The influencing factors of hearing protection device usage among noise-exposed workers in Guangdong Province: a structural equation modeling-based survey.

BACKGROUND: There are numerous complex barriers and facilitators to continuously wearing hearing protection devices (HPDs) for noise-exposed workers. Therefore, the present study aimed to investigate the relationship between HPD wearing behavior and hearing protection knowledge and attitude, HPD wearing comfort, and work-related factors. METHOD: A cross-sectional study was conducted with 524 noise-exposed workers in manufacturing enterprises in Guangdong Province, China. Data were collected on hearing protection knowledge and attitudes, HPD wearing comfort and behavior, and work-related factors through a questionnaire. Using structural equation modeling (SEM), we tested the association among the study variables. RESULTS: Among the total workers, 69.47% wore HPD continuously, and the attitudes of hearing protection (26.17 ± 2.958) and total HPD wearing comfort (60.13 ± 8.924) were satisfactory, while hearing protection knowledge (3.54 ± 1.552) was not enough. SEM revealed that hearing protection knowledge had direct effects on attitudes (ß = 0.333, p < 0.01) and HPD wearing behavior (ß = 0.239, p < 0.01), and the direct effect of total HPD wearing comfort on behavior was ß = 0.157 (p < 0.01). The direct effect also existed between work shifts and behavior (ß=-0.107, p < 0.05). Indirect relationships mainly existed between other work-related factors, hearing protection attitudes, and HPD wearing behavior through knowledge. Meanwhile, work operation had a direct and negative effect on attitudes (ß=-0.146, p < 0.05), and it can also indirectly and positively affect attitudes through knowledge (ß = 0.08, p < 0.05). CONCLUSION: The behavior of wearing HPD was influenced by hearing protection knowledge, comfort in wearing HPD, and work-related factors. The results showed that to improve the compliance of noise-exposed workers wearing HPD continuously when exposed to noise, the HPD wearing comfort and work-related factors must be taken into consideration. In addition, we evaluated HPD wearing comfort in physical and functional dimensions, and this study initially verified the availability of the questionnaire scale of HPD wearing comfort.

Noise-Induced Hearing Loss and Use of Hearing Protection Awareness among Medical Students in Saudi Arabia: Mixed Qualitative and Quantitative Study.

BACKGROUND: Noise-Induced Hearing Loss (NIHL) is a prevalent occupational hazard among healthcare professionals, including medical students. Despite its detrimental effects, the awareness and utilization of hearing protection measures among medical students in Saudi Arabia remain understudied. OBJECTIVE: Is to determine the level of awareness and understanding of NIHL among medical students in Saudi Arabia, as well as their knowledge and usage of hearing protection measures and to identify potential barriers and facilitators for hearing protection utilization. METHODS: A mixed-methods approach was employed, involving a questionnaire survey and semi-structured interviews. The survey collected data on demographics, knowledge of NIHL, and hearing protection practices among medical students. Subsequently, a semi-structured interview was conducted to obtain in-depth insights into the students' experiences, attitudes, and beliefs regarding NIHL and the use of hearing protection. RESULTS: The level about NIHL was 59.32%. Better access to information is associated with increased odds of awareness (odds ratio=3.07, p=0.012). Having relatives with hearing loss increases the odds of awareness (odds ratio =2.49, p=0.034). Individuals with hearing loss or impairment have higher odds of awareness (odds ratio =2.27, p=0.046). Ear Pain, temporary hearing loss, tinnitus, or ringing in the ear: These factors are not significantly associated with awareness of noise-induced hearing loss (p>0.05). Using hearing aids is strongly associated with increased odds of awareness (odds ratio =3.94, p=0.006).The quantitative analysis provided statistical information on the prevalence rates and factors influencing hearing protection usage, while the qualitative analysis uncover nuanced perspectives and experiences. CONCLUSION: This research will contribute to the understanding of NIHL and hearing protection practices among medical students in Saudi Arabia. Improving hearing protection awareness and practices among medical students can ultimately reduce the incidence of NIHL and promote a healthier work environment within the healthcare sector.

An acoustical environment survey of student music practice.

