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Prevalence of hearing loss worldwide,tinnitus zentrum mainz bretzenheim,steroids for hearing loss side effects - 2016 Feature

Author: admin | 25.01.2014 | Category: Tinnitus Hearing Loss

INTRODUCTION: Gestational malaria is related to very bad perinatal outcomes and antimalarial drugs used during pregnancy can be ototoxic to the fetus. OBJECTIVE: To determine the prevalence of hearing loss in newborns of mothers who had malaria and treated with antimalarial drugs during pregnancy. CONCLUSION: The prevalence of hearing loss in newborns of mothers who had vivax malaria and used chloroquine during pregnancy was 3%.
Hearing is one of the noblest of senses since its main function is related to the acquisition and development of oral language1,2. Hearing impairment is considered to be highly disabling due to its consequences on human communication, as well as its impact on cognitive and psychosocial development and the development of oral and written language6. The occurrence of malaria during pregnancy, particularly in the last trimester, can be determinant for infant health, with implications for fetal or neonatal development. In Brazil, the occurrence of malaria during pregnancy is common in endemic areas such as the states of Roraima, Rondonia, Para, Mato Grosso, Acre, and Amazonas11. In the municipality of Porto Velho (RO) malaria in pregnancy has been shown to be related to poor perinatal outcomes such as preterm birth, extremely low, very low and low birth weight, and death13. In another study, 12 children born to mothers who had been treated with antimalarial drugs during pregnancy had sensorineural hearing loss. In view of the above considerations, the objective of the present study was to verify the prevalence of hearing loss in newborns of mothers who had malaria and treated with antimalarial drugs during pregnancy and to characterize the audiologic findings according to newborn gestational age, birth weight, risk factors for hearing loss, type of malaria infection, type of medication used, and gestational period of malaria occurrence and drug treatment. A cross-sectional, quantitative, descriptive-analytical, observational study was conducted using a multifactorial approach. The number of women with malaria during pregnancy, who were admitted to the hospital during the period of data collection, was taken as the basis for sample size calculation. The study flow chart contains data regarding infant gender, date of birth, type of malaria infection, gestational period of infection, type of medications used, and presence of risk factors for hearing loss established by the Joint Committee on Infant Hearing (JCIH)16 and by the Multiprofessional Committee on Auditory Health (Comite Multiprofissional em Saude Auditiva - COMUSA)17. The puerperal women were contacted by the researcher while still in the maternity ward in order to investigate the occurrence of malaria during pregnancy. After signing the informed consent, the interview was conducted with the puerperal participants. The tests were performed in a quiet room in the presence of the mother or an accompanying person. The step of diagnostic evaluation was performed at the clinic responsible for the NHS program after hospital discharge. After this procedure, the diagnostic ABR test was performed to quantify and identify hearing impairment. Newborns who have had the electrophysiological threshold for tone bursts at 2000 Hz with bilateral 30 dBHL were considered patients with normal hearing and remained in auditory monitoring the NHS program up to 24 months. For data analysis, the distribution of the occurrence of the type of infection and of the gestational period when malaria occurred was first determined, followed by the determination of the distribution of the type of antimalarial medication used for treatment and the gestational period during which the medication was administered, using the test for equality of two proportions.
As for the risk factors for hearing loss found in association with the occurrence of malaria and the use of antimalarial drugs in pregnancy, the use of ototoxic medication by the newborn was the most frequent risk factor and this finding was significant when compared to the other risk factors, except for extracorporeal oxygenation (Table 4).
No relationship was observed between the NHS result and type of medication, risk factors for hearing loss, gestational period of infection, use of medication, or type of malaria infection (Table 5). The prevalence of hearing loss in our sample was 3% (n = 1), taking into account that two newborns did not undergo the audiological diagnosis. In the present study, Plasmodium vivax was the most frequent species found in women during pregnancy, as also reported in other studies10,13,19-21. The antimalarial drug most frequently used was chloroquine as recommended by the Brazilian Ministry of Health for the treatment of vivax malaria in pregnancy25. In a study conducted in Porto Velho (RO) on 66 newborns of mothers who used antimalarial drugs during pregnancy, three infants were born to mothers who were treated with primaquine and one was diagnosed with unilateral profound hearing loss21.
As for the gestational period during which the antimalarial drug was used, no difference was observed between trimesters. In the present study, the number of "pass" results in NHS was higher than the number of "failed" results, in agreement with other studies conducted in the same municipality14,21. Two of the four newborns who failed the screening test and who were referred to the clinic responsible for the program for diagnostic evaluation did not attend the assessment. The socioeconomic conditions of the families who participate in the NHS program and the lack of knowledge of the consequences of hearing loss are some factors that could explain the evasion in the population studied, considering that the results of the study showed a low educational level of the women who mainly had incomplete elementary school.
No relationship was found between the NHS results and the variables weight at birth and gestational age, despite having knowledge that gestational malaria is related to very bad perinatal outcomes, including low birth weight13 which could have enhanced the occurrence of hearing loss in newborns. The most frequent risk factor for hearing loss associated with malaria and antimalarial drug use in pregnancy was the use of ototoxic medication by the newborn, in agreement with other studies21,34. Urinary tract infection is common among young women and is the most frequent complication during pregnancy30, especially among primiparous women35.
The high level of bilirubin requiring blood transfusion was a risk factor for hearing loss in the infant diagnosed in the present study. Elevated serum levels of bilirubin are considered toxic to the auditory pathways and central nervous system39.
