Relationship Between Chloroquine or Hydroxychloroquine Use and Hearing Disorders: A Systematic Review and Meta-Analysis.

Background and Objectives: Chloroquine and its analog hydroxychloroquine are derivatives of 4-aminoquinoline and are regularly used in the treatment of malaria and autoimmune diseases. Among the side effects of these drugs, alterations associated with the auditory system are frequently mentioned. Thus, the aim of this systematic review is to systematically review publications on hearing disorders and chloroquine or hydroxychloroquine use. Materials and Methods: Inclusion criteria were observational or interventional studies on audiological assessment in participants who were using chloroquine or hydroxychloroquine. The methodological quality was independently assessed by two reviewers using the Meta-Analysis of Statistics: assessment and review Instrument. The certainty of the evidence was assessed using the GRADE tool. Results: A total of 1,372 non-duplicate papers were screened, out of which 17 were included in the final qualitative synthesis, and 5 studies in the meta-analysis. The odds ratio for the two subgroups evaluated did not show significance with no heterogeneity between the effects observed between the different diseases (I2=0%) and obtaining the global estimate of 0.76 (95% confidence interval [CI]=0.41-1.39; p>0.05). Despite the inclusion of papers with different disease samples, the heterogeneity observed in the analysis was low (I2= 0%) and prediction interval (95% PI=0.32-1.80; p>0.05) remained close to that estimated by the CI (95% CI=0.41-1.39; p>0.05). The certainty of the evidence assessed by the GRADE tool was considered very low due to the risk of bias, indirect evidence, and imprecision. Conclusions: The findings of this study suggest that the use of chloroquine/hydroxychloroquine is not associated with hearing disorders.

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.

Effect of Tinnitus on Sleep Quality and Insomnia

Abstract Introduction Tinnitus is a conscious perception of a sound resulting from abnormal activity within the nervous system. A relevant percentage of tinnitus patients report symptoms severe enough to significantly affect quality of life, including sleep disorders. Objectives To analyze the sleep quality, insomnia, daytime sleepiness, and risk of obstructive sleep apnea (OSA) in participants with tinnitus. Methods The sample comprised 18 adults and older adults aged between 18 and 85 years old (mean age = 58.7 ± 17.5 years old), females and males, with complaint of continuous tinnitus for > 1 month. The instruments used were the Tinnitus Handicap Inventory (THI) questionnaire, the Insomnia Severity Index, the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, and the STOP-Bang questionnaire. Results By means of the THI questionnaire, the tinnitus severity degree reported by most participants was mild (27.8%) and moderate (27.8%), having a positive (r = 0.582) and significant (0.011) correlation to sleep quality, measured by means of the Pittsburgh questionnaire. There was a positive correlation between the Insomnia Severity Index and tinnitus handicap (r = 0.499; p = 0.035). A total of 72.2% of the participants self-assessed their sleep quality as poor, in addition to moderate insomnia (27.8%), although there is low risk of OSA (66.7%), without complaints of excessive daytime sleepiness (72.2%). Conclusion Subjects with tinnitus complaint self-rated their sleep quality as poor. Moreover, the higher the reported tinnitus handicap, the greater the symptoms of insomnia. There was no influence of tinnitus in relation to daytime sleepiness and no relationship between the severity of tinnitus and the risk of OSA.

Effect of Tinnitus on Sleep Quality and Insomnia.

Introduction Tinnitus is a conscious perception of a sound resulting from abnormal activity within the nervous system. A relevant percentage of tinnitus patients report symptoms severe enough to significantly affect quality of life, including sleep disorders. Objective To analyze the sleep quality, insomnia, daytime sleepiness, and risk of obstructive sleep apnea (OSA) in participants with tinnitus. Methods The sample comprised 18 adults and older adults aged between 18 and 85 years old (mean age = 58.7 ± 17.5 years old), females and males, with complaint of continuous tinnitus for > 1 month. The instruments used were the Tinnitus Handicap Inventory (THI) questionnaire, the Insomnia Severity Index, the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, and the STOP-Bang questionnaire. Results By means of the THI questionnaire, the tinnitus severity degree reported by most participants was mild (27.8%) and moderate (27.8%), having a positive (r = 0.582) and significant (0.011) correlation to sleep quality, measured by means of the Pittsburgh questionnaire. There was a positive correlation between the Insomnia Severity Index and tinnitus handicap (r = 0.499; p = 0.035). A total of 72.2% of the participants self-assessed their sleep quality as poor, in addition to moderate insomnia (27.8%), although there is low risk of OSA (66.7%), without complaints of excessive daytime sleepiness (72.2%). Conclusion Subjects with tinnitus complaint self-rated their sleep quality as poor. Moreover, the higher the reported tinnitus handicap, the greater the symptoms of insomnia. There was no influence of tinnitus in relation to daytime sleepiness and no relationship between the severity of tinnitus and the risk of OSA.

