Evaluation of noise levels and noise sources in an Irish neonatal intensive care unit.

OBJECTIVES: This study: (i) quantified the typical noise levels in an Irish neonatal intensive care unit (NICU) and compared the values to recommendations by the American Academy of Paediatrics (AAP) and the European Standards for Care for Newborn Health (EFCNI) and to occupational exposure limit value and exposure action values; and (ii) qualified the perception of noise levels and the sources of noise across the various stakeholders within a typical NICU. METHODS: A noise survey was conducted in an Irish NICU. Observations identified practices and behaviours in the NICU that potentially had an impact on noise levels. Noise levels were compared to occupational exposure limits and AAP and EFCNI standards. A noise perception survey was conducted to identify noise sources and awareness of noise levels in the NICU. Results were analysed using SPSS Statistics to determine statistical significance. RESULTS: Noise levels recorded were consistent with previous similar studies and in all cases, the average noise levels recorded exceeded the 45 dBA as recommended by the AAP and EFCNI. There was a statistically significant difference (P < 0.01) between noise levels recorded on the day shift compared to the night shift. The perception of noise levels reported by nurses versus parents was found to be statistically significant (P = 0.001). 38.3% of all respondents reported having received no information or training with regard to noise in the NICU. There was a statistically significant difference in the perception of who is most likely to be affected by noise in the NICU, with nurses reporting those most likely to be affected by noise were patients, and parents reporting those most likely to be affected were staff (P = 0.003). CONCLUSIONS: This study supports the hypothesis that noise levels within the NICU are of concern and require regular assessment and monitoring. Training and awareness programmes are an important component to ensuring all persons in the NICU recognise their potential impact on noise levels in the NICU and in reducing the risk for patients and staff.

Prevalence of Hearing Loss Among Noise-Exposed US Workers Within the Utilities Sector, 2010-2019.

OBJECTIVE: This study's objective was to estimate hearing loss prevalence for noise-exposed US Utilities workers. METHODS: In this cross-sectional study of a retrospective cohort, audiograms were examined for 1.3 million workers (13,595 within utilities) from 2010-2019. Hearing loss prevalence and adjusted risk as compared with a reference industry were estimated. RESULTS: The hearing loss prevalence for noise-exposed Utilities workers (25%) was higher than for noise-exposed workers in all industries combined (20%). Some subsectors surpassed the prevalence for all industries combined and/or had adjusted risks significantly higher than the reference industry. The highest prevalence subsectors were Hydroelectric Power Generation (37%) and steam and Air-Conditioning Supply (29%). CONCLUSIONS: While often overlooked, noise-exposed workers in this sector have among the highest prevalences of hearing loss and significantly higher risks. Increased attention and better hearing conservation strategies are needed.

Niveles de ruido ambiental en dos unidades de cuidados intensivos pediátricos con diferente infraestructura / Comparative analysis of environmental noise levels in two paediatric intensive care units

OBJETIVOS: 1) Determinar los niveles de ruido ambiental en dos unidades de cuidados intensivos pediátricos (UCIP) de un hospital pediátrico de tercer nivel asistencial y 2) analizar si dichos valores cumplen con la normativa actual. MÉTODO: Estudio observacional, descriptivo y transversal llevado a cabo en dos UCIP con infraestructura diferente: boxes separados por cortinas y habitaciones individuales. Se empleó un sonómetro PCE-999 tipo 2 para determinar el ruido ambiental y la unidad de medida registrada fue en decibelios (dB). A la vez, se diseñó un documento de recogida de datos ad hoc diferenciando entre unidad (abierta y cerrada), hora de registro. RESULTADOS: Se recogió un total de 330 determinaciones, 72 en la UCIP abierta y 258 en la de habitaciones individuales. El ruido ambiental que imperaba en la unidad de críticos abierta fue de 56,74 ± 3,6 decibelios versus 50,36 ± 4,7 en la de boxes individuales, observándose valores mayores en el turno diurno. DISCUSIÓN: Tal como sucede en otros estudios previos, se observa que el ruido que impera en la unidad excede los límites permitidos. Además, se coincide con el hecho de que las principales fuentes de ruido ambiental de la UCI provienen de las alarmas, la maquinaria, como monitores o respiradores y las conversaciones entre profesionales sanitarios. CONCLUSIONES: Tras la presente investigación, se ha podido constatar que los niveles de ruido ambiental que imperan en las dos Unidades de Cuidados Intensivos Pediátricos analizadas son elevados. Los datos obtenidos apuntan a que la organización arquitectónica de concepto cerrado puede tener un impacto a la hora de disminuir la generación de dicho input medioambiental

AIMS: 1) To determine noise levels in two paediatric intensive care units (PICU) of a tertiary hospital and 2) to analyse whether these values comply with the current standards. METHOD: Observational, descriptive and cross-sectional study carried out in two PICU with different infrastructure: bays separated by curtains and individual bedrooms. A PCE-999 sound level meter was used to determine noise levels, which were registered in decibels (dB). At the same time, an ad hoc data recording document was designed in which we differentiated between each unit (open concept or closed), time of recording. RESULTS: A total of 330 tests, 72 from open PICUs and 258 from closed PICUs were collected. The noise in the open PICU was 56.74 ± 3.61 decibels versus 50.36 ± 4.71 in the closed PICU, obtaining the highest levels during the morning. DISCUSSION: As it occurs in other studies, noise levels exceed the allowed limits. At the same time, the main sources of noise in the PICU came from alarms, medical equipment, such as monitors or respirators, and conversations between health professional. CONCLUSIONS: This investigation has shown high levels of environmental noise in the two PICUs analysed. The data obtained indicate that the architectural concept of individual bedrooms may have an impact in decreasing this environmental input

Auditory effects of recreational and occupational noise exposure among dental students: a cross-sectional study / Efectos auditivos producto de la exposición a ruido recreacional y dental en estudiantes de odontología: un estudio transversal

ABSTRACT Purpose: to determine the auditory effects of noise exposure from recreational and occupational sources among dentistry students. Methods: forty-two dentistry students, routinely exposed to occupational noise, and 72 students from other health science schools were recruited (control group). Audiometric testing, otoacoustic emissions and questionnaires to assess recreational and occupational noise were applied to the sample. The presence of a notch was determined for each participant audiometry´s test based on the criteria proposed by Coles et al. Differences in notch prevalence were analyzed by applying univariate regression models as well as a multivariate model adjusted by covariates. Results: non-significant differences in auditory thresholds between groups were found. The controls exhibited a significantly higher prevalence of a notch at 4 kHz than the group exposed to noise. However, the differences were not statistically significant in the multivariate model adjusted by recreational noise exposure. Conclusions: the occupational noise exposure was not significantly associated to auditory system dysfunction. In addition, the differences in notch prevalence could be related to recreational noise exposure.