Chronic exposure to loud sound leads to noise-induced hearing loss. This is especially common in collegiate-level musicians. Existing methods for estimating exposure typically do not consider genre- or instrument-specific variability in soundscape/spectral characteristics. We measured sound exposure levels (SELs) across instruments, bands, and genres at a university music school. We found (1) considerable variability in SELs across instruments and bands, (2) that Jazz musicians are consistently exposed to the highest sound levels, and (3) that spectral features of music differ between instrument type and genre, and based on room size. These findings highlight the need for tailored guidelines that moderate the implementation of hearing conservation initiatives for collegiate musicians.

A novel model of sensorineural hearing loss induced by repeated exposure to moderate noise in mice: the preventive effect of resveratrol.

Sensorineural hearing loss (SNHL) induced by noise has increased in recent years due to personal headphone use and noisy urban environments. The study shows a novel model of gradually progressive SNHL induced by repeated exposure to moderate noise (8-kHz octave band noise, 90-dB sound pressure level) for 1 hr exposure per day in BALB/cCr mice. The results showed that the repeated exposure led to gradually progressive SNHL, which was dependent on the number of exposures, and resulted in permanent hearing loss after 5 exposures. Repeated exposure to noise causes a loss of synapses between the inner hair cells and the peripheral terminals of the auditory nerve fibers. Additionally, there is a reduction in the expression levels of c-fos and Arc, both of which are indicators of cochlear nerve responses to noise exposure. Oral administration of resveratrol (RSV, 50 mg/kg/day) during the noise exposure period significantly prevented the noise exposure-induced synapse loss and SNHL. Furthermore, the study found that RSV treatment prevented the noise-induced increase in the gene expression levels of the proinflammatory cytokine interleukin-1ß in the cochlea. These results demonstrated the potential usefulness of RSV in preventing noise-induced SNHL in the animal model established as gradually progressive SNHL.

[Study on the fit testing for the workers wearing hearing protection device in machinery manufacturing enterprises].

Objective: To investigate the occupational noise hazards in five machinery manufacturing enterprises, and to evaluate the individual noise reduction values and influencing factors of workers wearing hearing protection device (HPD) by individual fit testing. Methods: From November 2021 to January 2022, 5 machinery manufacturing enterprises in Bao'an District of Shenzhen were selected to conduct an occupational health survey to understand the noise exposure level of workers. The 3MTM E-A-RfitTM fitness test system was used to test the baseline individual sound attenuation value level (PAR) of the daily wear of the ear protecters for 485 workers in typical noise working positions. Workers whose PAR values could not meet the requirements of noise reduction at work were instructed to wear and repeated tests were conducted. PAR results of the workers before and after the intervention were collected and analyzed. Results: The noise workers who received the suitability test were mainly distributed in 24 types of work, the job noise exposure level was 80.2 dB (A) ~ 95.0 dB (A), and the job noise excess rate was 52.5% (138/263). The median baseline PAR [M (Q(1), Q(3)) ] for 485 workers was 6.0 (0.0, 14.0) dB. The baseline PAR of male workers, those with more than 15 years of working experience, those with more than 15 years of using ear guards, those who considered ear guards comfortable to wear, those with college degree or above, and those exposed to noise level 90 dB (A) were higher, and the difference was statistically significant (P<0.05). A total of 275 workers (56.7%) did not pass the baseline PAR test, and there was no statistically significant difference in the intervention rate of workers in different noise groups (P>0.05). PAR in subjects who did not pass baseline after intervention increased from 0.0 (0.0, 3.0) dB to 15.0 (12.0, 18.2) dB. Conclusion: The workplace noise hazard of machinery manufacturing enterprises is serious, and there is a great difference between the baseline PAR and the nominal value of the hearing guard worn by the noise exposed workers. The intervention measures can effectively improve the protective effect of wearing ear protectors.

Noise-induced hearing loss and hearing protection: Attitudes at a South African coal mine.