Hyperbilirubinemia is one of the risk factors for neonatal deafness and for the development of encephalopathies39, since high levels of bilirubin can damage the auditory system at the peripheral level by altering cochlear hair cells and at the central level in the cochlear, olivary and inferior olivary nuclei41. In addition to blood transfusion, the infant was exposed to ototoxic medication (gentamicin) which can cause different degrees of damage, with cochlear hair cells damage being typical42.
The prevalence of hearing loss obtained in this study was more than evident in research conducted at the same hospital5, and the value obtained could have been higher, since two newborns did not undergo the audiological diagnosis.
In addition, it highlights the need for audiological follow these children in order to evaluate the occurrence of possible progressive alterations as demonstrated in another study which found 12 cases of hearing loss in children born to mothers who had malaria and used antimalarial drugs in pregnancy15.
The main limitation of the present study, which is common in studies involving populations recruited from NHS programs, is failure to attend a visit for diagnostic evaluation. The prevalence of hearing loss in newborns of mothers who had malaria and treated with antimalarial drugs during pregnancy was 3% (n = 1), the mothers' newborn diagnosed infected with Plasmodium vivax in the first trimester and treated with chloroquine throughout pregnancy. In addition, it was observed that there is no relationship between the NHS findings with the variables weight of the newborn at birth, gestational age, type of medication, IRDA, pregnancy infection, medication use and infection type. Paper submitted to the ITJ-SGP (Publishing Management System) on September 24, 2014; and accepted on July 6, 2015. Key words: auditory domains, dizziness, hearing aid, nonveteran, pure tone thresholds, smoking, tinnitus, veteran, word recognition in competing message, word recognition in quiet.
Abbreviations: ANOVA = analysis of variance, EHLS = Epidemiology of Hearing Loss Study, HFPTA = high-frequency pure tone average, HHIE-S = Hearing Handicap Inventory for the Elderly-Screening (version), HL = hearing level, LE = left ear, NU-6 = Northwestern University Auditory Test No. The population-based EHLS was an outgrowth of the Beaver Dam Eye Study of age-related eye disorders that enrolled 4,926 participants between 1988 and 1990 [8-9]. The primary purpose of this study was to determine the prevalence of hearing loss among male veterans and nonveterans aged 48 to 92 years who were enrolled in the EHLS.
1.Is there a higher prevalence of hearing loss for pure tones among veterans compared with nonveterans in the EHLS?
2.Is there a higher prevalence of hearing impairment for word recognition in quiet and in competing message among veterans compared with nonveterans in the EHLS? 3.What is the prevalence of self-assessed hearing handicap among veterans compared with nonveterans?
4.Are veterans more or less likely to use hearing health care services (have their hearing tested, try hearing aids, continue to use hearing aids, etc.) compared with nonveterans? The demographic data in Table 1 provide information about the 590 nonveterans and 999 veterans included in EHLS. Number and percentage of nonveteran male participants and veterans in four demographic categories.
Table 2 provides the distributions for four general health categories and two ear-related categories for the two groups of participants.
Number and percentage of nonveteran and veteran male participants in six health categories. Table 3 describes certain service-related characteristics of the 999 veterans involved in the study.
Number and percentage of male veterans in respective branches of armed services and years of military service.
References1.Hochman JB, Stockley TL, Shipp D, Lin VY, Chen JM, Nedzelski JM (2010) Prevalence of connexin 26 (GJB2) and pendred (SLC26A4) mutations in a population of adult cochlear implant candidates. JavaScript is currently disabled, this site works much better if you enable JavaScript in your browser. Introducao: Na industria textil, o trabalho das maquinas produz ruido que pode causar danos irreversiveis na audicao nos trabalhadores. Introduction: In the Textile industry the work of the machines produce noise that can cause irreversible damage to workers hearing. INTRODUCAONas fabricas em geral e em especial na industria textil, o trabalho das maquinas, no setor de producao, produz ruidos indesejaveis, que quando muito intensos podem causar danos na audicao dos trabalhadores. West is an online newspaper aimed at providing the latest breaking news on welfare policies. Prevalence of hearing loss in newborns of mothers who had malaria and were treated with antimalaric drugs in pregnancy. All underwent neonatal hearing screening with otoacoustic emissions combined with automatic auditory brainstem response. Auditory sensory deprivation interferes with the ability to interpret speech sounds and results in economic and educational disadvantages2. The malaria parasites can easily cross the placental barrier or are transmitted through maternal-fetal transfusion9. The latest survey regarding the proportion of positive slides in pregnant women from the municipality of Porto Velho, Rondonia (RO), was performed in 2010 and revealed 331 cases of malaria in rural and urban areas, including 48 cases caused by P. In a study conducted in the same municipality, two newborns of mothers who had malaria and used antimalarial drugs in pregnancy were diagnosed with mild unilateral sensorineural hearing loss14.
This hearing loss was irreversible in eight of these children, with seven presenting profound hearing loss. All puerperal women received information about the objectives and methodology of the study and agreed to the procedures by signing the free informed consent form.
Transient otoacoustic emissions (TOAE) and automated auditory brainstem responses (AABR) were measured with an Accuscreen instrument (Madsen).
