Translation and cross-cultural adaptation of the Noise Exposure Questionnaire (NEQ) to Brazilian Portuguese. / Tradução e adaptação transcultural do Noise Exposure Questionnaire (NEQ) para o português brasileiro.

OBJECTIVE: To translate and cross-culturally adapt the Noise Exposure Questionnaire (NEQ) and 1-Minute Noise Screen (NEQ-S) instruments to Brazilian Portuguese. METHODS: Procedures widely known in health research were used in the translation and cross-cultural adaptation process, comprising the following steps: initial translation, synthesis of translations, back-translation, expert committee, pretest, and content and layout validation. Altogether, 60 workers participated in the pretest by answering the questionnaires and then evaluating them in terms of understandability, layout, clarity, and writing. Reliability was verified with Cohen's kappa test, and the internal consistency was analyzed with Cronbach's alpha coefficient. RESULTS: The translated and adapted versions of NEQ and NEQ-S were similar in terms of general and referential meanings. However, some modifications and adaptations were made to adapt them to the Brazilian reality. The kappa test indicated moderate agreement and Cronbach's alpha coefficient, substantial internal consistency. CONCLUSION: The translation and cross-cultural adaptation were carried out according to the methodology recommended in the national and international literature, performing the necessary equivalences to maintain the face and content validity with the original instrument. The availability of NEQ and NEQ-S in Brazilian Portuguese opens new fields of research to quantify yearly noise exposure more in-depth.

OBJETIVO: Traduzir e realizar a adaptação transcultural dos instrumentos Noise Exposure Questionnaire (NEQ) e 1-Minute Noise Screen (NEQ-S) para a versão em português brasileiro. MÉTODO: O processo de tradução e adaptação transcultural seguiu procedimentos amplamente utilizados em pesquisas da área da saúde, compostos pelas seguintes etapas: tradução inicial, síntese das traduções, retrotradução, comitê de especialistas, pré-teste, e validação do conteúdo e aparência. Na etapa de pré-teste, participaram 60 trabalhadores, que responderam aos questionários e, posteriormente, os avaliaram quanto ao: entendimento, aparência, clareza e escrita. Para a verificação da confiabilidade, foi utilizado o teste kappa de Cohen e para a análise da consistência interna foi aplicado o coeficiente alfa de Cronbach. RESULTADOS: As versões traduzidas e adaptadas dos questionários NEQ e NEQ-S mostraram-se semelhantes em relação ao significado geral e referencial. Entretanto, algumas modificações e adaptações foram realizadas, para adequação à realidade brasileira. O teste kappa indicou concordância moderada e o coeficiente alfa de Cronbach, consistência interna substancial. CONCLUSÃO: A tradução e a adaptação transcultural foram realizadas de acordo com a metodologia preconizada na literatura nacional e internacional, incluindo-se as equivalências necessárias para a manutenção da validade de face e conteúdo com o instrumento original. A disponibilização dos questionários NEQ e NEQ-S na versão da língua portuguesa brasileira abre novos campos de pesquisa para aprofundamento da quantificação de exposição anual ao ruído.

Tradução e adaptação transcultural do Noise Exposure Questionnaire (NEQ) para o português brasileiro / Translation and cross-cultural adaptation of the Noise Exposure Questionnaire (NEQ) to Brazilian Portuguese

RESUMO Objetivo Traduzir e realizar a adaptação transcultural dos instrumentos Noise Exposure Questionnaire (NEQ) e 1-Minute Noise Screen (NEQ-S) para a versão em português brasileiro. Método O processo de tradução e adaptação transcultural seguiu procedimentos amplamente utilizados em pesquisas da área da saúde, compostos pelas seguintes etapas: tradução inicial, síntese das traduções, retrotradução, comitê de especialistas, pré-teste, e validação do conteúdo e aparência. Na etapa de pré-teste, participaram 60 trabalhadores, que responderam aos questionários e, posteriormente, os avaliaram quanto ao: entendimento, aparência, clareza e escrita. Para a verificação da confiabilidade, foi utilizado o teste kappa de Cohen e para a análise da consistência interna foi aplicado o coeficiente alfa de Cronbach. Resultados As versões traduzidas e adaptadas dos questionários NEQ e NEQ-S mostraram-se semelhantes em relação ao significado geral e referencial. Entretanto, algumas modificações e adaptações foram realizadas, para adequação à realidade brasileira. O teste kappa indicou concordância moderada e o coeficiente alfa de Cronbach, consistência interna substancial. Conclusão A tradução e a adaptação transcultural foram realizadas de acordo com a metodologia preconizada na literatura nacional e internacional, incluindo-se as equivalências necessárias para a manutenção da validade de face e conteúdo com o instrumento original. A disponibilização dos questionários NEQ e NEQ-S na versão da língua portuguesa brasileira abre novos campos de pesquisa para aprofundamento da quantificação de exposição anual ao ruído.