RESUMEN Objetivo: determinar los efectos auditivos producto de la exposición a ruido recreacional y ocupacional en estudiantes de Odontología. Métodos: se reclutó a 42 estudiantes de odontología expuestos rutinariamente a ruido ocupacional, y a 72 estudiantes de otras carreras del área de la salud (grupo control). Se evaluó mediante audiometría, emisiones otoacústicas, junto con aplicar cuestionarios para determinar la exposición a ruido ocupacional y recreacional. A partir de los umbrales audiométricos e determinó la presencia de escotoma usando el criterio de Coles et al. Se analizaron las diferencias en prevalencia de escotomas entre los grupos mediante regresiones logísticas, ajustando por otras variables. Resultados: no existieron diferencias significativas en los umbrales audiométricos entre los grupos estudiados. El grupo control mostró mayor prevalencia de escotoma en 4 kHz al ajustar por sexo y edad, sin embargo, dejó de ser significativa al ajustar adicionalmente por exposición a ruido recreacional. Conclusiones: la exposición a ruido ocupacional no se asoció a alteraciones auditivas. Además, las diferencias en prevalencia de escotomas estarían relacionadas a exposición a ruido recreacional.

Sistema de auriculares en teleoperadores: estudio en una central de llamadas del sur de España / Headset System in Teleoperators: Study in a Call Centre in Southern Spain

Introducción: El personal teleoperador de las centrales de llamadas telefónicas, está sometido a ruido ambiental y al nivel sonoro de los auriculares con el posible desarrollo de pérdida auditiva. Objetivos: El objetivo principal del estudio fue evaluar si el tipo de sistema de auriculares empleado por los teleoperadores de una central de llamadas influía sobre la aparición de pérdida auditiva asimétrica. Material y métodos: Estudio observacional descriptivo realizado en teleoperadores de una central de llamadas del sur de España. Muestreo oportunista a partir del examen de vigilancia de salud de 2018, con audiometría y cuestionario auto-cumplimentado. La variable dependiente fue la presencia de pérdida auditiva asimétrica (diferencia de umbral interaural de 15 dB o más en al menos una frecuencia). Se realizó análisis bivariante, y se usaron los programas estadísticos SPSS versión 25 y EPIDAT versión 4.2. Resultados: La pérdida auditiva asimétrica en la muestra estudiada se relacionaba significativamente con la edad de los sujetos (Z = -3,606, p < 0,000), pero no con el tipo de sistema de auriculares utilizado ni con otras variables sociodemográficas, laborales o clínicas analizadas. Conclusiones: El uso de auriculares del sistema monoaural no parece influir sobre la pérdida auditiva asimétrica en el personal teleoperador de la muestra estudiada

Introduction: The Call Center Phone Operator is subject to environmental noise and to the headphones volume sound with possible hearing loss effects. Objectives: The main objective of the study was to assess whether the type of headphone system used by call center operators incidenced the asymmetrical hearing loss. Material and methods: Descriptive observational study carried out on teleoperators of a call centre in the south of Spain. Opportunity sampling technique carried out from the health surveillance examination from 2018, with audiometry and self-completed questionnaire. The dependent variable was the presence of asymmetric hearing loss (interaural threshold value of 15 dB or more in at least one frequency). Bivariate analysis was performed, and statistical programs SPSS version 25 and EPIDAT version 4.2 were used. Results: Asymmetric hearing loss in the studied sample was significantly related to the age of the subjects (Z = -3,606, p < 0,000), but not to the type of headphone system used or to other socio-demographic, occupational or clinical variables analysed. Conclusions: The use of mono headphones does not seem to be related with an asymmetric hearing loss in the telephone operators of the studied sample

Alteraciones auditivas, percepción y conocimientos de estudiantes sobre ruido en una clínica de enseñanza odontológica / Auditory alterations and student knowledge and perception on noise at a dental teaching clinic

RESUMEN Objetivo Identificar alteraciones auditivas en estudiantes de odontología y evaluar el nivel de conocimiento con relación a la pérdida auditiva inducida por ruido. Metodología Estudio transversal, se realizaron encuestas a estudiantes del tercer año curso diurno y cuarto año del curso nocturno de estomatología. Las variables estudiadas: trastornos auditivos y conocimiento sobre PAIR (pérdida auditiva inducida por ruido). Resultados Muestran la presencia de trastornos auditivos en 14,8% de los estudiantes, de los que 7,4% recibieron tratamiento. El 28,4% había realizado exámenes audio métricos. De los estudiantes, 24,6% tenían familiares con problemas de audición; 11,1% enfermedades preexistentes;49,3% necesitan repetición durante una conver-sación;34,4% estaba irritado en el ambiente de clases prácticas y consideraban las piezas de mano de alta rotación el instrumento más ruidoso; el 75,3% refirió usar audífonos y un 72,1% por más de 5 años. En relación a los resultados sobre conocimientos 93,8% afirmaron que el dentista es un profesional con riesgo de pérdida auditiva por ruido, pero el 83,9% no había recibido orientación sobre el PAIR. Respecto al protector auricular 77,7% lo conocía, pero sólo 3,7% lo había usado. Conclusión Los estudiantes de estomatología presentaron alteraciones auditivas inducidas por el ruido, y consideraban el local de las clases prácticas un ambiente ruidoso; es necesario un mayor conocimiento en los alumnos de las consecuencias negativas del ruido en la salud y la utilización de medidas de prevención para evitar la pérdida de la audición a largo plazo.(AU)

ABSTRACT Objective To identify auditory alterations in dentistry students and evaluate the level of knowledge in relation to noise-induced hearing loss. Materials and Methods Cross-sectional study. Surveys applied to third-year students of the day school, and fourth-year students of the night stomatology school. The variables studied were auditory disorders and knowledge about NIHL (noise-induced hearing loss). Results Hearing disorders were found in 14.8% of the students, of whom 7.4% were receiving treatment. Audiometric examinations were performed in 28.4% of the students. It was also found that 24.6% of the students had relatives with hearing problems; 11.1% had pre-existing conditions; 49.3% needed repetition during a conversation; 34.4% felt irritated during practical classes and considered high rotation hand pieces to be the noisiest instrument; and 75.3% reported using hearing aids (72.1% for more than 5 years). With regard to knowledge, 93.8% said that dentists are professionals at risk of hearing loss due to noise, but 83.9% had not received guidance on NIHL. Regarding the hearing protector, 77.7% knew about it, but only 3.7% had used it. Conclusion Stomatology students have noise-induced hearing loss, and also considered that the places where practical classes are given are a noisy environment. More knowledge is needed in students about the negative consequences of noise in health and the use of preventive measures to avoid hearing loss in the long term.(AU)

Prevalência de exposição a ruído ocupacional em trabalhadores brasileiros: resultados da Pesquisa Nacional de Saúde, 2013 / Prevalence of exposure to occupational noise in Brazilian workers: results of the Brazilian National Health Survey, 2013 / Prevalencia de exposición al ruido ocupacional de trabajadores brasileños: resultados de la Encuesta Nacional de Salud, 2013