Translation, adaptation, and cross-cultural validation into Brazilian portuguese of the hearing protection assessment questionnaire (HPA). / Tradução, adaptação e validação transcultural para o português brasileiro do questionário de Avaliação da Proteção Auditiva (APA).

PURPOSE: The aim of the present study is to translate, adapt, and cross-culturally validate the Brazilian Portuguese version of the questionnaire Hearing Protection Assessment Questionnaire (HPA). METHODS: The original instrument, developed in English, seeks to assess barriers and supports related to the use of hearing protection devices (HPD), as well as workers' knowledge, habits and attitudes towards occupational noise. The translation, adaptation, and cross-cultural validation of the questionnaire consisted of five steps: Translation of the questionnaire from English to Portuguese; 2) Reverse translation from Portuguese to English; 3) Analysis of the instrument by three experts in the field; 4) Pre-test of the questionnaire with ten workers; 5) Application of the instrument to 509 workers in a meatpacking industry after the pre-employment medical exam. RESULTS: The results indicate the construction and content validity of the Brazilian Portuguese version for use with a working population and its internal consistency. CONCLUSION: This study resulted in the translation, cultural adaptation, and validation of the Hearing Protection Assessment Questionnaire (HPA), in order to be used to assess the use of individual hearing protection in the occupational field, called Hearing Protection Assessment Questionnaire (HPA).

OBJETIVO: O objetivo do presente estudo foi traduzir, adaptar e validar transculturalmente a versão para língua portuguesa brasileira do questionário Hearing Protection Assessment Questionnaire (HPA). MÉTODO: O instrumento original, desenvolvido na língua inglesa, buscou avaliar as barreiras e suportes relacionados ao uso dos dispositivos de proteção auditiva (DPA), assim como o conhecimento, hábitos e atitudes dos trabalhadores frente ao ruído ocupacional. A tradução, adaptação e validação transcultural do questionário foi composta de cinco etapas: Tradução do questionário do inglês para o português; 2) Processo inverso de tradução do português para o inglês; 3) Análise do instrumento por três especialistas na área; 4) Pré-teste do questionário com 10 trabalhadores; 5) Aplicação do instrumento em 509 trabalhadores de uma indústria frigorífica após o exame admissional. RESULTADOS: os resultados indicam a validade de construção e conteúdo da versão em Português Brasileiro para o seu uso com uma população trabalhadora e a consistência interna do mesmo. CONCLUSÃO: Este estudo resultou na tradução, na adaptação cultural e validação do questionário Hearing Protection Assessment Questionnaire (HPA) com a finalidade de ser usado para avaliar o uso de proteção auditiva individual em âmbito ocupacional, denominado Questionário de Avaliação da Proteção Auditiva (APA).

Tradução, adaptação e validação transcultural para o português brasileiro do questionário de Avaliação da Proteção Auditiva (APA) / Translation, adaptation, and cross-cultural validation into Brazilian portuguese of the hearing protection assessment questionnaire (HPA)

RESUMO Objetivo O objetivo do presente estudo foi traduzir, adaptar e validar transculturalmente a versão para língua portuguesa brasileira do questionário Hearing Protection Assessment Questionnaire (HPA). Método O instrumento original, desenvolvido na língua inglesa, buscou avaliar as barreiras e suportes relacionados ao uso dos dispositivos de proteção auditiva (DPA), assim como o conhecimento, hábitos e atitudes dos trabalhadores frente ao ruído ocupacional. A tradução, adaptação e validação transcultural do questionário foi composta de cinco etapas: Tradução do questionário do inglês para o português; 2) Processo inverso de tradução do português para o inglês; 3) Análise do instrumento por três especialistas na área; 4) Pré-teste do questionário com 10 trabalhadores; 5) Aplicação do instrumento em 509 trabalhadores de uma indústria frigorífica após o exame admissional. Resultados os resultados indicam a validade de construção e conteúdo da versão em Português Brasileiro para o seu uso com uma população trabalhadora e a consistência interna do mesmo. Conclusão Este estudo resultou na tradução, na adaptação cultural e validação do questionário Hearing Protection Assessment Questionnaire (HPA) com a finalidade de ser usado para avaliar o uso de proteção auditiva individual em âmbito ocupacional, denominado Questionário de Avaliação da Proteção Auditiva (APA).

