Hearing Care: Safe Listening Method and System for Personal Listening Devices.

Excessive use of Personal Listening Devices (PLDs) and prolonged exposure to noise from loud music create many potential risks associated with hearing loss. To this end, the World Health Organization has published Recommendation ITU-T H.870 in 2019, which provides adults and children with a set of recommendations for sound dosage and operating times needed to avoid potential hearing risks. Some studies have investigated noise exposure of related applications for listening safety, resulting in some related recommendations and applications; however, these studies often do not pay attention to measurement error, which is important for human real noise exposure estimation to avoid hearing loss. This paper proposes a method for calculating noise exposure that can accurately calculate the actual noise sound-pressure level (SPL) and PLD dosage based on the WHO-ITU standard. We develop a calculation method and design a listening system that includes (i) a Safe Listening Personal Listening Device (SL-PLD) that can measure the listening dose in real time and control the output volume effectively, (ii) a Safe Listening Application (SL-APP) for assisting the SL-PLD to check the listening status in real time and provide alerts. Our experimental results show that (i) the proposed noise calculation method can reach 0.88 dB deviation under the 76 dB reference SPL and 98.8% accuracy, as compared to the SoundCheck tool measurement, (ii) the proposed SL-PLD controls the SPL output effectively as the dose increases, and (iii) the SL-APP determines the dosage usage and will provide a warning when the dosage exceeds a preset value. Therefore, users can adjust their listening behavior for more secure listening by using our methods and applications.

Objective Measurement of Listening Device Use and Its Relation to Hearing Acuity.

OBJECTIVES: To examine whether adolescents exceed recommended noise exposure limits when using personal listening devices (PLDs) and to investigate the relationship between objectively measured PLD use and hearing thresholds. STUDY DESIGN: Cross-sectional study. SETTING: This study was embedded within an ongoing prospective birth cohort study in Rotterdam, the Netherlands. Data were collected from May 2017 to September 2019. METHODS: A smartphone application was developed to measure daily noise exposure from PLDs. Listening habits were monitored among 314 adolescents with a mean age of 13 years 7 months (SD, 5 months), of whom 51.6% were male. Hearing acuity was measured by pure tone audiometry, and tympanometry was performed in both ears. RESULTS: Within the study group, 2.2% adolescents exceeded the recommended daily noise dose (85 dBA as an 8-hour time-weighted average) among all days when the application was active and 9.9% when among only the listening days. No significant correlation was found between the daily noise dose from PLDs and pure tone thresholds. CONCLUSIONS: The majority of adolescents exhibited listening habits that could be considered safe. As noise-induced hearing loss develops slowly over time, it could be that the effects of PLD use on hearing are not evident yet in this young population with a relatively short duration of PLD use.

Analysis of the Actual One-Month Usage of Portable Listening Devices in College Students.

Although contemporary researchers are concerned about overexposure of portable listening devices (PLD) for adolescents and young adults who often prefer listening to music at high levels for a long time, many of these studies have focused on either comparing sound pressure levels of various kinds of earphones or evaluating the recognition of noise-included hearing loss and listening habits through surveys. Further still, current criteria were developed for occupational noise-induced hearing loss, so there are only a few published guidelines for hearing insults due to recreational noise exposure. The present study, therefore, measures actual listening levels and PLD time in college students using a real-time measurement system and applying that gathered scientific data to the internationally recommended noise exposure standards. Thirty-four college students were asked to listen to music similar to their daily lifestyles for 4-weeks. After installing the application, the Google account that linked to the user's mobile phone was logged into the server communication. When a subject listened to music, the average and maximum listening levels and listening time could then be recognized as his or her Google account ID and stored in the database for analysis. User data was measured at 1-s intervals and delivered to the main server system every 5 s. The data were analyzed as LZeq for mean levels and LCpeak for maximum levels, and also for PLD use time. The mean of the preferred listening level was 68-70 dB SPL for 4 weeks with long enough break times. That is, the listening levels of college students were not high enough to induce instant hearing loss when they used PLD. However, there was a large individual difference in the listening levels and use times. When applied to three recommended noise exposure criteria, the number of exceeded subjects also differed from 0 to 56.72% depending on the criterion. We thus suggest that appropriate and standardized criteria for music-induced hearing loss might be proposed for recreational PLD users.