ABSTRACT Objective To translate and cross-culturally adapt the Noise Exposure Questionnaire (NEQ) and 1-Minute Noise Screen (NEQ-S) instruments to Brazilian Portuguese. Methods Procedures widely known in health research were used in the translation and cross-cultural adaptation process, comprising the following steps: initial translation, synthesis of translations, back-translation, expert committee, pretest, and content and layout validation. Altogether, 60 workers participated in the pretest by answering the questionnaires and then evaluating them in terms of understandability, layout, clarity, and writing. Reliability was verified with Cohen's kappa test, and the internal consistency was analyzed with Cronbach's alpha coefficient. Results The translated and adapted versions of NEQ and NEQ-S were similar in terms of general and referential meanings. However, some modifications and adaptations were made to adapt them to the Brazilian reality. The kappa test indicated moderate agreement and Cronbach's alpha coefficient, substantial internal consistency. Conclusion The translation and cross-cultural adaptation were carried out according to the methodology recommended in the national and international literature, performing the necessary equivalences to maintain the face and content validity with the original instrument. The availability of NEQ and NEQ-S in Brazilian Portuguese opens new fields of research to quantify yearly noise exposure more in-depth.

ELSA-Brasil: a 4-year incidence of hearing loss in adults with and without hypertension.

OBJECTIVE: To compare the incidence of hearing loss among adults stratified by the occurrence of hypertension, and to investigate the association between hypertension and hearing loss. METHODS: Longitudinal observational study, part of the Estudo Longitudinal da Saúde do Adulto (ELSA-Brasil, Longitudinal Study on Adult's Health). Data from the first and second waves were analyzed, including information from audiological assessment and general health of the subjects. As outcome, we considered the presence of hearing loss (hearing thresholds above 25 dBHL at frequencies from 500 Hz to 8 kHz) and, as exposure variable, hypertension (report of medical diagnosis of hypertension; and/or use of drugs to treat hypertension; and/or pressure systolic blood pressure ≥ 140 mmHg; or diastolic blood pressure ≥ 90 mmHg). As covariables for adjustment were considered: sex, age, education, race / ethnicity, income, smoking, diabetes, and occupational exposure to noise. Poisson regression analysis was conducted, estimating the crude and adjusted relative risks, with 95% confidence intervals, in order to assess the factors associated with hearing loss. RESULTS: In crude analyses, the incidence of hearing loss was higher for subjects with hypertension (9.7% versus 5.4%). The crude relative risks for hearing loss was almost double (1.93; 95%CI: 1.10-3.39) for subjects with hypertension in the right ear. In the adjusted analyses, the relative risks was not significant for the hypertension variable (1.42; 95%CI: 0.75-2.67). Being 60 years or older (RR: 5.41; 95%CI: 2.79-10.50) showed a statistically significant association with hearing loss, indicating that older adults have higher relative risks for hearing loss. CONCLUSION: In the adjusted analyses controlled for multiple risk factors there was no association between hypertension and hearing loss. The dichotomous variable age (being 60 years or older), on the other hand, has shown a significant association with hearing loss.

Noise Exposure, Headsets, and Auditory and Nonauditory Symptoms in Call Center Operators.

PURPOSE: This study evaluates the exposure of call center operators (CCOs) to occupational noise, its association with auditory and nonauditory symptoms, and the feasibility of monaural and binaural headsets. METHOD: We measured the noise exposure sound pressure levels (SPLs) with the microphone-in-real-ear technique and administered a questionnaire on auditory/nonauditory symptoms and headset preference. RESULTS: We assessed 79 CCOs with normal hearing. Overall, 98.7% of the participants reported at least one auditory symptom, and 88.6% reported at least one nonauditory symptom after using the headset. We found significant associations between the headset volume setting and the number of auditory and nonauditory symptoms and between sharp increases in sound level and tinnitus. The microphone-in-real-ear diffuse-field-related SPLs with monaural headsets (85.5 dBA) were significantly higher than those with binaural headsets (83.1 dBA). Binaural headsets were the preference of 84.8% of the subjects. The SPLs of the binaural headsets were significantly lower than those of the monaural headsets in the subjects who preferred the binaural headsets. CONCLUSIONS: CCOs with normal hearing reported auditory and nonauditory symptoms, highlighting the need for attention and further investigation. The binaural headsets were preferable, as they were associated with a lower SPL and a higher call quality. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.18361463.

