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One quarter of all workers in British Columbia are exposed to occupational noise loud enough to damage their hearing. This compact disc features filtered music and speech to simulate what it is like to have a high frequency hearing loss.
This is a guide to hearing conservation programs and includes the essential requirements for employers and workers. Occupational Audiologists at WorkSafeBC can advise and assist you in developing your program. This is a technical document that gives details on how noise surveys should be performed and how the results should be reported. This document explains how occupational noise measurements can be refined and used to calculate noise exposure levels. Friends and families of hard of hearing people will find these tips helpful for communication. Basic information for the concerned parent: Ear Infections and Early Learning has information that sheds light on the effects of hearing loss that comes and goes on children’s development. Research Summary: Otitis media with effusion (OME) often results in hearing loss for children with the condition. Much acclaimed by educational audiologists, this 1.5 MB hearing loss simulator is free for download and ready for use to demonstrate the effects of hearing loss to families, teachers, class peers and others.
Another approach is to provide a visual representation of a student’s estimated access to verbal instruction as identified with the Functional Listening Evaluation. Environmental Microphone only first, then FM Microphone only second, in noise, person speaking is 3 feet from listener. 1, 4, 8, 12 and 20 channel cochlear implant simulations for speech and music        Source: The Hearing Journal published an article by Patrick M.
For an interesting video simulation of the advancements in cochlear implants, including improvements in speech understanding view this video.
AAA Childhood Hearing Screening Guidelines 2011 – Karen Anderson, PhD chaired the subcommittee that developed this 78-page document regarding the identification of hearing loss needs for children from 6 months of age through high school. For those of you who are wondering, yes the top photo is of a younger Karen Anderson and her oldest son Grant (circa 1995).
This interactive ebook gives an overview of noise-induced hearing loss and explains what is required of a hearing loss prevention program that benefits both workers and employers. An important part of the review is hearing test information, which indicates the extent of occupational hearing loss for a particular worksite. Anyone who has worked through the companion document, Occupational Noise Surveys, may need the information in Basic Noise Calculations. Lawn mowing, fitness classes, truck and tractor pulls, airplanes, table saws, rock concerts, snowmobiles---all these environments can be too loud. In order to provide appropriate and effective audiologic management, it is important to understand the impact of OME on speech recognition ability when hearing loss is present. Performance, fatigue and stress in open-plan offices: The effects of noise and restoration on hearing impaired and normal hearing individuals. Children with hearing loss are usually more fatigued than their typically hearing friends or siblings.
A ready-made handout showing classroom directions imposed over 100 puzzle pieces is a very effective way of visually showing the impact of hearing loss. In addition to specific hearing screening protocol recommendations, the document includes background information on prevalence of hearing loss, economic and educational impacts, determining program effectiveness, and considerations for management of hearing screening programs.
This book also provides general information on implementing a hearing loss prevention program. Deaf to the Danger contains three, short scenarios (warehouse, sawmill, and packaging plant) that demonstrate just some of the dangers associated with wearing earbuds on the job. Refer to the webpage on cholesteatomas for more information about this disease and how it can effect learning. This study examined the speech recognition abilities of normal-hearing six- and seven-year-old children (n = 12) and adults (n = 12) using monosyllabic words and nonsense syllables presented at two levels of simulated conductive hearing loss characteristic of OME. Average speech recognition scores decreased as the degree of simulated conductive hearing loss increased. Desloge (of Sensimetrics Corporation) in its July 2007 issue entitled “Hearing loss and prosthesis simulation in audiology”.
Development of a video for pure tone hearing screening in schools. Journal of Educational Audiology, 17, 62-76). Other permanent damage can also be caused from longstanding hearing loss due to middle ear infection.