The results obtained during hearing screening and diagnostic evaluation were recorded on the study flow chart. Women who confirmed the presence of the disease were invited to participate in the study and received information about the objective and importance of the study and the procedures used. When necessary, the records of the women and their newborns were accessed to complement the information if the mother could not answer the question or was in doubt. For electrophysiological assessment of hearing, the infants remained lying in the crib or on the mother's lap during natural non-sedated sleep. For this test, a probe microphone with a latex bulb was introduced into the external auditory canal of the newborn and emissions were evoked with a broadband click at an intensity of 80 dB SPL. For this test, the skin in the areas of electrode placement (high forehead and mastoids) was cleaned to permit adequate impedance. Diagnostic evaluation consisted of tympanometry, diagnostic TOAE, diagnostic ABR, and an appointment with the otorhinolaryngologist.
The NHS results were correlated with birth weight and gestational age by analysis of variance (ANOVA). Two of the four infants that failed the NHS and that were referred to the clinic responsible for the program for further tests abandoned the program. The audiologic findings of this newborn included the bilateral presence of TOAE; absence of waves I, III and V at 90 dB in the click ABR test accompanied by the presence of cochlear microphonism, and tympanometry revealed normal mobility of the tympano-ossicular system. In addition to the fact that the mother had malaria and made use of antimalarial drugs during pregnancy, the newborn was exposed to ototoxic medication (gentamicin) for 9 days and required exchange transfusion due to hyperbilirubinemia. This finding was statistically significant when compared to the occurrence of the disease in the third trimester. The use of primaquine is contraindicated for the treatment of pregnant women, irrespective of the Plasmodium species involved and gestational period, and during the breast-feeding period until 6 months25. This infant had no associated risk factor for hearing loss, suggesting that the medication administered possibly caused or potentiated the occurrence of hearing impairment.
However, the frequency of antimalarial drug use was higher in the second trimester, although the frequency of malaria occurrence was higher in the first trimester of gestation. Despite an attempt to perform an active search, as routinely done, the mothers could not be contacted by telephone. The infant can be infected at the time of delivery, through hematogenic dissemination, or postpartum36. Neonatal hyperbilirubinemia is toxic to the auditory pathways and central nervous system29 and newborns submitted to exchange transfusion are considered to be at high risk for the development of auditory neuropathy38.
In the latter, the yellow color is more intense in the subthalamic nucleus and globus pallidus and may be present in the hippocampus, geniculate bodies, vestibular, cochlear and oculomotor nuclei, cerebellum and spinal cord40. Other studies have demonstrated a close relationship between hearing impairment and hyperbilirubinemia5,39,40. A close relationship between hearing impairment and use of ototoxic medication has been reported for newborns30,43,44. The chance of these newborns have hearing loss is high, since the NHS was performed with use of combined technical (OAE and AABR), which reduces the chance of false positives. Active search was necessary in various cases of the present sample, but contacting the participants was unsuccessful in two cases.
Audiological findings highlighted in this newborn indicate the presence of alteration in retrocochlear auditory pathways that are compatible with the auditory neuropathy spectrum.
The IRDA, concomitant with malaria and the use of antimalarial drugs during pregnancy, most common was the use of ototoxic medication by the newborn, but hyperbilirubinemia with exchange transfusion was one of the risk indicators found in newborns diagnosed with hearing loss. This article reports the results of several auditory measures from 999 veteran and 590 nonveteran males 48 to 92 years of age included in the EHLS.
6, PTA = pure tone average, RE = right ear, SD = standard deviation, SNR = signal-to-noise ratio, VA = Department of Veterans Affairs. Studies indicate the prevalence of hearing loss in the elderly population (>65 years) ranges from 27 to 45 percent and increases with age [1-6]. Of the 4,541 available participants at the 5-year follow-up visit of the Eye Study, 3,753 individuals (82.6%) agreed to participate in the EHLS between March 1993 and July 1995 [7]. The percentage of nonveterans and veterans in each of the four age groups varied, which is reflected in the significant χ2.
Handedness was the same for both groups of participants with 89 percent responding right handed, 7 percent responding left handed, and 4 percent responding ambidextrous (data not shown in Table 2).
Mutations in connexin 26 (CX26), are a major cause in many countries and are largely dependent on ethnic groups.


Objetivo: O objetivo do estudo e determinar a prevalencia de PAIR em trabalhadores de uma industria textil na cidade de Brusque (SC), verificar sua intensidade, caracterizar os principais sintomas auditivos, observar a faixa etaria mais acometida, identificar o setor de maior risco e relacionar com o tempo de exposicao ao ruido. Objective: The purpose of this research is to determine the prevalence of NIHL in workers of a textile industry in Brusque - SC, to verify its intensity, characterize the main hearing symptoms, observe the age groups most affected, indentify the riskiest sector and correlate with the time of exposure to the noise. A exposicao ao ruido por tempo prolongado, pode levar a disacusia.As lesoes auditivas consequentes a perda auditiva induzida pelo ruido (PAIR) decorrem de alteracoes na estrutura interna da coclea que acarreta lesoes irreversiveis e sintomas como hipoacusia, zumbidos, plenitude auricular e otalgia. Exposure to hazardous workplace noise and use of hearing protection devices among US workers-NHANES, 1999-2004. Hearing difficulty attributable to employment by industry and occupation: an analysis of the National Health Interview Survey--United States, 1997 to 2003.
The burdens of age-related and occupational noise-induced hearing loss in the United States.
Prevalence of hearing loss and differences by demographic characteristics among US adults: data from the National Health and Nutrition Examination Survey, 1999-2004.
Tracking population health based on self-reported impairments: Trends in the prevalence of hearing loss in US adults, 1976-2006. Effectiveness of a tailored intervention to increase factory workers' use of hearing protection.