BACKGROUND:  Negative attitudes and beliefs are major contributing factors to the rising numbers of noise-induced hearing loss (NIHL) cases in coal mines both locally and internationally. International literature confirms limited knowledge surrounding employees' attitudes and beliefs regarding NIHL and hearing protection devices (HPDs), hence the need for the study. OBJECTIVES:  To ascertain the attitudes and beliefs about NIHL and HPD use among employees at a large scale underground coal mine in Mpumalanga. METHOD:  A descriptive and exploratory cross-sectional study was conducted using a self-administered questionnaire, developed by the National Institute for Occupational Safety and Health (NIOSH) on Beliefs about Hearing Protection and Hearing Loss (BHPHL). Participants (n = 241) included employees from a coal mine in Mpumalanga, South Africa. RESULTS:  Out of 241 completed surveys, this study found that 84% were aware of when to replace earmuffs; 95% believed wearing HPDs could prevent hearing loss in noisy environments; 83% felt their hearing was impacted by loud noise. Additionally, 86% mentioned discomfort from earmuff pressure; 95% emphasised HPD importance; and 95% used HPDs around loud sounds. Moreover, 98% knew how to properly wear earplugs, while lower education levels were linked to higher susceptibility to NIHL. CONCLUSION:  The study identified positive attitudes towards NIHL and HPD use, but existing NIHL cases must be acknowledged. Organisations can use the findings to develop tailored hearing conservation programmes (HCP), including education, involving employees in protection decisions and promoting diligent HPD usage.Contribution: This study contributes to the limited literature on noise perceptions, NIHL, and HPD use in mining, emphasising the impact attitude has on HPD use and assessing the effect of miners NIHL knowledge on compliance. The findings, unique to coal mining, hold significance for enhancing hearing conservation and reducing NIHL.

Personalized Porous Gelatin Methacryloyl Sustained-Release Nicotinamide Protects Against Noise-Induced Hearing Loss.

There are no Food and Drug Administration-approved drugs for treating noise-induced hearing loss (NIHL), reflecting the absence of clear specific therapeutic targets and effective delivery strategies. Noise trauma is demonstrated results in nicotinamide adenine dinucleotide (NAD+) downregulation and mitochondrial dysfunction in cochlear hair cells (HCs) and spiral ganglion neurons (SGNs) in mice, and NAD+ boosted by nicotinamide (NAM) supplementation maintains cochlear mitochondrial homeostasis and prevents neuroexcitatory toxic injury in vitro and ex vivo, also significantly ameliorated NIHL in vivo. To tackle the limited drug delivery efficiency due to sophisticated anatomical barriers and unique clearance pathway in ear, personalized NAM-encapsulated porous gelatin methacryloyl (PGMA@NAM) are developed based on anatomy topography of murine temporal bone by micro-computed tomography and reconstruction of round window (RW) niche, realizing hydrogel in situ implantation completely, NAM sustained-release and long-term auditory preservation in mice. This study strongly supports personalized PGMA@NAM as NIHL protection drug with effective inner ear delivery, providing new inspiration for drug-based treatment of NIHL.

Noise-induced hearing loss in the pre-industrial era: early contributions in De Morbis Artificum by Bernardino Ramazzini (1633-1714).

OBJECTIVE: Noise-induced hearing loss is the most prevalent occupational disease worldwide and is historically associated with the Industrial Revolution. This study analyses early descriptions of this disorder during the pre-industrial period in the work of the Italian physician Bernardino Ramazzini (1633-1714). METHOD: Primary and secondary historical literature were reviewed. RESULTS: Ramazzini described hearing loss in corn millers and in coppersmiths and recognised that this disorder is irreversible and progressive when exposure to noise continues. He also seemed to describe tinnitus. He further suggested the use of earplugs as a preventive measure for these classes of workers. Ramazzini's anatomical and pathological knowledge appears to be based on ancient authors; he did not discuss contemporaneous medical authors' work on hearing function. CONCLUSION: Despite some limitations, Ramazzini's work appears pioneering for his time and represents an important milestone in the history of otolaryngology.

Training to Improve Spatial Hearing and Situation Awareness when Wearing Hearing Protection.

