Hearing Damage Research Articles

Assessment and Management of Platinum-Related Ototoxicity in Children Treated for Cancer.

Platinum compounds are a group of chemotherapeutic agents included in many pediatric and adult oncologic treatment protocols. The main platinum compounds are cisplatin, carboplatin, and oxaliplatin. Their use in clinical practice has greatly improved long-term survival of pediatric patients, but they also cause some toxic effects: ototoxicity, myelosuppression, nephrotoxicity, and neurotoxicity. Hearing damage is one of the main toxic effects of platinum compounds, and it derives from the degeneration of hair cells of the ear, which, not having self-renewal capacity, cannot reconstitute themselves. Hearing loss from platinum exposure is typically bilateral, sensorineural, and permanent, and it is caused by the same mechanisms with which platinum acts on neoplastic cells. According to available data from the literature, the optimal timing for the audiological test during and after treatment with platinum compounds is not well defined. Moreover, no substances capable of preventing the onset of hearing loss have been identified.

Individual Fit Testing of Hearing-Protection Devices Based on Microphones in Real Ears among Workers in Industries with High-Noise-Level Manufacturing.

Hearing-protection devices (HPDs) are particularly important in protecting the hearing of workers. The aim of this study was to prevent hearing damage in workplaces in Taiwan. It was conducted to determine the actual sound attenuation of the personal attenuation rating (PAR) values when wearing HPDs via measurements from field microphones in workers’ real ears (F-MIRE). Across 105 measurement trials for the Classic™ roll-down foam earplug HPDs worn by the workers, there were 23 cases of ineffective protection (including caution and fail); the proportion was 20% (including the first measurement and re-wear of HPDs after education and training). In addition, re-education and training in how to wear the HPDs was provided, improving wearing skills. A total of 29 testees wearing the Classic™ roll-down foam earplug HPDs failed to meet the pass standard for the first PAR test, and 6 of them improved and subsequently passed the PAR test. The improvement rate was 20%. These 23 testees switched to another HPD, namely Kneading-Free Push-Ins™ earplugs. From this group, 16 effective sound attenuation values were obtained, with an improvement rate of 70%. However, seven testees failed to pass the PAR test, and after education, training, and replacement of HPDs with different types, they still could not pass the PAR test. At that time, even if the UltraFit™ pre-molded earplugs were adopted again for wear and replacement, they were still unable to pass the PAR test. This HPD was eventually replaced with the PELTOR X4A Earmuff HPD and then tested again, with these HPDs finally passing the PAR test. In Taiwan, the use of fit testing has been increasing but it is not a common practice, and few studies on hearing-protection fit testing have been conducted in this country. The goal of this study was to gain more insight into the current hearing protection situation, including field attenuation of HPDs obtained by workers, the effects of training on improving the attenuation of HPDs after F-MIRE measurements, and the awareness of hearing health and motivation on the use of HPDs in a high-noise-level environment.

Toward an improved hearing safety standard for impulse noise exposure in the Canadian Armed Forces

Introduction: Current hearing safety standards for the Canadian Armed Forces (CAF) do not adequately address exposure limits for mitigation of noise-induced hearing loss (NIHL) from weapon noise. Recommendations for updating the hearing safety standard are being formulated by the recently initiated Noise Health Hazard Working Group (NHHWG). In this article, we aim to provide a way forward for the NHHWG. Methods: On the basis of experience with auditory research, noise measurement, acoustic standards development, interactions with CAF members, and a review of the literature, we present an overview of the current state of knowledge regarding impulse noise. The topics include impulse noise measurement, engineering and administrative controls for noise exposure, and use of personal hearing protection devices (HPDs). Results: Although technology for impulse noise measurements and ways to account for HPDs have improved substantially in recent years, not much has changed in hearing damage risk criteria. Energy-based metrics can account for the impulse duration and frequency-dependent characteristics of the HPD, which are important considerations in calculating allowed exposures. Discussion: The NHHWG is recommended to focus on measurements of current weapons systems in various configurations and training environments and to evaluate the use of energy-based metrics, together with frequency-dependent HPD insertion loss.

Regulations to reduce risk of hearing damage in concert venues.

In 2015, the World Health Organization (WHO) convened a group of researchers and industry experts to tackle the risk of noise-induced hearing loss from loud music exposure because of personal listening devices and entertainment venues...

