiberglass-reinforced plastic boat manufacturers. METHODS: From 252 male employees, we measured postural stability and urine mandelic and phenylglycolic acid concentrations. Individual exposure to styrene in breathing zone was measured for 148 workers. For analysis, 88 matched pairs were selected. RESULTS: The postural stability of laminators was aggravated compared with nonlaminators. This impairment was observed in young workers, and it worsened with age. CONCLUSIONS: This study documents styrene as an additional risk factor in impaired postural stability, with the negative effects of the styrene exposure starting already in younger workers.

Effect of impulse vibration on red blood cells in vitro.

OBJECTIVES: This study was carried out to evaluate the damage induced in red blood cells by exposure to impulse vibration. METHODS: The peak accelerations of impulse vibration included 50, 100, 200, 250 and 300 x 10(3) km/s2. A blood sample was put in a container filled with heparin so that there was no space inside. For each peak acceleration the exposure durations of 10, 20, and 30 minutes were used. The repetition rate of the impulses was 1 cycle per second (1 cycle/s). After the vibration exposure, the percentage of damaged red blood cells was calculated. Then the red blood cells were studied microscopically. RESULTS: Each vibration caused damage to red blood cells with all durations. The higher the peak acceleration and the longer the exposure duration, the more the damage to the red blood cells. Of the five impulse vibration levels with the three exposure durations, the largest damage was done by the vibration exposure with a peak acceleration of 300 km/s2 for 30 minutes with a mean value of 76.7% for the damaged cells, followed by the exposure with a peak acceleration of 300 km/s2 for 20 minutes with 55.5% of the cells being damaged. For exposure for 20 and 30 minutes, the vibration with peak accelerations of higher than 200 km/s2 provoked damage to red blood cells out of proportion to those with peak accelerations lower than 200 km/s2. CONCLUSIONS: Impulse vibration was shown in vitro to cause damage to red blood cells. It is suggested that the damage of red blood cells depends on both the peak acceleration and exposure duration of impulse vibration.

Modelling the risk of noise-induced hearing loss among military pilots.

Noise is a significant risk factor in aviation, especially in military aviation. Even though our earlier studies have shown that the risk of noise-induced hearing loss (NIHL) among military pilots is small and the monitoring of their hearing is effective, we still need to develop methods of assessing the risk of NIHL more effectively at both the general and individual levels. In addition, many other risk factors are considered to contribute to the development of hearing impairment. The novel NoiseScan data management system enables assessment of the risk of developing hearing impairment on the basis of known risk factors. This study investigates the risk of hearing impairment among Finnish Air Force pilots using reasonably accurate noise exposure data and other risk factors for hearing impairment. This risk is also compared with that of industrial workers, whose risk followed the ISO 1999 prediction. Hearing among Finnish military pilots turned out to be better than predicted by the ISO 1999 model. The industrial workers had a larger number of risk factors than the pilots. Owing to the small number of risk factors, the hearing of pilots corresponds to approximately the 80th percentile, being 9-13 dB better than the 50th percentile obtained with the industrial population.

Modelling the risk of noise-induced hearing loss among military pilots.

Noise is a significant risk factor in aviation, especially in military aviation. Even though our earlier studies have shown that the risk of noise-induced hearing loss (NIHL) among military pilots is small and the monitoring of their hearing is effective, we still need to develop methods of assessing the risk of NIHL more effectively at both the general and individual levels. In addition, many other risk factors are considered to contribute to the development of hearing impairment. The novel NoiseScan data management system enables assessment of the risk of developing hearing impairment on the basis of known risk factors. This study investigates the risk of hearing impairment among Finnish Air Force pilots using reasonably accurate noise exposure data and other risk factors for hearing impairment. This risk is also compared with that of industrial workers, whose risk followed the ISO 1999 prediction. Hearing among Finnish military pilots turned out to be better than predicted by the ISO 1999 model. The industrial workers had a larger number of risk factors than the pilots. Owing to the small number of risk factors, the hearing of pilots corresponds to approximately the 80th percentile, being 9-13 dB better than the 50th percentile obtained with the industrial population.

NoiseChem: an European Commission research project on the effects of exposure to noise and industrial chemicals on hearing and balance.

Exposure to multiple physical and chemical agents is common in occupational environments but workplace hazards and occupational safety criteria for combined exposures are lacking. NoiseChem is an European Commission research project examining the effects of exposure to noise and chemicals on hearing and balance. Partners in Sweden, Finland, France, Denmark, UK and Poland with expert guidance from partners in the USA will examine workers and study the mechanisms of action in animals to determine the levels of risk associated with joint exposure to noise and solvents. This paper briefly outlines the project details.

NoiseChem: An European Commission research project on the effects of exposure to noise and industrial chemicals on hearing and balance.

Exposure to multiple physical and chemical agents is common in occupational environments but workplace hazards and occupational safety criteria for combined exposures is lacking. NoiseChem is an European Commission research project examining the effects of exposure to noise and chemicals on hearing and balance. Partners in Sweden, Finland, France, Denmark, UK and Poland with expert guidance from partners in USA will examine workers and study the mechanisms of action in animals to determine the levels of risk associated with joint exposure to noise and solvents. This paper briefly outlines the project details.

Individual Risk Factors in the Development of Noise-Induced Hearing Loss.

We have analysed the association of noise-induced hearing loss with various risk factors among 685 workers in forest, shipyard, and paper mills. Occupational histories, health, environmental factors, and noise exposures of each worker were retrieved from the database of NoiseScan, our expert program on hearing. The mean hearing level at 4 kHz was 21.5 dB +/- 20.3 dB HL. It correlated significantly with age, noise emission level and noise exposure level. However, these factors could only explain about 2 dB HL of the variation in hearing level. Impulse noise in the shipyard work caused increase in hearing level of 12 dB HL at 4 kHz when compared to steady state noise exposure of forest work. Hearing level correlated with serum cholesterol levels, use of analgesics, blood pressure and smoking. An elevated cholesterol level increased hearing loss in both the high- and low-exposure groups. The use of analgesics did not increase a permanent threshold shift in the low-exposure group, but did in the high-exposure group. Systolic blood pressure, smoking, cholesterol level and the use of painkillers explained 36 % of the variation in hearing level at 4 kHz, whereas noise exposure alone explained 25 % of the corresponding variation.