ABSTRACT Purpose The aim of the present study is to translate, adapt, and cross-culturally validate the Brazilian Portuguese version of the questionnaire Hearing Protection Assessment Questionnaire (HPA). Methods The original instrument, developed in English, seeks to assess barriers and supports related to the use of hearing protection devices (HPD), as well as workers' knowledge, habits and attitudes towards occupational noise. The translation, adaptation, and cross-cultural validation of the questionnaire consisted of five steps: Translation of the questionnaire from English to Portuguese; 2) Reverse translation from Portuguese to English; 3) Analysis of the instrument by three experts in the field; 4) Pre-test of the questionnaire with ten workers; 5) Application of the instrument to 509 workers in a meatpacking industry after the pre-employment medical exam. Results The results indicate the construction and content validity of the Brazilian Portuguese version for use with a working population and its internal consistency. Conclusion This study resulted in the translation, cultural adaptation, and validation of the Hearing Protection Assessment Questionnaire (HPA), in order to be used to assess the use of individual hearing protection in the occupational field, called Hearing Protection Assessment Questionnaire (HPA).

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 impairment among workers and satisfaction with the use of hearing aids.

BACKGROUND: Hearing problems can have adverse effects on an individual's job performance, as well as on unemployment or underemployment and increased risk of stress-related sick leave. OBJECTIVE: To investigate hearing impairment among workers and satisfaction with the use of hearing aids. METHODS: Cross-sectional study with workers who are hearing aid users. Subjects underwent pure tone audiometry and answered the Hearing Handicap Inventory for Adults and the Satisfaction with Amplification in Daily Life questionnaires. RESULTS: Participants were 36 workers between 36 and 75 years old, with an average age of 53.47 years, 52.7% male and 47.3% female. There was a mild to moderate hearing handicap perception, with worse results for women in the emotional domain. As hearing loss increased, workers' frustration increased when talking to coworkers. Everyone was satisfied with the use of their hearing aids. Satisfaction increased with increasing age and decreased with increasing hearing loss. The greater the frustration when talking to co-workers, the lower the overall satisfaction with hearing aid use; the lower the satisfaction with the competence of the professional who assisted in adapting the hearing aid; the lower the satisfaction in environments with background noise and overall worse personal image. The worse the attitudes and emotional responses of workers regarding their hearing impairment, the lower the overall satisfaction with the hearing aid. CONCLUSIONS: Despite the use of hearing aids, workers perceive having a hearing impairment, especially women. As hearing loss and frustration in talking with co-workers increased, satisfaction decreased.

Brainstem Auditory Evoked Potentials in infants aged 1 to 24 months during a hearing health care service.

OBJECTIVES: Assessing infants' hearing is of utmost importance, as hearing at this phase is required for the development of oral language. Through hearing, human beings are capable of developing communication. The Brainstem Auditory Evoked Potentials are an indispensable test to diagnose deafness in infants. This study aimed to analyze the results of the Brainstem Auditory Evoked Potentials in children with risk factors for hearing loss. METHODS: This cross-sectional study analyzed the Brainstem Auditory Evoked Potentials in 123 infants aged 1 to 24 months at a hearing health care service. The Vivosonic Integrity V500 equipment, which enabled the child to be awake while the testing was carried out, was used in this study. The data were compared by gestational age and sex, according to the standards suggested in the equipment handbook. RESULTS: A significant difference was verified for age ranges 4 to 6 months, 13 to 15 months (waves I and V), and 7 to 9 months (wave V). The lower values in absolute wave latencies were comparable to data from the equipment handbook, justifying the need for standardization of the screening process. CONCLUSION: There are some differences between the standards in the equipment handbook and those observed in our study. These results will serve as a reference for the standardization of the equipment used in the hearing health care service.

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.