INTRODUCTION: Hearing protection devices (HPDs) are standard personal protective equipment in military settings, but many service members may choose to not use HPDs because they impair spatial hearing and situation awareness. In an effort to reduce barriers to compliance by improving situation awareness while wearing HPDs, this study investigated whether brief training could counteract spatial hearing deficits when wearing HPDs. Participant's ability to correctly apply the HPDs across days was also examined. MATERIALS AND METHODS: Young adults were randomly assigned to one of two groups: training or control (n = 25/group). Participants in each group performed a spatial hearing task while wearing HPDs and in an open ear condition without HPDs. Individual targets were battlefield sounds or white noise presented from a speaker array that surrounded the participant in the horizontal plane. After presentation of each target sound, the participant then controlled a white noise "auditory pointer," which they moved to the perceived location of the target. The two primary measures were the percent of trials with very large errors (> 45°), which were usually due to confusing front and back locations, and absolute localization, which is the difference between the pointer location and the true sound location. Both groups were tested on Days 1 (baseline) and 5 (post-test). On Days 2 to 4, the training group wore HPDs while receiving auditory and visual feedback after each trial. RESULTS: Across all participants on Day 1, wearing HPDs increased the frequency of very large errors by about 3× and impaired localization by about 40%, relative to the open ear condition. When comparing performance at baseline (Day 1) and post-training Day 5, the training group with HPDs had significant reductions in very large errors and improved absolute localization (P values < .001). The training group also had significant improvements from Days 1 to 5 in the open ear condition. When the control group wore HPDs, there were also significant improvements from Days 1 to 5 (fewer very large errors and better localization), with smaller effect sizes vs. the training group. Controls did not have significant improvement in the open ear condition, but had similar trends. Most participants consistently applied the HPDs, but a subset of ∼20% frequently failed to achieve the criterion attenuation of 15 dB (over 0.25-4.0 kHz) in both ears. CONCLUSIONS: These findings show that simple, relatively brief practice and training can substantially reduce HPD impairments on spatial hearing and situation awareness. The gains from training and practice can inform the development of relatively simple, brief methods to reduce HPD spatial hearing impairments, potentially leading to increased HPD compliance. Longitudinal data show that a subset of participants would not have received the full benefit of hearing protection because of improper application of the HPDs.

Measuring earplug noise attenuation: A comparison of laboratory and field methods.

Hearing protection device (HPD) fit-testing is a recommended best practice for hearing conservation programs as it yields a metric of the amount of attenuation an individual achieves with an HPD. This metric, the personal attenuation rating (PAR), provides hearing health care, safety, and occupational health personnel the data needed to select the optimal hearing protection for the occupational environment in which the HPD will be worn. Although commercial-off-the-shelf equipment allows the professional to complete HPD fit tests in the field, a standard test methodology does not exist across HPD fit-test systems. The purpose of this study was to compare the amount of attenuation obtained using the "gold standard" laboratory test (i.e., real-ear attenuation at threshold [REAT]) and three commercially available HPD fit-test systems (i.e., Benson Computer Controlled Fit Test System [CCF-200] with narrowband noise stimuli, Benson CCF-200 with pure tone stimuli, and Michael and Associates FitCheck Solo). A total of 57 adults, aged 18 to 63, were enrolled in the study and tested up to seven earplugs each across all fit-test systems. Once fitted by a trained member of the research team, earplugs remained in the ear throughout testing across test systems. Results revealed a statistically significant difference in measured group noise attenuation between the laboratory and field HPD fit-test systems (p < .0001). The mean attenuation was statistically significantly different (Benson CCF-200 narrowband noise was +3.1 dB, Benson CCF-200 pure tone was +2.1 dB, and Michael and Associates FitCheck Solo was +2.5 dB) from the control laboratory method. However, the mean attenuation values across the three experimental HPD fit-test systems did not reach statistical significance and were within 1.0 dB of one another. These findings imply consistency across the evaluated HPD fit-test systems and agree with the control REAT test method. Therefore, the use of each is acceptable for obtaining individual PARs outside of a laboratory environment.

New Paradigm of Music Listening: Hearing Protection Perceptions and Treatment Decision-Making Among Music Venue Attendees.