Both age groups scored significantly poorer for nonsense syllables than for monosyllabic words. People who use cochlear implants will perceive sound at a loudness that is quieter than typical hearing and they will be significantly at a disadvantage when listening in noisy situations and at a distance. In general, the children performed more poorly than the adults with the exception of the easiest listening condition for word stimuli. Furthermore, children appeared less able than adults to use their knowledge of familiar words to improve performance. These findings suggest that rehabilitative strategies may best be focused on combining familiarization techniques and amplification options. In Sweden more than 10% of the population have some hearing impairment and among those more than half are of working age. Of course you can select as many other items as you want, but to be able to use the audio simulations you need the above components. For example, it appears that no research has considered whether hearing impaired individuals' work performance is disrupted by background speech or how stressful they experience a noisy background to be.If noise has a negative effect on office workers, one important strategy is to find ways to attenuate the negative outcomes. Restorative effects are typically seen after a break as less fatigue, reduced psychophysiological activity (e.g. In addition we investigated the restorative effects of 14 minutes break with two different restorative conditions.
Hearing impairment and performance in Noise Most studies concerning individuals with hearing impairment have focused on performance and listening effort in tasks involving speech processing. The results show that background noise has a larger effect for the hearing impaired than for normal hearing individuals in these tasks (for a review, see.
By itself, a hearing loss may be favorable when performing visual tasks in office noise, as the noise is not as prominent or intelligible for the hearing impaired as it is for individuals with normal hearing. On the other hand, most individuals with a serious hearing impairment use a hearing aid, which may amplify the sound to a normal hearing level. However, the hearing aid may also distort the speech signal, [13] which may lead to more distraction for the hearing impaired. Recruitment, which refers to the finding that the same increase in signal strength gives a larger increase in perceived loudness in a non-normal ear than in the normal ear [14] may also play a part here by leading to the perception of sharp onsets of sound that capture attention away from focal task processing much like an auditory deviant. In the present study we included noise with temporal variations of speech, phones ringing, and office clatter etc. Hearing impairment, fatigue and stress Babisch [16] reviewed findings concerning stress hormones in relation to research on the cardiovascular effects of noise. Interestingly there are some studies showing specific effects of noise on stress that are related to hearing and noise sensitivity.
For example, Melamed and Bruhis [17] performed a field study on industrial workers and have shown that the workers had increased urinary cortisol levels after a day without wearing hearing protection compared with when using them (i.e.
Therefore, higher cortisol levels could be expected in individuals who are highly sensitive to sounds because of a hearing impairment. However, to the authors' knowledge no studies have been reported that demonstrate such a relationship.
Restoration The study of restoration in different contexts has been guided by different theoretical approaches that entail different outcomes over time. We also include another task, mental arithmetic, which has been shown to be cognitively fatiguing to perform. More precisely, we expect a nature movie without sound (positive stimuli) to be more restorative than noise (negative stimuli). We also had two different between-participants restorative conditions at the end of the high noise sessions. The participants either watched a nature movie with no sound or listened to office noise without a movie (between-participants manipulations).
During the low noise session all participants sat in quiet during the restorative period, to assure the same session length in both noise conditions. The participants with hearing impairment were recruited from the Swedish association of the Hard of Hearing Persons (HRF) and we only included those in the age span 20-65 years old. In the next step we recruited matched normal hearing participants following the criteria of the same gender, age (accepted with small age variation), occupation and education as the hearing impaired individuals.
Out of the 38 participants, 20 had earlier worked with office tasks, and 10 had some experience with open-plan offices. Participants' hearing abilities were screened [see [Figure 1]a and b for the means of the audiograms for the hearing impaired and normal hearing group]. The criterion to be included in the hearing impaired group was a mean hearing loss of 28 dB or more over the frequencies 500, 1000, 2000 and 4000 Hz, which did not give any overlap between the two groups. The participants with hearing-aids were told to have them turned on during the experiments.
Participants were informed of the nature of the study before participating and they were randomly assigned to the two sequence orders of the two noise conditions.
The room was designed to simulate a neutral open-plan office including windows to a white room with simulated outdoor lighting.

Ambient conditions in the indoor environment were kept approximately constant throughout the experiments. Luminance was set to 480-520 lx incident on the height of the seating in each workstation and met the current recommendations in Sweden for work with computers. At each end of the set of cubicles a pane of glass was installed to better avoid direct sounds from the loudspeakers to the participants sitting close by. Noise conditions We recorded the noise used in the experiment in an actual open-plan office in Sweden. From the multi-channel recording, one hour of office noise was extracted, edited and reproduced in the test room with eight loudspeakers, two at each wall, and one subwoofer.
