Avaliação audiológica em policiais com e sem queixa de zumbido / Audiological assessment in police officers with and without tinnitus complaint / Evaluación audiológica en policías con y sin queja de acúfeno

Introdução: O serviço militar é um dos setores onde os trabalhadores são expostos a níveis elevados de ruído, principalmente no treinamento com armas de fogo. A exposição excessiva a este agente insalubre é considerada o fator mais importante para a diminuição da audição e o aparecimento do zumbido. Objetivo: caracterizar e comparar o perfil audiológico de policiais militares com e sem queixa de zumbido. Material e método: este é um estudo retrospectivo no qual participaram 72 policiais militares, do gênero masculino, subdivididos em dois grupos: grupo I composto por 36 policiais que não apresentavam queixa de zumbido e grupo II por 36 policiais com queixa de zumbido. Os resultados foram analisados estatisticamente. Resultados: a média de idade dos policiais do grupo I foi de 38,81 anos e média de tempo de serviço de 16,22. Para o grupo II a média de idade foi de 40,5 anos e média de tempo de serviço de 18,94 anos. Os policiais do grupo II apresentaram uma prevalência maior de perda auditiva, porém não houve diferença estatisticamente significante entre os grupos. Com relação às emissões otoacústicas produto de distorção observou-se que os dois grupos apresentaram ausência de resposta nas frequências de 6000 e 8000 Hz. Conclusão: 52,8% dos policiais com queixa de zumbido e 33,4% dos sem queixa apresentaram audiogramas sugestivos de perda auditiva induzida por ruído. A comparação entre os grupos mostrou que a média dos limiares tonais estava dentro dos padrões de normalidade e foi observada ausência de emissão otoacústica por produto de distorção em duas frequências.(AU)

Introduction: The military service is one of the sectors in which workers are exposed to high noise levels, especially when training with firearms. Excessive exposure to this unhealthy agent is considered the most important factor for hearing loss and on set of tinnitus. Objective: to characterize and compare the audiological profile of police officers with and without tinnitus. Material and Method: this is a retrospective study comprised by 72 police officers, males, divided in two groups: group I was composed by 36 police officers who did not have tinnitus and group II by 36 police officers with tinnitus. The results were statistically analyzed. Results: The average age of group I was 38,81 years and average time inservice of 16,22 years, and for group II, average age of 40,5 years and average time in service of 18,94 years. Group II showed a higher prevalence of hearing loss, but there was no statistically significantdifference between groups. Regarding distortion product otoacoustic emissions, it was observed that the two groups showed no response in the frequencies of 6.000 and 8.000 Hz. Conclusion: 52.8% of policeofficers with tinnitus and 33,4% of police officers without tinnitus had audiograms that suggest noiseinduced hearing loss. The comparison between the groups showed that hearing thresholds average waswithin normal limits and absence of distortion product otoacoustic emissions at two frequencies was observed.(AU)

Introducción: El servicio militar es uno de los sectores en que los trabajadores son expuestos a niveles elevados de ruido, principalmente en el entrenamiento con armas de fuego. La excesiva exposición a este agente insalubre es considerada como el factor más importante para la disminución de la audición y el aparecimiento del acufeno. Objetivo: caracterizar y comparar el perfil audiológico de policías militares con y sin quejas de acufeno. Material y método: este estudio es retrospectivo en el que participaron 72 policías militares, del género masculino, subdivididos en 2 grupos: grupo I compuesto por 36 policíasque no presentaban queja de acufeno y el grupo II compuesto por 36 policías con queja de acufeno. Los resultados fueron analizados estadísticamente. Resultados: El promedio de edad de los policías del grupo I fue de 38,81 años y el promedio de tiempo de servicio de 16,22 años . Para el grupo II promedio de edad fue de 40,5 años y el promedio de tiempo de servicio de 18,94 años. Los policías del grupo II presentaron una prevalencia mayor de pérdida auditiva, pero no hubo diferencia estadísticamente significante entrelos grupos. En relación a las emisiones otacústicas, producto de distorsión, se observó que los dos grupos presentaron ausencia de respuesta en las frecuencias de 6000 y 8000 Hz. Conclusión: 52,8% de los policías con queja de acufeno y 33,4% sin queja, presentaron audiogramas sugestivos de pérdida auditiva inducida por ruido. La comparación entre los grupos demostró que la media de los umbrales tonales estaba dentro de los patrones de normalidad y se observó ausencia de emisión otacústica como producto de distorsión en dos frecuencias.(AU)

Avaliação audiológica em policiais com e sem queixa de zumbido / Audiological assessment in police officers with and without tinnitus complaint / Audiological assessment in police officers with and without tinnitus complaint

Introdução: O serviço militar é um dos setores onde os trabalhadores são expostos a níveis elevados de ruído, principalmente no treinamento com armas de fogo. A exposição excessiva a este agente insalubre é considerada o fator mais importante para a diminuição da audição e o aparecimento do zumbido. Objetivo: caracterizar e comparar o perfil audiológico de policiais militares com e sem queixa de zumbido. Material e método: este é um estudo retrospectivo no qual participaram 72 policiais militares, do gênero masculino, subdivididos em dois grupos: grupo I composto por 36 policiais que não apresentavam queixa de zumbido e grupo II por 36 policiais com queixa de zumbido. Os resultados foram analisados estatisticamente. Resultados: a média de idade dos policiais do grupo I foi de 38,81 anos e média de tempo de serviço de 16,22. Para o grupo II a média de idade foi de 40,5 anos e média de tempo de serviço de 18,94 anos. Os policiais do grupo II apresentaram uma prevalência maior de perda auditiva, porém não houve diferença estatisticamente significante entre os grupos. Com relação às emissões otoacústicas produto de distorção observou-se que os dois grupos apresentaram ausência de resposta nas frequências de 6000 e 8000 Hz. Conclusão: 52,8% dos policiais com queixa de zumbido e 33,4% dos sem queixa apresentaram audiogramas sugestivos de perda auditiva induzida por ruído. A comparação entre os grupos mostrou que a média dos limiares tonais estava dentro dos padrões de normalidade e foi observada ausência de emissão otoacústica por produto de distorção em duas frequências.