Noise Reduction Based on Training Intervention and Using Visual Signs in Neonatal Intensive Care Units (NICUs)

Noise may cause hearing damage and delayed growth and development in newborns in neonatal intensive care units. Hence, it is necessary to reduce noise in these environments. Training and use of visual signs have been investigated as the interventional strategies with the aim of reducing noise level and exposure in neonatal intensive care units. This quasi-experimental study (before and after design) was conducted in the NICU of Birjand University of Medical Sciences Hospital (BUMSH NICU). According to ISO9612 standard, equivalent and maximum noise level in the NICU was measured by a calibrated sound level meter TES model 1358C at various stations during different shifts. Subsequently, the training and visual signs (flags and posters) were utilized as the interventions and SPSS version 18 was used for data analysis. The average equivalent and maximum noise level were calculated between 43.5–69.2 and 55.3–79.2 dBA, respectively, which is above the standards recommended by the American Academy of Pediatrics (AAP). Staff conversation, equipment and alarms were among the main sources of noise pollution. The equivalent noise level showed meaningful reduction before and after the interventions (personnel training and visual signs usage) at night. Noise in our NICU was greater than the recommended sound levels of 45 dBA. However, training and visual signs interventions seemed effective in reducing noise levels, particularly during the night shift. Since conversation was identified as the main noise source, future research is recommended to determine personality traits in healthcare professionals and promote a culture of silence.

Randomized control trial evaluating the effectiveness of ear plugs in hearing loss in NICU preterm babies

Background: The prevalence of hearing loss is higher in neonates admitted to NICU compared to the general population. Preterm babies are more vulnerable to the hearing damage due to their immature inner ear exposing them to various high frequency noises in the NICU to which they were not accustomed. Most NICU in India exceed the recommended sound levels. In order to reduce damage to the ears, foam-based earplugs are used to reduce the sound intensity reaching the ears of these premature babies.Methods: Babies admitted to NICU are allocated alternatively to receive earplugs or not. Cases are preterm babies with earplugs and controls are the ones without earplugs. The incidence of hearing loss is found by OAE testing of the ears at the end of NICU stay.Results: Out of 40 in each group, 6 babies in control group failed the OAE compared the 3 in the earplug group. Babies who did wear earplugs had longer period of NICU stay.Conclusions: Use of earplugs in babies admitted to NICU reduced the incidence of hearing loss and also length of NICU stay.

Оценка экономической эффективности мероприятий по борьбе с производственным шумом

An assessment of the socio-economic aspects of the negative impact of noise on the human body is given. The procedure for calculating the expected annual economic efficiency of implementing measures to reduce in-plant noise is considered. The dependence of the risk of hearing damage on the equivalent noise level and duration of operation is given. The relationship between measures to reduce in-plant noise and economic losses of the enterprise is established.

Salt-Inducible Kinase 3 Haplotypes Associated with Noise-Induced Hearing Loss in Chinese Workers

Introduction: Noise-induced hearing loss (NIHL) is a common occupational disease that represents an irreversible hearing damage to the auditory system. It has been identified as a complicated disease involving both environmental and genetic factors. More efforts need to be made to explore the genes associated with susceptibility to NIHL. The main aim of this research is to detect the associations between SIK3 polymorphisms and NIHL susceptibility in Han people in China. Methods: A case-control study was performed in 586 cases and 639 controls in a textile factory matched for sex, age, smoking, drinking, work time with noise, and intensity of noise exposure. Three single nucleotide polymorphisms (SNPs) (rs493134, rs6589574, and rs7121898) of SIK3 were genotyped in the participants. Then, the main influences of the SNPs on and their interactions with NIHL were assessed. Results: Under the allelic model, distributions of rs493134 T, rs6589574 G, and rs7121898 A in the NIHL group are statistically different from those of the normal group (p = 0.001, p < 0.001, and p = 0.019, respectively). The following haplotype analysis shows that TAA (rs493134-rs6589574-rs7121898) may have a protective effect, while TGA (rs493134-rs6589574-rs7121898) (OR = 1.49, 95% CI = 1.25–1.79) may be a risk factor for NIHL. Multifactor dimensionality reduction analysis shows that the interaction of the 3 selected SNPs is associated with NIHL susceptibility (OR = 1.88, 95% CI = 1.50–2.36). Conclusion: The results suggest that 3 SNPs (rs493134, rs6589574, and rs7121898) of SIK3 may be an important part of NIHL susceptibility and can be applied in the prevention, early diagnosis, and treatment of NIHL in noise-exposed Chinese workers.