In the high noise condition, additional phone and sound signals were added to the office noise.
The speech signals were conversations recorded from radio, from which we cut away one of the voices to simulate telephone conversations.
The high noise was reproduced with an equivalent A-weighted sound level of 60 L Aeq in the room. In the low noise condition the added phone and sound signals were excluded and the noise was low pass filtered, which reduced L Aeq in the room by 12 dBA. The one hour office noise tape was looped once, and the sound signals in the latter hour were rotated 180 degrees to equalize noise exposure throughout the room.The sound level measurements showed the same L Aeq in the first and second hour of the reproduced office noise. The statistical distribution of sound pressure levels was similar in the high and low noise conditions except that the equivalent levels differed by 30 dB.
The Speech Transmission Index (STI) was the same for the high noise condition (60 dB) in this study, as for the high noise condition (51 dB) in the earlier study by Jahncke et al.
The speech noise in the low noise condition was now so close to the hearing threshold that it was not possible to hear the weakest speech sounds. Restoration conditions After two hours of work in office noise the participants went through a restoration period for 14 minutes. Two different restorative conditions were tested after the high noise condition: half of the participants saw a movie with clips of nature environments in quiet and half of the participants were exposed to continued office noise. In the analysis of restoration effects only the movie and office noise conditions were compared, as the quiet condition differed from these to conditions also with respect to the preceding noise condition.
The other cognitive tasks were included twice to measure change across time in noise, except for the reading comprehension task that was included once per session because of the time it took to perform [see [Figure 2] for an overview of the task order].
The same presentation order of dependent measures was used for all participants to control for the timing between task and noise.
The task always started with a difficult expression that was followed by an easy expression and so on.
The scores were the sum of correct answers (divided in the easy task and the difficult task) and the mean response time for the expressions (also divided in the easy task and the difficult task).Word memoryMemory for words was measured with a Proactive interference (PI) task, which taps the ability to inhibit information that once was relevant for recall but has since become irrelevant for the task.
After a given list of ten words had been presented, participants were required to free recall the words from the most recent list and ignore (suppress) words from earlier lists.
We used the following categories: "fish and other water living creatures", "fruits and vegetables", "animals", "cloths and accessories", "kitchen- and gardening tools", "countries" and "cities in Sweden".
The orders of the categories within each experimental session were counterbalanced between participants. One sentence at a time was presented and the participant decided when the next sentence should be presented by clicking the space button. In 25 of the 43 sentences one word was missing and the participants were given a choice between four alternatives. Sometimes the information for the correct choice was in the text that no longer was on the screen, sometimes the information appeared on the screen simultaneously. The scores were the sum of correct answers and the time it took to complete the reading task.When all the text was read, two variations of memory questions were posed. In the first set the participant was presented with a sentence and was asked to judge whether the sentence was taken from the text read or not. In some of these sentences an important word from the original text had been changed and in other sentences there was no similarity with the original text. In the second set there were questions about the information stated explicitly in the text, (e.g. Scores were the sum of correctly marked details.Search taskIn this task participants had to locate a specific object among different information channels.
The participants were asked to find the object that met a set of criteria, either by using two columns (easy) or four columns (difficult). Therefore this task taps processes required to search through and understand the contents of a table with information, while successively updating and memorizing which information is most correct according to the target criterion. Each number was presented for 400 milliseconds followed by a pause of 350 milliseconds before the next number was presented. After the eight digits were presented an answer box appeared on the computer screen with the numbers 1-8 in random order.
Each block consisted of 27 lists and only numbers written at their correct positions were scored correct. Self ratings of fatigue Perceived sleepiness and motivation were measured with the Swedish Occupational Fatigue Inventory (SOFI) developed by Åhsberg, Gamberale and Kjellberg.
Lack of energy was measured with the words "worn out" and "exhausted", Lack of motivation with the words "passive" and "uninterested", and Sleepiness with the words "sleepy" and "the number of yawns for the last ten minutes" on a scale ranged from 1 = not at all to 4 = a lot.