ELSA-Brasil: a 4-year incidence of hearing loss in adults with and without hypertension

ABSTRACT OBJECTIVE To compare the incidence of hearing loss among adults stratified by the occurrence of hypertension, and to investigate the association between hypertension and hearing loss. METHODS Longitudinal observational study, part of the Estudo Longitudinal da Saúde do Adulto (ELSA-Brasil, Longitudinal Study on Adult's Health). Data from the first and second waves were analyzed, including information from audiological assessment and general health of the subjects. As outcome, we considered the presence of hearing loss (hearing thresholds above 25 dBHL at frequencies from 500 Hz to 8 kHz) and, as exposure variable, hypertension (report of medical diagnosis of hypertension; and/or use of drugs to treat hypertension; and/or pressure systolic blood pressure ≥ 140 mmHg; or diastolic blood pressure ≥ 90 mmHg). As covariables for adjustment were considered: sex, age, education, race / ethnicity, income, smoking, diabetes, and occupational exposure to noise. Poisson regression analysis was conducted, estimating the crude and adjusted relative risks, with 95% confidence intervals, in order to assess the factors associated with hearing loss. RESULTS In crude analyses, the incidence of hearing loss was higher for subjects with hypertension (9.7% versus 5.4%). The crude relative risks for hearing loss was almost double (1.93; 95%CI: 1.10-3.39) for subjects with hypertension in the right ear. In the adjusted analyses, the relative risks was not significant for the hypertension variable (1.42; 95%CI: 0.75-2.67). Being 60 years or older (RR: 5.41; 95%CI: 2.79-10.50) showed a statistically significant association with hearing loss, indicating that older adults have higher relative risks for hearing loss. CONCLUSION In the adjusted analyses controlled for multiple risk factors there was no association between hypertension and hearing loss. The dichotomous variable age (being 60 years or older), on the other hand, has shown a significant association with hearing loss.

Hearing loss, tinnitus, and hypertension: analysis of the baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

OBJECTIVES: To investigate the association among hypertension, tinnitus, and sensorineural hearing loss and evaluate the influence of other covariates on this association. METHODS: Baseline data (2008-2010) from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) were analyzed. Altogether, 900 participants were evaluated. The baseline assessment consisted of a 7-hour examination to obtain clinical and laboratory variables. Hearing was measured using pure-tone audiometry. RESULTS: Overall, 33.3% of the participants had hypertension. Participants with hypertension were more likely to be older, male, and diabetic compared to those without hypertension. The prevalence of tinnitus was higher among hypertensive participants and the odds ratio for tinnitus was higher in participants with hypertension than in those without hypertension. However, the difference was not significant after adjusting for age. Audiometric results at 250-8,000 Hz were worse in participants with hypertension than in those without hypertension in the crude analysis; however, the differences were not significant after adjustment for age, sex, diagnosis of diabetes, and exposure to noise. No significant difference was observed in hearing thresholds among participants having hypertension for <6 years, those having hypertension for ≥6 years, and individuals without hypertension. CONCLUSION: Hearing thresholds were worse in participants with hypertension. However, after adjusting for age, sex, diagnosis of diabetes, and exposure to noise, no significant differences were observed between participants with and without hypertension. A higher prevalence of tinnitus was observed in participants with hypertension compared to those without hypertension, but without significance after adjusting for age.

Hearing loss, tinnitus, and hypertension: analysis of the baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

OBJECTIVES: To investigate the association among hypertension, tinnitus, and sensorineural hearing loss and evaluate the influence of other covariates on this association. METHODS: Baseline data (2008-2010) from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) were analyzed. Altogether, 900 participants were evaluated. The baseline assessment consisted of a 7-hour examination to obtain clinical and laboratory variables. Hearing was measured using pure-tone audiometry. RESULTS: Overall, 33.3% of the participants had hypertension. Participants with hypertension were more likely to be older, male, and diabetic compared to those without hypertension. The prevalence of tinnitus was higher among hypertensive participants and the odds ratio for tinnitus was higher in participants with hypertension than in those without hypertension. However, the difference was not significant after adjusting for age. Audiometric results at 250-8,000 Hz were worse in participants with hypertension than in those without hypertension in the crude analysis; however, the differences were not significant after adjustment for age, sex, diagnosis of diabetes, and exposure to noise. No significant difference was observed in hearing thresholds among participants having hypertension for <6 years, those having hypertension for ≥6 years, and individuals without hypertension. CONCLUSION: Hearing thresholds were worse in participants with hypertension. However, after adjusting for age, sex, diagnosis of diabetes, and exposure to noise, no significant differences were observed between participants with and without hypertension. A higher prevalence of tinnitus was observed in participants with hypertension compared to those without hypertension, but without significance after adjusting for age.