Hearing prevention program: how speech-language pathologists and audiologists work in the occupational health area / Programa de preservação auditiva: como atuam os fonoaudiólogos da área da saúde do trabalhador

ABSTRACT Objective: to characterize speech-language pathologists/audiologists and their interventions in the occupational health area, regarding the Hearing Prevention Program (HPP). Methods: a cross-sectional, quantitative study with 74 speech-language pathologists/audiologists from several regions of Brazil, working in the areas of Occupational Health and Audiology. The participants answered a questionnaire on their professional and educational profile, as well as on their work related to the HCP components. For data analysis, statistical procedures were used (Chi-Square Test and the test of difference in proportions, at the significance level of 0.05 - 5%), in relation to the variables of gender, age, job position, time since their graduation and academic training in occupational safety and health. Results: the speech-language pathologists/audiologists, mostly women, who reported performing the HPP, were older than 30 years, had specific postgraduate courses, but still had doubts about the Program implementation, they worked for companies with over 1,000 employees, disregarding their employment status, performing interventions, such as: hearing management and guidance on the correct use of ear protectors. Conclusion: a high number of speech-language pathologists in the Occupational Health area have not developed a complete hearing conservation program to this date.

RESUMO Objetivo: caracterizar os fonoaudiólogos e as ações que desenvolvem na área da saúde do trabalhador com relação ao Programa de Preservação Auditiva (PPA). Métodos: estudo quantitativo, transversal, com 74 fonoaudiólogos de diversas regiões do Brasil que trabalham em Saúde do Trabalhador e Audiologia. Os participantes responderam a um questionário sobre seu perfil profissional, formação e atuação em relação aos componentes do PPA. Para a análise dos dados utilizou-se procedimentos estatísticos (teste Qui-Quadrado e o teste de diferença de proporções, ao nível de significância 0,05 - 5%) em relação às variáveis sexo, idade, função, tempo de formado e formação acadêmica em saúde e segurança do trabalho. Resultados: os fonoaudiólogos, a maioria mulheres, que relataram realizar o PPA, tinham idade superior a 30 anos; fizeram cursos de pós-graduação específica, mas ainda apresentavam dúvidas em relação à implantação do Programa; estavam em empresas com mais de 1000 funcionários, independentemente de seu regime de trabalho, realizando ações como: gerenciamento auditivo e orientação sobre utilização correta de protetores auriculares. Conclusão: há ainda um número elevado de fonoaudiólogos na área de Saúde do Trabalhador que não desenvolvem um programa de preservação auditiva na íntegra.

Brainstem Auditory Evoked Potentials in infants aged 1 to 24 months during a hearing health care service

OBJECTIVES: Assessing infants' hearing is of utmost importance, as hearing at this phase is required for the development of oral language. Through hearing, human beings are capable of developing communication. The Brainstem Auditory Evoked Potentials are an indispensable test to diagnose deafness in infants. This study aimed to analyze the results of the Brainstem Auditory Evoked Potentials in children with risk factors for hearing loss. METHODS: This cross-sectional study analyzed the Brainstem Auditory Evoked Potentials in 123 infants aged 1 to 24 months at a hearing health care service. The Vivosonic Integrity V500 equipment, which enabled the child to be awake while the testing was carried out, was used in this study. The data were compared by gestational age and sex, according to the standards suggested in the equipment handbook. RESULTS: A significant difference was verified for age ranges 4 to 6 months, 13 to 15 months (waves I and V), and 7 to 9 months (wave V). The lower values in absolute wave latencies were comparable to data from the equipment handbook, justifying the need for standardization of the screening process. CONCLUSION: There are some differences between the standards in the equipment handbook and those observed in our study. These results will serve as a reference for the standardization of the equipment used in the hearing health care service.

Hearing Assessment of Neonates at Risk for Hearing Loss at a Hearing Health High Complexity Service: An Electrophysiological Assessment.

Introduction Hearing is the main sensory access in the first years of life. Therefore, early detection and intervention of hearing impairment must begin before the first year of age. Objective To analyze the results of the electrophysiological hearing assessment of children at risk for hearing loss as part of the newborn hearing screening (NHS). Methods This is a cross-sectional study held at a hearing health public service clinic located in Brazil, with 104 babies at risks factors for hearing loss referred by public hospitals. A questionnaire was applied to parents, and the auditory brainstem response (ABR) test was held, identifying those with alterations in the results. The outcome of the NHS was also analyzed regarding risk factor, gestational age and gender. Results Among the 104 subjects, most of them were male (53.85%), and the main risk factor found was the admission to the neonatal intensive care unit (NICU) for a period longer than 5 days (50.93%). Eighty-five (81.73%) subjects were screened by NHS at the maternity and 40% of them failed the test. Through the ABR test, 6 (5.77%) infants evidenced sensorineural hearing loss, 4 of them being diagnosed at 4 months, and 2 at 6 months of age; all of them failed the NHS and had family history and admission at NICU for over 5 days as the most prevalent hearing risks; in addition, family members of all children perceived their hearing impairment. Conclusion Advances could be observed regarding the age of the diagnosis after the implementation of the NHS held at the analyzed public service clinic.