For each participant, the exact time after the bladder had been emptied by voluntary voiding was noted, the total urine volume was measured, and 40 ml of urine was mixed in 100 ml glass bottles containing 0.5 ml 2 M HCL as a preservative. It is however, unclear how to handle the timing of the measurements of the peak response in cortisol as there might be a time lag before the reaction is measurable. Procedure Data collection took place at a simulated office at the University of Gävle. Participants went through a practice session for one hour, several days in advance of the first experimental session.
The experimental sessions were run between four and seven pm and for each participant, one day separated the two sessions.
The procedure for one experimental session is presented in [Figure 2].After the first urine and saliva samples, the participants completed the SOFI and performed the first block of fatigue tasks in quiet.
After the fatigue tasks they preceded through the first block of cognitive tasks while one of the two different noise conditions (low noise, or high noise) was played back. The session order of the noise conditions was counterbalanced but not the cognitive tasks between the experimental sessions. The Search task and Word memory task were counterbalanced between participants within one session to reduce the risk of an order effect because of the different task categories. After 1.5 hours of work the participants left the simulated office for the second urine sample.
In the beginning of this block a saliva sample was collected and the SOFI was again completed.The next phase was the restoration period wherein the participants were instructed to put their headphones on. In the high noise condition the participants either watched a nature movie with no sound or listened to office noise (without any film) during the restoration period. In the low noise condition all participants sat in quiet for 14 minutes to keep the same session length. After the restoration period the participants put off their headphones and went through the last fatigue block in silence. The whole procedure took about three hours to complete and one to eight participants were tested at each occasion.
Statistical analyses Because of failures to follow instructions 3 participants were excluded from the analyses of the noise effects, leaving 34 participants for further analysis. One participant was excluded from the analyses of the restoration effects due to equipment malfunctioning during the restoration period. There are further data missing for the following number of participants in these measures: SART (1), Reading comprehension (2), Search task (9), SOFI (4), Norepinephrine (3), and Epinephrine (3) due to lack of answers and equipment malfunctioning.
A General Linear Model (SPSS version 18) with repeated measures (mixed) design was used for the analysis of noise and fatigue effects. When Mauchly's test indicated significant non-sphericity in the variance-covariance matrix for the within-subject analyses, the Greenhouse-Geisser adjusted degrees of freedom and corresponding P-values are reported for the F-tests. For both sections the presentation order begins with the effects on cognitive performance, then on psychophysiological stress and then finally on self-ratings of fatigue. Noise effects on cognitive performance during work In the design, noise conditions (high and low) was a within-participant variable.
Therefore, there is no support for Hypothesis 1 (a) - that mathematical performance was impaired by noise level.However, there was an interaction between noise and hearing on performance speed. As shown in [Figure 3]a both the hearing impaired- and normal hearing groups appeared to work faster in the easy tasks in high noise than in low noise.
In the difficult tasks [Figure 3]b the hearing impaired appeared to work faster in high noise than in low noise, whereas the normal hearing groups performed at about the same speed in both high and low noise.
The interaction contradicts Hypothesis 2 because the hearing impaired worked faster in high noise than the normal hearing individuals.
Error bars are the standard errors of the mean (B) Math performance in the difficult task for the normal hearing and hearing impaired participants in high and low noise. This contradicts Hypothesis 1 (a) which predicts impaired performance during the higher noise level. Further, as shown in [Figure 4], the hearing impaired participants appeared to do worse (had more omissions) in the word memory task (PI) during high noise, than in the low noise condition, whereas the opposite was true for the group with normal hearing.
Again, only when hearing status was considered, an effect of noise level was seen.As shown in [Figure 5] the participants with a hearing impairment appeared to remember more sentences in low noise compared to those in high noise, while the normal hearing group showed the opposite effect.

The participants had only a few correct answers in the difficult part of the Search task which suggests a floor effect. Noise effects on acute psychophysiological stress during work Since there are large individual variations in stress hormone levels, the analyses of the physiological measures were only conducted with noise as a within-participant comparison. There was no main effect of noise, but in low noise the hearing impaired and normal hearing participants had approximately the same cortisol levels at all measurement occasions, whereas in high noise the hearing impaired group had higher levels than the group with normal hearing. However, there was no significant main effect of noise on the level of catecholamines over time and no interaction between noise and hearing.
Noise effects on self ratings of fatigue during work In this section the focus is only on the noise effects which were measured Pre work and Post work.