Personal Music Players and Hearing Loss: The HUNT Cohort Study.

It is unclear whether the current average use of personal music players (PMPs) including mobile phones has affected hearing in the general population. The association between the use of PMPs and hearing loss was assessed in a large population cross-sectional and follow-up study with the following distribution: cross-sectional (2018): n = 26,606, 56% women, mean age 54 years and 20-year follow-up (baseline 1998): n = 12,115, 57% women, mean age at baseline 43 years. Hearing threshold was determined as pure-tone average over the frequencies 3, 4, and 6 kHz. We used linear regression to assess relationships between hearing threshold and PMP use (yes), duration (1-2/2-6/>6 h per week), or sound volume (low/medium/high), with nonuse as reference. The PMP use increased from 8% in 1998 to 30% in 2018. Compared with nonusers, neither use nor duration was related to hearing threshold. As to sound volume, listening at low levels was associated with better thresholds (-2.5 dB [-4.1 to -0.8]), while listening at high levels was associated with worse thresholds (1.4 dB [0.1 to 2.8]). We adjusted for age, sex, baseline hearing threshold, education, noise exposure, ear infections, head injury, and daily smoking. The association with sound volume was nearly twice as strong when adjusting for hearing threshold at baseline. Accordingly, the possibility of reverse causality was reduced although not eliminated by the follow-up design. This large population study showed no association between normal PMP use and 20-year progression in hearing; however users listening to high levels increased their hearing threshold.

The possibility of cochlear synaptopathy in young people using a personal listening device.

OBJECTIVE: To evaluate the association of listening to music loudly through personal listening devices with cochlear synaptopathy in young adults. METHODS: Fifty healthy young adults selected among 109 volunteers were included in the study. Participants of high risk (n=25) and low risk (n=25) groups estimated according to ETDNL (estimated total daily noise level) were evaluated using pure tone audiometry, tympanometry, matrix test, electrocochleography (EcochG) and auditory brainstem response (ABR) to evaluate the occurrence of cochlear synaptopathy. RESULTS: Audiometric thresholds between the groups were not significantly different (p>0.05). High risk group participants showed poorer performance than the low-risk group on the TurMatrix test, in non-adaptive noise with -5 SNR and -7.5 SNR, and at the 50% understanding SNR level with headphones (p<0.01). There was no difference in the adaptive free field in noise test at which 50% understanding was achieved (p>0.05). The AP amplitudes on EcochG and wave V amplitudes on ABR were significantly smaller in the high-risk group (p<0.05). There was no association between ETDNL and I/V ratio on ABR. CONCLUSION: Poorer performance in TurMatrix and other electrophysiologic tests revealed the negative effect of personal listening devices on the auditory system. Our findings support the hypothesis that personal listening devices could cause cochlear synaptopathy. Long-term studies are needed to determine the effects of binaural hearing and duration of noise exposure on the auditory system.

Personal Listening Device Use Habits, Listening Belief, and Perceived Change in Hearing Among Adolescents.

PURPOSE: This study aimed to identify personal listening device (PLD) usage habits, listening belief, and perceived change in hearing, and to investigate how the variables related to perceived change in hearing among adolescents. METHODS: The participants were 183 middle school students and 233 high school students from Ulsan. Data were collected by self-reported questionnaires from August 1, 2019, to October 22, 2019, and analyzed with descriptive statistics, χ2 test, Mann-Whitney U test, and hierarchical multiple logistic regression. RESULTS: Most students started to use PLDs from elementary school, and mean preferred listening level was 70.13 dB. Mean perceived susceptibility to music-induced hearing loss (MIHL) and perceived barriers to prevent MIHL were 5.18 and 3.40, respectively. Perceived change in hearing was reported on 14.2% of middle school students and 32.2% of high school students, and as the average score of perceived barriers to prevent MIHL increases by one point, the odds of decrease in hearing increase by 2.05 times (p < .001) and 1.35 times (p < .05), respectively. CONCLUSION: Considering that most adolescents are exposed to PLD in elementary schools and about a quarter experienced a decrease in hearing after PLD use, educational programs on hearing conservation are required to start as early as in schools. Particularly, knowledge and skills to overcome barriers to prevent MIHL should be emphasized in educational programs.