OBJECTIVE: Investigate the prevalence of hearing protection (HP) use and behavioral motivations and barriers among adults attending music venues. STUDY DESIGN: Cross-sectional online survey study. SETTING: Noise exposure levels at popular social music venues often exceed national guidelines. METHODS: Surveys were distributed on online music communities. Respondents (n = 2352) were asked about demographics, HP use at music venues, knowledge about noise exposure impact, and perceptions of HP use. Data were characterized through descriptive statistics. Multivariable regression analysis explored differences in knowledge and perception between HP users and nonusers. RESULTS: In this cohort (mean age 29 ± 7 years, 61% male), HP users were significantly more aware of the impact of music venues on hearing (P < .01), believed their hearing ability had decreased after attending music venues (P < 0.01), and believed HP could protect from hearing loss (P < .01) than non-HP users. HP nonusers most frequently cited never considering HP (14.45%) and apathy about it affecting music quality (12.71%). Common sources of HP information were recommended by a friend/peer. Multivariable regression analysis accounting for demographics, medical history, and attendance characteristics found belief that HP use at music venues could protect from hearing loss (ß = 0.64, 95% confidence interval [CI] = [0.49-0.78]) and HP use (ß = 1.73, 95% CI = [1.47-1.98]) were significantly associated with increased subjective enjoyment while wearing HP. CONCLUSION: HP users and nonusers have significantly different perceptions of HP use and its impact. Our findings have implications for understanding motivations and barriers related to HP use and developing strategies to promote HP use at music venues.

Noise risk assessment practices of four South African manufacturing and utilities companies.

BACKGROUND:  The South African Noise Induced Hearing Loss (NIHL) Regulations, mandates employers to conduct a noise risk assessment, which records specific variables for determining the status of exposure and the need for implementation of control measures. OBJECTIVES:  The study evaluated company noise risk assessment practices for alignment with legal requirements and specific risk assessment guidelines. METHOD:  Convenience sampling was used to select the four manufacturing and utilities companies that participated in the study. The participating companies submitted latest noise risk assessment records for evaluation through the READ approach. RESULTS:  The noise risk assessment records of three of the four companies omitted the recording of factors such as the reasonable deterioration in or failure of control measures, adequate control and formalisation of hearing conservation programmes (HCPs). When evaluated against the South African National Standard 31000 Risk Assessment guidelines, the risk assessment processes of the respective companies were lacking in addressing aspects related to establishing communication and consultation, evaluation, adapting, continually improving, leadership and commitment, and integration. CONCLUSION:  The recorded information on the noise risk assessment reports from the four participating companies were incomplete, negatively affecting subsequent HCP management processes and decision-making. Future studies should investigate other aspects such as the implementation status of recommended noise controls as well as their effectiveness as recorded in the noise risk assessment records.Contribution: This study provided firsthand insights of company noise risk assessment practices, specifically identifying functional and technical areas requiring improvement to enhance current efforts directed towards the minimisation of NIHL within HCPs. The study highlighted that the current practices on recording noise risk assessment information remain incomplete, adversely diminishing the impact of the assessment as an important decision-making tool. The identified technical issues specifically, when addressed, will increase trust on the decisions derived from noise risk assessments.

[Research on the protective effect of hearing protective device for workers exposed to noise in a motor manufacturing enterprise].

Objective: To understand the current situation of noise hazard in a motor manufacturing enterprise, and to explore the protective effect of workers wearing hearing protective device and its possible influencing factors. Methods: In November 2021, a total of 179 noise workers wearing hearing protective devices in a motor manufacturing company in a city were selected as research objects. Personal attenuation rating (PAR) of workers wearing hearing protective devices was measured. Baseline PAR was analyzed for different subgroups of basic demographic information, noise exposure, and the use of hearing protective devices to evaluate the effect of the intervention. Baseline PAR was compared using nonparametric tests. Results: There were 179 workers from 35 positions in 4 types of work, and the over-standard noise rate was 51.2% (42/82), among which the noise exposure intensity of motor equipment debugging workers was the highest [94.4 dB (A) ]. Compared the baseline PAR of different characteristics, it was found that the baseline PAR of male workers, workers whose daily noise exposure time were <8 h, workers who had used the hearing protective devices for 10 to 14 years, and workers who thought the hearing protective devices were comfortable were all higher, and the differences were statistically significant (P<0.05). Baseline PAR passing rate was 43.0% (77/179), and PAR of 102 workers who did not pass baseline test increased from 0 (0, 3) dB before intervention to 14 (12, 16) dB after intervention, with statistical significance (P<0.05) . Conclusion: The noise hazard in this motor manufacturing enterprise is serious, and the protective effect of workers wearing hearing protective devices is not good. Gender, daily noise exposure time, years and comfort of wearing hearing protective device are the possible influencing factors of poor protective effect.