Introduction: The military service is one of the sectors in which workers are exposed to high noise levels, especially when training with firearms. Excessive exposure to this unhealthy agent is considered the most important factor for hearing loss and on set of tinnitus. Objective: to characterize and compare the audiological profile of police officers with and without tinnitus. Material and Method: this is a retrospective study comprised by 72 police officers, males, divided in two groups: group I was composed by 36 police officers who did not have tinnitus and group II by 36 police officers with tinnitus. The results were statistically analyzed. Results: The average age of group I was 38,81 years and average time inservice of 16,22 years, and for group II, average age of 40,5 years and average time in service of 18,94 years. Group II showed a higher prevalence of hearing loss, but there was no statistically significantdifference between groups. Regarding distortion product otoacoustic emissions, it was observed that the two groups showed no response in the frequencies of 6.000 and 8.000 Hz. Conclusion: 52.8% of policeofficers with tinnitus and 33,4% of police officers without tinnitus had audiograms that suggest noiseinduced hearing loss. The comparison between the groups showed that hearing thresholds average waswithin normal limits and absence of distortion product otoacoustic emissions at two frequencies was observed.

Introducción: El servicio militar es uno de los sectores en que los trabajadores son expuestos a niveles elevados de ruido, principalmente en el entrenamiento con armas de fuego. La excesiva exposición a este agente insalubre es considerada como el factor más importante para la disminución de la audición y el aparecimiento del acufeno. Objetivo: caracterizar y comparar el perfil audiológico de policías militares con y sin quejas de acufeno. Material y método: este estudio es retrospectivo en el que participaron 72 policías militares, del género masculino, subdivididos en 2 grupos: grupo I compuesto por 36 policías que no presentaban queja de acufeno y el grupo II compuesto por 36 policías con queja de acufeno. Los resultados fueron analizados estadísticamente. Resultados: El promedio de edad de los policías del grupo I fue de 38,81 años y el promedio de tiempo de servicio de 16,22 años .Para el grupo II promedio de edad fue de 40,5 años y el promedio de tiempo de servicio de 18,94 años. Los policías del grupo II presentaron una prevalencia mayor de pérdida auditiva, pero no hubo diferencia estadísticamente significante entre los grupos. En relación a las emisiones otacústicas, producto de distorsión, se observó que los dos grupos presentaron ausencia de respuesta en las frecuencias de 6000 y 8000 Hz. Conclusión: 52,8% de los policías con queja de acufeno y 33,4% sin queja, presentaron audiogramas sugestivos de pérdida auditiva inducida por ruido. La comparación entre los grupos demostró que la media de los umbrales tonales estaba dentro de los patrones de normalidad y se observó ausencia de emisión otacústica como producto de distorsión en dos frecuencias.

The Effects of Musical Auditory Stimulation of Different Intensities on Geometric Indices of Heart Rate Variability.

BACKGROUND: Music has been proven to promote changes in cardiac autonomic modulation. However, it is not clear whether the effects of the auditory stimulation on heart rate variability (HRV) are dependent on its intensity. OBJECTIVE: The study intended to investigate the acute effects on the geometric HRV indices of auditory stimulation with heavy metal and baroque music using different intensities of auditory stimulation. DESIGN: The study was a nonrandomized, clinical trial. SETTING: The study was conducted at the facility of the Faculty of Sciences of the São Paulo State University, on the campus in Marilia, Brazil. PARTICIPANTS: Participants were 24 healthy women aged between 18 and 27 y. INTERVENTION: HRV was recorded for each participant for 10 min at rest. Subsequently, participants were exposed to baroque or heavy metal music through an earphone. They were exposed to 3 equivalent sound levels-60-70 decibels (dB), 70-80 dB, and 80-90 dB-for 5 min in each intensity range. After the first session of baroque or heavy metal music, participants rested for an additional 5 min. Then they were exposed to the other musical style. The first style played for each musical period was randomly selected for all individuals and then the other style would be played automatically for the second session. OUTCOME MEASURES: The HRV analysis was performed using the following geometrical methods: (1) the triangular index (RRtri), (2) the triangular interpolation of the RR interval histogram (TINN), and (3) the Poincaré plot, using SD1-the standard deviation of the instantaneous variability of the beat-to beat heart rate (HR), SD2-the standard deviation of the long-term, continuous, RR interval variability, and the SD1/SD2 ratio-the ratio between the short- and long-term variations among the RR intervals. RESULTS: The classic baroque music by Johann Pachelbel, "Canon in D Major," did not induce significant changes in the geometric indices of HRV at 60-70 dB, 70-80 dB, or 80-90 dB. However, auditory stimulation with heavy metal music, using "Heavy Metal Universe" by Gamma Ray, decreased the RRtri, TINN, and SD2 at 2 specific sound pressures (60-70 dB and 80-90 dB). CONCLUSIONS: Auditory stimulation with the selected baroque music did not alter cardiac autonomic modulation, but the selected, heavy metal style of music in the lower and higher intensities reduced the global component of HRV acutely.

Oral Contraceptives Attenuate Cardiac Autonomic Responses to Musical Auditory Stimulation: Pilot Study.