A re-examination of risk estimates from the NIOSH Occupational Noise and Hearing Survey (ONHS).
This is the main finding contained in a Japanese research, made up of data obtained from 13 eligible studies conducted between 1977 and 2011. Those who failed were referred to audiological diagnosis with evoked otoacoustic emissions and brainstem auditory evoked potential associated with tympanometry (1000 Hz). Furthermore, hearing is essential for interpersonal relationships and relationships with the environment2. Any type of hearing loss can compromise language, learning, cognitive development and social inclusion of the child7, and it is therefore important that hearing impairment is detected as early as possible. A study demonstrated that pregnant women infected with Plasmodium falciparum present clinical and laboratory alterations, such as altered hemoglobin, hematocrit, creatinine, urea, bilirubin, and glucose.
The treatment indicated for the mothers was chloroquine, chloroquine combined with quinine, and quinine combined with Fansidar.
The study was conducted at the maternity unit of a referral hospital for high-risk pregnancies in the capital of Rondonia. The following eligibility criteria were established for formation of the sample: newborns of women who had malaria in pregnancy, newborns participating in the NHS Program, and newborns born or hospitalized in the maternity unit of the state referral hospital for high-risk pregnancies in Porto Velho (RO) whose mothers agreed to participate in the study by signing the free informed consent form. Adopting a level of significance of 95% and a sampling error of 6%, the estimated sample size was 35 newborns.
Personal data for subsequent contact were also recorded in case it was necessary to schedule a day and time for a new assessment during both the screening and diagnostic evaluation phases. Mothers who agreed to participate in the study signed two copies of the free informed consent form, one was given to them and the other was kept by the responsible researcher. Infants presenting normal outer hair cell function obtained a "pass" result, which occurs automatically.
Tympanometry, which investigates tympano-ossicular system function, excluding possible middle ear alterations, was performed using a 1000-Hz probe tone since it is more sensitive in identifying these alterations in infants aged 0 to 4 months18. The frequency of risk factors for hearing loss was analyzed by the test for equality of two proportions and the NHS results were correlated with variables such as type of malaria infection, gestational period when malaria occurred, type of antimalarial agent and gestational period when it was used. The otorhinolaryngologist requested imaging exams to evaluate possible involvement of the central auditory pathway. The Plasmodium species contracted by the mother during the first trimester of gestation was the vivax type. This result differs from that reported in another study21 conducted in the same city, in which the distribution of malaria was homogenous across the three trimesters. In contrast, the World Health Organization recommends the use of primaquine under medical supervision26. In the present study, the participants reported the use of antimalarial drugs in more than one trimester, as recommended by the Brazilian Ministry of Health that indicate chloroquine as chemoprophylaxis against P.
In this respect, it is important for the mother to have a minimum educational level, financial resources and harmony in social and marital relationships to seek the best health measures for her child31. Authors said that the lower the birth weight, the greater the chances of failure in the NHS32,33, which was not observed in this study. This result highlights the need to develop other studies with this population, but in larger samples.
In addition, the rapid discharge of the participants, which is a major obstacle of NHS programs, may have contributed to the small sample size.
O conhecimento, a valorizacao da triagem auditiva neonatal e a intervencao precoce da perda auditiva. Hearing aids fitting process in users that are seen in a federal public institution: part I--results and implications with the amplification device. Avaliacao eletrofisiologica de recem-nascidos de maes que fizeram uso de antimalaricos na gestacao.
Estudio de los efectos ototoxicos en 725 pacientes tratados con antimalaricos en el hospital central de Maputo (Mozambique). Year 2007 position statement: Principles and guidelines for early hearing detection and intervention programs. Accoustic immitance measures in infants with 226 and 1000 hz probes: correlation with otoacoustic emissions and otoscopy examination. Retardo no crescimento intrauterino, baixo peso ao nascer e prematuridade em recem-nascidos de gravidas com malaria, na Colombia.
Achados audiologicos de recem-nascidos de maes que fizeram uso de antimalaricos no periodo gestacional [Resumo n.
Fatores de riscos associados a transmissao de malaria humana, em areas de ressacas, nos bairros Novo Horizonte e Zerao, Macapa, Amapa, Brasil.
Determinants of intermittent preventive treatment of malaria during pregnancy (IPTp) utilization in a rural town in Western Nigeria. Indicadores de risco para perda auditiva em neonatos e lactentes atendidos em um programa de triagem auditiva neonatal.
Triagem auditiva em um hospital publico de Belo Horizonte, Minas Gerais, Brasil: deficiencia auditiva e seus fatores de risco em neonatos e lactantes. Analysis of transient otoacoustic emissions and brainstem evoked auditory potentials in neonates with hyperbilirubinemia. Perda auditiva neonatal associada a hiperbilirrubinemia por deficiencia de glicose-6-fosfato desidrogenase: relato de caso. Sequelas auditivas e neuropsicomotoras em recem-nascidos de termo ictericos tratados pelos metodos convencionais. Comparacao das alteracoes auditivas em recem-nascidos da UTI neonatal expostos e nao expostos a antibioticos.
Medico do Setor de Saude Auditiva e Implante Coclear Universidade de Brasilia - UnB, Professor Substituto Otorrinolaringologia Universidade de Brasilia - UnB. Professor e orientador do programa de pos-graduacao em Ciencias da Saude e Ciencias Medicas da Universidade de Brasilia - UnB.