O objetivo foi descrever a prevalência de exposição ocupacional a ruído e analisar os fatores associados a essa condição na população brasileira. Neste estudo transversal, de base populacional, utilizaram-se dados da Pesquisa Nacional de Saúde (PNS) de 2013. A amostra foi composta de 36.442 brasileiros com 18 anos ou mais de idade. A variável desfecho foi a exposição autorreferida a ruído durante o trabalho. Para avaliar os possíveis fatores associados à exposição a ruído, foi utilizado o teste qui-quadrado de Pearson, assim como o modelo de Poisson, com variâncias robustas, tanto uni quanto multivariado. Os resultados obtidos identificaram prevalência de exposição ao ruído de 32,1%, variando de 40,9% (Santa Catarina) a 21,9% (Piauí). Houve menor prevalência entre as mulheres (RP = 0,57; IC95%: 0,55-0,59) e no grupo com 55 anos ou mais (RP = 0,70; IC95%: 0,65-0,76). Detectou-se maior prevalência na faixa de 25 a 54 anos (RP = 1,00; IC95%: 0,95-1,06), nível médio de instrução (RP = 1,36; IC95%: 1,29-1,44), relato de cansaço (RP = 1,35; IC95%: 1,30-1,40), dificuldade auditiva (RP = 1,27; IC95%: 1,19-1,35), história de acidente de trabalho (RP = 1,37; IC95%: 1,25-1,50). A prevalência de autorrelato de exposição a ruído ocupacional foi superior àquela observada em três países da América Latina. Maior prevalência entre homens, trabalhadores jovens e menos escolarizados era esperada. As associações com problemas auditivos e não auditivos sugerem medidas sistêmicas. Ajustes das perguntas da PNS são desejáveis para favorecer comparabilidade e monitoramento.

The objectives were to describe the prevalence of occupational exposure to noise and to analyze associated factors in the Brazilian population. This cross-sectional population-based study used data from the Brazilian National Health Survey (PNS, 2013). The sample consisted of 36,442 Brazilians 18 years or older. The outcome variable was self-reported exposure to noise during work. To assess possible factors associated with exposure to noise, we used Pearson's chi-square test and the univariate and multivariate Poisson model with robust variance. The results showed 32.1% prevalence of exposure to noise, varying from 40.9% (Santa Catarina, Brazil) to 21.9% (Piauí, Brazil). Prevalence was lower in women (PR = 0.57; 95%CI: 0.55-0.59) and in individuals 55 years or older (PR = 0.70; 95%CI: 0.65-0.76). Higher prevalence was associated with the 25-54-year age bracket (PR = 1.00; 95%CI: 0.95-1.06), middle schooling level (PR = 1.36; 95%CI: 1.29-1.44), self-reported fatigue (PR = 1.35; 95%CI: 1.30-1.40), hearing impairment (PR = 1.27; 95%CI: 1.19-1.35), and history of work-related accident (PR = 1.37; 95%CI: 1.25-1.50). Prevalence of self-reported exposure to occupational noise was higher than in three other Latin American countries. Higher prevalence among men, younger workers, and those with less schooling was expected. The associations with auditory and non-auditory problems suggest the need for systemic interventions. Adjustments to the questions in the PNS are desirable to favor comparability and monitoring.

El objetivo fue describir la prevalencia de exposición ocupacional al ruido y analizar factores asociados a esta condición en la población brasileña. En este estudio transversal, de base poblacional, se utilizaron datos de la Encuesta Nacional de Salud (PNS) de 2013. La muestra estaba compuesta por 36.442 brasileños con 18 años o más de edad. La variable desenlace fue la exposición autoinformada al ruido durante el trabajo. Para evaluar los posibles factores asociados a la exposición al ruido se utilizó el test chi-cuadrado de Pearson, así como el modelo de Poisson con variancias robustas, tanto uni- como multivariado. Los resultados obtenidos identificaron una prevalencia de exposición al ruido de 32,1%, variando de 40,9% (Santa Catarina) a 21,9% (Piauí). Menor prevalencia entre las mujeres (RP = 0,57; IC95%: 0,55-0,59) y en el grupo con 55 años o más (RP = 0,70; IC95%: 0,65-0,76). Mayor prevalencia en la franja de 25 a 54 años (RP = 1,00; IC95%: 0,95-1,06), nivel medio de instrucción (RP = 1,36; IC95%: 1,29-1,44), relatos de cansancio (RP = 1,35; IC95%: 1,30-1,40), dificultad auditiva (RP = 1,27; IC95%: 1,19-1,35), historia de accidente laboral (RP = 1,37; IC95%: 1,25-1,50). La prevalencia de autoinforme de exposición a ruido ocupacional fue superior a la observada en tres países latinoamericanos. La mayor prevalencia entre hombres, trabajadores jóvenes y menos escolarizados era esperada. Las asociaciones con problemas auditivos y no auditivos sugieren medidas sistémicas. Es deseable que se produzcan ajustes en las preguntas de la PNS para favorecer comparabilidad y el monitoreo.

Estudio Transversal: Hipoacusia Laboral Inducida por Ruido en Personal de Aeronáutica del Ejército Ecuatoriano y Factores Asociados. Quito ­ Ecuador, 2014 - 2016 / Cross-sectional research: Noise-induced Occupational Hypoacusis in Aeronautical Personnel of the Ecuadorian Army and Associated Factors. Quito - Ecuador, 2014 - 2016

INTRODUCCIÓN: La hipoacusia laboral inducida por ruido es una patología ocupacional frecuente, responsable de pérdidas de la audición sino se controla a tiempo. El objetivo del estudio fue establecer la prevalencia de hipoacusia laboral inducida por ruido y factores relacionados en el personal de aeronáutica del ejército. MÉTODOS: Estudio transversal analítico en el personal tripulación del ejército ecuatoriano, Quito ­ Ecuador, período 2014 ­ 2016 que relacionó asociación causal entre hipoacusia laboral inducida por ruido con variables como edad, función, rango, antecedentes de hipoacusia en el servicio militar. Se trabajó con todo el personal de vuelo, 112 militares en servicio activo. RESULTADOS: El promedio de edad fue de 37 años. Todos eran varones. El 55.4 % pertenecía a tropa y 44. 6 % eran oficiales. El 44.6 % eran pilotos; 28.6 % mecánicos y 26.8 % ingenieros de vuelo. La prevalencia de hipoacusia general fue del 35.6 %; la de hipoacusia unilateral fue del 19.6 % y de la bilateral del 16 %. La frecuencia de antecedentes de hipoacusia laboral asociada a ruido en la aeronáutica fue del 60.7 %. La prevalencia de hipoacusia leve fue del 17.8 %; moderada con 6.7 % y severa con 1.35 %. Las variables asociadas a hipoacusia laboral inducida por ruido en el personal militar en funciones de vuelo fueron: la edad, el rango, la función y antecedentes de hipoacusia. El oído izquierdo suele afectarse más que el derecho. La hipoacusia bilateral más frecuente fue la leve derecha con agudeza normal izquierda (10.7 %). CONCLUSIONES: La hipoacusia laboral inducida por ruido es multifactorial y puede ser reversible si se detiene el causal o si se llevan a cabo medidas de protección adecuadas. El nivel de hipoacusia en el personal militar de vuelo tiene asociación con: la edad, el rango, la función y los antecedentes de hipoacusia laboral en funciones de vuelo.