CONTEXT: The literature presents contradictory results regarding the effects of contraceptives on cardiac autonomic regulation. OBJECTIVE: The research team aimed to evaluate the effects of musical auditory stimulation on cardiac autonomic regulation in women who use oral contraceptives. DESIGN: The research team designed a transversal observational pilot study. SETTING: The setting was the Centro de Estudos do Sistema Nervoso Autônomo (CESNA) in the Departamento de Fonoaudiologia at the Universidade Estadual Paulista (UNESP) in Marília, SP, Brazil. PARTICIPANTS: Participants were 22 healthy nonathletic and nonsedentary females, all nonsmokers and aged between 18 and 27 y. INTERVENTIONS: Participants were divided into 2 groups: (1) 12 women who were not taking oral contraceptives, the control group; and (2) 10 women who were taking oral contraceptives, the oral contraceptive group. In the first stage, a rest control, the women sat with their earphones turned off for 20 min. After that period, the participants were exposed to 20 min of classical baroque music (ie, "Canon in D Major," Johann Pachelbel), at 63-84 dB. OUTCOME MEASURES: Measurements of the equivalent sound levels were conducted in a soundproof room, and the intervals between consecutive heartbeats (R-R intervals) were recorded, with a sampling rate of 1000 Hz. For calculation of the linear indices, the research team used software to perform an analysis of heart rate variability (HRV). Linear indices of HRV were analyzed in the time domain: (1) the standard deviation of normal-to-normal R-R intervals (SDNN), (2) the root-mean square of differences between adjacent normal R-R intervals in a time interval (RMSSD), and (3) the percentage of adjacent R-R intervals with a difference of duration greater than 50 ms (pNN50). The study also analyzed the frequency domain-low frequency (LF), high frequency (HF), and LF/HF ratio. RESULTS: For the control group, the musical auditory stimulation reduced (1) the SDNN from 52.2 ± 10 ms to 48.4 ± 16 ms (P = .0034); (2) the RMSSD from 45.8 ± 22 ms to 41.2 ± 19 ms (P = .0128); (3) the pNN50 from 25.5 ± 19 to 22.0 ± 18 (P = .0211); and (4) the LF (ms2) from 954.8 ± 457 ms2 to 686.2 ± 491 ms2 (P = .0024). In the oral contraceptive group, no significant changes occurred for the HRV indices during exposure to music. CONCLUSIONS: Musical auditory stimulation had a greater influence on cardiac autonomic regulation in women who did not use oral contraceptives.

Evaluation of hearing protection used by police officers in the shooting range.

INTRODUCTION: Impact noise is characterized by acoustic energy peaks that last less than a second, at intervals of more than 1s. OBJECTIVE: To quantify the levels of impact noise to which police officers are exposed during activities at the shooting range and to evaluate the attenuation of the hearing protector. METHODS: Measurements were performed in the shooting range of a military police department. An SV 102 audiodosimeter (Svantek) was used to measure sound pressure levels. Two microphones were used simultaneously: one external and one insertion type; the firearm used was a 0.40 Taurus® rimless pistol. RESULTS: The values obtained with the external microphone were 146 dBC (peak), and a maximum sound level of 129.4 dBC (fast). The results obtained with the insertion microphone were 138.7 dBC (peak), and a maximum sound level of 121.6 dBC (fast). CONCLUSION: The findings showed high levels of sound pressure in the shooting range, which exceeded the maximum recommended noise (120 dBC), even when measured through the insertion microphone. Therefore, alternatives to improve the performance of hearing protection should be considered.

Evaluation of hearing protection used by police officers in the shooting range / Avaliação da proteção auditiva utilizada por policiais em estande de tiros

Introduction: Impact noise is characterized by acoustic energy peaks that last less than a second, at intervals of more than 1 s. Objective: To quantify the levels of impact noise to which police officers are exposed during activities at the shooting range and to evaluate the attenuation of the hearing protector. Methods: Measurements were performed in the shooting range of a military police department. An SV 102 audiodosimeter (Svantek) was used to measure sound pressure levels. Two microphones were used simultaneously: one external and one insertion type; the firearm used was a 0.40 Taurus® rimless pistol. Results: The values obtained with the external microphone were 146 dBC (peak), and a maximum sound level of 129.4 dBC (fast). The results obtained with the insertion microphone were 138.7dBC (peak), and a maximum sound level of 121.6 dBC (fast). Conclusion: The findings showed high levels of sound pressure in the shooting range, which exceeded the maximum recommended noise (120 dBC), even when measured through the insertion microphone. Therefore, alternatives to improve the performance of hearing protection should be considered. .

Introdução: O ruído de impacto é caracterizado por apresentar picos de energia acústica de duração inferior a um segundo, em intervalos superiores a um segundo. Objetivo: Quantificar os níveis de ruído de impacto a que o policial militar fica exposto durante atividades de tiro com armas de fogo e analisar a atenuação do protetor auricular utilizado. Método: As medições foram realizadas no estande de tiros de um Batalhão da Polícia Militar. Para a medição dos níveis de pressão sonora foi utilizado um audiodosímetro modelo SV 102 (Svantek). Foram utilizados dois microfones simultaneamente: um externo e outro tipo inserção, e a arma utilizada foi a pistola calibre 40, da marca Taurus®. Resultados: Os valores obtidos no microfone externo foram de 146 dBC (pico) e ruído máximo de 129,4 dBC (fast). Os resultados obtidos no microfone de inserção foram de 138,7 dBC (pico) e ruído máximo de 121,6 dBC (fast). Conclusão: Nossos achados evidenciaram elevados níveis de pressão sonora no estande de tiros, que ultrapassaram os limites máximos recomendados (120 dBC), mesmo em medição com microfone de inserção. Portanto, alternativas para melhorar o desempenho da proteção auditiva devem ser consideradas pela equipe de segurança da corporação. .