The auditory measures included pure tone thresholds, tympanometry and acoustic reflexes, word recognition in quiet and in competing message, and the Hearing Handicap Inventory for the Elderly-Screening (HHIE-S) version. The results from one population-based study focusing on the prevalence of hearing loss, the Epidemiology of Hearing Loss Study (EHLS) conducted in Beaver Dam, Wisconsin [7], indicated that 46 percent of older adults were affected by hearing loss. We examined self-assessed hearing handicap using the Hearing Handicap Inventory for the Elderly-Screening (HHIE-S) version [12].
The encouraging statistic is that current smoking is down to about 15 percent in both groups, which demonstrates a substantial decrease in smoking for both groups of participants. The purpose of our study was to evaluate the prevalence of GJB2 mutations among affected individuals from south of Iran. Casuistica e Metodo: Foi realizado estudo transversal em amostra causualizada de 184 trabalhadores divididos proporcionalmente em cada setor, avaliados atraves de entrevista, exame otoscopico e audiometria ocupacional. Method: A transversal study of 184 workers divided proportionally in each sector of work, evaluated through interviews, otoscopic exam. Niveis elevados de ruido maiores que 85 dBNA durante 8 horas diarias, por longo tempo sao suficientes para causar dano coclear (1).O diagnostico de PAIR e realizado pela historia de exposicao em ambiente ruidoso, exame otorrinolaringologico com enfase na otoscopia e exame audiometrico A perda auditiva deve ter se desenvolvido gradualmente num periodo de, geralmente, 6 a 10 anos de exposicao continua a niveis elevados de ruido no trabalho. Population-based approaches sometimes use self-reports to obtain an index of morbidity or risk for a health issue. Comparing diabetic patients with non-diabetic ones, researchers have found a higher prevalence of hearing impairment in the former, consistent regardless of age and gender. Data were obtained through interviews with the mothers' and analyzing the patient chart and the newborn, and underwent to statistical tests analysis of variance, equality of two proportions and Chi-square test (p = 0.05).
Therefore, hearing impairment during the first years of life of a child can interfere with the acquisition and development of speech and language3-5.
Newborn hearing screening (NHS) continues to be the only strategy able to detect early hearing alterations that could interfere with the quality of life of an individual5,8. At this hospital, an NHS Program is provided by a private clinic accredited by the National Health System (Sistema Unico de Saude - SUS), where diagnosis and intervention are performed. Excluded were infants born to mothers who were unable to report the occurrence and gestational period of malaria infection and infants born in other maternity units who were therefore not seen at the NHS service of the maternity unit where the study was conducted. It was not possible to include more subjects because the period scheduled was not sufficient to continue the process.
Disposable insert earphones and electrodes were used for the two instruments, as well as disposable gloves, gauze and 70% alcohol to clean the infant's face and for fixation of the electrodes. Risk factors were analyzed by the chi-squared test in order to determine the relationship between the findings and the variables mentioned. Antimalarial drug use was more frequent in the second trimester of gestation, but most participants reported use of the medication in more than one trimester (Table 2).
The results of these exams indicated the presence of bilateral impairment of the retrocochlear auditory pathways, findings compatible with the spectrum of auditory neuropathy. This divergence may be explained by the difference in the period of data collection between the two studies, since the present study was conducted during the dry season (June to November), with the occurrence of malaria being related to climatic22-24 and environmental factors and an increase in transmission being observed at the end of the rainy season22. However, this indication has become rare as observed in the present study and other studies in which pregnant women had malaria during pregnancy and were treated with chloroquine14,27. No relationship between the NHS results and gestational age agrees with evidenced by other researchers29.
Even if NHS is performed daily, including weekends and holidays, the large number of births per day in the maternity unit where the study was conducted leads to early discharge and the consequent loss of some newborns. Ary Pinheiro (Porto Velho- RO) causados pela malaria durante a gestacao no periodo de 2001 a 2003 em usuarias do SUS.
Hearing loss in the auditory domains of pure tone thresholds, word recognition in quiet, and word recognition in competing message increased with age but were not significantly different for the veterans and nonveterans.
The prevalence of hearing loss increased with age and was more common in men than in women.
Because the EHLS queried the participants about their status as a veteran from one of the U.S. Except for 132 homebound residents who were tested in their homes, all other auditory testing was completed in a sound booth.
The nonveteran and veteran groups also were significantly different in the education category.
The two groups of participants did not differ in the three remaining general health categories in Table 2, diabetes, history of myocardial infarction, and history of head injury. Fifty patients presenting with autosomal recessive non-syndromic hearing loss from Fars, province in south of Iran, were studied for mutations in GJB2 gene and screened by direct sequencing. Resultados: A prevalencia de PAIR foi 28,3% PAIR, com predominio de perdas auditivas de grau l (46,2%), segundo a classificacao de Merluzzi. Because direct audiometric measures of hearing ability are available only on select populations, a self-report measure could more readily provide an estimate of population prevalence. It is thought that high blood sugar levels brought on by diabetes may lead to hearing loss by damaging blood vessels in the ears. Cochlear damage initially involves the outer hair cells, generally affecting high-frequency hearing. The final sample consisted of 35 mothers who had malaria and used antimalarial drugs in pregnancy and their children. Subjects who needed to complete the diagnostic phase were referred to the clinic responsible for the NHS program.