TIMELY APPLICATION OF HEARING AIDS HELPS PRESERVE SPEECH DISCRIMINATION ABILITY

Background Hearing damage has been related to certain brain conditions, particularly cognitive impairment. Hearing aids are commonly prescribed to compensate for hearing loss. In the current study, the time from when a hearing aid was first used by a patient was studied in terms of their speech discrimination ability in comparison with matched individuals who used no hearing aids. Material and methods Some 204 patients were enrolled and classified into two groups: 102 patients willing to use a hearing aid as soon as their hearing loss was diagnosed (Aided Group) and 102 patients who were also diagnosed with hearing loss but did not adopt hearing aids (Unaided group). The mean hearing threshold (HT) at octave intervals from 125 to 8000 Hz, speech reception threshold (SRT), and speech discrimination score (SDS) were compared between the two groups of patients at 18 and 36 months. Results According to measurements 36 months after a patient’s first attendance, patients who did not use a hearing aid immediately had significantly lower SDS scores compared to patients who decided to use hearing aids early on. This clearly demonstrates that timely application of hearing aids can prevent the loss of speech perception capabilities. Conclusions It is suggested that the golden time for hearing aid application is important. Hearing aids worn during the early stages of hearing loss can lead to improved speech discrimination ability. If there is hearing loss while discrimination is good (80% or higher), a hearing aid will be very useful. However, if discrimination is poor the results will not be as good.

Effect of Noise Cancelling Devices on Dental Handpieces Using Ear Model

This study intended to evaluate noise level of dental handpieces and the effects of noise cancelling devices. An ear model was designed to measure the level of the noise delivered to the inner ear during dental handpiece operation. The level of noise was measured in various conditions using the ear model and the portable noise meter. Noise level was measured again after applying of 4 different noise cancelling devices to the model ear.&lt;br/&gt;The noise level of dental handpieces was 82.5 - 84.4 dB. When 4 types of noise canceling devices were applied, the noise level reduced to 67.4 - 73.8 dB. All 4 devices had statistically significant effect in reducing the noise of the handpiece.&lt;br/&gt;Considering the intensity and exposure time, noise in dental clinics can cause hearing damage to dentists. For protection from the risk of occupational hearing damages, noise canceling devices can be recommended.

Chemical Modifications Reduce Auditory Cell Damage Induced by Aminoglycoside Antibiotics.

Although aminoglycoside antibiotics are effective against Gram-negative infections, these drugs often cause irreversible hearing damage. Binding to the decoding site of the eukaryotic ribosomes appears to result in ototoxicity, but there is evidence that other effects are involved. Here, we show how chemical modifications of apramycin and geneticin, considered among the least and most toxic aminoglycosides, respectively, reduce auditory cell damage. Using molecular dynamics simulations, we studied how modified aminoglycosides influence the essential freedom of movement of the decoding site of the ribosome, the region targeted by aminoglycosides. By determining the ratio of a protein translated in mitochondria to that of a protein translated in the cytoplasm, we showed that aminoglycosides can paradoxically elevate rather than reduce protein levels. We showed that certain aminoglycosides induce rapid plasma membrane permeabilization and that this nonribosomal effect can also be reduced through chemical modifications. The results presented suggest a new paradigm for the development of safer aminoglycoside antibiotics.

Hearing Damage Induced by Blast Overpressure at Mild TBI Level in a Chinchilla Model

The peripheral auditory system and various structures within the central auditory system are vulnerable to blast injuries, and even blast overpressure is at relatively mild traumatic brain injury (TBI) level. However, the extent of hearing loss in relation to blast number and time course of post-blast is not well understood. This study reports the progressive hearing damage measured in chinchillas after multiple blast exposures at mild TBI levels (103-138kPa or 15-20psi). Sixteen animals (two controls) were exposed to two blasts and three blasts, respectively, in two groups with both ears plugged with foam earplugs to prevent the eardrum from rupturing. Auditory brainstem response (ABR) and distortion product otoacoustic emission (DPOAE) were measured in pre- and post-blasts. Immunohistochemical study of chinchilla brains were performed at the end of experiment. Results show that the ABR threshold and DPOAE level shifts in 2-blast animals were recovered after 7days. In 3-blast animals, the ABR and DPOAE shifts remained at 26 and 23dB, respectively after 14days. Variation of auditory cortex damage between 2-blast and 3-blast was also observed in immunofluorescence images. This study demonstrates that the number of blasts causing mild TBI critically affects hearing damage.