Testes tonais de padrão de frequência e duração no Brasil: revisão de literatura / Pitch pattern sequence and duration pattern tests in Brazil: literature review / Pitch pattern sequence and duration pattern tests in Brazil: literature review

Este estudo tem como tema o teste de padrão de frequência e de duração no Brasil e como objetivo revisar e explanar sobre a avaliação do processamento auditivo temporal no Brasil, mais especificamente sobre os testes tonais de ordenação temporal (teste de padrão de frequência e duração). Para atingir tal objetivo foi realizado um trabalho de revisão sistemática da literatura em periódicos nacionais, acessados eletronicamente na base de dado Scielo e Lilacs, sem restrição ao ano de publicação. A pesquisa foi estruturada por meio dos descritores: processamento temporal, processamento auditivo temporal, testes temporais, testes tonais de padrão de frequência e testes tonais de padrão de duração, percepção auditiva e testes auditivos. A pesquisa retornou 33 publicações nacionais sendo 28 artigos de periódicos, uma dissertação de mestrado e quatro teses de doutorado. Com isso, pode-se perceber que a utilização de testes que avaliem a habilidade de ordenação temporal no Brasil é recente, sendo notável o aumento significante das publicações nos últimos cinco anos. Desta forma, o emergente conhecimento possibilitado pelo acesso aos testes no Brasil permite ampliar um campo de pesquisa a todos os profissionais comprometidos com este tema.

This study has as a theme the pitch pattern and duration tests in Brazil and as a purpose to review and explain the temporal auditory processing evaluation in Brazil, specifically the temporal ordering tasks (pitch pattern and duration pattern tests). In order to achieve this objective was performed a systematic literature review on national journals, electronically accessed on the Scielo and Lilacs database, no restrictions related to year of publication. The research was structured using the descriptors: temporal processing, auditory temporal processing, temporal tests, pitch pattern sequence test, duration pattern test, auditory perception and auditory tests. The survey returned 33 national publications including 28 articles from journals, a master thesis and four doctoral theses. Thus, it can be seen that the use of the tests to assess the ability of temporal ordering in Brazil are recent and it’s remarkable the significant increase of publications over the last past years. The emerging knowledge in Brazil made possible by the access to the tests allows extending a research field to all professionals committed to this issue.

Neurophysiological aspects of musical auditory stimulation on the cardiovascular system / Aspectos neurofisiológicos do estímulo auditivo musical sobre o sistema cardiovascular

INTRODUCTION: The literature has shown that musical stimulation can influence the cardiovascular system, however, the neurophysiological aspects of this influence are not yet fully elucidated. OBJECTIVE: This study describes the influence of music on the neurophysiological mechanisms in the human body, specifically the variable blood pressure, as well as theneural mechanisms of music processing. METHODS: Searches were conducted in Medline, PEDro, Lilacs and SciELO using the intersection of the keyword "music" with the keyword descriptors "blood pressure" and "neurophysiology". RESULTS: There were selected 11 articles, which indicated that music interferes in some aspects of physiological variables. CONCLUSION: Studies have indicated that music interferes on the control of blood pressure, heart and respiratory rate, through possible involvement of limbic brain areas which modulate hypothalamic-pituitary functions.Further studies are needed in order to identify the mechanisms bywhich this influence occurs.

INTRODUÇÃO: A literatura já demonstrou que o estímulo musical pode influenciar o sistema cardiovascular, porém, os aspectos neurofisiológicos desta influência ainda não estão totalmente elucidados. OBJETIVO: Este estudo descreve a influência da música nos mecanismos neurofisiológicos no organismo humano, especificamente na variável pressão arterial, bem como os mecanismos neurais do processamento da música. MÉTODOS: Foram realizadas buscas nas bases Medline, PEDro, SciELO e Lilacs, utilizando o cruzamento da palavra-chave "music" com os descritores "blood pressure" e "neurophysiology". RESULTADOS: Foram selecionados 11 artigos, que indicaram que a música interfere em alguns aspectos nas variáveis fisiológicas. CONCLUSÃO: Os estudos demonstraram que a música interfere no controle da pressão arterial, frequência cardíaca e respiratória, por meio do possível envolvimento de áreas límbicas cerebrais, que modulam funções hipotálamo-hipofisárias. Mais estudos são necessários para identificar os mecanismos pelos quais essa influência ocorre.

Análise acústica em brinquedos ruidosos / Acoustics analysis of the noisy toys

OBJETIVO: analisar os níveis de ruídos emitidos por brinquedos nacionalmente comercializados, utilizados por crianças de 1 a 5 anos; comparar os valores entre os brinquedos com e sem selo do Inmetro (Instituto Nacional de Metrologia, Normalização e Qualidade Industrial) e analisar o espectro acústico dos brinquedos, com o intuito de identificar a área da cóclea que pode ser mais afetada por esses ruídos. MÉTODO: as medições foram realizadas em 20 brinquedos sonoros (10 com o selo do Inmetro e 10 sem o selo) com o uso do decibelímetro digital em sala acusticamente tratada, e a análise dos sons emitidos pelos brinquedos foi realizada por meio do programa Praat. RESULTADOS: a intensidade do ruído dos brinquedos com o selo do Inmetro posicionados a 2,5 cm do equipamento variou de 61,50 a 91,55 dB(A) e 69,75 a 95,05 dB(C) e a referente à distância de 25 cm variou entre 58,30 a 79,85 dB(A) e 62,50 a 83,65 dB(C). A intensidade do ruído dos brinquedos sem o selo do Inmetro a 2,5 cm variou entre 67,45 a 94,30 dB(A) e 65,4 a 99,50 dB(C) e na distância de 25 cm registrou desde 61,30 a 87,45 dB(A) e 63,75 a 97,60 dB(C), portanto os achados demonstraram que existem brinquedos ruidosos que ultrapassam os valores recomendados pela legislação vigente em ambos os grupos, com e sem selo do Inmetro. CONCLUSÃO: os brinquedos sem o selo do Inmetro apresentaram valores de intensidade significantemente maior em relação ao outro grupo, oferecendo maior risco à saúde auditiva das crianças.