Hearing assessment of neonates at risk for hearing loss at a hearing health high complexity service: an electrophysiological assessment

Introduction: Hearing is the main sensory access in the first years of life. Therefore, early detection and intervention of hearing impairment must begin before the first year of age. Objective: To analyze the results of the electrophysiological hearing assessment of children at risk for hearing loss as part of the newborn hearing screening (NHS). Methods: This is a cross-sectional study held at a hearing health public service clinic located in Brazil, with 104 babies at risks factors for hearing loss referred by public hospitals. A questionnaire was applied to parents, and the auditory brainstem response (ABR) test was held, identifying those with alterations in the results. The outcome of the NHS was also analyzed regarding risk factor, gestational age and gender. Results: Among the 104 subjects,most of them weremale (53.85%), and the main risk factor found was the admission to the neonatal intensive care unit (NICU) for a period longer than 5 days (50.93%). Eighty-five (81.73%) subjects were screened by NHS at the maternity and 40% of them failed the test. Through the ABR test, 6 (5.77%) infants evidenced sensorineural hearing loss, 4 of them being diagnosed at 4months, and 2 at 6 months of age; all of them failed the NHS and had family history and admission atNICU for over 5 days as themost prevalent hearing risks; in addition, familymembers ofall children perceived their hearing impairment. Conclusion: Advances could be observed regarding the age of the diagnosis after the implementation of the NHS held at the analyzed public service clinic (AU)

Integralidade do cuidado na atenção à saúde auditiva do adulto no SUS: acesso à reabilitação / Care integrality in adult hearing health service in the Unified Health System: access to rehabilitation

RESUMO Objetivo Caracterizar a indicação e analisar a percepção dos usuários quanto a queixas e benefícios do uso de próteses auditivas concedidas pelo Sistema Único de Saúde (SUS). Métodos Estudo transversal, quantitativo, que analisou 100 usuários de próteses auditivas no retorno inicial após adaptação, em um serviço de média e alta complexidade em saúde auditiva. Foram coletados dados dos prontuários relativos às características da perda auditiva, da seleção e adaptação da prótese auditiva, e do tempo de uso. Foi realizada entrevista para investigar a percepção de queixas e benefícios com o uso da prótese auditiva. Resultados Houve predomínio dos seguintes aspectos: a faixa etária de 66 a 90 anos; Ensino Fundamental incompleto; perda auditiva sensorioneural de graus leve e moderado; ligeira/discreta dificuldade de compreensão da fala. Foram adaptadas 184 próteses, sendo a maioria retroauricular e de Tipo A; o tempo de espera entre a indicação e a adaptação foi entre 33 e 88 dias; o principal benefício da prótese auditiva foi a melhora da compreensão/interação social, e a queixa principal referiu-se a problemas de regulagem. Conclusão A maior parte dos usuários relatou benefícios com a utilização da prótese para a compreensão de fala e a interação social, e a queixa mais referida foi a regulagem.

ABSTRACTPurpose: To characterize the referral and analyze the perception of the users regarding the complaints and benefits of the use of hearing aids granted by the Unified Health System. Methods A cross-sectional, quantitative study that analyzed 100 users of hearing aids in the initial visit after fitting, in a service of medium and high complexity in hearing health. Data were collected from the medical records and analyzed the characteristics of the hearing loss, the selection and fitting of hearing aids and the length of time using them. An interview was carried out to investigate the perception of complaints and benefits with the use of hearing aids. Results Among the users of hearing aids, the age range of 66-90 years was predominant; schooling, incomplete middle school prevailed; mild to moderate sensorineural hearing loss, slight / discreet difficulty understanding speech; 184 prostheses were adapted, the majority of those were retroauricular and Type A; the waiting time between the referral and fitting was between 33-88 days, the main benefit of the hearing aid was the improvement of social understanding / interaction and the main complaint referred to problems of adjustment. Conclusion Most users reported benefits with prosthesis use for speech comprehension and social interaction; the most mentioned complaint was adjustment.

Educational intervention assessment aiming the hearing preservation of workers at a hospital laundry. / Avaliação de intervenção educativa voltada à preservação auditiva de trabalhadores de uma lavanderia hospitalar.