Training in the proper use of earplugs: An objective evaluation.

BACKGROUND: Discrepancies between attenuation obtained in the laboratory and the field are caused by several factors associated with hearing protection devices (HPDs). The effects of some factors can be minimized with proper training provided to HPD users. OBJECTIVE: To evaluate the effectiveness of an educational intervention for improving the correct use of earplugs as HPDs in workers exposed to occupational noise by using the F-MIRE method and by comparing pre- and post-training attenuation values and pass/fail rates. METHODOLOGY: The personal attenuation ratings (PARs) of two types of earplugs were obtained (140 individuals) using E-A-Rfit™ equipment. Each HPD was evaluated under two scenarios: first after the user only read the packaging instructions, and then after the user read guidelines and participated in a training program. The results obtained were automatically classified by the software as "Approved" or "Failed". RESULTS: There was a significant post-training increase in the binaural PAR values for both HPDs. The percentages of passes pre- and post-training showed that training users in the proper fit of the HPD was effective; both types had statistically significant differences. CONCLUSION: This study found a statistically significant increase in PARs and the number of workers passing evaluations after HPD fit training, demonstrating the effectiveness of this educational intervention.

Longitudinal evaluation of a hearing protector fit training program.

OBJECTIVE: The present study evaluates a training program for fitting different hearing protection devices (HPDs) based on personal attenuation rating (PAR) before, immediately after, and six months after training. METHODS: A total of 67 workers from a public university in the city of São Paulo, Brazil, were invited to participate in the measurement of PARs for foam and silicone protectors through the 3M™ E-A-Rfit Validation System. Two evaluations were performed for each protector at each sampling date: one after reading printed material (the package instructions) and another after being trained by an audiologist. The same procedures were repeated after six months. The final sample consisted of 30 individuals. ANOVA was used for statistical analysis. RESULTS: Larger PAR values ​​were observed after training by the audiologist, and smaller values ​​were observed after six months. Then, after re-training, the values increased again. There were no statistically significant differences in PAR among the HPDs tested. Even after the two training sessions, 23 to 27% of the subjects did not obtain adequate PAR values. CONCLUSION: These findings emphasize the need for continual worker training in the correct fit of earplug HPDs and the importance of longitudinal PAR monitoring. In addition, some workers, despite the training provided, did not adapt to the HPDs used. Therefore, it is essential that other protection methods and/or other HPD types are made available to these individuals.

Effects of diabetes mellitus and systemic arterial hypertension on elderly patients' hearing / Effects of diabetes mellitus and systemic arterial hypertension on elderly patients' hearing

Abstract Introduction: Chronic diseases can act as an accelerating factor in the auditory system degeneration. Studies on the association between presbycusis and diabetes mellitus and systemic arterial hypertension have shown controversial conclusions. Objective: To compare the initial audiometry (A1) with a subsequent audiometry (A2) performed after a 3 to 4-year interval in a population of elderly patients with diabetes mellitus and/or systemic arterial hypertension, to verify whether hearing loss in these groups is more accelerated when compared to controls without these clinical conditions. Methods: 100 elderly individuals participated in this study. For the auditory threshold assessment, a previous complete audiological evaluation (A1) and a new audiological evaluation (A2) performed 3-4 years after the first one was utilized. The participants were divided into four groups: 20 individuals in the diabetes mellitus group, 20 individuals in the systemic arterial hypertension group, 20 individuals in the diabetes mellitus/systemic arterial hypertension group and 40 individuals in the control group, matching them with each study group, according to age and gender. ANOVA and Kruskal-Wallis statistical tests were used, with a significance level set at 0.05. Results: When comparing the mean annual increase in the auditory thresholds of the A1 with the A2 assessment, considering each study group and its respective control, it can be observed that there was no statistically significant difference for any of the frequencies for the diabetes mellitus group; for the systemic arterial hypertension group, significant differences were observed after 4 kHz. For the diabetes mellitus and systemic arterial hypertension group, significant differences were observed at the frequencies of 500, 2 kHz, 3 kHz and 8 kHz. Conclusion: It was observed that the systemic arterial hypertension group showed the greatest decrease in auditory thresholds in the studied segment when compared to the other groups, suggesting that among the three studied conditions, hypertension seems to have the greatest influence on hearing.