Performance Evaluation of Active Noise Control for a Real Device Casing

Reduction of noise generated by devices is an important problem, both in industrial environments where high sound pressure levels may damage hearing, and in households where the sound pressure level is usually moderate, but may cause discomfort and stress. Classically used passive methods often have poor performance for low frequencies. Alternatively, active control can be used to improve noise reduction in this frequency range. In the proposed approach, noise generated by devices may be reduced by controlling vibrations of the casing. The authors previously confirmed the performance of the proposed active control approach using a dedicated noise-canceling casing. Herein, we describe further development and application of the method to an off-the-shelf washing machine. Electrodynamic actuators were installed on four walls of the washing machine. The performance of the control systems was experimentally evaluated during the real spinning phase and the results are reported here.

Sound power determination for centrifugal pumps used for local agricultural irrigation in Romania

Technological enhancements in the domain of agriculture have led to easing the burden of physical work and increased productivity. Irrigation has always been one of the most crucial elements needed for a high yielding crop, given the current uncertainty of climate change, where climate is increasing in unpredictability. Even though a wide array of methods has been developed in recent years, for the Romanian local agricultural irrigation, a popular method remains using motor-pumps. But the issue with this type of equipment is that during active functioning, it produces high sustained levels of noise pollution, and the risk of operator hearing damage is relatively unknown for long term exposures (years). In this paper, the levels of acoustic power of an irrigation motor-pump model WHT-60 were determined, taking into consideration the required standards, and directives, necessary for this activity, imposed by the European Union for all member countries.

Application of Hyperbaric Therapy Following Acoustic Trauma – Case Report

Introduction: Acoustic trauma is noise-induced hearing damage. It can occur as a result of a strong sound stimulus or explosion, which causes a pressure wave, which causes in the organism the damage of structures filled with air, e.g. tympanic membrane. Acoustic trauma has many consequences in the form of: deterioration or complete loss of hearing, tinnitus, crackling, feeling of confusion and constant fatigue, headaches and dizziness. It also has a significant impact on the quality of life – it hinders people-to-people contacts and prevents professional activities and may be the cause of depressive disorders. Acoustic trauma can be treated, among others, through the use of hyperbaric therapy, which has a wide spectrum of activity in many fields of medicine. Aim: The aim of the study was to present the legitimacy of using oxygen treatment at increased pressure in a patient after acute acoustic trauma. Material and method: The study was conducted at Hyperbaric Therapy Center CREATOR in Lodz (Didactic and Research Center of the Medical University of Lodz). As a research method, case study was used in an individual patient after an acoustic trauma. Using the extended interview questionnaire and analysis of available medical records. Conclusion: Hyperbaric therapy may be a useful method in the treatment of acute acoustic trauma.

Desarrollo de un sistema de medición de parámetros acústicos biaurales

Este trabajo trata del desarrollo de un sistema destinado al registro de sonido holofónico y a la obtención de parámetros acústicos biaurales que caracterizan la percepción espacial del sonido. En la primera parte se presenta la implementación de un prototipo de maniquí acústico de bajo costo, simulador de cabeza y torso (HATS), al que se le analizaron sus características antropométricas y sus respuestas en frecuencia. En la segunda parte se describen los algoritmos desarrollados para procesar los datos medidos a través del HATS. Finalmente se muestras algunos resultados calculados con el sistema desarrollado y se los compara con los obtenidos mediante un software comercial. Las aplicaciones del sistema de medición desarrollado son varias, entre ellas pueden mencionarse: el registro de sonidos 3D, el cálculo de parámetros subjetivos en acústica de salas, o la medición de dosis de ruido para evaluar el daño auditivo de las personas expuestas a ruido a través de auriculares.

A Retrospective Cohort Study of Longitudinal Audiologic Assessment in Single and Fractionated Stereotactic Radiosurgery for Vestibular Schwannoma.