BDNF-enriched small extracellular vesicles protect against noise-induced hearing loss in mice.

Noise-induced hearing loss (NIHL) is one of the most prevalent acquired sensorineural hearing loss etiologies and is characterized by the loss of cochlear hair cells, synapses, and nerve terminals. Currently, there are no agents available for the treatment of NIHL because drug delivery to the inner ear is greatly limited by the blood-labyrinth barrier. In this study, we used mesenchymal stem cell-derived small extracellular vesicles (MSC-sEVs) as nanoscale vehicles to deliver brain-derived neurotrophic factor (BDNF) and evaluated their protective effects in a mouse model of NIHL. Following intravenous administration, BDNF-loaded sEVs (BDNF-sEVs) efficiently increased the expression of BDNF protein in the cochlea. Systemic application of sEVs and BDNF-sEVs significantly attenuated noise-induced cochlear hair cell loss and NIHL in CBA/J mice. BDNF-sEVs also alleviated noise-induced loss of inner hair cell ribbon synapses and cochlear nerve terminals. In cochlear explants, sEVs and BDNF-sEVs effectively protected hair cells against H2O2-induced cell loss. Additionally, BDNF-sEVs remarkably ameliorated H2O2-induced oxidative stress, cell apoptosis, and cochlear nerve terminal degeneration. Transcriptomic analysis revealed that many mRNAs and miRNAs were involved in the protective actions of BDNF-sEVs against oxidative stress. Collectively, our findings reveal a novel therapeutic strategy of MSC-sEVs-mediated BDNF delivery for the treatment of NIHL.

Preventing Excessive Noise Exposure in Infants, Children, and Adolescents.

Noise affects people of all ages. Noise-induced hearing loss, a major problem for adults, is also a problem for young people. Sensorineural hearing loss is usually irreversible. Environmental noise, such as traffic noise, can affect learning, physiologic parameters, sleep, and quality of life. Children and adolescents have unique vulnerabilities. Infants and young children must rely on adults to remove them from noisy situations; children may not recognize hazardous noise exposures; teenagers often do not understand consequences of high exposure to music from personal listening devices or attending concerts and dances. Personal listening devices are increasingly used, even by small children. Environmental noise has disproportionate effects on underserved communities. This statement and its accompanying technical report review common sources and effects of noise as well as specific pediatric exposures. Because noise exposure often starts in infancy and effects are cumulative, more attention to noise in everyday activities is needed starting early in life. Pediatricians can potentially lessen harms by raising awareness of children's specific vulnerabilities to noise. Safer listening is possible. Noise exposure is underrecognized as a serious public health issue in the United States. Greater awareness of noise hazards is needed at a societal level.

Preventing Excessive Noise Exposure in Infants, Children, and Adolescents.