Infants who failed the test were directly referred for diagnostic evaluation, a procedure adopted by the program to prevent abandonment by the mothers, in addition to the fact that ABR is not affected by vernix which would justify retesting within 15 days. Infection occurred more frequently in the first trimester of gestation and this result was significant when compared to the third trimester (Table 1). No significant differences were found between participant groups on the HHIE-S; however, regarding hearing aid usage, mixed differences were found.
Anecdotally, the percept is that because of noise exposure experienced in the military service, veterans have more hearing loss than do nonveterans. Finally, from Table 2, the two groups of participants did not differ in the rates at which either dizziness or tinnitus had been experienced in the past year. Os sintomas mais frequentes foram hipoacusia (30,8%), dificuldade de compreensao da fala (25%), zumbido (9,6%), plenitude auricular (5,8%), tontura (3,8%) e otalgia (3,8%). O exame audiometrico revela uma perda auditiva sempre neurosensorial, irreversivel, em geral simetrica, com entalhes principalmente nas frequencias de 2000 a 4000 Hz (2).Apesar do conhecimento do diagnostico e de programas de prevencao adotados nas industrias, esta patologia ainda representa ainda um serio problema de saude ocupacional, principalmente nas industrias texteis.
We explored the feasibility of self-reported hearing ability as an index of population hearing health using existing data from a large intervention trial with noise-exposed factory workers. To date, no studies have focused on the prevalence of hearing loss among the veteran population. In this context, a veteran refers to anyone who served in any branch of the military services.
Word-recognition in quiet and in competing message were evaluated on one ear with the Department of Veterans Affairs (VA) female speaker version [14-15] of Northwestern University Auditory Test No. O setor com maior indice de PAIR foi engenharia industrial com 44,4%, seguidos da fiacao com 38,9% e tecelagem com 38,8%, BET (beneficiamento, estamparia e tinturaria) com 23,8% e administracao com 3,8%.
The purpose of this study was to describe and compare the perceived and measured hearing ability among a group of noise-exposed factory workers, and to determine the prevalence of hearing loss in this group.
Anyway, such results need to be improved by more precise tests taking into account other factors such as an exact measuring of noise level and the difference between Type 1 and Type 2 diabetes. Of the 3,753 EHLS participants, 1,021 (27.2%) reported military service with 22 females and 999 males.


McAlexander,Richard Neitzel Journal of Urban Health. Because the 22 females were a substantial minority (2.2%), only the data from 1,589 males (veterans and nonveterans) were analyzed. The ear selected for word recognition was either the ear with better (lower) pure tone thresholds or the right ear (RE) if the pure tone thresholds were equal. The most common mutations were 35delG followed by V153I with an allele frequency of 7 and 6 %, respectively.
In quiet, the word-recognition materials were presented nominally 36 dB above the 2,000 Hz threshold in the test ear.
In this study, 30 % of our subjects were found to have the causative variants or polymorphisms in GJB2 and the c.35delG mutation was the most common cause in our patients.
The workers who had been working for more than 20 years were also the most affected (42.9%).
Of the veterans, 70.3 percent served during wartime, most of which were in World War II (n = 396), Korea (n = 220), and Vietnam (n = 86). However, more study with larger sample size as well as in vitro functional study for these new variants in Xenopus oocytes is required. Conclusion: The occurrence of NIHL was significant in 1st degree, associated to hipoacusis.
Noise exposure can be avoided when purchasing new equipment through a "buy quiet" purchase policy. In a slightly different viewpoint in this article, pure tone thresholds are considered but one domain of auditory function with other domains, including word recognition in quiet and the word recognition in the competing message. Com o aumento destas industrias no Brasil, especialmente no Vale do Itajai em Santa Catarina, o numero de pessoas expostas ao ruido vem aumentando consideravelmente, decorrendo dai a importancia de monitoracao de audicao nos trabalhadores, o diagnostico precoce de PAIR e sua prevencao, atraves de programa de conservacao auditiva. The prevalence of hearing loss in the nonveteran and veteran populations of the Beaver Dam cohort was examined in these three domains of auditory function. O objetivo desse trabalho e determinar a prevalencia de perda auditiva induzida pelo ruido em trabalhadores de uma industria textil na cidade de Brusque (SC), verificar a intensidade da patologia, caracterizar os principais sintomas audiologicos, verificar a faixa etaria de maior prevalencia, identificar o setor da industria de maior risco e relacionar os casos ao tempo de exposicao ao ruido.CASUISTICA E METODOEste estudo transversal foi realizado no periodo entre Junho e Novembro de 2004. The analyses used the chi-square test of association for categorical variables, the Mantel Haenszel chi-square test of trend for ordinal data [17], and t-tests of mean differences for continuous data (SAS Institute, Inc; Gary, North Carolina). The standard defines a comprehensive hearing conservation program including noise exposure monitoring, administrative or engineering controls, audiometric testing of employees, provision of hearing protection, employee training, and record keeping.
Tambem era questionado sobre doencas sistemicas como doencas das vias aereas, DM, HAS, Sifilis, Sarampo, Caxumba, tireoideopatias, doencas renais e antecedentes como problemas otologicos previos, cirurgias previas, problemas na familia e historia exposicao ao ruido nao ocupacional.Apos a entrevista, realizava-se a otoscopia, com um otoscopio portatil de pilha, para avaliacao do conduto auditivo externo e membrana do timpano. Por ultimo, era realizado a audiometria tonal e analise das curvas audiometricas apos um repouso auditivo de, no minimo, 14 horas por parte dos trabalhadores (1).