OBJECTIVE: Evaluate the effectiveness of educational interventions on hearing health developed at a hospital laundry. METHODS: Quantitative assessment conducted at a hospital laundry. The study sample comprised 80 workers of both genders divided into two groups: Study Group (SG) and Control Group (CG). The educational interventions in hearing preservation were evaluated based on a theoretical approach using the Participatory Problem-based Methodology in five workshops. To assess the results of the workshops, an instrument containing 36 questions on knowledge, attitudes, and practices in hearing preservation at work was used. Questionnaires A and B were applied prior to and one month after intervention, respectively. The answers to both questionnaires were analyzed by group according to gender and schooling. RESULTS: Results of the pre-intervention phase showed low scores regarding knowledge about hearing health in the work setting for both groups, but significant improvement in knowledge was observed after intervention in the SG, with 77.7% of the answers presenting significant difference between the groups. There was also an improvement in the mean scores, with 35 responses (95.22%) presenting scores >4 (considered adequate). The women presented lower knowledge scores than the men; however, these differences were not observed in the SG after the workshops. Schooling was not a relevant factor in the assessment. CONCLUSION: The educational proposal grounded in the Participatory Problem-based Methodology expanded knowledge about hearing health at work among the participants.

OBJETIVO: Avaliar a efetividade das ações educativas em saúde auditiva desenvolvidas em uma lavanderia hospitalar. MÉTODO: Pesquisa avaliativa de abordagem quantitativa realizada numa lavanderia hospitalar. A população do estudo foi constituída por 80 trabalhadores, de ambos os gêneros, subdivididos em Grupo Intervenção GI e Grupo Sem Intervenção GSI. Foram avaliadas as ações educativas sobre preservação auditiva realizadas na abordagem teórica da Metodologia Problematizadora e Participativa, num total de 5 oficinas. Para avaliar os resultados das oficinas, foi utilizado um instrumento com 36 questões sobre conhecimentos, atitudes e práticas em preservação auditiva no trabalho. A Versão "A" foi aplicada antes da intervenção e a Versão "B", após um mês de seu término. Analisaram-se as respostas dos questionários A e B por grupos com e sem intervenção em relação ao gênero e escolaridade. RESULTADOS: Os resultados encontrados na fase pré-intervenção demonstraram que os dois grupos apresentaram problemas no conhecimento relacionado à saúde auditiva no trabalho. Após a intervenção educativa, houve aumento significativo do conhecimento em relação à saúde auditiva no trabalho do GI com 77,77% das questões que apresentaram diferenças significantes entre os grupos. Houve melhora na média de pontuação com 35 (97,22%) questões apresentando pontuação maior que 4 (considerada resposta adequada). O gênero feminino apresentou conhecimentos inferiores ao masculino, porém, após as oficinas, essas diferenças não foram observadas no GI. A escolaridade não foi um fator relevante neste estudo. CONCLUSÃO: A proposta educativa pautada na metodologia problematizadora ampliou o conhecimento referente à saúde auditiva no trabalho entre os participantes.

Hearing risk in motorcycle taxi drivers of a Southern Brazilian city / Risco auditivo em mototaxistas de uma cidade do sul do Brasil

ABSTRACT Objective: to characterize the hearing profile of motorcycle taxi drivers and analyze the risk of their exposure to noise. Methods: a cross-sectional study with 17 motorcycle taxi drivers of a city on the Southern coast of Brazil, in 2008. Noise was measured at workplace and during a standard route. The dose of exposure to noise was calculated, a questionnaire on the perception of auditory and extra-auditory effects was applied and an auditory hearing assessment through threshold tonal audiometry was performed. Results: at workplace, noise was around 73dBA (decibels, A scale), and while commuting, noise was above 100% for a 12-hour working day. Strain and stress/fatigue after work were reported by 58.8% of the subjects and 52.9% of them showed hearing losses, five presenting characteristic noise-induced hearing losses (NIHL). However, the motorcycle taxi drivers did not associate the adverse health effects to the continuous exposure to noise. Conclusion: the motorcycle taxi drivers presented hearing risk, 29% of them presenting hearing alterations with characteristics suggestive of noise-induced hearing loss, which makes the implementation of auditory conservation programs of extremely importance for this class of workers.