PURPOSE: to analyze the levels of noise emitted by nationally-sold toys for use by children from 1 to 5 year old; to compare the values among the toys with and without the seal of Inmetro (National Institute of Metrology, Standardization and Industrial Quality) and to analyze the sound spectrum of toys, in order to identify the area of the cochlea that may be more affected by these noises. METHOD: measurements were performed on 20 sound toys (10 with the seal of the Inmetro and 10 without the seal) with the use of digital sound level meter in an acoustically treated room, and the sound analysis was performed using the Praat program. RESULTS: toys placed at 2.5 cm from the equipment with the seal of the Inmetro had an intensity ranging from 61.50 to 91.55 dB (A) and from 69.75 to 95.05 dB (C), positioned at 25 cm ranged from 58.3 to 79.85 dB (A) and from 62.50 to 83.65 dB (C). The results of the toys without warranty stamps placed at 2.5 cm ranged from 67.45 to 94.30 dB (A) and 65.4 to 99.50 dB (C) and the distance of 25 cm recorded from 61. 30 to 87.45 dB (A) and 63.75 to 97.60 dB (C), so that the findings demonstrated that there are noisy toys that go beyond the values recommended by the current legislation in both groups, with and without warranty stamps . CONCLUSION: the toys without the seal of Inmetro showed intensities values significantly higher than the other group, offering more risk to the children’s hearing health.

Sound pressure level in a municipal preschool

AIM: To evaluate the sound pressure level to which preschool students are exposed. METHODS: This was a prospective, quantitative, nonexperimental, and descriptive study. To achieve the aim of the study we used an audio dosimeter. The sound pressure level (SPL) measurements were obtained for 2 age based classrooms. Preschool I and II. The measurements were obtained over 4 days in 8-hour sessions, totaling 1920 minutes. RESULTS: Compared with established standards, the SPL measured ranged from 40.6 dB (A) to 105.8 dB (A). The frequency spectrum of the SPL was concentrated in the frequency range between 500 Hz and 4000 Hz. The older children produced higher SPLs than the younger ones, and the levels varied according to the activity performed. Painting and writing were the quietest activities, while free activities period and games were the noisiest. CONCLUSION: The SPLs measured at the preschool were higher and exceeded the maximum permitted level according to the reference standards. Therefore, the implementation of actions that aim to minimize the negative impact of noise in this environment is essential.

Firefighters' noise exposure: A literature review.

AIM: To review the literature about the effects of environmental noise on the hearing ability of firefighters. METHOD: The PubMed and Scielo databases were searched and studies from 2002 to 2012 that included the keywords firefighters, noise, and hearing loss were identified. Initially, 24 studies were selected, but only 10 met the inclusion criteria of investigating the effects of occupational noise on firefighters. RESULTS: Only 2 (20%) studies quantified levels of sound pressure and performed audiological tests to identify associations with noise intensity and 3 (30%) questionnaire-based studies reported that these professionals are more susceptible to hearing loss. Four (50%) studies found that noise exposure damages the auditory system in this population. DISCUSSION: These findings indicate that there is a necessity for preventive measures to be adopted by this population since it is considered to be at risk. CONCLUSION: In recent years, there have been few studies of firefighters' exposure to occupational noise, but our findings show the importance of new studies that include proper means of quantifying their exposure to noise in different work environments, in order to identify possible adverse conditions as well as to aid in the diagnosis of hearing loss.

Sound pressure level in a municipal preschool.

AIM: To evaluate the sound pressure level to which preschool students are exposed. METHOD: This was a prospective, quantitative, nonexperimental, and descriptive study. To achieve the aim of the study we used an audio dosimeter. The sound pressure level (SPL) measurements were obtained for 2 age based classrooms. Preschool I and II. The measurements were obtained over 4 days in 8-hour sessions, totaling 1920 minutes. RESULTS: Compared with established standards, the SPL measured ranged from 40.6 dB (A) to 105.8 dB (A). The frequency spectrum of the SPL was concentrated in the frequency range between 500 Hz and 4000 Hz. The older children produced higher SPLs than the younger ones, and the levels varied according to the activity performed. Painting and writing were the quietest activities, while free activities period and games were the noisiest. CONCLUSION: The SPLs measured at the preschool were higher and exceeded the maximum permitted level according to the reference standards. Therefore, the implementation of actions that aim to minimize the negative impact of noise in this environment is essential.