Foi utilizado um audiometro "Interacoustics" modelo AC 40 com certificados de calibracao a cada ano. Several groups of researchers have recently mined these data in order to estimate prevalence and trends in hearing loss in the United States. As interpretacoes das audiometrias tonais foram classificadas, primeiramente, de acordo com os criterios de DAVID e SILVERMANN (8).
Em seguida identificou-se as curvas audiometricas indicativas de PAIR, de acordo com SANTINHO e COUTO (9). Por ultimo as audiometrias indicativas de PAIR foram classificadas de acordo com intensidade, segundo a classificacao de Merluzzi (10).
Em relacao a presenca de disacusias auditivas 105 trabalhadores (57,1%) estavam normais, 52 (28,3%) apresentaram curvas audiometricas compativeis com perda auditiva induzida pelo ruido e 27 (44,7%) tinham perdas auditivas por outras causas. They found that prevalence of hearing loss had decreased from 12% in 1993 to 8.1% for men, and from 7% in 1993 to 4% for women in 2000, and remained stable through 2006. Sensitivity and specificity are classic measures that reflect the percent agreement between a true state and a screening test.
Sensitivity is the ability of the screening test to accurately identify the presence of true morbidity, while specificity is a measure of a test to accurately identify the absence of morbidity.
As described in [Table 1], single items are the norm, and there are varying approaches to the questions and response formats. One of the earliest measures still in use today in the National health interview study (NHIS) was evaluated in 1970 for the National center for health statistics.
Sensitivity was significantly higher (65%) for bilateral loss, compared to 46% for unilateral loss, and 41% for high frequency loss. The best performing subjective measure of hearing loss had a sensitivity of 71% and specificity of 71% with respect to the audiometric measure. As can be seen in the review of these studies, there is wide variability in the methods used to measure self-report, the samples studied, and in the sensitivity and specificity found. These results illustrate the need for further study with a variety of measures of perceived hearing ability and target populations.In the secondary analysis reported here, we used three alternative methods of interpreting audiogram results, as there is no consensus on this definition in the literature. The goal of the current study was to compare a self-report questionnaire item measuring perceived hearing ability with the gold standard of measured hearing ability, the audiogram. The original survey data collection was completed through a computer interface that presented questions in printed format on-screen and offered audio narration of the question. The original study [15] utilized an experimental design to test alternative interventions to increase workers' use of hearing protection. To be included in this analysis, all subjects must have been exposed to 80 or greater decibels (A-weighted, 8-hour TWA) of noise at work, and they must have responded to questions regarding their perceived hearing ability (n=2691). Descriptive variables reported in this study included gender, ethnicity, age, education level, years employed at the site, level of noise exposure, rate of hearing protection use, perceived hearing ability, and audiogram data. Data were available for the frequencies of 500, 1000, 2000, 3000, 4000, 6000, and 8000 Hz in each ear. The study used three alternative methods of measuring the true state of hearing status, as there is no consensus on this definition in the literature.
These methods to calculate hearing status were (a) Kerr et al, [12] (b) OSHA, and (c) Prince et al. No comparison with previous hearing threshold measures was made.In the measure of hearing loss used by Prince, [17] calculation weights were assigned to the frequencies of 1000, 2000, 3000, and 4000 Hz averaged over both ears to obtain a single value. Using the Prince method, hearing loss was defined as having a hearing threshold value of greater than 25 dB for the combined ear value for the weighted frequencies of 1000, 2000, 3000, and 4000 kHz.Sample descriptive data were summarized using percent distributions, means and standard deviations. The chi-square (for use with categorical variables) and t-test (for variables with a quantitative mean score) were used to examine between group differences on distributions of demographic variables for those who perceived hearing loss and those who did not.
McNemar's test was used to examine the relationship between the dichotomized perceived hearing groups and each of the alternative approaches to the audiogram-defined hearing status. For each threshold frequency, the Mann-Whitney U-test was used to examine for mean score differences on the original perceived hearing variable scale (1 = excellent, 2 = good, 3 = fair, and 4 = poor) between those identified with and those without measured hearing loss (>25dB). Sensitivity and specificity were computed for perceived hearing loss against each of the three measures of hearing loss, using the assumption that the audiometric data were the true state.
The mean noise exposure level was 91 dBA, and subjects reported using hearing protection about 77% of the time when exposed to hazardous noise.
Compared to those without reported hearing loss, the group reporting hearing loss had a higher percent of white males, was older, worked longer at the plant, reported lower use of hearing protection, and had a lower rate of high school graduation.
Of those classified as having perceived hearing loss, 19% reported having poor hearing, and 81% reported fair hearing. The percent of cases with a threshold value greater than 25 dB in either ear is reported by each frequency. The McNemar's test identified a significant difference in the distribution of hearing loss between the left and right ears. There was a greater prevalence of hearing loss in the left ear compared to the right for all frequencies except at the frequency of 8000 Hz. The Mann-Whitney U-test for differences in the rank ordinal scores was significant at all frequencies, and perceived hearing scores were all in the expected direction. For all frequencies, subjects identified as having no measured hearing loss reported better perceived hearing scores. The frequencies associated with the highest (best) sensitivity levels were 500 Hz for the left ear, and 1000 Hz for the right ear. The 4000 Hz frequency was associated with the highest value for the specificity measures for both ears. At just over 90%, the 4000 Hz measure suggests a high congruence between measured and perceived hearing ability among those with no measured hearing loss.
These findings suggest that although sensitivity was highest in the lower frequencies, it was low overall.