BACKGROUND: Hearing loss is induced by noise in job and is a frequent illness, responsible of hearing loss if it is not controlled on time. The aim of this study is establish the prevalence of hearing loss and related factors in army aviation personnel. METHODS: An analytical cross - sectional study of the Ecuadorian army crew, Quito - Ecuador, between 2014 and 2016, which related a causal association between hearing loss induced by noise in job with variables such as age, function, rank and backgrounds of hearing loss in military service. It worked with all the personnel of flight 112 military in active service. RESULTS: The mean age was 37 years. All were male. 55.4% belonged to troops and 44. 6 % were officers. 44.6 % were pilots; 28.6 % were mechanics and 26.8 % were flight engineers. The prevalence of general hearing loss was 35.6 %. The prevalence of unilateral hearing loss was 19.6 % and bilateral prevalence was 16 %. The frequency of antecedents of occupational hearing loss associated with aviation noise in this staff was of 60.7 %. The prevalence of mild hearing loss was 17.85 %; moderate hearing loss 6.7 % and severe of 1.35 %, no profound hearing loss was reported. The variables associated with decreased auditory acuity are: age, aviation exercise time, range, function, and history of hearing loss within the aeronautical field. Bilateral damage has a statistical tendency with age and association with the range. No deep hearing loss was found. CONCLUSION: Noise-induced occupational hearing loss is multifactorial and may be reversible if the cause is stopped or appropriate protective measures are taken. The level of hearing loss in military flight personnel has an association with: age, range, function, and history of occupational hearing loss in flight functions.

Evaluación epidemiológica de la exposición a ruido en trabajadores de policía local y bomberos / Epidemiological evaluation of noise exposure in workers local police and firefighters

La discusión acerca de la exclusión de determinados puestos de trabajo del ámbito de la aplicación de la Ley 31/1995, finalizó con la Sentencia del Tribunal de Justicia de las Comunidades Europeas (12//01/2006). Objetivos: Conocer el riesgo de presentar una audiometría anormal relacionada con el trabajo, en aras de poder establecer relación entre el puesto y la exposición. Material y Métodos: Estudio de casos y controles realizado durante el periodo 2006-2010 entre agentes de Policía Local, Bomberos y personal de Administración. De una población accesible de 881 trabajadores se reclutaron a 631 que cumplían criterios de inclusión. De forma aleatoria y estratificada por sexo y edad, la muestra seleccionada fue de 389 (207 casos y 182 controles). Se realizó un análisis estadístico mediante contraste de medias independientes y porcentajes y como medida de asociación se calculó la Odds Ratio (OR) para los grupos de estudio y análisis multivariante de regresión logística así como curvas ROC. Resultados: En el análisis univariante, edad, puesto de trabajo (POL) y umbrales OSHA presentaron diferencias significativas, con una OR de 2,8 (p<0.001) en el grupo de Policía Local. En el multivariante, edad, umbrales OSHA y puesto de Policía Local (OR 2,8), siguen siéndolo. El área bajo la curva ROC fue para OSHA (0,815). Conclusiones: El puesto de policía local muestra mayor riesgo de lesión neurosensorial que el de administrativo; y la evaluación epidemiológica de la salud se muestra como herramienta eficaz para la evaluación de los riesgos (AU)

The discussion about the exclusion of certain jobs in the field of application of Law 31/1995, ended with the judgment of the Court of Justice of the European Communities (12 / 01/2006). Objective: to know the risk of abnormal audiometry work-related, in order to be able to establish relationship between the position and exposure. Material and Methods: a case-control study conducted during the period 2006-2010 among local police officers, firefighters and personal Administration. An accessible population of 881 workers were recruited 631 who met inclusion criteria. Random and stratified by sex and age, the selected sample was 389 (207 cases and 182 controls). Statistical analysis was performed using contrast independent means and percentages and as a measure of association calculated the odds ratio (OR) for groups of multivariate analysis and logistic regression analysis and ROC curves. Results: in the univariate analysis, age, job (POL) and OSHA thresholds differ significantly, with an odds ratio of 2.8 (p<0.001) in the group of local police. In multivariate, age, OSHA thresholds and local police station (OR 2.8), remain so. The area under the ROC curve was to OSHA (0.815) Conclusions: the local police station shows higher risk of sensoneural injury than administrative staff, and the epidemiological assessment of health is shown as an effective tool for risk assessment (AU)

Aproximación a un modelo de costo eficacia de protectores auditivos en el ambiente laboral / Approach to a cost-effectiveness model of hearing protectors in the workplace

INTRODUCCIÓN: La escasa información disponible en relación con modelos de evaluación de costo efectividad de la protección auditiva, para la prevención de la hipoacusia neurosensorial inducida por el ruido laboral en Colombia, así como la confiabilidad de la información del nivel de atenuación de ruido que es suministrada por los fabricantes de elementos de protección auditiva, justificaron el desarrollo de esta investigación. OBJETIVOS: Proponer un modelo de evaluación de costo eficacia de protectores auditivos ofertados en el mercado colombiano, frente a las necesidades de atenuación contra el ruido establecidas por la legislación colombiana. Materiales y MÉTODOS: Se elaboró un modelo de costo eficacia de protectores auditivos en Colombia. Para ello se seleccionó del total de la oferta existente en el mercado colombiano un protector tipo copa y otro tipo inserción, a los cuales se les aplicó la metodología ANSI S3.19 para determinar el Nivel de Reducción del Ruido (NRR). En la prueba participaron 21 sujetos. En el modelo se consideraron variables como el costo equivalente anual, el nivel de atenuación real y la relación costo eficacia. RESULTADOS: El nivel de atenuación del ruido suministrado en las fichas técnicas del fabricante difiere del encontrado en la prueba realizada para cada uno de los protectores, en el caso de los de tipo copa su eficacia es del 37% menos de lo esperado y para los de inserción del 59%. El cálculo de la Razón de Costo Efectividad (RCE) para los protectores tipo copa muestra un valor de $90.055 por cada unidad de eficacia, mientras que la RCE de los protectores de inserción es de $465.034. Discusión/CONCLUSIONES: Aunque las diferencias en el nivel de eficacia observado pueden estar afectadas por factores humanos, la metodología de la prueba y las características propias del protector auditivo, estos hallazgos son consistentes con la recomendación de National Institute for Occupational Safety and Health (NIOSH) sobre la reducción del NRR. Es importante considerar la aplicación de modelos de costo eficacia para la selección y adquisición de elementos de protección personal en las empresas, lo que lleva incorporar una política de protección al trabajador coherente con los recursos disponibles en la empresa para tal fin