Resumo: Introdução: Doenças crônicas podem atuar como fator de aceleração na degeneração do sistema auditivo. Os estudos sobre a associação da presbiacusia com o diabetes mellitus e com a hipertensão arterial sistêmica mostraram conclusões controversas. Objetivo: Comparar a audiometria inicial (A1) com uma audiometria sequencial (A2) feita com um intervalo de três a quatro anos em uma população de idosos portadores de diabetes mellitus e/ou hipertensão arterial sistêmica, a fim de saber se a perda de acuidade auditiva nesses grupos é mais acelerada comparados com controles sem essas condições clínicas. Método: Participaram deste estudo 100 idosos. Para a análise dos limiares auditivos, foram usadas: uma avaliação audiológica completa feita anteriormente (A1) e uma nova avaliação audiológica (A2) feita após três a quatro anos da primeira. Os participantes foram distribuídos em quatro grupos: 20 indivíduos no grupo com diabetes mellitus, 20 no grupo hipertensão arterial sistêmica, 20 no grupo diabetes mellitus/hipertensão arterial sistêmica e 40 indivíduos no grupo controle, foram pareados com cada grupo de estudo, de acordo com as características referentes a idade e sexo. Foram usados os testes estatísticos Anova e Kruskal-Wallis, com nível de significância de 0,05. Resultados: Na comparação da média de aumento anual dos limiares auditivos da avaliação A1 com a avaliação A2, considerando cada grupo estudo e seu respectivo controle, pode-se observar que para o grupo diabetes mellitus não houve diferença estatisticamente significante para qualquer das frequências; para o grupo hipertensão arterial sistêmica foram observadas diferenças significantes a partir de 4 kHz. Já para o grupo diabetes mellitus/hipertensão arterial sistêmica foram observadas diferenças significantes nas frequências de 500, 2k, 3k e 8 kHz. Conclusão: Verificou-se que o grupo hipertensão arterial sistêmica foi o que apresentou maior queda dos limiares auditivos no segmento estudado, quando comparado com os outros grupos, sugeriu que entre as três condições estudadas a hipertensão parece ser a que teve maior influência sobre a audição.

Effects of a vestibular rehabilitation program on workers in the working environment: a pilot study / Efeitos de um programa de reabilitação vestibular em trabalhadores no ambiente de trabalho: estudo piloto

ABSTRACT Objective: to verify the effect of a vestibular rehabilitation program on workers with dizziness from the Division of Nutrition and Dietetics at a University Hospital. Methods: a total of 13 employees between 42 and 65 years of age participated, of whom, 1 was male, and 12, females. They were evaluated before and after the vestibular rehabilitation program using the Dizziness Handicap Inventory, Work Ability Index and Visual Analog Scale. The program was conducted in groups at the workplace. Statistical analysis was performed using the analysis of variance test for paired factors and the chi-square test. Results: in the pre- and post-vestibular rehabilitation comparison, significant differences were found in the Dizziness Handicap Inventory and Visual Analogue Scale scores. In the qualitative analysis of the Work Ability Index, an increase was observed in the number of workers who considered their ability to work to have improved. Conclusion: vestibular rehabilitation conducted in groups and in the working environment was effective in improving dizziness complaint in workers at the Division of Nutrition and Dietetics. It is believed that the positive experience of this program may be extended to other areas.

RESUMO Objetivo:verificar o efeito de um programa de reabilitação vestibular em trabalhadores com tonturas da Divisão de Nutrição e Dietética de um Hospital Universitário. Métodos: participaram 13 trabalhadores, um do sexo masculino e 12 do feminino, com idades entre 42 e 65 anos. Todos foram avaliados pré e pós programa de reabilitação vestibular por meio do Dizziness Handicap Inventory, Índice de Capacidade para o Trabalho e Escala Visual Analógica. O programa foi realizado em grupos no local de trabalho. Na análise estatística foram utilizados o teste análise de variância para um fator pareado e o Qui-quadrado. Resultados: na comparação pré e pós reabilitação vestibular foram verificadas diferenças significantes na pontuação do Dizziness Handicap Inventory e da Escala Visual Analógica. Na análise qualitativa do Índice de Capacidade para o Trabalho observou-se aumento do número de trabalhadores que passaram a considerar melhor sua capacidade para o trabalho. Conclusão: a reabilitação vestibular realizada em grupos e no próprio ambiente de trabalho mostrou-se efetiva para a melhora na queixa de tontura nos trabalhadores da Divisão de Nutrição e Dietética. Acredita-se que a experiência positiva deste programa possa ser estendida para outros setores.