Fractionated stereotactic radiosurgery (SRS) for vestibular schwannomas (VS) has been theorized to allow for tumor control with higher rates of hearing preservation in selected patients with useful hearing. However, there is a paucity of literature with formal audiologic measures of hearing preservation to support the standard use of fractionated SRS in VS. We hypothesized that fractionation would diminish the amount of hearing damage. To evaluate the relationship between audiologic performance and SRS fractionation scheme. We performed an IRB-approved retrospective review of patients treated with 1, 3, or 5 fraction SRS for VS at our institution from 1998 to 2016. Pre- and post-SRS audiograms with speech awareness threshold (SAT) in treated and contralateral ears were obtained. Contralateral ear measurements were used for hearing normalization to account for presbycusis. Fifty-six patients with median audiologic follow-up 2.0 yr (mean 2.66 yr, min-max 0.50-9.45 yr) were included. Patients treated with single fractionation had a significantly worsened SAT (dB) compared to patients treated with 5 fractions (P=.008) and compared to all multifraction patients (P=.009) at 12 to 24 mo follow-up. This retrospective analysis supports the use of fractionated SRS to preserve hearing in patients with VS. SAT can be used as an objective metric of hearing response to radiosurgery.

Application of ventricular shunt for children with post-infective hydrocephalus

To investigate the effects of ventricular shunt placement in children with post-infective hydrocephalus. Methods: A total of 24 cases of post-infectious hydrocephalus, who received ventricular shunt, were enrolled. Age, gender, disease progression, clinical manifestation, laboratory data, treatment, prognosis, complication, and sequela for each patient were retrospectively reviewed. Results: Of the 24 cases, 8 had a full recovery, 11 had slight sequela, 2 had severe sequela, 1 was in vegetative state, and 2 died because of bacterial meningitis and tubercular meningitis. Epilepsy, mental impairment, visual and hearing damage were the main sequelae. Conclusion: Ventricular shunt is the preferred treatment in children with post-infective hydrocephalus, which shows positive clinical efficacy and can improve the long-term prognosis of such patients.

Occupational noise exposure: A review of its effects, epidemiology, and impact with recommendations for reducing its burden.

Exposure to hazardous noise is one of the most common occupational risks, both in the U.S. and worldwide. Repeated overexposure to noise at or above 85 dBA can cause permanent hearing loss, tinnitus, and difficulty understanding speech in noise. It is also associated with cardiovascular disease, depression, balance problems, and lower income. About 22 million U.S. workers are currently exposed to hazardous occupational noise. Approximately 33% of working-age adults with a history of occupational noise exposure have audiometric evidence of noise-induced hearing damage, and 16% of noise-exposed workers have material hearing impairment. While the Mining, Construction, and Manufacturing sectors typically have the highest prevalence of noise exposure and hearing loss, there are noise-exposed workers in every sector and every sector has workers with hearing loss. Noise-induced hearing loss is preventable. Increased understanding of the biological processes underlying noise damage may lead to protective pharmacologic or genetic therapies. For now, an integrated public health approach that (1) emphasizes noise control over reliance on hearing protection, (2) illustrates the full impact of hearing loss on quality of life, and (3) challenges the cultural acceptance of loud noise can substantially reduce the impact of noise on worker health.

A Review of Gunshot Noise as Factor in Hearing Disorders

The impulse noise produced by personal weapons (guns, rifles, shotguns) during military activity, and while people engage in sport, training and hunting, is a threat to the auditory systems of soldiers, civilians, policemen, hunters, forest officers, sportspeople and bystanders not actively engaged in professional or recreational firing. An overview of noise levels generated by different types of weapon is provided, and potential short-term and long-term consequences for the human auditory system are described. The mean values of LC, peak sound pressure level during the shot, at the shooter's ears, for various types of weapons are approximately 160 dB SPL. These are levels that can cause permanent, irreversible negative effects on hearing (hearing loss, tinnitus, etc.) even as a result of a single shot being fired. One of the largest groups of weapon users in Poland (about 120 thousand) are hunters and field masters. They are not obligated by any regulations to protect their auditory systems from impulse noise. This means that this group of firearm users is at particularly high risk of hearing damage. On the basis of the literature review, it is shown that hearing exposure to high-level impulse noise such as a gunshot can result in such consequences as damage to the middle ear and destruction of the outer/inner hair cells in the cochlea. Especially difficult to diagnose is 'hidden hearing loss', i.e. damage to the synaptic connections between the hair cells of the inner ear and the auditory nerve fibres, which is not reflected in the results of basic audiometric testing and can cause hearing problems many years after impulse noise exposure. The wide range of negative consequences of gunfire noise clearly indicates the need for the hearing of the shooters to be protected.