INTRODUCTION: In Colombia the poor information available of cost effectiveness assessment models of hearing protection to prevent work noise-induced sensorineural hearing loss, as well as the reliability of information on the level of Noise Reduction Rating (NRR) that is provided by the manufacturers of hearing protectors is the justification for development of this research. OBJECTIVES: The aim of this study is proposed a model for evaluating cost-effectiveness of hearing protectors in the Colombian market according to needs against noise attenuation provided by Colombian laws. MATERIALS AND METHODS: In the study was designed a model of cost effectiveness of hearing protectors in Colombia. For this purpose would selected one earmuffs and one earplugs offered in the Colombian market. The methodology applied was ANSI S3.19 to determine the NRR. The trial involved 21 subjects. The model considered variables as the annual equivalent cost, the real attenuation level and the Cost Effectiveness ratio. RESULTS: Noise Reduction Rating provided by the manufacturers technical specifications differ from the results found in the trial. In earmuffs was 37% less than expected and earplugs was 59%. The CER for earmuffs was COP $ 90,055 for one unit of effectiveness, while CER earplugs was COP $ 465,034. Discussion/CONCLUSIONS: Differences in the level of efficacy observed may be affected by human factors, the trial methodology and the characteristics of the hearing protector; however these findings are consistent with the NIOSH recommendation on reducing NRR. It is important to consider application of cost-effectiveness models for the selection and buy personal protective equipment in enterprises, leading to incorporate a worker protection policy according to the resources available in the Company

Evaluación de los parámetros de hipoacusia laboral en trabajadores activos y su relación con los niveles de glucemia basal / Evaluation of hearing loss parameters in workers and its relationship with fasting blood glucose levels

INTRODUCCIÓN: La hipoacusia ocupacional por ruido se considera dentro de los planes de prevención de enfermedades profesionales más comunes. Además del examen de las condiciones laborales se deben tener en cuenta otros factores personales que aumentan el riesgo de hipoacusia, como la diabetes. OBJETIVOS: Explorar la pérdida de audición en el ámbito laboral y su relación con las alteraciones de las cifras de glucemia basal en ayunas. MÉTODOS: Se realizó un estudio observacional y transversal en el que se incluyeron 1.636 trabajadores de empresas del sector servicios. Se hicieron audiometrías tonales completas midiendo: alta frecuencia (AF), índice de pérdida precoz (ELI), índice promedio conversacional (SAL) y pérdida pérdida monoaural y binaural. Los resultados se categorizaron según las cifras de glucemia basal: G1 (< 100 mg/dl), G2 (100-125 mg/dl) y G3 (> 125 mg/dl). RESULTADOS: Según la AF y el ELI el 11% de los trabajadores en cada caso presentaron claro indicio de sordera. Las mujeres con niveles G3 obtuvieron diferencias significativas en los resultados del índice AF y ELI respecto al grupo G1 (p = 0,038 y 0,046, respectivamente). Se encontró una asociación positiva de hipoacusia y niveles de glucemia G3 en las pruebas de AF (OR: 0,338; p = 0,002), ELI (OR: 0,407; p = 0,007) y monoaural del oído izquierdo (OR: 4,77 × 10-5; p = 0,006). CONCLUSIONES: Pese a las limitaciones metodológicas de este estudio, existen indicios para pensar que los trabajadores con niveles elevados de glucemia basal podrían presentar un mayor riesgo de padecer hipoacusia de altas frecuencias

INTRODUCTION: Hearing loss due to noise is considered within the prevention plans of the most common occupational diseases. In addition to evaluation of working conditions, other personal factors increasing the risk of hypoacusis, such as diabetes, should be taken into account. OBJECTIVES: To explore hearing loss in the workplace and its relationship to impaired fasting baseline blood glucose levels. METHODS: An observational, cross-sectional study enrolling 1636 workers from service companies was conducted. Full audiometric evaluation was performed at different frequencies: high frequency (HF), early loss index (ELI), speech average loss (SAL), and monaural and binaural loss. RESULTS: were categorized by baseline blood glucose levels: G1 (<100 mg/dl), G2 (100-125 mg/dl), and G3 (> 125 mg/dl). RESULTS: Based on both HF and ELI, 11% of workers had clear indication of deafness. Women with G3 levels showed significant differences in the results of HF and ELI indexes as compared to the G1 group (p = .038 and .046, respectively). A positive association was found between hearing loss and G3 blood glucose levels in HF (OR: .338; p = .002), ELI (OR: .407; p = .007), and the monaural test in the left ear (OR: 4.77 × 10−5; p = .006). CONCLUSIONS: Despite the methodological limitations of this study, there is evidence for an increased risk of high frequency hearing loss in workers with high baseline blood glucose levels

Trade-offs between assessor team size and assessor expertise in affecting rating accuracy in assessment centers / Trade-offs entre tamaño del equipo evaluador y pericia del evaluador y su efecto sobre la precisión de la valoración en los assessment centers

We investigated the effects of assessor team size on the accuracy of ratings in a presentation exercise as it is commonly used in assessment centers and compared it to the effects of two factors related to assessor expertise (assessor training and assessor background). On the basis of actual ratings from a simulated selection setting (N = 383), we sampled assessor teams of different sizes and with different expertise and determined the accuracy of their ratings in the presentation exercise. Of the three factors, assessor training had the strongest effect on rating accuracy. Furthermore, in most conditions, using larger assessor teams also led to more accurate ratings. In addition, the use of larger assessor teams compensated for having not attended an assessor training only when the assessors had a psychological background. Concerning assessor background, we did not find a significant main effect. Practical implications and directions for future research are discussed(AU)

Investigamos los efectos del tamaño del equipo evaluador sobre la precisión de las valoraciones en un ejercicio de presentación tal como es habitualmente utilizado en los AC y lo comparamos con los efectos de dos factores relacionados con la pericia del evaluador (entrenamiento e historial). Sobre las valoraciones en una situación simulada de selección (N = 383), muestreamos equipos de evaluadores de diferente tamaño y con diferente pericia y determinamos la precisión de sus valoraciones en el ejercicio de presentación. De los tres factores, el entrenamiento de evaluadores tuvo el efecto más fuerte sobre la precisión de la valoración. Además, en la mayoría de las condiciones, usar equipos con mayor número de evaluador también da lugar a valoraciones más precisas. También, el uso de equipos mayores compensó la falta de asistencia de un valorador al entrenamiento cuando los evaluadores tenían formación psicológica. En relación con esto último, no encontramos un efecto principal significativo. Se comentan las implicaciones para la práctica y la investigación futura(AU)