Effects of diabetes mellitus and systemic arterial hypertension on elderly patients' hearing.

INTRODUCTION: Chronic diseases can act as an accelerating factor in the auditory system degeneration. Studies on the association between presbycusis and diabetes mellitus and systemic arterial hypertension have shown controversial conclusions. OBJECTIVE: To compare the initial audiometry (A1) with a subsequent audiometry (A2) performed after a 3 to 4-year interval in a population of elderly patients with diabetes mellitus and/or systemic arterial hypertension, to verify whether hearing loss in these groups is more accelerated when compared to controls without these clinical conditions. METHODS: 100 elderly individuals participated in this study. For the auditory threshold assessment, a previous complete audiological evaluation (A1) and a new audiological evaluation (A2) performed 3-4 years after the first one was utilized. The participants were divided into four groups: 20 individuals in the diabetes mellitus group, 20 individuals in the systemic arterial hypertension group, 20 individuals in the diabetes mellitus/systemic arterial hypertension group and 40 individuals in the control group, matching them with each study group, according to age and gender. ANOVA and Kruskal-Wallis statistical tests were used, with a significance level set at 0.05. RESULTS: When comparing the mean annual increase in the auditory thresholds of the A1 with the A2 assessment, considering each study group and its respective control, it can be observed that there was no statistically significant difference for any of the frequencies for the diabetes mellitus group; for the systemic arterial hypertension group, significant differences were observed after 4kHz. For the diabetes mellitus and systemic arterial hypertension group, significant differences were observed at the frequencies of 500, 2kHz, 3kHz and 8kHz. CONCLUSION: It was observed that the systemic arterial hypertension group showed the greatest decrease in auditory thresholds in the studied segment when compared to the other groups, suggesting that among the three studied conditions, hypertension seems to have the greatest influence on hearing.

Analysis of possible factors of vocal interference during the teaching activity.

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

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

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

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

Evaluation of the hearing protector in a real work situation using the field-microphone-in-real-ear method. / Avaliação do protetor auditivo em situação real de trabalho pelo método field Microphone-in-real-ear.

Purpose To evaluate the effectiveness of the attenuation of a hearing protector (HP) in a real work situation using the field-microphone-in-real-ear method (f-MIRE). Methods Eighteen individuals of both genders (mean age of 47.17±8 years) participated in this study. In the workplace, the personal attenuation level of the HP was assessed using the f-MIRE method, followed by orientation about the importance of using the HP, cleaning and storing the device, and training for effective placement. Results The analyses showed a significant statistic attenuation for all of the collected data (total noise, by frequency band and dose) when the noise levels in the lapel microphone and the probe microphone were compared. In the comparison of the attenuation values provided by the manufacturer and those found in this study, we observed higher values for the manufacturer in all frequency bands. No difference was observed for the noise levels in the different activities and times evaluated. Conclusion The findings of this study enabled us to know the personal level of attenuation of the HP during a real work situation, which was within the limits of tolerance. It was also possible to collect information about the environmental noise to which these workers are exposed. We noticed situations where this level exceeded the safety values, and therefore it is recommended the use of the HP. It is important that more studies are conducted using the f-MIRE method, because it may be an ally to assess the effectiveness of the HP attenuation in the workplace.

Avaliação do protetor auditivo em situação real de trabalho pelo método field Microphone-in-real-ear / Evaluation of the hearing protector in a real work situation using the field-microphone-in-real-ear method

RESUMO Objetivo Avaliar a eficácia da atenuação de um protetor auditivo em uma situação real de trabalho utilizando o método f-Microphone-in-real-ear (f-MIRE). Métodos Participaram 18 indivíduos, de ambos os gêneros (média de idade 47,17±8 anos). No local de trabalho, foi realizada a avaliação do nível pessoal de atenuação do Protetor Auditivo (PA) pelo método Field Microphone-in-Real-Ear (f-MIRE), seguido por orientações sobre a importância do uso do PA, higienização, armazenamento e treinamento para sua colocação efetiva. Resultados As análises mostraram que houve atenuação estatisticamente significante para todos os dados coletados (ruído total, por banda de frequência e dose) quando comparados os níveis de ruído no microfone lapela e no microfone sonda. Na comparação entre os valores de atenuação fornecidos pelo fabricante e os encontrados neste estudo, observou-se valores maiores para o fabricante em todas as bandas de frequência. Não houve diferença para os níveis de ruído nas diferentes atividades e horários avaliados. Conclusão Os achados do presente estudo possibilitaram conhecer o nível pessoal de atenuação do protetor auditivo durante uma situação real de trabalho, que estava dentro dos limites de tolerância. Também foi possível coletar informações sobre o ruído do ambiente em que esses trabalhadores estão expostos, onde observamos situações nas quais esse nível ultrapassava os valores de segurança, sendo assim recomendável o uso do PA. É importante que mais estudos sejam realizados utilizando o método f-MIRE, pois pode ser um aliado para avaliar a eficácia da atenuação do PA no local de trabalho.