RESUMO Objetivo: caracterizar o perfil audiológico de mototaxistas e analisar o risco de suas exposições ao ruído. Métodos: estudo transversal, com 17 mototaxistas de uma cidade no litoral do Sul do Brasil, 2008. Realizou-se a avaliação do ruído no posto de trabalho e durante um trajeto padrão. Calculou-se a dose de exposição ao ruído, aplicou-se um questionário sobre a percepção de efeitos auditivos e extra-auditivos e realizou-se avaliação auditiva por audiometria tonal limiar. Resultados: no posto de trabalho o ruído esteve em torno de 73 dBA (decibéis, escala A) e no trajeto, apresentou dose de ruído superior a 100% para uma jornada de trabalho de 12 horas. A irritabilidade e a fadiga/estresse após o trabalho foi relatada por 58,8% dos sujeitos e 52,9% deles apresentaram perdas auditivas destes, cinco com características de PAIR. Porém, os mototaxistas não relacionaram as consequências à saúde com a exposição contínua ao ruído. Conclusão: os mototaxistas apresentaram risco auditivo e 29% do total pesquisado, alterações auditivas com características sugestivas de perda induzida pelo ruído, o que torna a implantação de Programas de Conservação auditiva de grande valia para esta classe de trabalhadores.

Intervenções educativas voltadas à prevenção de perda auditiva no trabalho: uma revisão integrativa / Educational interventions on prevention of hearing loss at work: an integrative review

Resumo Objetivo: analisar a produção científica sobre intervenções educativas desenvolvidas para a prevenção auditiva de trabalhadores expostos ao ruído. Método: revisão integrativa, descritiva e analítica de produções científicas publicadas no período 2005-2016, em idioma inglês e português, disponíveis nas bases de dados LILACS, MEDLINE, PubMed, SciELO e Google Scholar. Resultados: inicialmente foram identificados 137 artigos e após aplicação dos critérios de inclusão e exclusão, 16 artigos foram selecionados (9 internacionais, 7 nacionais) para análise. As categorias profissionais nos estudos foram: mineiros, operários da construção civil, bombeiros, operários de empresa de equipamentos eletrônicos, agricultores, trabalhadores de frigorífico, teleoperadores, trabalhadores de universidade, pescadores industriais e trabalhadores de empresa alimentícia. A maioria dos estudos visava a mudança de atitude em relação aos protetores auriculares. Os estudos internacionais basearam-se em teoria comportamental e pretendiam aumentar a intenção de uso e a utilização de protetores auriculares; apenas um deles visou a redução do nível de ruído no ambiente de trabalho. Dos estudos nacionais, 3 utilizaram abordagens comportamentais e 4 desenvolveram ações educativas, mas somente 1 referiu metodologia participativa. Conclusão: intervenções educativas focadas apenas na utilização de protetores auriculares mostraram-se insuficientes, indicando a necessidade de ações educativas mais abrangentes e participativas, associadas a medidas de controle ambiental.

Abstract Objective: to analyze the scientific production about educational interventions aimed at prevention of Noise-Induced Hearing Loss at work. Method: descriptive and analytical integrative review of scientific literature published between 2005-2016, in English and Portuguese, available in LILACS, MEDLINE, SciELO, PubMed and Google Scholar. Results: initially, 137 articles were identified; after application of inclusion and exclusion criteria, 16 articles (9 international, 7 national) were selected for analysis. The occupational categories included in the studies were: miners, firefighters, telemarketers, farmers, industrial fishermen, and workers of universities, electronic equipment industry, construction, meat processing, and food companies. Most studies aimed at changing the attitude towards hearing protectors. The international investigations were based on behavioral approaches and had the purpose of increasing intent of use and use of hearing protectors; only one of them was aimed at reducing noise level in the work environment. Among the national studies, three adopted behavioral approaches, and four developed educational activities, but only one mentioned a participatory methodology. Conclusion: educational interventions, which were only focused on the use of hearing protectors, were insufficient, indicating that they must be more comprehensive and participatory, as well as associated with environmental control measures.

Avaliação de intervenção educativa voltada à preservação auditiva de trabalhadores de uma lavanderia hospitalar / Educational intervention assessment aiming the hearing preservation of workers at a hospital laundry