Estudo do espectro sonoro nos limiares de altas frequências em trabalhadores expostos ao ruído / Study of the noise spectrum on high frequency thresholds in workers exposed to noise

O grau de nocividade do ruído pode ser quantificado e qualificado com base em algumas características do som como sua intensidade, o tipo de espectro, duração e a distribuição da exposição ao ruído durante a jornada de trabalho. OBJETIVO: Avaliar o espectro de ruído e a configuração audiométrica em trabalhadores. MATERIAIS E MÉTODOS: Estudo de coorte contemporânea com corte transversal, realizado no Distrito Federal. Realizou-se avaliação ambiental (análise espectral) do ruído em empresas de diferentes ramos de atividade econômica e avaliação audiológica em 347 trabalhadores. RESULTADOS: A análise espectral revelou picos em diferentes frequências em cada ramo de atividade (8 kHz-metalúrgico, 4 kHz-marmoraria e 2 kHz-madeireira). Verificou-se que as frequências de 14 kHz e 16 kHz apresentaram diferenças significativas entre os ramos de atividade, com maior prevalência no metalúrgico. CONCLUSÃO: A utilização de medidor de nível de pressão sonora, acoplado a analisador de frequência e a avaliação audiométrica de altas frequências possibilitam a detecção precoce de danos auditivos que, por sua vez, viabiliza melhor direcionamento das ações preventivas.

Noise level can be quantified and qualified based on sound characteristics such as intensity, type of spectrum, duration and distribution of the noise exposure during one's working hours. OBJECTIVE: To assess noise spectrum and the audiometric configuration of workers. MATERIALS AND METHODS: Contemporary cross-sectional cohort carried out in the Federal District - Brazil. We did an environmental analysis (spectral analysis) of the noise in companies from different industries, with audiological assessment of 347 workers. RESULTS: The spectral analysis revealed peaks at different frequencies for each industry investigated (8 kHz-metallurgical, 4 kHz-stone Works and 2 kHz-wood works). We noticed that the frequencies of 14 kHz and 16 kHz had significant differences between the various industries, with a greater prevalence of the metallurgical. CONCLUSION: The use of noise pressure measuring device, coupled to a frequency analyzer and high frequency audiometric assessment yielded an early detection of hearing damage, helping better organize preventive measures.

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.

Efecto de la exposición a ruido en entornos laboralessobre la calidad de vida y rendimiento / Effects of noise exposure in working places on quality of life and performance

Objetivos: La exposición laboral a ruido origina efectos sobre la salud de carácter no auditivo. El objetivo de este estudio es estimar la asociación entre exposición a ruido en entornos laborales y la aparición de alteraciones en la conducta, rendimiento y síntomas psicosomáticos. Metodología: Estudio de prevalencia a partir de datos de la VI Encuesta Nacional de Condiciones de Trabajo analizando como variable independiente la exposición a ruido y como variables dependientes los "síntomas que manifiesta el trabajador" tratados de forma individual o por grupo de síntomas según su naturaleza: conductual, psicosomáticos y rendimiento. La asociación entre exposición y efecto se analizó mediante la prueba de X2 y se calculó el OR de prevalencias ajustado por ritmo de trabajo (IC95%) para medir la asociación entre "exposición a ruido" y grupos de síntomas de forma cruda en el conjunto de la población y de forma estratificada por ramas de actividad. Resultados: El 36,5% de la población trabajadora está expuesta a ruido en su puesto de trabajo. Se observa una mayor prevalencia de los grupos de síntomas conductuales, psicosomáticos y de rendimiento (p<0,001) entre los trabajadores expuestos a ruido frente a no expuestos. La rama de Actividades Sanitarias presenta los mayores valores de OR para el grupo de síntomas conductuales (OR=2,53 [1,71-3,75]) y de rendimiento (OR=2,26, [1,43-3,56]) y la Industria Química presenta el mayor grado de asociación entre exposición a ruido y síntomas psicosomáticos (OR=5,37, [1,13-25,55]). Conclusiones: Se observa una asociación estadísticamente significativa entre exposición a ruido y alteraciones de conducta, rendimiento y síntomas psicosomáticos en la población trabajadora española (AU)

Aims: Occupational noise exposure could produce extra-auditory effects. The purpose of this study was to investigate whether occupational noise exposure can influence human behaviour, performance and development of psychosomatic symptoms. Methodology: Cross-sectional study, from the Data-base of Spanish VI National Survey on Working Conditions, "noise exposure" has been analyzed as independent variable and: "symptoms self-reportered by workers" as effect variable, considering them independently or grouped variables in behavioural, psychosomatic and performance symptoms. The relationship between exposure and effect was analyzed by X2 test. Prevalence adjusted Odds Ratio by work rhythm (95% CI), were estimated to measure the association between perceived noise annoyance and grouped symptoms in the population and in the different branches of activity. Results: 36.5% of the working population is exposed to noise in their workplace. There is a higher prevalence of behavioural symptoms group, psychosomatic and performance (p <0.001) among workers exposed to noise compared to unexposed. Health Care Sector reported the highest risk for behavioural (OR=2,53 [1,71-3,75]) and performance symptoms(OR=2,26, [1,43-3,56]) . Chemical Industry had a prevalence ratio between noise and psychosomatic symptoms of (OR=5,37 [1,13-25,55]). Conclusions: Our results found and statistic significant association between noise annoyance exposure and behavioural, performance and development of psychosomatic symptoms in the Spanish working population (AU)

Revisión sistemática y evidencia sobre exposición profesional a ruido y efectos extra-auditivos de naturaleza cardiovascular / Systematic review and evidence on occupational noise exposure and extra-auditory effects of cardiovascular nature

Trabajo de revisión que tiene como objetivo conocer el nivel de evidencia existente sobre los efectos cardiovasculares debidos a la exposición profesional al ruido, mediante el análisis sistemático de la producción científica publicada entre 1995 y 2008. La búsqueda de las referencias bibliográficas se realizó mediante términos “Major Topic” y “MeSH” para MEDLINE y términos “Decriptors” para OSH update. Se recuperaron un total de 236 referencias y se incluyeron en la revisión todos los estudios experimentales, estudios de cohortes y estudios casos control y aquellos estudios trasversales que cumplieron, al menos, con cinco de los nueve criterios que la declaración STROBE establece para los estudios observacionales. Fueron seleccionados para su revisión a texto completo un total de 23 artículos: 12 estudios transversales, 7 estudios de cohortes, dos estudios casos control, 1 meta-análisis y 1 estudio experimental.La asignación del nivel de evidencia se realizó de acuerdo a los criterios SIGN. La selección y revisión de los artículos se realizó mediante revisión por pares, los casos de discrepancia entre pares se resolvió mediante consenso. En relación con los efectos cardiovasculares de la exposición laboral a ruido, nuestra revisión encuentra un mayor nivel de evidencia (1++) para el incremento de la tensión arterial e incremento de la frecuencia cardiaca. Estudios con nivel de evidencia 2++ muestran resultados en esa misma dirección.La enfermedad isquémica, infarto agudo de miocardio y coronariopatía muestran un nivel de evidencia 2++.La alteraciones metabólicas de lípidos y alteraciones de parámetros vasculares disponen de un nivel bajo de evidencia 3.El control del ruido en entornos laborales es un factor de prevención del riesgo cardio-vascular. HTA, riesgo coronario y otras enfermedades cardiovasculares deben considerarse en los protocolos de vigilancia médica específica de los trabajadores expuestos a ruido (AU)