The scale ranged from 1 = not at all to 4 = a lotClick here to viewFurther, the hearing impaired participants and the normal hearing participants rated themselves at about the same level of sleepiness during the low noise exposure. The scale ranged from 1 = not at all to 4 = a lotClick here to viewIn summary, the hearing impaired participants were more tired during high noise exposure than the normal hearing participants, which is in line with Hypothesis 2.
Effects of restoration on cognitive performance As a first step we analyzed if the participants had a drop in arithmetic performance from Pre work to Post work during high noise to establish that the participants were in a state of need for cognitive restoration.
Although discrepancies were found in performance between session orders, the overall pattern showed decreased quality and increased speed during work in high noise exposure.
As shown in [Figure 8]a the normal hearing participants performed better (correct answers) after restoration with a movie, while their performance declined after continued noise exposure. As shown in [Figure 8]b, the opposite pattern emerged for the hearing impaired participants with decreased performance with movie and improved performance with noise.
The scale ranged from 0-12 pts of correct answers (b) Arithmetic performance in the restorative conditions movie and noise at Post work and Post rest, for hearing impaired. The scale ranged from 0-12 pts of correct answersClick here to view Effects of restoration on acute psychophysiological stress No effect of restoration was found on the urinary catecholamines and salivary cortisol, yielding no support for Hypotheses 3. However, see the effects of time on the urinary catecholamines and salivary cortisol under the section "Noise effects on acute psychophysiological stress" above. However, the hearing impaired showed the opposite pattern with an increase in motivation after a restorative period in noise and a decrease with movie [Figure 9]b.
The scale ranged from 1 = not at all passive to 4 = very passive (b) Self-ratings for lack of motivation for the comparison movie vs.
The scale ranged from 1 = not at all passive to 4 = very passiveClick here to viewFor the other SOFI-variables there was a session-order interaction, which made us leave those analyses from further consideration.In summary, only the normal hearing participants followed Hypothesis 3, with increased motivation after restoration with the movie and loss in motivation with noise. Math, Memory for words, Reading, Search task and Serial recall), contradicting Hypothesis 1 a. The high noise level tested was 60 L Aeq , which is in the region of a normal speech level. However, when exploring the effects of hearing status, we found an interaction between hearing and noise level in line with Hypothesis 2 for two of the tasks. The hearing impaired participants were more affected by high noise than the normal hearing, as shown by decreased performance in memory for the contents of a text, and a tendency for decreased performance in the memory for words test. Possibly, noise at 60 L Aeq was distracting for the hearing impaired as they presumably are more sensitive for noise.An interesting result was also that the normal hearing participants worked better overall during high noise than low noise. For example, Yerkes and Dodson's [33] theory predicts a need of a higher level of arousal for optimal performance on easy tasks than more difficult tasks (i.e.
If most of the tasks we employed were perceived as quite easy to the participants they most probably needed arousing stimuli (i.e.
In line with this, Suedfeld and Loewen [34] have showed that feelings of arousal can increase with noise. The subjective ratings also showed that the participants had significantly higher motivation in high noise than low noise, although sleepiness increased over time. However, there are some difficulties with these theories, particularly in specifying the optimum level of arousal.One notable result was that the easy math tasks benefited from a higher noise level. This benefit is in line with a previous study by Loed, Holding and Baker [35] which showed that background noise can increase performance of simple arithmetic's (i.e.
The lack of an interaction with noise level may be explained by earlier studies showing that some tasks are not vulnerable to a variation in noise intensity; rather performance is impaired by the changing properties of the sound.
The present results therefore support the finding that only some tasks are impaired by office noise. Effects of noise on acute stress The participants showed a significant decline in cortisol in both noise conditions over time, consistent with the decline that occurs as a part of normal circadian variation. However, there was a tendency for the hearing impaired participants to show higher stress levels over time in high noise compared to low noise.
The same pattern of decline over the experimental session in both noise conditions was also evident in the norepinephrine, measured from urine. In summary, we found no main effect of noise on stress hormones, contradicting Hypothesis 1b.