RESUMO Objetivo Avaliar a efetividade das ações educativas em saúde auditiva desenvolvidas em uma lavanderia hospitalar. Método Pesquisa avaliativa de abordagem quantitativa realizada numa lavanderia hospitalar. A população do estudo foi constituída por 80 trabalhadores, de ambos os gêneros, subdivididos em Grupo Intervenção GI e Grupo Sem Intervenção GSI. Foram avaliadas as ações educativas sobre preservação auditiva realizadas na abordagem teórica da Metodologia Problematizadora e Participativa, num total de 5 oficinas. Para avaliar os resultados das oficinas, foi utilizado um instrumento com 36 questões sobre conhecimentos, atitudes e práticas em preservação auditiva no trabalho. A Versão "A" foi aplicada antes da intervenção e a Versão "B", após um mês de seu término. Analisaram-se as respostas dos questionários A e B por grupos com e sem intervenção em relação ao gênero e escolaridade. Resultados Os resultados encontrados na fase pré-intervenção demonstraram que os dois grupos apresentaram problemas no conhecimento relacionado à saúde auditiva no trabalho. Após a intervenção educativa, houve aumento significativo do conhecimento em relação à saúde auditiva no trabalho do GI com 77,77% das questões que apresentaram diferenças significantes entre os grupos. Houve melhora na média de pontuação com 35 (97,22%) questões apresentando pontuação maior que 4 (considerada resposta adequada). O gênero feminino apresentou conhecimentos inferiores ao masculino, porém, após as oficinas, essas diferenças não foram observadas no GI. A escolaridade não foi um fator relevante neste estudo. Conclusão A proposta educativa pautada na metodologia problematizadora ampliou o conhecimento referente à saúde auditiva no trabalho entre os participantes.

ABSTRACT Objective Evaluate the effectiveness of educational interventions on hearing health developed at a hospital laundry. Methods Quantitative assessment conducted at a hospital laundry. The study sample comprised 80 workers of both genders divided into two groups: Study Group (SG) and Control Group (CG). The educational interventions in hearing preservation were evaluated based on a theoretical approach using the Participatory Problem-based Methodology in five workshops. To assess the results of the workshops, an instrument containing 36 questions on knowledge, attitudes, and practices in hearing preservation at work was used. Questionnaires A and B were applied prior to and one month after intervention, respectively. The answers to both questionnaires were analyzed by group according to gender and schooling. Results Results of the pre-intervention phase showed low scores regarding knowledge about hearing health in the work setting for both groups, but significant improvement in knowledge was observed after intervention in the SG, with 77.7% of the answers presenting significant difference between the groups. There was also an improvement in the mean scores, with 35 responses (95.22%) presenting scores >4 (considered adequate). The women presented lower knowledge scores than the men; however, these differences were not observed in the SG after the workshops. Schooling was not a relevant factor in the assessment. Conclusion The educational proposal grounded in the Participatory Problem-based Methodology expanded knowledge about hearing health at work among the participants.

Quality of life, perception and knowledge of dentists on noise / Qualidade de vida, percepção e conhecimento de dentistas sobre o ruído

ABSTRACT Purpose: to analyze the perception and knowledge of dentists on occupational noise, its prevention, and effects on their health and quality of life. Methods: a cross-sectional study carried out with 54 dentists of both genders. Two questionnaires were applied: one addressing issues of perception and knowledge on noise and its effects, and another on Quality of Life (SF 36). Results: the workplace noise was considered within medium intensity, and a health risk. Some professionals (59.2%) reported knowing noise prevention methods, although they do not use them. Complaints and the most frequently reported symptoms were irritability, difficulty in understanding speech and tinnitus. The perception of the Quality of Life was worse among men. There was association between pain and perception of noise intensity. Conclusion: noise was considered, regardless of gender, harmful to health and associated with perception of musculoskeletal pain. Symptoms and complaints caused by noise have been reported to negatively impact the professional activity of dentists, however, most of them do not adopt preventive measures.

RESUMO Objetivo: analisar a percepção e conhecimento de odontólogos sobre o ruído, sua prevenção e efeitos na saúde e qualidade de vida. Métodos: estudo transversal, realizado com 54 dentistas de ambos os gêneros. Aplicou-se dois questionários: um abordando a percepção e conhecimento sobre exposição a ruído e seus efeitos e outro sobre Qualidade de Vida (SF-36). Resultados: no ambiente de trabalho odontológico, o ruído foi percebido em média intensidade e considerado um risco à saúde. Alguns profissionais (59,2%) relataram conhecer métodos de prevenção dos efeitos do ruído, porém não os utilizam. As principais queixas e sintomas foram irritabilidade, dificuldade na compreensão da fala e zumbido. A percepção sobre a Qualidade de Vida foi pior entre os homens. Houve associação entre o domínio Dor com a percepção da intensidade do ruído. Conclusão: o ruído foi considerado, independente do gênero, como nocivo à saúde e se relacionou com a percepção de dor musculoesquelética. Foram relatados sintomas e queixas associados ao ruído que podem impactar negativamente a atividade profissional dos odontólogos, mas a maioria não adota medidas preventivas.