Review aimed to identify the level of scientific evidence about the relationship between cardiovascular diseases and occupational noise exposure, by a systematic analysis of the scientific literature published between 1995 and 2008. “Major Topic” and “MeSH” terms for MEDLINE and “Decriptors” for OSH update was used for the search of references. We retrieved a total of 236 references. Experimental studies, cohort studies and case control studies were all included in the review and those cross-sectional studies with at least five of the nine criteria from the STROBE declaration provides for observational studies. 23 articles were selected for full text review: 12 cross-sectional studies, 7 cohort studies, two case control studies, 1 meta-analysis and 1 experimental study.The evidence level was performed according to SIGN criteria. The selection and review of articles was done by peer review, cases of disagreement between pairs was resolved by consensus.Our review found a higher level of evidence (1++) for increasing blood pressure and increased heart rate and occupational noise exposure. Studies with a level of evidence 2++ show results in the same direction.Ischemic heart disease, myocardial infarction and coronary diseases show a level of evidence 2++.Metabolic changes of lipid parameters and vascular abnormalities have a low level of evidence 3.Noise control in working environments is a measure for cardiovascular risk prevention. Hypertension, coronary risk and other cardiovascular diseases should be considered in medical surveillance practice of workers exposed to noise (AU)

Nível de ruído no ambiente de trabalho do professor de educação física em aulas de ciclismo indoor / Nivel de ruido en el ambiente de trabajo del profesor de educación física en aulas de ciclismo indoor / Level of noise at the workplace environment among physical education teachers in indoor bike classes

OBJETIVO: Analisar o nível de ruído no ambiente de trabalho do professor de educação física durante as aulas de ciclismo indoor e sua associação com alguns aspectos da saúde. MÉTODOS: Estudo transversal conduzido com 15 professores de educação física de diferentes academias de ginástica, na cidade do Rio de Janeiro (RJ), em 2007. As características do processo e da organização do trabalho e as queixas de saúde relatadas pelos professores foram coletadas por meio de questionário padronizado. Para verificação dos transtornos psiquiátricos menores foi usado o SRQ-20 (Self-Report Questionnaire). As medidas de pressão sonora foram realizadas em um aparelho portátil. O nível de pressão foi medido em dB(A) no nível equivalente de energia em diferentes pontos da sala e momentos da aula. As análises estatísticas utilizadas foram a ANOVA, o qui-quadrado e a correlação de Pearson. RESULTADOS: Os níveis de pressão sonora variaram entre 74,4 dB(A) e 101,6 dB(A). Os valores médios encontrados durante as aulas foram: a) aquecimento (média= 88,45 dB(A)); b) parte principal (média= 95,86 dB(A)); e, fechamento (média= 85,12 dB(A)). O ruído de fundo apresentou o valor médio de 66,89 dB(A). Houve diferenças significativas (p<0,001) entre os valores médios de ruído de fundo e as fases da aula. O ruído não se correlacionou aos transtornos psiquiátricos menores. CONCLUSÕES: Os profissionais de educação física que trabalham com ciclismo indoor estão sujeitos a níveis elevados de pressão sonora em suas aulas. Este agente físico tem sido associado a diversos problemas de saúde e, portanto, requerer um controle mais amplo.

OBJECTIVE:To analyze the level of noise at the workplace environment among Physical Education teachers during indoor bike classes and its association with some aspects of health. METHODS: Cross-sectional study carried out in 15 different gyms with 15 teachers in Rio de Janeiro (Southeastern Brazil) in 2007. A standardized questionnaire, tested in relation to its replication, was used in order to find out the characteristics of the process and the way this job is organized, as well as complaints related to health reported by these teachers. The SRQ-20 (Self-Report Questionnaire) was utilized in order to verify the existence of minor psychiatric disturbances. The levels of sound pressure were measured by a portable appliance. The level of pressure was verified in dB(A) at equivalent energy levels (Leq) in different places of the room at different moments during the class. ANOVA, chi-square and Pearson's correlation analyses were performed. RESULTS: The levels of sound pressure varied from 74.4 dB(A) to 101.6 dB(A). The results during the class were: a) warm-up (mean=88.45 dB(A)); b) main part (mean= 95.86 dB(A)); and, closure (mean= 85.12 dB(A)). The mean background noise was 66.89 dB(A)). There were significant differences (p<0.001) among the background noise levels within different moments of the class. The noise was not related to minor psychiatric disturbances. CONCLUSIONS: Physical education professionals working with indoor bike classes are under high levels of sound pressure during their classes. This physical agent has been related to several health problems and should therefore be more controlled.

OBJETIVO: Analizar el nivel de ruido en el ambiente de trabajo del profesor de educación física durante las aulas de ciclismo indoor y su asociación con algunos aspectos de la salud. MÉTODOS: Estudio transversal conducido con 15 profesores de educación física de diferentes academias de ejercicio, en la ciudad de Río de Janeiro (Sureste de Brasil), en 2007. Las características del proceso y de la organización de trabajo y los reclamos de salud relatados por los profesores fueron colectados por medio de cuestionario estandarizado. Para verificar los trastornos psiquiátricos menores fue usado el SRQ-20 (Self Report Questionnaire). Las medidas de presión sonora fueron realizadas en un aparato portátil. El nivel de presión fue medido en dB(A) en el nivel equivalente de energía en diferentes puntos de la sala y momentos de la clase. Los análisis estadísticos utilizados fueron el ANOVA, el chi-cuadrado y la correlación de Pearson. RESULTADOS: Los niveles de presión sonora variaron entre 74,4 dB(A) y 101,6 dB(A). Los valores promedios encontrados durante las aulas fueron: a) Calentamiento (promedio= 88,45 dB(A)); b) Parte principal (promedio= 95,86 dB(A)); y, encierre (promedio= 85,12 dB(A)). El ruido de fondo presentó el valor promedio de 66,89 dB(A). Hubo diferencias significativas (p<0,001) entre los valores promedios de ruido de fondo y las fases del aula. El ruido no se correlacionó a los trastornos psiquiátricos menores. CONCLUSIONES: Los profesionales de ecuación física que trabajan con ciclismo indoor están sujetos a niveles elevados de presión sonora en sus aulas. Este agente físico ha sido asociado a diversos problemas de salud y, por lo tanto, requiere un control más amplio.