Personal Music Players Use and Other Noise Hazards among Children 11 to 12 Years Old.

Exposure to loud music-due to widespread personal music players (PMPs) and noisy leisure activities-are major risk factors for noise induced hearing loss (NIHL) in adolescents. However, there is little evidence of the impact of noise on the hearing of younger children. This study aimed to explore an association between PMP use and hearing, and to identify other sources of noise among children. The study sample consisted of 1032 children aged 11-12 years old. Hearing thresholds were determined from 0.5 to 8 kHz. PMP use and other noise exposures were evaluated using a survey. We found that 82% of the children had a PMP, and 78% were exposed to noise when playing computer games. An audiometric notch was documented in 1.3% of the children. Only 11.5% of the children ever used hearing protection while engaged in noisy activities. We found no convincing evidence of an association between PMP use and hearing thresholds, although our results suggest that tinnitus may be an early sign of NIHL in young children. The study shows a need to provide children, their parents, and educators with knowledge of how to take care of hearing, including how to avoid and minimize noise exposure.

Personal Audio System: Hearing Symptoms, Habits, and Sound Pressure Levels Measured in Real Ear and a Manikin.

Purpose The aims of this study were to characterize hearing symptoms, habits, and sound pressure levels (SPLs) of personal audio system (PAS) used by young adults; estimate the risk of developing hearing loss and assess whether instructions given to users led to behavioral changes; and propose recommendations for PAS users. Method A cross-sectional study was performed in 50 subjects with normal hearing. Procedures included questionnaire and measurement of PAS SPLs (real ear and manikin) through the users' own headphones and devices while they listened to four songs. After 1 year, 30 subjects answered questions about their usage habits. For the statistical analysis, one-way analysis of variance, Tukey's post hoc test, Lin and Spearman coefficients, the chi-square test, and logistic regression were used. Results Most subjects listened to music every day, usually in noisy environments. Sixty percent of the subjects reported hearing symptoms after using a PAS. Substantial variability in the equivalent music listening level (Leq) was noted (M = 84.7 dBA; min = 65.1 dBA, max = 97.5 dBA). A significant difference was found only in the 4-kHz band when comparing the real-ear and manikin techniques. Based on the Leq, 38% of the individuals exceeded the maximum daily time allowance. Comparison of the subjects according to the maximum allowed daily exposure time revealed a higher number of hearing complaints from people with greater exposure. After 1 year, 43% of the subjects reduced their usage time, and 70% reduced the volume. A volume not exceeding 80% was recommended, and at this volume, the maximum usage time should be 160 min. Conclusions The habit of listening to music at high intensities on a daily basis seems to cause hearing symptoms, even in individuals with normal hearing. The real-ear and manikin techniques produced similar results. Providing instructions on this topic combined with measuring PAS SPLs may be an appropriate strategy for raising the awareness of people who are at risk. Supplemental Material https://doi.org/10.23641/asha.12431435.

Use of Personal Listening Devices and Knowledge/Attitude for Greater Hearing Conservation in College Students: Data Analysis and Regression Model Based on 1009 Respondents.

Given the concern regarding increased hearing loss in young people who use personal listening devices (PLDs), the present study analyzes the experience of PLDs among college students to identify their knowledge of and attitude toward hearing conservation. It also explains their relationship between knowledge of hearing loss and attitude-related hearing conservation as a questionnaire response using a regression model. A total of 1009 Korean college students responded to an online questionnaire. As a survey tool, the Personal Listening Device and Hearing Questionnaire was adapted as a Korean version with 78 modified items under 9 categories. Using principal component analysis, specific factors were extracted, and their relationships and paths were confirmed using multiple regression analysis. The results of the knowledge category of the questionnaire indicate that most respondents knew how to maintain healthy hearing and understood the signs of hearing loss. Regardless, many college students habitually use PLDs at high levels in noisy environments; they do not recognize how to prevent hearing loss. Even though they continue their current use pattern for PLDs, they also had a positive attitude toward receiving more information about hearing conservation. According to the regression model, the students' self-reported hearing deficits were due to the volume rather than the frequent use. Interestingly, knowledge about hearing loss may encourage students to develop a positive attitude toward reasonable restriction of PLD use. When PLD users have detailed knowledge about the hearing loss provided by professionals, we believe that most will avoid serious hearing problems and its risks and maintain a judicious attitude toward their own conservation.

