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Andrea Cintra Lopes1, Karina Aki Otubo2, Talita Costa Basso3, Erica Juliana Innocenti Marinelli3, Jose Roberto Pereira Lauris4.
Introduction: Studies on the occupational exposure show that noise has been reaching a large part of the working population around the world, and NIHL (noise-induced hearing loss) is the second most frequent disease of the hearing system.
INTRODUCTION When we think of the diversity of health problems generated by the productive processes, there emerges the need for experiences that find the understanding of health aggravation provoked by the work in social groups.
In 2005, the manufacturing sector had a nonfatal occupational illness incidence rate of 66.1 cases per 10,000 workers.
Longitudinal surveys help us understand long-term changes, such as how events that happened when a person was in high school affect labor market success as an adult. The Spotlight examines how earnings and wages have changed over time and how they differ within a geographic area, industry, or occupation.
Objective: To review the audiometry results of employees at the campus of the University of Sao Paulo, Bauru.
The speed of changes of these productive processes involves the appearing of risk situations due to the implementation of new technologies and manners of work organization and, therefore, a change to the health standard of the working class (1). We may consider to be an important factor of this process the increase of pollution rates, mainly in the big cities. The participants were divided into 2 groups: those with tonal thresholds within acceptable thresholds and those who presented auditory thresholds alterations, that is tonal thresholds below 25 dB (NA) in any frequency (Administrative Rule no. Given the third major cause of environmental pollution, behind water and air pollution (2), the noise is the most frequent physical agent harmful to health in the work environment, and is characterized as a the factor of most prevalence for the origin of occupational diseases (3). The intense noise occupational exposure may be characterized as an acoustic trauma (sudden loss, resulting from a single exposure to intense noise), threshold temporary alteration (audibility threshold elevation that is recovered gradually after exposure to noise) and PAINPSE -High Pressure Levels Induced Hearing Loss (characterized by the degeneration of hair cells of the Corti's Organ) (2,4,5). In Brazil, PAINPSE is known to represent one of the most frequent diseases among our workers, and is the second major cause of hearing loss in adults, second only to presbycusis (6). PAINPSE is defined as the hearing loss generated by high sound pressure levels, with alterations of the auditory thresholds, of neurosensorial, generally bilateral type, resulting from occupational noise exposure, and its main features include irreversibility and gradual progression with the time of risk exposure (7). The results of high frequencies Audiometry confirmed worse thresholds than those obtained in the conventional audiometry in the 2 groups evaluated.
Its natural history initially shows the affection of the auditory thresholds in one or more frequencies ranging from 3000Hz to 6000Hz. Conclusion: The use of high frequencies audiometry proved to be an important register as a hearing alteration early detection method.