ABSTRACT Purpose To evaluate the effectiveness of the attenuation of a hearing protector (HP) in a real work situation using the field-microphone-in-real-ear method (f-MIRE). Methods Eighteen individuals of both genders (mean age of 47.17±8 years) participated in this study. In the workplace, the personal attenuation level of the HP was assessed using the f-MIRE method, followed by orientation about the importance of using the HP, cleaning and storing the device, and training for effective placement. Results The analyses showed a significant statistic attenuation for all of the collected data (total noise, by frequency band and dose) when the noise levels in the lapel microphone and the probe microphone were compared. In the comparison of the attenuation values provided by the manufacturer and those found in this study, we observed higher values for the manufacturer in all frequency bands. No difference was observed for the noise levels in the different activities and times evaluated. Conclusion The findings of this study enabled us to know the personal level of attenuation of the HP during a real work situation, which was within the limits of tolerance. It was also possible to collect information about the environmental noise to which these workers are exposed. We noticed situations where this level exceeded the safety values, and therefore it is recommended the use of the HP. It is important that more studies are conducted using the f-MIRE method, because it may be an ally to assess the effectiveness of the HP attenuation in the workplace.

Training on hearing protector insertion improves noise attenuation.

PURPOSE: To determine the efficacy of hearing protector insertion by comparing attenuation values measured by objective (MIRE) and subjective (REAT) methods in groups with and without training. METHODS: The study included 80 male subjects assigned to experimental (with training) and control (without training) groups. The following procedures were performed: occupational history, objective and subjective assessment of hearing protectors. Only subjects in the experimental group received training and guidance on proper hearing protector insertion. RESULTS: Attenuation values were significantly higher in the experimental group than in the control group at all frequencies (500, 1000, 2000, and 4000 Hz) investigated through the objective (MIRE) and subjective (REAT) methods. In addition, attenuation values in the control group were lower than those provided by the hearing protector manufacturer. CONCLUSION: Both objective and subjective attenuation tests demonstrated the efficacy of training on insertion of hearing protectors because the group that received training on proper hearing protection insertion exhibited higher attenuation values than the untrained group.

Interaction between diabetes mellitus and hypertension on hearing of elderly.

INTRODUCTION: Chronic diseases and metabolic changes may act as accelerating factor in the degeneration of the auditory system due to age. However, studies involving an association between hearing loss and diabetes mellitus (DM) and hypertension (HA) in the elderly have shown controversial conclusions. Thus, further studies on this topic are needed in order to elucidate the effect of these chronic diseases on the auditory system. AIM: To compare the hearing thresholds of elderly patients with DM, HA and DM + HA with a control group (CG). METHODS: Retrospective study was conducted through survey charts of 80 elderly people with full hearing assessment, between 2008 and 2012. Subjects were divided into four groups: DM, HA, DM + HA and without chronic diseases known (CG). The ANOVA, Tukey and Mauchly tests, with a significance level of 0.05, were used. RESULTS: There was no statistically significant difference between the ears, which are grouped. Comparisons between the means of hearing thresholds of CG and DM or HA showed no statistically significant differences. However, a statistically significant difference in the comparison between these three groups and DM + HA group for several of the frequencies evaluated was observed. CONCLUSION: It was found that older adults with DM and hypertension associated showed greater hearing impairment in comparison with the other groups, suggesting a synergistic effect of the two chronic diseases on hearing.

Training on hearing protector insertion improves noise attenuation / Atenuação do protetor auditivo após treinamento para colocação

ABSTRACT Purpose: To determine the efficacy of hearing protector insertion by comparing attenuation values measured by objective (MIRE) and subjective (REAT) methods in groups with and without training. Methods: The study included 80 male subjects assigned to experimental (with training) and control (without training) groups. The following procedures were performed: occupational history, objective and subjective assessment of hearing protectors. Only subjects in the experimental group received training and guidance on proper hearing protector insertion. Results: Attenuation values were significantly higher in the experimental group than in the control group at all frequencies (500, 1000, 2000, and 4000 Hz) investigated through the objective (MIRE) and subjective (REAT) methods. In addition, attenuation values in the control group were lower than those provided by the hearing protector manufacturer. Conclusion: Both objective and subjective attenuation tests demonstrated the efficacy of training on insertion of hearing protectors because the group that received training on proper hearing protection insertion exhibited higher attenuation values than the untrained group.