Relação entre os achados da avaliação audiométrica e das emissões otoacústicas em policiais militares / Relationship between the findings of pure-tone audiometry and otoacoustic emission tests on military police personnel

INTRODUÇÃO: As emissões otoacústicas podem ser uma alternativa para avaliação coclear na perda auditiva induzida por ruído (PAIR). OBJETIVO: verificar a correlação entre os achados da audiometria tonal e os resultados das emissões otoacústicas produto de distorção (EOAPD) em policiais militares. MÉTODO: a partir de estudo transversal e retrospectivo, 200 policiais militares foram submetidos à avaliação audiológica - audiometria tonal liminar e EOAPD. RESULTADOS: considerando o disposto na Portaria 19 do Ministério do Trabalho, os resultados foram sugestivos de perda auditiva induzida por níveis de pressão sonora elevados em 58 indivíduos, distribuídos da seguinte forma: 28 (48,3%) casos bilaterais e 30 (51,7%) casos unilaterais, sendo 15 (25,85%) em cada orelha. A análise de correlação entre a audiometria e as EOAPD, demonstrou significância estatística na maior parte das frequências testadas, em ambas as orelhas, confirmando que quanto maior o grau de perda auditiva, menor a amplitude das EOAPD. Além disso, foi observada existência de diferença significativa das amplitudes das EOAPD entre indivíduos normo ouvintes e portadores de perda auditiva, confirmando o rebaixamento das respostas no grupo com perda da audição. CONCLUSÃO: considerando que houve correlação entre a audiometria e o teste de EOAPD, concluímos que as emissões otoacústicas podem ser uma ferramenta complementar, para a detecção e controle de PAIR em policias militares.

INTRODUCTION: Otoacoustic emissions can be an alternative for cochlear evaluation in noise induced hearing loss (NIHL). OBJECTIVE: To investigate the correlation between the findings of audiometry results and distortion product otoacoustic emissions (DPOAE) in the military police. METHOD: from cross-sectional and retrospective study, 200 military police officers were submitted to audiological evaluation - pure tone audiometry and DPOAE. RESULTS: considering the provisions of Ordinance 19 of the Labour Department, the results were suggestive of induced hearing loss by high sound pressure levels in 58 individuals, distributed as follows: 28 (48.3%) bilateral cases and 30 (51.7%) unilateral cases, and 15 (25.85%) in each ear. The correlation between the audiometric and DPOAE showed statistical significance in most of the frequencies tested in both ears, confirming that the greater the degree of hearing loss, the smaller the DPOAE amplitudes. In addition, there was observed significant difference between the DPOAEs amplitudes of normal subjects and listeners with hearing loss, confirming the lowering of responses in the group with hearing loss. CONCLUSION: considering that the correlation between pure tone audiometry and DPOAE, we conclude that otoacoustic emissions can be a complementary tool for the detection and control of NIHL in military police.

Inserção de graduados em fonoaudiologia de uma universidade pública em programas de pós-graduação / Insertion of speech and language therapy undergraduate students, from a public university, in communication disorder graduate programs

OBJETIVO: caracterizar a inserção de egressos do Curso de Fonoaudiologia da Universidade Estadual Paulista (UNESP) - Marília, em Programas de Pós-Graduação (PPG) Stricto Sensu brasileiros. MÉTODO: foram utilizadas listas de graduados e Curriculum Vitae do egresso e do orientador. RESULTADOS: dos 537 formados, 16,57 por cento cursaram/estavam cursando PPG e destes, 98,88 por cento em mestrado e 37,08 por cento também em doutorado. Na grande área de conhecimento, 50 por cento dos egressos de mestrado vincularam-se predominantemente a programas em Ciências da Saúde, 31,80 por cento em Ciências Humanas e 13,64 por cento em Linguística, Letras e Artes. No doutorado, 33, 33 por cento em Ciências Humanas, 30,30 por cento em Ciências da Saúde e em Linguística, Letras e Artes. Quanto à área de conhecimento, predominou a vinculação, no mestrado, de 30,68 por cento em Fonoaudiologia, 28,41 por cento em Educação, 13,64 por cento em Linguística e 9,09 por cento em Medicina I; e, no doutorado, de 33,33 por cento em Educação, 30,30 por cento em Linguística e 9,09 por cento em Fonoaudiologia; 55,68 por cento dissertações e 51,52 por cento teses focalizaram a linguagem. A UNESP predominou com 39,77 por cento no mestrado e 48,48 por cento no doutorado. Predominou a vinculação a Programas com conceito 4 para 52,27 por cento dos egressos do mestrado e 45,45 por cento do doutorado. Quando constou a informação (55,68 por cento), todos receberam fomento. O Teste de Razão de Verossimilhança não indicou diferenças significativas dos percentuais obtidos entre o mestrado e o doutorado. CONCLUSÃO: os resultados superaram os apresentados para o mesmo Estado, mostraram a característica interdisciplinar da Ciência Fonoaudiológica e o predomínio de temática em linguagem.

PURPOSE: to characterize the insertion of undergraduate students from a Speech and Language Therapy Course at São Paulo State University - UNESP in Graduate Programs. METHOD: we used a list and the Curriculum Vitae of these students and their respective mentors. RESULTS: of the 537 graduates, 16.57 percent attended/were attending Graduate Programs, and of these, 98.88 percent were working at a Master Program and 37.08 percent at a Doctoral. Regarding the broad area of knowledge, 50 percent of master's students were enrolled in Health Science programs, 31.80 percent in Humanities and 13.64 percent in Linguistics. For doctoral level, 33, 33 percent were enrolled in Humanities and 30.30 percent in Health Sciences as well as in Linguistics. Regarding the knowledge specific area, 30.68 percent of Master's students were enrolled in Speech Pathology programs, 28.41 percent in Education, 13.64 percent in Linguistics and 9.09 percent in Medicine I. For doctorate level, 33.33 percent were enrolled in Education programs, 30.30 percent in Linguistics and 9.09 percent in Speech Pathology. Additionally, 55.68 percent dissertations and 51.52 percent thesis were focused on the language area. UNESP was the university that most attended: 39.77 percent and 48.48 percent students in master and doctoral programs, respectively. Among the overall students, 52.27 percent from master and 45.45 percent from doctoral levels were linked to programs with concept grade 4. When the information was available, all received scholarship. Test of Reason of Probabilities did not show significance differences between master and doctoral levels. CONCLUSION: findings were higher than previously reported for the same state, showing the highly interdisciplinary nature of the field of Communication Disorders, and the predominance of "Language" as the studied theme.