One Step Closer towards a Reliable Tinnitus Pitch-Match Frequency Determination Using Repetitive Recursive Matching.

INTRODUCTION: The determination of the tinnitus pitch-match (PM) frequency is not straightforward but an important audiological assessment recommended for clinical and research purposes. We evaluated repetitive recursive matching using an iPod-based matching procedure as a method to estimate a patient's PM frequency without audiometric equipment. METHODS: One hundred and seventeen patients with chronic tonal tinnitus (uni- and bilateral tinnitus) measured their tinnitus in 10 sessions using a self-administered automated iPod-based procedure comprising a recursive 2 interval forced-choice test. RESULTS: Mean SD of the PM frequency of all participants across sessions was 0.41 octaves. The internal consistency measured by Cronbach's α was very high (0.8->0.95). As an example, 7 PMs obtained excellent internal consistency (α = 0.93). The exclusion of the first and/or second session led to more definite PMs with a decreased SD. Outliers were identified by PMs departing 2 SDs (i.e., 0.94 octaves) from the mean variability (n = 5). CONCLUSION: Repetitive recursive matching together with recommendations for the exclusion of initial and redundant sessions as well as outlier identification and treatment can enable a reliable estimation of the PM frequency.

Reliability and criterion validity of the "Gyroscope" application of the iPod™ for measuring lumbar range of motion.

BACKGROUND: Recent technologies, such as the iPod, are often equipped with an accelerometer and magnetometer, which, through software applications, can perform various inclinometric functions. These applications have the potential to measure and quantify range of motion (ROM). OBJECTIVE: The purpose of this study was to estimate the iPod "Gyroscope" application intra- and inter-rater reliability as well as its criterion validity in healthy participants lumbar ROM assessment. METHODS: The sample consisted of 29 healthy participants. For the estimation of intra- and inter-reliability, two examiners measured the lumbar ROM of each participant twice using the iPod. To estimate the criterion validity, the measures were compared to those obtained with the Back Range of Motion Device (BROM; lateral flexion) and the double inclinometer (flexion and extension). Reliability and validity were then established using the intraclass correlation coefficient (ICC). RESULTS: We observed a moderate to high intra-rater reliability (ICCs = 0.67-0.91) and a moderate to high inter-rater reliability for each movement (ICCs = 0.72-0.89). For the criterion validity, the ICCs were all high (ICCs = 0.65-0.89). CONCLUSION: Our results provide evidence that the iPod "Gyroscope" application can be used to assess lumbar ROM for all movements.

Sonotherapy in the reduction of anxiety and postoperative pain in patients with regional anesthesia as a sole technique: randomized, controlled clinical trial.

OBJECTIVE: To determine if sonotherapy reduces the anxiety level and postoperative pain in adults undergoing outpatient orthopedic surgery under regional anesthesia. METHOD: A randomized, double-blind, placebo-controlled study in 80 adult patients undergoing orthopedic surgery, 40 received intervention with sonotherapy and 40 did not receive it. Pain, anxiety in the preoperative period, immediate postoperative, high, 24 and 48 hours later were measured. Hemodynamic parameters were measured in four moments. RESULTS: No significant differences were found between the two groups in the pain scales neither anxiety. A significant reduction of the systolic blood pressure was observed after the application of sonotherapy and in recovery. There was no difference in other hemodynamic variables such as heart rate, respiratory rate, arterial oxygen saturation or diastolic blood pressure between groups, however, the observed changes in some of them occurred faster in the intervention group. CONCLUSIONS: In adult patients undergoing outpatient orthopaedic surgery under regional anaesthesia, sound therapy is a novel strategy that significantly reduces systolic blood pressure, considered as an indicator of decreased anxiety. However, in our study, no difference could be demonstrated in terms of pain control or the need for additional sedation or analgesia.

