国際生活機能分類(International Classification of Functioning, Disability and Health: ICF)にみた福祉・保健・医療の専門職協働における連携に関する貢献と課題

Auditory and non-auditory effects of noise on health

Noise is pervasive in everyday life and can cause both auditory and non-auditory health eff ects. Noise-induced hearing loss remains highly prevalent in occupational settings, and is increasingly caused by social noise exposure (eg, through personal music players). Our understanding of molecular mechanisms involved in noise-induced haircell and nerve damage has substantially increased, and preventive and therapeutic drugs will probably become available within 10 years. Evidence of the non-auditory eff ects of environmental noise exposure on public health is growing. Observational and experimental studies have shown that noise exposure leads to annoyance, disturbs sleep and causes daytime sleepiness, aff ects patient outcomes and staff performance in hospitals, increases the occurrence of hypertension and cardiovascular disease, and impairs cognitive performance in schoolchildren. In this Review, we stress the importance of adequate noise prevention and mitigation strategies for public health.

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Auditory and non-auditory eff ects of noise on health

Background
The vasculature and neural system of the inner ear may be affected by diabetes.

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Diabetes and Hearing Impairment in the United States: Audiometric Evidence from the National Health and Nutrition Examination Survey, 1999 to 2004

To give a systematic review of the development of noise-induced hearing loss (NIHL) in working life. A literature search in MEDLINE, Embase, Web of Science, Scopus, and Health and Safety Abstracts, with appropriate keywords on noise in the workplace and health, revealed 22,413 articles which were screened by six researchers. A total of 698 articles were reviewed in full text and scored with a checklist, and 187 articles were found to be relevant and of sufficient quality for further analysis. Occupational noise exposure causes between 7 and 21 % of the hearing loss among workers, lowest in the industrialized countries, where the incidence is going down, and highest in the developing countries. It is difficult to distinguish between NIHL and age-related hearing loss at an individual level. Most of the hearing loss is age related. Men lose hearing more than women do. Heredity also plays a part. Socioeconomic position, ethnicity and other factors, such as smoking, high blood pressure, diabetes, vibration and chemical substances, may also affect hearing. The use of firearms may be harmful to hearing, whereas most other sources of leisure-time noise seem to be less important. Impulse noise seems to be more deleterious to hearing than continuous noise. Occupational groups at high risk of NIHL are the military, construction workers, agriculture and others with high noise exposure. The prevalence of NIHL is declining in most industrialized countries, probably due to preventive measures. Hearing loss is mainly related to increasing age.

https://link.springer.com/content/pdf/10.1007%2Fs00420-015-1083-5.pdf

Occupational noise exposure and hearing: a systematic review.

The contribution of noise exposure to fatigue at work was studied in a survey study and three field studies. The survey study was based on a questionnaire covering symptoms and work place exposure answered by 50 000 state employees. Noise exposure was also estimated from their type of job and self-rated noise exposure. Fatigue and headache were found to be more common among the noise exposed groups even after control for the effects of other critical variables. Study 2 compared reaction times before and after a week's work in high noise exposure and one in low exposure exposure in a group of aeroplane mechanics. Reaction times were prolonged after work in the noise week, whereas an opposite trend was seen in the control week. Study 3 showed a gradual increase of reaction times during a week of noise exposure in a group of aeroplane technicians. Study 4 compared reaction times and subjective fatigue among naval crews on a day with low and a day with high noise exposure. In one of the studied boat types the development of fatigue during the work day was accentuated on the day with high exposure.

Fatigue after work in noise - an epidemiological survey study and three quasi-experimental field studies

The aim of the study was to investigate the incidence and the relative risk of significant threshold shift (STS, ≥15 dB deterioration at any ear and audiometric frequency) during primary military service (7–9 months), and to investigate whether subjects with an initial slight hearing loss (thresholds ≥ 25 dB HL at any audiometric frequency and ear) were under increased risk. The investigation was made as a prospective audiometric study and included 747 men. An age-matched group of 138 individuals served as an unexposed control group, whose incidence of STS was 2.9%. In the exposed group the incidence was 7.9% and the relative risk 2.7 risk ratio (RR). In the subgroup of 95 persons, who already at reporting-for-training had a mild hearing loss, the incidence was 17%. The relative risk for STS in this group compared to the control group was 6.8 (RR), and compared to those with normal hearing at reporting was 3.1 (RR). In spite of hearing conservation efforts, hearing deterioration still occurs, above all in...