Acoustic and psychoacoustic analysis of the noise produced by the police force firearms.

UNLABELLED: Police officers are exposed to impact noise coming from firearms, which may cause irreversible injuries to the hearing system. AIM: To evaluate the noise exposure in shooting stands during gunfire exercises, to analyze the acoustic impact of the noise produced by the firearms and to associate it with tonal audiometry results. STUDY DESIGN: Cross-sectional. MATERIALS AND METHODS: To measure noise intensity we used a digital sound level meter, and the acoustic analysis was carried out by means of the oscillations and cochlear response curves provided by the praat software. 30 police officers were selected (27 males and 3 females). RESULTS: The peak level measured was 113.1 dB(C) from a .40 pistol and 116.8 dB(C) for a .38 revolver. The values obtained for oscillation and praat was 17.9 ± 0.3 Barks, corresponding to the rate of 4,120 and 4,580 Hz. Audiometry indicated greater hearing loss at 4,000Hz in 86.7% of the cases. CONCLUSION: With the acoustic analysis it was possible to show cause and effect between the main areas of energy excitation of the cochlea (praat cochlear response curve) and the frequencies of low hearing acuity.

Acoustic and psychoacoustic analysis of the noise produced by the police force firearms / Análise acústica e psicoacústica do ruído de armas utilizadas pela Polícia Militar

Police officers are exposed to impact noise coming from firearms, which may cause irreversible injuries to the hearing system. AIM: To evaluate the noise exposure in shooting stands during gunfire exercises, to analyze the acoustic impact of the noise produced by the firearms and to associate it with tonal audiometry results. STUDY DESIGN: Cross-sectional. MATERIALS AND METHODS: To measure noise intensity we used a digital sound level meter, and the acoustic analysis was carried out by means of the oscillations and cochlear response curves provided by the praat software. 30 police officers were selected (27 males and 3 females). RESULTS: The peak level measured was 113.1 dB(C) from a .40 pistol and 116.8 dB(C) for a .38 revolver. The values obtained for oscillation and praat was 17.9±0.3 Barks, corresponding to the rate of 4,120 and 4,580 Hz. Audiometry indicated greater hearing loss at 4,000Hz in 86.7 percent of the cases. CONCLUSION: With the acoustic analysis it was possible to show cause and effect between the main areas of energy excitation of the cochlea (praat cochlear response curve) and the frequencies of low hearing acuity.

Os policiais militares estão expostos a ruídos de impacto provenientes de armas de fogo, os quais são capazes de causar lesões irreversíveis ao sistema auditivo. OBJETIVO: Avaliar a exposição ao ruído no estande de tiros durante os exercícios de tiro, analisar acusticamente o ruído de impacto e relacioná-lo com os resultados de audiometria tonal. FORMA DE ESTUDO: Transversal. MATERIAL E MÉTODO: A medição do ruído foi feita por meio de decibelímetro digital e a análise acústica foi feita no software Praat, levantando as curvas de oscilograma e cocleograma. Foi selecionada uma amostra de 30 policiais militares (27 masculinos e 3 femininos). RESULTADOS: Os picos máximos medidos no estante de tiros foram de 113,1 dB(C) para pistola .40 e 116,8 dB(C) para revólver .38. Os valores obtidos por meio da relação entre o oscilograma temporal e cocleograma Praat ficaram entre 17,9±0,3 Barks, correspondendo à faixa entre 4120 e 4580 Hz. As medidas da audiometria indicaram maior perda auditiva na faixa de 4000Hz em 86,7 por cento dos casos. CONCLUSÃO: A partir da análise acústica dos tiros, foi possível demonstrar causa e efeito entre as principais áreas de excitação de energia na cóclea (cocleograma Praat) e as frequências com diminuição de acuidade auditiva.

Perfil audiológico em policiais militares do estado de São Paulo / Audiology profile in the military police state of São Paulo

Introdução: Os policiais militares constituem uma população exposta a ruído de impacto devido aos treinamentos com armas de fogo. Objetivo: Pesquisar o perfil audiológico em policiais militares do estado de São Paulo, e correlacionar à idade e o tempo de exposição com os achados audiológicos. Método: Neste estudo de série de casos, transversal, foi realizada avaliação audiológica em 200 policiais militares sendo 169 (84,5%) do gênero masculino e 31 (15,5%) do feminino, com idades entre 25 e 45 anos (média de 38,83±5,05), com média de tempo de serviço de 16,80±6,27 anos. Resultados: As principais queixas apontadas foram: zumbido (n= 52 / 26%), disacusia (n=36 / 18%), plenitude auricular (n=24 / 12%) e autofonia (n=24 / 12%). Na imitanciometria foram encontradas 100% de curvas tipo A (JERGER, 1970), e houve presença de recrutamento em 20 (10%) casos. Segundo os resultados da audiometria tonal, os dados obtidos demonstraram que 54 (27%) orelhas direita e 56 (28%) orelhas esquerda apresentaram perda auditiva. Os graus de perda com maior ocorrência foram 1 e 2 (MERLUZZI et al., 1979), com 85 (42,5%) casos. Houve correlação significativa entre a idade e o tempo de exposição com a piora dos limiares audiométricos em ambas as orelhas. Conclusão: A partir da análise dos dados audiológicos foi possível verificar que os policiais militares são uma população que apresenta risco para desenvolver a perda auditiva. Sendo assim, vemos a necessidade de implementação de programa de conservação auditiva para os policiais militares...