OBJETIVO: Evaluar la eficacia de la sonoterapia en la diminución de la ansiedad y el dolor posoperatorio en adultos llevados a cirugía ambulatoria de ortopedia bajo anestesia regional. MÉTODO: estudio aleatorizado, doble ciego, controlado con placebo, en 80 pacientes adultos sometidos a cirugía ortopédica; 40 recibieron intervención con sonoterapia y 40 no la recibieron. Se midieron el dolor y la ansiedad en el preoperatorio, en el posoperatorio inmediato, al alta, y 24 y 48 horas después. Se midieron parámetros hemodinámicos en cuatro momentos. RESULTADOS: No se encontraron diferencias significativas entre ambos grupos en las escalas de dolor ni ansiedad. Se observó una reducción significativa de la presión arterial sistólica luego de la aplicación de la intervención y en recuperación. No se observaron diferencias en otras variables hemodinámicas entre los grupos, pero la reducción de algunas ocurre de forma más rápida en el grupo de intervención. CONCLUSIONES: En pacientes adultos llevados a cirugía ambulatoria de ortopedia bajo anestesia regional, la sonoterapia es una estrategia novedosa que reduce la presión arterial sistólica, y esto puede considerarse como un indicador de disminución de la ansiedad. En nuestro estudio no se pudo demostrar diferencia en términos de control del dolor ni de requerimiento de sedación o analgesia adicional.

Whole-Body Vibration Associated with Dozer Operation at an Australian Surface Coal Mine.

Bulldozers are used extensively on surface mine sites and have been previously identified as being associated with high amplitude whole-body vibration exposures. Previous investigations of this equipment have involved either a very small number of measurements, or measurements of very short duration (or both); or the data obtained were incompletely reported. This research reports 69 measurements (median duration 440 min) obtained from 15 different dozers during operation at a surface coal mine. More than one-third of vertical vibration measurements exceeded the ISO2631.1 Health Guidance Caution Zone when expressed as VDV(8). Considerable variability in measurement amplitudes was found. This was also true within measurements obtained from the same dozers on different shifts suggesting, by a process of elimination, that the remaining variability in whole-body vibration amplitude is a function of some combination of task characteristics, geology, and operator behaviour; rather than equipment-related variability, such as maintenance, suspension, seating, or track design. Short-comings in the evaluation methods provided by ISO2631.1 are highlighted.

Risk Assessment of Recreational Noise-Induced Hearing Loss from Exposure through a Personal Audio System-iPod Touch.

BACKGROUND: Recreational noise-induced hearing loss (RNIHL) is a major health issue and presents a huge economic burden on society. Exposure to loud music is not considered hazardous in our society because music is thought to be a source of relaxation and entertainment. However, there is evidence that regardless of the sound source, frequent exposure to loud music, including through personal audio systems (PAS), can lead to hearing loss, tinnitus, difficulty processing speech, and increased susceptibility to age-related hearing loss. PURPOSE: Several studies have documented temporary threshold shifts (TTS) (a risk indicator of future permanent impairment) in subjects that listen to loud music through their PAS. However, there is not enough information regarding volume settings that may be considered to be safe. As a primary step toward quantifying the risk of RNIHL through PAS, we assessed changes in auditory test measures before and after exposure to music through the popular iPod Touch device set at various volume levels. RESEARCH DESIGN: This project design incorporated aspects of both between- and within-subjects and used repeated measures to analyze individual groups. STUDY SAMPLE: A total of 40 adults, aged 18-31 years with normal hearing were recruited and randomly distributed to four groups. Each group consisted of five males and five females. DATA COLLECTION AND ANALYSIS: Subjects underwent two rounds of testing (pre- and postmusic exposure), with a 30-min interval, where they listened to a playlist consisting of popular songs through an iPod at 100%, 75%, 50%, or 0% volume (no music). Based on our analysis on the Knowles Electronic Manikin for Acoustic Research, with a standardized 711 coupler, it was determined that listening to the playlist for 30 min through standard earbuds resulted in an average level of 97.0 dBC at 100% volume, 83.3 dBC at 75% volume, and 65.6 dBC at 50% volume. Pure-tone thresholds from 500-8000 Hz, extended high-frequency pure tones between 9-12.5 kHz, and distortion product otoacoustic emissions (DPOAE) were obtained before and after the 30-min music exposure. Analysis of variance (ANOVA) was performed with two between-subjects factors (volume and gender) and one within-subjects factor (frequency). Change (shift) in auditory test measures was used as the outcome for the ANOVA. RESULTS: Results indicated significant worsening of pure-tone thresholds following music exposure only in the group that was exposed to 100% volume at the following frequencies: 2, 3, 4, 6 and 8 kHz. DPOAEs showed significant decrease at 2000 and 2822 Hz, also only for the 100% volume condition. No significant changes were found between pre- and postmusic exposure measures in groups exposed to 75%, 50%, or 0% volume conditions. Follow-up evaluations conducted a week later indicated that pure-tone thresholds had returned to the premusic exposure levels. CONCLUSIONS: These results provide quantifiable information regarding safe volume control settings on the iPod Touch with standard earbuds. Listening to music using the iPod Touch at 100% volume setting for as little as 30 min leads to TTS and worsening of otoacoustic emissions, a risk for permanent auditory damage.