Estudo comparativo de exames audiométricos de metalúrgicos expostos a ruído e ruído associado a produtos químicos / Comparative study of audiometrics tests on metallurgical workers exposed to noise only as well as noise associated to the handling of chemical products

A exposição a produtos químicos ototóxicos na presença ou não do ruído pode provocar danos irreversíveis na audição dos trabalhadores em um período significativamente menor de exposição. Objetivo: Realizar um estudo comparativo, através de exames audiométricos, em trabalhadores expostos somente a ruído e ruído associado a produtos químicos. Métodos: 155 metalúrgicos (18 - 50 anos) expostos a ruído (grupo I) e a ruído e produtos químicos (grupo II) por um período que varia de 3 a 20 anos. Resultados: diferença significativa na proporção de perda auditiva ocupacional da orelha direita entre os grupos I (3,6%) e II (15,5%). Proporção de perda auditiva ocupacional no profissional significativamente maior no grupo II (18,3%) em relação ao grupo I (6%). Com respeito ao tempo médio de exposição aos agentes agressores, o grupo I esteve exposto por tempo significativamente maior. Estudo retrospectivo. Discussão: O fato de ter havido maior comprometimento da orelha direita no grupo II é controverso e merece ser pesquisado futuramente, pois alguns estudos revelam que a orelha esquerda seria mais suscetível à lesão por ruído. Conclusão: O grupo II apresentou proporcionalmente maior prevalência de perda auditiva quando comparado ao grupo I, mesmo tendo estado exposto aos agentes agressores por um menor tempo médio.

Exposure to ototoxic chemical products in the presence or absence of noise can cause irreversible injury to the hearing of workers for a significantly short period of exposure period. Aim: to perform a comparative study, through audiometric tests, in workers exposed to noise only and noise associated with chemical products. Materials and Methods:155 steel workers (18 - 50 years) exposed to noise (group I), and exposed to noise and chemical products (group II) for a period that varies from 3 to 20 years. Results: significant difference in the rate of occupational hearing loss in the right ear between groups I (3.6%) and II (15.5%). A significantly higher rate of occupational hearing loss in group II (18.3%) and I (6%). With respect to the average time of exposure to aggressive agents, group I was exposed by a significantly higher time. Retrospective study. Discussion: The fact that the right ear was more affected in group II is controversial and should be better investigated in the future, since some studies show that the left ear would be more prone to noise-induced hearing loss. Conclusion: group II had proportionally a higher rate of hearing loss when compared with group I, even after having been exposed to aggressive agents for a lower average time.

Attributable fraction of work accidents related to occupational noise exposure in a Southeastern city of Brazil

Noise is the most frequent type of occupational exposure and can lead to both auditory and extra-auditory dysfunction as well as increasing the risk of work accidents. The purpose of this study was to estimate the attributable fraction of work accidents related to occupational noise exposure in a medium-sized city in Southeast Brazil. In this hospital-based case-control study, including 600 cases and 822 controls, the odds ratio of work accidents (controlled for several covariables) was obtained classifying occupational noise exposure into four levels and determining the prevalence at each level. Based on these data, the calculated attributable fraction was 0.3041 (95 percentCI: 0.2341-0.3676), i.e., 30 percent of work accidents in the study area were statistically associated with occupational noise exposure. The authors discuss the causes of this association and the implications for the prevention of work accidents.

O ruído é o mais freqüente dos agentes de exposição ocupacional. Pode proporcionar o desenvolvimento de disfunções auditivas e extra-auditivas, bem como o aumento do risco para acidentes do trabalho. O objetivo deste estudo foi estimar a fração de acidentes do trabalho atribuível à exposição ocupacional ao ruído, ocorridos em uma cidade de porte médio localizada no Sudeste do Brasil. A partir de um estudo caso-controle de base hospitalar, com 600 casos e 822 controles, obtiveram-se os odds ratio de acidentes do trabalho controlados para diversas covariáveis, relacionando trabalhadores expostos ao ruído em quatro níveis, bem como da prevalência destas exposições. Com estes resultados, estimou-se a fração atribuível como 0,3041 (IC95 por cento: 0,2341-0,3676), o que equivale a dizer que mais de 30 por cento dos acidentes do trabalho ocorridos nesta localidade são estatisticamente associados à exposição ocupacional ao ruído. Discute-se a causalidade dessa relação e suas implicações para a prevenção dos acidentes do trabalho.

Intensidade de ruído em hospital de 222 leitos na 18ª Regional de Saúde - PR / Noise level in a 222 bed hospital in the 18th health region - PR

A poluição sonora ambiental torna-se hoje onipresente e beira o intolerável. Nos hospitais, os avanços tecnológicos trazem, como conseqüência, níveis de ruído potencialmente danosos. Muito do ruído no hospital provém mais de dentro, do que de fora desse ambiente, sendo as principais causas de ruído em Unidade de Terapia Intensiva, por exemplo, os equipamentos e a conversação entre a equipe hospitalar. O objetivo deste trabalho foi avaliar o nível de ruído nos diversos ambientes hospitalares, em Hospital de 222 leitos na 18ª RS de Saúde - PR. MATERIAIS E MÉTODOS: Conduziu-se, em março de 2005 no período de 24 horas, em dez setores. Forma de Estudo: Aferição do nível de ruído ambiental utilizando um Decibelímetro modelo 1350. RESULTADOS: O nível de ruído encontrado em nosso estudo apresentou média total de 63,7 dB(A), que excede os valores máximos permitidos de 45 dB recomendados pela Associação Brasileira de Normas Técnicas (1987). CONCLUSÃO: Nos setores analisados, o nível de ruído encontrado neste está consideravelmente acima do recomendado. A equipe hospitalar deve estar consciente do ruído e dos efeitos deste, para que possa atuar de maneira mais efetiva na redução da poluição sonora, beneficiando assim a função laborativa dos profissionais e recuperação dos pacientes.

Environment noise pollution is common place today, at intolerable levels. In hospitals, technological developments have, as a consequence, potentially harmful noise levels. Much of the hospital noise comes from inside, rather than outside, and the major source of such noise is the Intensive Care Unit, for example equipment and hospital staff talk. Our goal with the present study was to investigate the noise level present in the different hospital environments, within a 222 bed hospital located at the 18th health zone, PR. MATERIALS AND METHODS: The study was carried out in March, 2005, during a period of 24 hours, in tem different sectors. CASE STUDY: We checked environmental sound level by means of a model 1350 decibel meter. RESULTS: The sound level found in our study was of 63.7 dB(A) in average, which exceeds the 45 dB recommended by the Brazilian Association of Technical Standards (1987). CONCLUSION: In the analyzed sectors, the sound level was considerably above the recommended maximum. The hospital staff should be aware of this noise level and its effects, so that they may act in a more efficient way in order to reduce this noise pollution; thus benefiting the professionals and patient recovery.