Once ceased the exposure, there will be no progression of the hearing reduction (8,9,10,11). 25% of the exposed working population is estimated (12,13,14,15) to have PAINPSE in some degree. In spite of being the most frequent aggravation to the workers' health, its prevailing data are not yet much known in Brazil. This reinforces the importance of notification that enables the awareness of the reality and dimensions the required prevention and assistance measures (2). Once there is no clinical treatment for this kind of hearing loss, the prevention of the problem is very important with adoption of environmental actions, associated to the use of individual protection equipment; even though the legislation in force in Brazil has not been avoiding the dissemination of the professional deafness (16,17).
In the literature researched, it was necessary to investigate the auditory health conditions of workers at the University of Sao Paulo, Bauru campus, allocated in environments whose level of sound pressure exceeds 80dBNPS (action level), comprising hearing losses prevention programs, aiming to minimize the risks of occupation origin auditory deficiency and then enabling the maintenance of the auditory quality of the respective individuals.
METHOD This study relied on the participation of the employees of the University of Sao Paulo who remain exposed to environmental noise at intensity above 80 dBNPS (action level), during the day's work of 8 hours, located at the University Campus of Bauru, and are periodically submitted to Audiological Assessment. This assessment is part of the (PPRA) Environmental Risks Prevention Program and the (PCMSO) Program for Medical Control and Occupational Health, set up by the Institution's (SESMIT) Specialized Service of Work Safety and Medicine. For survey of data regarding the clinical and occupational history of the participants, a specific interview was carried out by means of a questionnaire.
After the interview, the (MAE) External Acoustic Meatus Inspection was performed aiming at verifying possible commitments that could interfere with the specific evaluations, such as, occlusion of the canal resulting from wax.
In the data collection the Siemens trademark audiometer, model SD50 was used with auricular phones HAD 200, Vibrasom acoustic cabin, and was duly calibrated by meeting the norms of audiometer gauging according to INMETRO.
In addition to (AT-AC) Conventional Threshold Tonal Audiometry, whose frequencies analyzed comprise the ranges from 250Hz to 8000Hz, the (AT-AF) High Frequencies Tonal Audiometry was also used because according to studies carried out, it is an early diagnosis instrument for auditory alterations resulting from some etiological agents, such as, levels of high sound pressure levels (18). The data collected were stored in a software (Microsoft Excel) for further statistical analysis. 19 of the Ministry of Labor and Employment - 1998).RESULTS The analysis of the 40 audiometries (80 ears) allowed the characterization of the auditory profile of workers who are exposed to noise (Graphic 1). In the performance of this analysis 39 exams were considered due to the occurrence of 2.5% (N=1) of unilateral light hearing loss (right ear). As well as the studies about PAINPSE (8,9,10,11) point out that the auditory thresholds are initially affected in one or more frequencies of the range of 3000Hz to 6000Hz, the values found in this study proved that in addition to confirming such findings, the frequency of 6000 Hz was mostly affected (Table 1). Considering the general average of the two groups involved (based on Administrative Rule no.


The average found for frequencies of 3000 Hz, 4000 Hz and 6000 Hz, was of 15 dB for the left ear and 16 for the right ear.
In the investigation of correlation between the age of the participants with tonal thresholds (Table 2), we confirmed that the (AT-AF) High Frequencies Tonal Audiometry presented significant values compared to the (AT-AC) Conventional Tonal Audiometry Frequencies. The own PAINPSE is characterized by a constellation of signs and symptoms that go beyond a hearing loss and may not be limited to a simple quantitative loss of the auditory sensitivity (21).
Among the auditory complaints found with major occurrence (Graphic 2), we find tinnitus, followed of headache, dizziness, otorrhea and otalgia. A study carried out (22,23) found similar symptoms in metallurgic workers and there was a major prevalence of complaints of difficulty for speech perception, hypacusis, tinnitus, sensation of auricular plenitude, otorrhea and dizziness.
In the cases found in workers of the city of Bauru (24), the prevalence of tinnitus (48%) in the 284 workers exceeded the findings of another study (25), 28% of the cases, because according to the authors, the symptom subjectivity is a factor of higher difficulty and scarcity of data in the study of tinnitus.
The precedence relating to acoustic trauma were not considered to be relevant because they were reported in only 2 cases (5%), but the exposure to chemicals, 30%, followed of the exposure to vibration and heat (20%), and work accident (10%), contribute for the findings of important relevance in the area which the factors that contribute in the auditory sensitivity regard. The literature presents several works that show the existence of auditory lesion as a result from occupational exposure to Chemicals (PQ), even in the absence of noise, and others that seek to demonstrate an interaction between noise and chemicals (12,26). According to some studies (27), the relative estimated risk for the development of hearing loss was of 10.9 for noise and toluene, considering that the data were found in workers of a graphic with a higher prevalence of hearing loss in high frequency (3000 to 8000 Hz, in the group exposed to noise and toluene 53%). However, the audiometric findings suggest the exposure associated between noise and chemicals potentializes the risk of hearing loss. Due to high levels of sound pressure, there is the need for use of hearing protection devices by the workers (28). A questionnaire carried out in a metallurgic industry (28) obtained results similar to the predominance of use of insertion type IPE. Relation of the number of users (in percentage %), in the use of IPE - Individual Protection Equipment.



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