A preliminary study on time-compressed speech recognition in noise among teenage students who use personal listening devices.

OBJECTIVE: To compare speech perception obtained with different time compression rates in teenagers that do or do not use personal listening devices (PLDs). DESIGN: Teenagers in a high school were recruited to complete questionnaires reporting their recreational noise exposure using PLDs. The dose of individual recreational noise exposure was calculated. The individuals with the most and least doses of recreational noise were selected and grouped into PLD users and non-PLD users. Normal rate and time-compressed (60% and 70%) speech recognition in quiet and noisy conditions was measured. STUDY SAMPLE: PLD user and non-PLD user group each included 20 participants. RESULTS: ANOVA analysis showed that the effect of group, background, compression rate, and interactions between any two factors are significant. Post hoc analysis showed that the speech recognition scores with normal rate in quiet and noise and those obtained from time-compressed speech in the quiet condition were not significantly different between PLD users and non-PLD users. However, differences in the time-compressed speech recognition scores (60% and 70%) in noisy conditions between the two groups were statistically significant. CONCLUSIONS: The fast-speed speech recognition in noise decreased significantly in PLD users compared with that in non-PLD users selected by extreme entertainment exposure.

Use of digital audio players by high school students: measurement of use intensity and usage habits. / Utilização de estéreos pessoais por alunos do ensino médio: mensuração da intensidade utilizada e hábitos de uso.

PURPOSE: The main goal of this study was to measure the sound pressure level of digital audio players of high school students and investigate their auditory and non-auditory complaints, and their hearing habits. Another goal was to consider the concern with hearing health and the knowledge sources used by young people to gather information about the subject. METHODS: This is an observational, descriptive, quantitative, and cross-sectional study, which had the participation of high school students. The first step was an examination of transient-evoked optoacoustic emissions, followed by the application of a questionnaire and the measurement of the volume of audio players. RESULTS: The results showed harmful habits of young people regarding hearing health, such as an excessive time of use (hours, days and years) and high volume levels of digital audio players (DAPs), as well as symptoms that may point to hearing loss. It was found that most young people seem to be concerned about their hearing; however, there is no change of attitude to such situations. CONCLUSION: The students develop the habit of using DAPs at very early ages and, in many cases, this habit is practiced with the equipment operating at high intensities, which can cause several hearing losses in these students.

OBJETIVO: Esta pesquisa teve como objetivo mensurar em um ambiente ruidoso o nível de pressão sonora dos estéreos pessoais de jovens do ensino médio, levantar suas queixas auditivas e extra-auditivas e seus hábitos de uso. Considerando-se ainda a preocupação com a saúde auditiva e as fontes utilizadas pelos jovens para obtenção de informações sobre o assunto. MÉTODO: Trata-se de um estudo observacional, descritivo, quantitativo, de delineamento transversal, do qual participaram jovens do ensino médio. Inicialmente foi realizado o exame de emissões otoacústicas evocadas por estímulos transientes, seguido da resolução de um questionário e a mensuração do nível de pressão sonora dos reprodutores de música utilizados em situação ruidosa simulada. RESULTADOS: A partir da mensuração dos estéreos pessoais, foram encontradas as intensidades mínima, de 69 dB(A), e máxima, de 93 dB(A). Os resultados mostraram hábitos nocivos à saúde auditiva sendo realizados pelos jovens, tais como tempo de uso (horas, dias e anos) e intensidade utilizada nos estéreos pessoais, assim como sintomas que podem indicar suscetibilidade a perdas auditivas. Observou-se que os jovens, em sua maioria, afirmam preocupar-se com sua audição, no entanto não há mudança de atitude diante dessas situações. CONCLUSÃO: O hábito do uso do estéreo pessoal é iniciado muito cedo dentro da população escolar e, em muitos casos, esse costume é praticado com o equipamento em intensidades elevadas, o que pode acarretar diversos prejuízos a esses alunos.