Noise exposure is a major cause of hearing loss in adults. Yet, noise affects people of all ages, and noise-induced hearing loss is also a problem for young people. Sensorineural hearing loss caused by noise and other toxic exposures is usually irreversible. Environmental noise, such as traffic noise, can affect learning, physiologic parameters, and quality of life. Children and adolescents have unique vulnerabilities to noise. Children may be exposed beginning in NICUs and well-baby nurseries, at home, at school, in their neighborhoods, and in recreational settings. Personal listening devices are increasingly used, even by small children. Infants and young children cannot remove themselves from noisy situations and must rely on adults to do so, children may not recognize hazardous noise exposures, and teenagers generally do not understand the consequences of high exposure to music from personal listening devices or attending concerts and dances. Environmental noise exposure has disproportionate effects on underserved communities. In this report and the accompanying policy statement, common sources of noise and effects on hearing at different life stages are reviewed. Noise-abatement interventions in various settings are discussed. Because noise exposure often starts in infancy and its effects result mainly from cumulative exposure to loud noise over long periods of time, more attention is needed to its presence in everyday activities starting early in life. Listening to music and attending dances, concerts, and celebratory and other events are sources of joy, pleasure, and relaxation for many people. These situations, however, often result in potentially harmful noise exposures. Pediatricians can potentially lessen exposures, including promotion of safer listening, by raising awareness in parents, children, and teenagers. Noise exposure is underrecognized as a serious public health issue in the United States, with exposure limits enforceable only in workplaces and not for the general public, including children and adolescents. Greater awareness of noise hazards is needed at a societal level.

[Noise pollution in the working environment]. / Pollution sonore dans le milieu professionnel.

NOISE POLLUTION IN THE WORKING ENVIRONMENT. Hearing damage due to exposure to noise in the workplace has been recognised as a professional disease since 1963. It first manifests itself as auditory fatigue, which can be assessed by Echoscan and which requires preventive measures, before bilateral hearing loss sets in, usually symmetrical, initially producing a very characteristic auditory scotoma centred on the 4000 Hz frequency. This irreversible hearing loss may be accompanied by tinnitus, more rarely by hyperacusis, as well as other extra-auditory manifestations: stress, high blood pressure or sleep disorders. The regulations aimed at protecting workers against noise trauma impose collective measures, the wearing of individual protectors and, above all, hearing monitoring every two years. Recognition as a professional disease of hearing damage resulting from professional exposure to noise damage enables the worker to be compensated and to be helped in the acquisition of hearing aids, if prescribed.

POLLUTION SONORE DANS LE MILIEU PROFESSIONNEL. L'atteinte auditive liée à une exposition aux bruits sur le lieu de travail est reconnue comme maladie professionnelle depuis 1963. Elle se manifeste d'abord par une fatigue auditive qu'il est possible d'objectiver par Echoscan et qui impose des mesures préventives avant que ne s'installe une surdité bilatérale, habituellement symétrique, réalisant au début un scotome auditif très caractéristique centré sur la fréquence de 4 000 Hz. Cette surdité irréversible peut s'accompagner d'acouphènes, plus rarement d'hyperacousie ainsi que d'autres manifestations extra-auditives : stress, hypertension artérielle ou encore troubles du sommeil. La réglementation visant à protéger les travailleurs contre les traumatismes sonores impose des mesures collectives, le port de protecteurs individuels mais surtout une surveillance de l'audition effectuée tous les deux ans. La reconnaissance comme maladie professionnelle de l'atteinte auditive consécutive à une exposition professionnelle aux bruits lésionnels permet d'indemniser le travailleur et de l'aider lors de l'acquisition de prothèses auditives éventuellement prescrites.

GRAIL gene knockout mice protect against aging-related and noise-induced hearing loss.

BACKGROUND: Hearing loss is a global health issue and its etiopathologies involve complex molecular pathways. The ubiquitin-proteasome system has been reported to be associated with cochlear development and hearing loss. The gene related to anergy in lymphocytes ( GRAIL ), as an E3 ubiquitin ligase, has not, as yet, been examined in aging-related and noise-induced hearing loss mice models. METHODS: This study used wild-type (WT) and GRAIL knockout (KO) mice to examine cochlear hair cells and synaptic ribbons using immunofluorescence staining. The hearing in WT and KO mice was detected using auditory brainstem response. Gene expression patterns were compared using RNA-sequencing to identify potential targets during the pathogenesis of noise-induced hearing loss in WT and KO mice. RESULTS: At the 12-month follow-up, GRAIL KO mice had significantly less elevation in threshold level and immunofluorescence staining showed less loss of outer hair cells and synaptic ribbons in the hook region compared with GRAIL WT mice. At days 1, 14, and 28 after noise exposure, GRAIL KO mice had significantly less elevation in threshold level than WT mice. After noise exposure, GRAIL KO mice showed less loss of outer hair cells in the cochlear hook and basal regions compared with WT mice. Moreover, immunofluorescence staining showed less loss of synaptic ribbons in the hook regions of GRAIL KO mice than of WT mice. RNA-seq analysis results showed significant differences in C-C motif chemokine ligand 19 ( CCL19 ), C-C motif chemokine ligand 21 ( CCL21 ), interleukin 25 ( IL25 ), glutathione peroxidase 6 ( GPX6 ), and nicotinamide adenine dinucleotide phosphate (NADPH) oxidase 1 ( NOX1 ) genes after noise exposure. CONCLUSION: The present data demonstrated that GRAIL deficiency protects against aging-related and noise-induced hearing loss. The mechanism involved needs to be further clarified from the potential association with synaptic modulation, inflammation, and oxidative stress.