Indeed, all three methods of analysis demonstrated high rates of hearing loss in the sample studied. Prevalence of hearing loss in the sample studied here was somewhat lower than that reported by Kerr et al. The best sensitivities were at the middle frequencies (1000-2000 Hz) in the farmers (72%) and construction (60%) workers. The best specificities were at 4000 Hz in all three worker groups: farmers (91%), construction laborers (70%), and factory workers (90%-91%).
While the self-report instruments were similar in these two studies, differences in sensitivity and specificity between studies may be explained by the differences in measured hearing ability between these two groups.
Although the sensitivity of the questionnaire was low in all three groups studied (construction laborers, farmers, and factory workers), it performed somewhat better in the farmer group. This difference may be related to higher levels of hearing loss in speech frequencies (up to 37%) in this worker group.
Although not identical, the definition of hearing loss used in this study most comparable to that used by Agrawal is the OSHA definition. The worker group in this study showed a higher rate of hearing loss (42%) than in the Agrawal study. This difference may be explained, in part, by differences between samples in noise exposure, as well as measurement methods. Due to the challenges inherent in obtaining adequate numbers of audiometric results for workers, there is a need for development of reliable and valid self-report measures of hearing ability. Our single-item measure of perceived hearing ability resulted in low sensitivity, and is therefore a poor measure of actual hearing loss. Although NHANES surveys 5000 Americans annually, it conducts audiograms on only a subset of this sample, which includes but is not representative of the US workforce.
Therefore, there remains a need for future development of a non-audiometric, subjective measure of hearing ability. For example, Ikeda [9] suggests extrapolating actual hearing ability from a measure of perceived hearing, then correcting for self-report bias.There was great disparity in the prevalence of hearing loss depending on the definition of hearing loss used. Specifically, the Kerr et al method identified 1854 cases, while the Prince method identified 798 cases.
Lacking a standard definition of hearing loss allows under- or over-reporting of prevalence, depending on approach. Researchers and clinicians need to clearly describe their definition of hearing loss when reporting prevalence and screening results.To be effective in prevention of noise-induced hearing loss, hearing protection must be used nearly all of the time a person is exposed to high noise. In the sample studied here, workers reported use of hearing protection between 69% and 80% of the time they were exposed to high noise.
This rate of use of hearing protection is therefore lower than ideal, and is not expected to fully protect workers from the negative effects of noise exposure. NIOSH [3] estimates that failure to use hearing protection during just 30 minutes of daily noise exposure results in a 50% loss in effectiveness of hearing protection. Although programs to support full worker adherence to hearing protection device use are laudable, engineering, and administrative measures to reduce noise exposure are also needed.In the sample studied here, lower perceived hearing ability was associated with the speech frequencies (500-2000 Hz).
Unfortunately, this is consistent with the insidious nature of NIHL, where the early losses in the higher frequencies are less likely to be detected by the affected person. This suggests that those workers with measured low frequency loss likely demonstrate large losses across all frequencies, and in the speech range frequencies in particular. Hence, perceptions of hearing loss are likely to be increased (and very real) for those who demonstrate measured low frequency losses.Perceived hearing ability had low sensitivity regardless of the definition of measured hearing loss used. This finding is consistent with audiometric screening tests identifying hearing loss before the subject identifies it. The low sensitivity suggests that perceived hearing as measured in this study is a poor measure of hearing ability and is not an acceptable substitute for audiometric screening.
While individual employers with hearing conservation programs may examine their databases of serial audiograms for changes over time, these data are not currently aggregated across employers and industries. Moreover, the United States does not currently has a worker hearing status surveillance program.
Surveillance data are needed to evaluate the effectiveness of hearing conservation policies and programs, and to make recommendations to improve their effectiveness. NIOSH has advocated a hierarchy of controls approach, which prioritizes alternative control measures. For example, this hierarchy gives higher preference to engineering controls (such as preventing or containing noise hazards).
Since at least 1996, NIOSH has advocated "buy quiet" programs in industry as a means of reducing workers' noise exposure. This engineering control technique is preferred over use of personal protective equipment, as it reduces ambient noise levels as well as reliance on workers' adherence to hearing protector use in environments where noise hazards are present.
The extent of implementation of this NIOSH recommendation, as well as its effectiveness, is to date unknown. More information is needed about the use and effectiveness of this and other engineering and administrative measures to protect worker hearing. For example, the European Commission has initiated collaborations among local, national, and EU levels, aimed at reducing noise exposure through strategies such as developing noise exposure databases, expert groups, and research. This heavy reliance on the least desirable of control measures is contrary to the hierarchy of hazard controls.Monitoring the effectiveness of hearing conservation programs is problematic.
Healthy People 2020 has identified the annual National Health and Nutrition Examination Survey (NHANES) as the mechanism for collecting data on progress on Objective ENT-VSL-6 (increase use of hearing protection devices).
However, the annual sample size for selected segments of the working population is too small to provide reliable estimates, requiring the aggregation of several years of data for reliable estimates. This is consistent with other studies [8],[13],[14] that demonstrate a discrepancy between measured and perceived hearing loss.Because not all noise-exposed workers benefit from hearing conservation programs, there is a need for the development and implementation of surveillance methods, policies, and programs that address the needs of all segments of labor.
These surveillance measures will be useful in the identification of hearing health needs among workers, prioritization of these needs, evaluation of effectiveness of hearing conservation programs, and prevention of hearing loss.



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