Introduction: The military police are a population exposed to noise impact due to training with firearms. Objective: To investigate the audiological profile of the military police in São Paulo state, and to correlate the age and duration of exposure and audiological findings. Method: In this study of case series, cross-sectional audiological evaluation was performed in 200 police officers being 169 (84.5%) were male and 31 (15.5%) females, aged between 25 and 45 years (mean 38.83 ± 5.05), average service time of 16.80 ± 6.27 years. Results: The main complains were: tinnitus (n=52/26%), hearing loss (n=36/18%), ear fullness (n=24/12%) and autophonia (n=24/12%). Impedance were found in 100% of type A curves (JERGER, 1970), and recruitment was present in 20 (10%) cases. According to the results of audiometry, the data showed that 54 (27%) right ears and 56 (28%) left ears had hearing loss. The degree of loss with higher prevalence was 1 and 2 (MERLUZZI et al., 1979), 85 (42.5%) cases. There was significant correlation between age and exposure time with the worsening of audiometric thresholds in both ears. Conclusion: From the audiological data analysis was possible that the military police are a population that presents a risk to develop hearing loss. Thus, we see the need for implementation of hearing conservation program for the military police...

Audiological evaluation in workers exposed to noise and pesticide.

UNLABELLED: Noise-induced hearing loss has been studied for many years and today many experts also investigate the synergic action of chemical products, since they can be potentially ototoxic. AIM: to investigate the audiological findings in workers exposed to occupational noise and pesticide and to compare it to data from noise-exposed workers. STUDY DESIGN: Clinical retrospective. MATERIAL AND METHOD: individuals that had been exposed to pesticide and noise (group I), and individuals that had been exposed to noise only (group II). RESULTS: The classification of the audiometric findings showed in that group I: 35% had normal hearing thresholds, 53.75% had degree 1 hearing loss and 11.25% had degree 2 hearing loss; and group II had 57.5% of normal hearing, 40% had degree 1 hearing loss and only 2.5% had degree 2 hearing loss. The analysis of the audiometric findings also showed a significant worsening after comparing groups I and II thresholds, in the frequency of 3 kHz on the left ear and 4 kHz on both ears. CONCLUSION: The analysis showed that group I had worse audiometric thresholds compared to group II.

Avaliação audiológica em trabalhadores expostos a ruído e praguicida / Audiological evaluation in workers exposed to noise and pesticide

A perda auditiva induzida por ruído é estudada há muitos anos, e atualmente a literatura especializada estuda também a ação sinérgica dos produtos químicos, uma vez que eles podem ser potencialmente ototóxicos. OBJETIVO: Pesquisar os achados audiológicos em trabalhadores expostos ao ruído ocupacional e a praguicidas e comparar com os dados obtidos em trabalhadores expostos ao ruído. FORMA DE ESTUDO: Clínico retrospectivo. MATERIAL E MÉTODO: Foram analisados os prontuários de indivíduos que foram expostos ao praguicida e ao ruído (grupo I), e indivíduos que foram somente expostos ao ruído (grupo II). RESULTADOS: A classificação dos achados audiométricos revelou para o grupo I: 35 por cento orelhas normais, 53,75 por cento com perda auditiva de grau 1 e 11,25 por cento com perda de grau 2. Enquanto que o grupo II apresentou 57,5 por cento de orelhas normais, 40 por cento com perda auditiva de grau 1 e apenas 2,5 por cento com perda de grau 2. A análise dos achados audiométricos demonstrou também uma piora significativa após a comparação entre os limiares do grupo I e grupo II, na frequência de 3 kHz orelha esquerda e na frequência de 4kHz em ambas as orelhas. CONCLUSÃO: A análise mostrou que o grupo I tem limiares audiométricos piores comparado ao grupo II.

Noise-induced hearing loss has been studied for many years and today many experts also investigate the synergic action of chemical products, since they can be potentially ototoxic. AIM: to investigate the audiological findings in workers exposed to occupational noise and pesticide and to compare it to data from noise-exposed workers. STUDY DESIGN: Clinical retrospective. MATERIAL AND METHOD: individuals that had been exposed to pesticide and noise (group I), and individuals that had been exposed to noise only (group II). RESULTS: The classification of the audiometric findings showed in that group I: 35 percent had normal hearing thresholds, 53.75 percent had degree 1 hearing loss and 11.25 percent had degree 2 hearing loss; and group II had 57.5 percent of normal hearing, 40 percent had degree 1 hearing loss and only 2.5 percent had degree 2 hearing loss. The analysis of the audiometric findings also showed a significant worsening after comparing groups I and II thresholds, in the frequency of 3 kHz on the left ear and 4 kHz on both ears. CONCLUSION: The analysis showed that group I had worse audiometric thresholds compared to group II.

Hearing loss in patients with diabetes mellitus.

UNLABELLED: The relationship between diabetes mellitus and hearing loss is described as 'controversial' in the literature, given that in the clinical realm many patients present dysacusis while others do not. AIM: this study aims to investigate the relationship between hearing loss and diabetes mellitus and add to the knowledge being developed in this area. STUDY DESIGN: cross-sectional clinical trial. MATERIALS AND METHOD: in our study we analyzed the medical charts of 50 adult patients of both genders, aged above 45 years, and diagnosed with diabetes mellitus, seen in our institution in 2006 and 2007, and compared them to the charts of 50 metabolic disease-free individuals. RESULTS: this study found statistically significant worse audiometric thresholds among patients with diabetes mellitus when compared to patients in the control group. CONCLUSION: the results identified in this study point to a correlation between hearing loss and diabetes mellitus. This possibility should therefore be further investigated by health care workers providing care to patients with diabetes mellitus, in the form of closer follow-up on the auditory health of this patient group.