A current affair: worker perceptions of noise exposure and occupational hearing loss in Australian coal mines.

BACKGROUND: The objective of the online survey was to determine worker attitudes towards, perceptions on hearing loss, and management of workplace noise; and to identify barriers within current strategies that prevent effective management of hearing health in Australian mines. DESIGN: This cross-sectional study utilized a modified survey design, initially designed for use by Safe Work Australia for a broader study published in 2010. STUDY SAMPLE: The survey questionnaire was made available online to volunteer participants, recruited with the assistance of State and National Health and Safety, and mining organizations. Volunteer participants were required to be proficient in English, be employed by an Australian underground or open cut mine, including coal processing plants; or work as a contractor on one of the specified mine sites. All mining employees, regardless of occupation, job title, and occupational hearing loss classification or status, were invited to complete the questionnaire. RESULTS: Almost 60% of respondents indicated that they had high noise exposure for than 10 yr or more, and have some trouble hearing, mostly associated with infrequent tinnitus. Nearly 71% of these workers believe that the noise control strategies in their workplaces are effective, but this mostly refers to the use of hearing protection devices. CONCLUSION: The results indicate that general knowledge on the cause and effect of noise exposure in the workplace is well understood. However, due to the long latency associated with the development of noise-induced hearing loss (NIHL), there is an issue urgency in terms of risk management. It is surprising that most of the respondents recommended more inspections and administrative controls, especially since most respondents were health, safety, and environment (HSE) professionals. HSE professionals should be advocating for higher order, more permanent solutions, and not purely administrative controls and personal protective equipment. These findings raise the question of whether there is a multifaceted working-culture issue that needs to be addressed, in combination with higher order control implementation.

Reinvigorating engineered noise controls: a systems approach.

OBJECTIVES: Hearing loss is a major worldwide health issue affecting an estimated 1.5 billion people. Causes of hearing loss include genetics, chemicals, medications, lifestyle habits such as smoking, and noise. Noise is probably the largest contributing factor for hearing loss. Noise arises from the workplace, ambient environment, and leisure activities. The easiest noise sources to control are workplace and environmental. Workplace noise is unique in that the employer is responsible for the noise and the worker. Also, workers may be exposed to much higher levels of noise than they would accept elsewhere. Employers follow the traditional hierarchy of controls (substitution/engineering, administrative, personal protective equipment [PPE]). Substituting or engineering a lower noise level actually reduces the hazard present to the worker but demand more capital investment. Administrative and PPE controls can be effective, but enforcement and motivation are essential to reducing risk and there is still some hearing loss for a portion of the workers. The challenge is to estimate the costs more clearly for managers. A systems engineering approach can help visualize factors affecting hearing health. MATERIAL AND METHODS: In this study, a systems engineering causal loop diagram (CLD) was developed to aid in understanding factors and their interrelationships. The CLD was then modeled in VenSim. The model was informed from the authors' expertise in hearing health and exposure science. Also, a case study was used to test the model. The model can be used to inform decision-makers of holistic costs for noise control options, with potentially better hearing health outcomes for workers. RESULTS: The CLD and cost model demonstrated a 4.3 year payback period for the engineered noise control in the case study. CONCLUSIONS: Systems thinking using a CLD and cost model for occupational hearing health controls can aid organizational managers in applying resources to control risk. Int J Occup Med Environ Health. 2023;36(5):672-84.