RESUMO Objetivo: Determinar a eficácia da colocação do protetor auditivo comparando os valores de atenuação obtidos pelos métodos objetivo (MIRE) e subjetivo (REAT) em grupos com e sem treinamento. Métodos: Participaram do estudo 80 indivíduos do sexo masculino, separados em grupo pesquisa (com treinamento) e controle (sem treinamento). Os procedimentos realizados foram: anamnese e avaliações objetiva e subjetiva do protetor auditivo. Apenas os indivíduos do grupo pesquisa receberam treinamento e orientações para colocar corretamente o protetor auditivo. Resultados: Os valores de atenuação no grupo pesquisa foram maiores com diferenças estatisticamente significantes em relação ao grupo controle em todas as frequências (500, 1000, 2000 e 4000 Hz) investigadas por meio dos métodos objetivo (MIRE) e subjetivo (REAT). Além disso, os valores de atenuação no grupo controle foram menores do que as previstas pelo fabricante do protetor auditivo. Conclusão: Ambos os métodos de avaliação da atenuação (objetivo e subjetivo) demonstraram a eficácia da colocação do protetor auditivo. Entretanto, o grupo que recebeu treinamento para colocação adequada do protetor auditivo apresentou valores de atenuação maiores do que o grupo sem treinamento.

Interação entre diabetes mellitus e hipertensão arterial sobre a audição de idosos / Interaction between diabetes mellitus and hypertension on hearing of elderly

RESUMO Introdução: Doenças crônicas e alterações metabólicas podem atuar como fator de aceleração na degeneração do sistema auditivo decorrente da idade. No entanto, estudos envolvendo a associação entre a perda auditiva com a diabetes mellitus (DM) e com a hipertensão arterial (AH) em idosos mostraram conclusões controversas. Sendo assim, novos estudos sobre essa temática são necessários, a fim de elucidarmos o efeito dessas doenças crônicas sobre o sistema auditivo. Objetivo: Comparar os limiares auditivos de idosos portadores de DM, de HA e de DM+AH com um grupo controle (GC). Métodos: Estudo retrospectivo realizado por meio de levantamento de prontuários de 80 idosos com avaliação audiológica completa, entre 2008 e 2012. Os idosos foram distribuídos em quatro grupos: portadores de DM, portadores de AH, portadores de DM+AH e sem doenças crônicas conhecidas (GC). Foram utilizados os testes estatísticos ANOVA, Tukey e Mauchly, com nível de significância de 0,05. Resultados: Não houve diferença estatisticamente significante entre as orelhas, sendo esses resultados agrupados. As comparações entre as médias dos limiares auditivos dos grupos GC e DM ou AH não mostraram diferenças estatisticamente significantes, entretanto houve diferença estatisticamente significante na comparação entre esses três grupos e o grupo DM+AH para várias das frequências da audiometria avaliadas. Conclusão: Verificou-se que idosos com DM e AH associados apresentaram maior comprometimento auditivo com relação aos outros grupos, sugerindo um efeito sinérgico das duas doenças crônicas sobre a audição.

ABSTRACT Introduction: Chronic diseases and metabolic changes may act as accelerating factor in the degeneration of the auditory system due to age. However, studies involving an association between hearing loss and diabetes mellitus (DM) and hypertension (HA) in the elderly have shown controversial conclusions. Thus, further studies on this topic are needed in order to elucidate the effect of these chronic diseases on the auditory system. Aim: To compare the hearing thresholds of elderly patients with DM, HA and DM + HA with a control group (CG). Methods: Retrospective study was conducted through survey charts of 80 elderly people with full hearing assessment, between 2008 and 2012. Subjects were divided into four groups: DM, HA, DM + HA and without chronic diseases known (CG). The ANOVA, Tukey and Mauchly tests, with a significance level of 0.05, were used. Results: There was no statistically significant difference between the ears, which are grouped. Comparisons between the means of hearing thresholds of CG and DM or HA showed no statistically significant differences. However, a statistically significant difference in the comparison between these three groups and DM + HA group for several of the frequencies evaluated was observed. Conclusion: It was found that older adults with DM and hypertension associated showed greater hearing impairment in comparison with the other groups, suggesting a synergistic effect of the two chronic diseases on hearing.