A study of hearing changes among military conscripts in the Swedish Army.

The influence of military service on self-assessed hearing symptoms and measured auditory function was studied as well as the efficacy of the Hearing Conservation Program (HCP) of the Swedish Armed Forces. 839 conscripts were recruited for the study at reporting to military service. They were all exposed to noise over the risk-limits from weapons and vehicles and used earmuffs and/or earplugs. Questionnaires and pure tone screening audiometry were studied at the start and the end of the military service. Retrospective information regarding audiometry at conscription before military service was included as control. The prevalence values of tinnitus were 23% before and 32% after the service and of sensitivity to noise 16% and 19% respectively. The prevalence values of hearing impairment were 6.3% at conscription, 14.5% at reporting to military service, and 24% after the training period. The incidence values of hearing decline were 3.7% during the period with no military noise exposure and 6.6% during the military service. Acoustic accident increased the risk of worsened tinnitus and sensitivity to noise four times and for a high frequency hearing decline six times. We observed elevated prevalence values of tinnitus, sensitivity to noise and hearing impairment at discharge compared to before military service. We observed an elevated risk of hearing decline during military service. Acoustic accident increased the risk of tinnitus, noise sensitivity and hearing decline. We suggest improvements regarding inclusion criteria for military service, and for education regarding the HCP.

The influence of military service on auditory health and the efficacy of a Hearing Conservation Program.

The aim of the study was to estimate the prevalence of the exposure to ototraumatic factors and auditory symptoms, and to analyse the relations between these factors in a group of young healthy men. A total of 839 men, 19-22 years old, were recruited for the study when reporting for primary military service. A questionnaire was distributed and audiometry was performed. The prevalence of tinnitus, sensitivity to noise, and measured hearing impairment in the study group was 23.2%, 15.5%, and 14.5% respectively. Exposure to occupational noise often was reported by 21.4%, and playing loud music often by 16.5%. The young men who had experienced tinnitus after noise exposure had an elevated risk of high frequency hearing impairment, tinnitus, and sensitivity to noise. Those who played loud music had elevated prevalence values of tinnitus but not of hearing impairment. In this young group we observed high prevalence values of ototraumatic factors and auditory symptoms. We also observed significant correlations between tinnitus after noise exposure, self-assessed hearing symptoms, and hearing impairment.

Self-assessed auditory symptoms, noise exposure, and measured auditory function among healthy young Swedish men.

Aims: To study the hearing of 18-year-old men by using screening audiograms obtained at military conscription. Methods: The study group comprised 301,873 Swedish men belonging to six age cohorts born from 1953 to 1977 who had been screened at age 18 years from 1971 to 1995. The prevalence of mild to moderate hearing loss was investigated. Results: Of the entire study group, 13.1% had elevation of one or more pure tone thresholds. In most cases, 11.9%, the elevation was situated in the high-frequency region. High-frequency hearing loss was more common in the left ear (7.5%) than in the right ear (6.2%). The prevalence of hearing loss decreased during the period 1971 to 1981 from 15.7% to 8.3%. During the last part of the study period, 1986 to 1995, the prevalence increased from 9.8% to 16.3%. The increase included mild to moderate degrees of hearing loss with thresholds below 35 dB HL. The prevalence of threshold elevations was highest in sparsely populated areas of Sweden and lowest in large, metropolitan...

Per Muhr

Papers

Fatigue after work in noise - an epidemiological survey study and three quasi-experimental field studies

A study of hearing changes among military conscripts in the Swedish Army.

The influence of military service on auditory health and the efficacy of a Hearing Conservation Program.

Self-assessed auditory symptoms, noise exposure, and measured auditory function among healthy young Swedish men.

Prevalence of hearing loss among 18-year-old Swedish men during the period 1971-1995