The results merely showed a weak tendency in line with Hypothesis 2 demonstrating that the hearing impaired participants were more stressed by the high noise condition compared to the normal hearing participants. Effects of noise on self-ratings of fatigue In both noise conditions there was an increase of sleepiness and loss of motivation over time. Instead there was an interaction between noise and hearing status in line with Hypothesis 2.
However, during high noise the hearing impaired were expected to be more tired than the normal hearing participants. Restoration The participants felt sleepier, less motivated and less energetic from Pre work to Post work, and their performance quality decreased in the arithmetic task during the work period.
This supports earlier findings [8] that normal hearing participants restore better with a nature movie than with noise.
However, for the hearing impaired participants of the present study, the opposite pattern emerged. Both their performance and motivation decreased after restoration with the nature movie, and improved after noise exposure.
This is difficult to explain, but one possible explanation is that continued noise exposure might have counteracted their possibilities to slow down, relax, and feel how sleepy they were.Further, no restorative effects were found on the salivary cortisol and urinary catecholamines.
The stress hormones showed a decline over time in accordance with the normal circadian rhythm.In summary, Hypothesis 3 only held for the normal hearing participants' performance and motivation. They showed significantly increased performance and motivation after restoration with the movie and decreased performance and motivation with noise.
A comparison with our previous experiment Jahncke et al, [8] reported an experiment with open-plan office noise, cognitive performance, restoration and subjective ratings that in many respects is comparable to the experiment reported here.
For instance the participants in the previous study were young (mean age = 26 years) students at the University of Gävle, while the participants in the study reported here were older (mean age close to 50 years) and had less formal schooling and had different occupations. To probe whether this difference had any impact on the difference in results between the two experiments, a follow up statistical comparison was made between the results on a comparable test (i.e.
Limitations It should be acknowledged that this study was small in scale and that we had additional problems with missing data.
The lack of interactions especially may have been seriously influenced by the small N in our samples. It is possible that different results may have been found in a larger sample, especially when considering how much variation there may be in the hearing impaired group.Further, we cannot tell whether we would have observed an increase in fatigue if we had not conducted our study from 4-7 pm. This for most office work would be towards the end of the working day and another choice of time frame might have changed the results. However, we choose to conduct these studies during the afternoon as this is more appropriate for measuring the stress hormones, as we expect a decrease in stress hormone levels in the afternoon.
If the stress hormones are measured when a daily increase is expected we could not rule out whether the increase is due to noise or the circadian rhythm.According to the stress hormones, most of the tasks employed were most probably perceived as quite easy to the participants. This could explain why we did not see any main effect of noise on the stress hormones in our study.It can also be questioned if it is of real-life relevance to watch a nature movie with no sound as a tool to be used in real office life.
Outside the experimental studies it is probably of better practical use to take a walk in a real nature environment during the break. Further, we are not able to say whether it is the silence, the nature, or both that are important as our stimuli contained both these features.
However, they were not distracted when they performed the two tasks (Serial recall and Search task) that are underpinned by processes, which previously have shown to be insensitive to noise level.The hearing impaired individuals were also more fatigued by a higher noise exposure than people with normal hearing and they tended to have higher stress hormone levels during high noise compared to the low noise.
The present study however, cannot disentangle whether the effects reported are a result of hearing impairment or a result of the use of hearing aids.
The participants might also have used different types of hearing aids, which can differ in performance and suitability for our test conditions. The impact also varies with the hearing characteristics of the persons exposed to noise and the tasks they perform.
For example, it is rarely possible for hearing impaired persons to decrease the negative impact from surrounding noise by turning off the hearing aids, when the work requires a readiness for phone calls and communication with colleagues. These results underscore the need to address the issue of how to enhance restorative qualities within the noisy environments of our daily surroundings. We would like to thank Staffan Hygge and Terry Hartig for helpful advice in planning and conducting this study.
We are also grateful to Kenth Dimberg at the University of Gävle for analyzing the urine samples and Lars Holmberg at the Stress Research Institute, Stockholm University for analyzing the saliva samples. We also thank Anders Kjellberg, John Marsh, Patrik Sörqvist and the anonymous reviewers for helpful comments on this manuscript, the Swedish Association of Hard of Hearing People (HRF) for generous support, and Ecophon and S-line office for their donations to furnish the simulated open- plan office.

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