Longitudinal analysis of leisure noise exposure among adolescents with special focus on portable listening devices: the OHRKAN cohort study.

The aim was to investigate leisure noise exposure and sociodemographic determinants of risky leisure noise exposure over five years in 2148 students visiting grade 9 of any school type in a German city from 2009-2011. Within the OHRKAN cohort study, leisure noise exposure was calculated from literature-retrieved sound pressure levels (SPLs) and self-reported duration of 18 leisure activities at baseline and two follow-ups. Risky exposure was defined as exceeding 85 dB(A) averaged over a 40-h-week. Determinants of risky total leisure noise (TLN) exposure and risky exposure to portable listening devices (PLDs) were investigated using generalised estimating equations (GEEs). Up to 73% of students exceeded noise levels of 85 dB(A) at some timepoint. The noise exposure and importance of different leisure activities changed with increasing age. Risky exposure to TLN and PLDs was associated with lower education, single parent households and being male. Risky PLD exposure was additionally associated with a migrant background. Current prevention measures for leisure noise exposure must be extended to at-risk groups. Besides enhancing campaigns in lower education schools, acoustical insulation in sports halls, noise warnings on tools or in videogames could address especially men. Migrants need education about healthy PLD use in their native language if necessary.

Early Indication of Noise-Induced Hearing Loss in Young Adult Users of Personal Listening Devices.

OBJECTIVES: The recent integration of portable music players into cell phones has further increased the use of personal listening devices (PLD) among young adults, raising concerns about potentially hazardous effects on hearing. METHODS: Assessment of young adults' hearing ability and listening preferences by subjective and objective measurement. Young adult users of PLDs (n = 50; 30 females, 20 males; mean age = 24.1 ± 4.2 years; average PLD use = 6.1 ± 2.1 years) were included. Subjective assessment of listening preferences was performed via a questionnaire as well as objective assessment of preferred volume levels in different background noise environments and hearing tests. RESULTS: Preferred volume levels were significantly correlated with hearing thresholds. Most participants exhibited safe listening behavior according to National Institute for Occupational Safety and Health criteria. We identified a substantial high-risk subgroup of PLD users (22% of participants, daily use ⩾2 h at ⩾91 dB) in which pure tone audiometry showed increased hearing thresholds at 4000 and 6000 Hz, potentially indicating an early manifestation of noise-induced hearing loss (NIHL). CONCLUSIONS: These findings suggest that preventive measures may be warranted to prevent a future increase of clinically relevant NIHL among heavy users of PLDs.

Good agreement between smart device and inertial sensor-based gait parameters during a 6-min walk.

BACKGROUND: Traditional laboratory-based kinetic and kinematic gait analyses are expensive, time-intensive, and impractical for clinical settings. Inertial sensors have gained popularity in gait analysis research and more recently smart devices have been employed to provide quantification of gait. However, no study to date has investigated the agreement between smart device and inertial sensor-based gait parameters during prolonged walking. RESEARCH QUESTION: Compare spatiotemporal gait metrics measured with a smart device versus previously validated inertial sensors. METHODS: Twenty neurologically healthy young adults (7 women; age: 25.0 ±â€¯3.7 years; BMI: 23.4 ±â€¯2.9 kg/m2) performed a 6-min walk test (6MWT) wearing inertial sensors and smart devices to record stride duration, stride length, cadence, and gait speed. Pearson correlations were used to assess associations between spatiotemporal measures from the two devices and agreement between the two methods was assessed with Bland-Altman plots and limits of agreement. RESULTS: All spatiotemporal gait metrics (stride duration, cadence, stride length and gait speed) showed strong (r>0.9) associations and good agreement between the two devices. SIGNIFICANCE: Smart devices are capable of accurately reflecting many of the spatiotemporal gait metrics of inertial sensors. As the smart devices also accurately reflected individual leg output, future studies may apply this analytical strategy to clinical populations, to identify hallmarks of disability status and disease progression in a more ecologically valid environment.