해외산업간호정보 - 미국 산업안전보건연구원(National Institute for Occupational Safety and Health) 소개

Cobalt toxicity in humans—a review of the potential sources and systemic health effects

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.

Background: Hearing loss is defined as worsening of hearing acuity and is usually expressed as an increase in the hearing threshold Tinnitus, defined as “ringing in the ear”, is a common and often disturbing accompaniment of hearing loss Hearing loss and environmental exposures to noise are increasingly recognized health problems Objectives: The objective was to assess whether the exposure-response relationship can be established between exposures to non-occupational noise and permanent hearing outcomes such as permanent hearing loss and tinnitus Methods: Information sources: Computer searches of all accessible medical and other databases (PubMed, Web of Science, Scopus) were performed and complemented with manual searches The search was not limited to a particular time span, except for the effects of personal listening devices (PLDs) The latter was limited to the years 2008–June 2015, since previous knowledge was summarized by SCENIHR descriptive systematic review published in 2008 Study eligibility criteria: The inclusion criteria were as follows: the exposure to noise was measured in sound pressure levels (SPLs) and expressed in individual equivalent decibel values (LEX,8h), the studies included both exposed and reference groups, the outcome was a permanent health effect, ie, permanent hearing loss assessed with pure-tone audiometry and/or permanent tinnitus assessed with a questionnaire The eligibility criteria were evaluated by two independent reviewers Study appraisal and synthesis methods: The risk of bias was assessed for all of the papers using a template for assessment of quality and the risk of bias The GRADE (grading of recommendations assessment, development, and evaluation) approach was used to assess the overall quality of evidence Meta-analysis was not possible due to methodological heterogeneity of included studies and the inadequacy of data Results: Out of 220 references identified, five studies fulfilled the inclusion criteria All of them were related to the use of PLDs and comprised in total of 1551 teenagers and young adults Three studies used hearing loss as the outcome and three tinnitus There was a positive correlation between noise level and hearing loss either at standard or extended high frequencies in all three of the studies on hearing loss In one study, there was also a positive correlation between the duration of PLD use and hearing loss There was no association between prolonged listening to loud music through PLDs and tinnitus or the results were contradictory All of the evidence was of low quality Limitations: The studies are cross-sectional No study provides odds ratios of hearing loss by the level of exposure to noise Conclusions: While using very strict inclusion criteria, there is low quality GRADE evidence that prolonged listening to loud music through PLDs increases the risk of hearing loss and results in worsening standard frequency audiometric thresholds However, specific threshold analyses focused on stratifying risk according to clearly defined levels of exposure are missing Future studies are needed to provide actionable guidance for PLDs users No studies fulfilling the inclusion criteria related to other isolated or combined exposures to environmental noise were identified

WHO Environmental Noise Guidelines for the European Region: A Systematic Review on Environmental Noise and Permanent Hearing Loss and Tinnitus

Background Twenty-two million workers are exposed to hazardous noise in the United States. The purpose of this study is to estimate the prevalence of hearing loss among U.S. industries. Methods We examined 2000–2008 audiograms for male and female workers ages 18–65, who had higher occupational noise exposures than the general population. Prevalence and adjusted prevalence ratios (PRs) for hearing loss were estimated and compared across industries. Results In our sample, 18% of workers had hearing loss. When compared with the Couriers and Messengers industry sub-sector, workers employed in Mining (PR ¼ 1.65, CI ¼ 1.57–1.73), Wood Product Manufacturing (PR ¼ 1.65, CL ¼ 1.61– 1.70), Construction of Buildings (PR ¼ 1.52, CI ¼ 1.45–1.59), and Real Estate and Rental and Leasing (PR ¼ 1.59, CL ¼ 1.51–1.68) had higher risks for hearing loss. Conclusions Workers in the Mining, Manufacturing, and Construction industries need better engineering controls for noise and stronger hearing conservation strategies. More hearing loss research is also needed within traditional ‘‘low-risk’’ industries like Real Estate. Am. J. Ind. Med. 56:670–681, 2013. 2012 Wiley Periodicals, Inc.

Prevalence of hearing loss in the United States by industry.

TEMA: consciencia fonologica e o aprendizado da leitura e escrita. OBJETIVO: realizar uma revisao de literatura acerca do tema com o objetivo de retomar conceitos dispostos recentemente na literatura e oferecer ao Fonoaudiologo a possibilidade de revisao de suas praticas para (re)formulacao de estrategias terapeuticas. CONCLUSAO: e possivel observar que os estudos convergem para a importante relacao no desenvolvimento das habilidades de consciencia fonologica com o desenvolvimento da leitura e escrita. Tal fato reforca a necessidade de revisao de nossa pratica clinica e cientifica para a criacao e difusao de estrategias preventivas e/ou de remediacao envolvendo atividades ludicas que englobam a consciencia da crianca na manipulacao dos sons da fala. Uma importante area de pesquisa na Fonoaudiologia do Brasil deveria convergir para o estudo e criacao de ferramentas facilitadoras ao Fonoaudiologo.

/pdf/consciencia-fonologica-e-o-processo-de-aprendizagem-de-20w0u1h03n.pdf

Consciência fonológica e o processo de aprendizagem de leitura e escrita: implicações teóricas para o embasamentoda prática fonoaudiológica

A exposicao a produtos quimicos ototoxicos na presenca ou nao do ruido pode provocar danos irreversiveis na audicao dos trabalhadores em um periodo significativamente menor de exposicao. OBJETIVO: Realizar um estudo comparativo, atraves de exames audiometricos, em trabalhadores expostos somente a ruido e ruido associado a produtos quimicos. METODOS: 155 metalurgicos (18 - 50 anos) expostos a ruido (grupo I) e a ruido e produtos quimicos (grupo II) por um periodo que varia de 3 a 20 anos. RESULTADOS: diferenca significativa na proporcao de perda auditiva ocupacional da orelha direita entre os grupos I (3,6%) e II (15,5%). Proporcao de perda auditiva ocupacional no profissional significativamente maior no grupo II (18,3%) em relacao ao grupo I (6%). Com respeito ao tempo medio de exposicao aos agentes agressores, o grupo I esteve exposto por tempo significativamente maior. Estudo retrospectivo. DISCUSSAO: O fato de ter havido maior comprometimento da orelha direita no grupo II e controverso e merece ser pesquisado futuramente, pois alguns estudos revelam que a orelha esquerda seria mais suscetivel a lesao por ruido. CONCLUSAO: O grupo II apresentou proporcionalmente maior prevalencia de perda auditiva quando comparado ao grupo I, mesmo tendo estado exposto aos agentes agressores por um menor tempo medio.

/pdf/estudo-comparativo-de-exames-audiometricos-de-metalurgicos-xgg6d0xig8.pdf

Estudo comparativo de exames audiométricos de metalúrgicos expostos a ruído e ruído associado a produtos químicos

OBJETIVO: avaliar o processamento auditivo em idosos atraves do teste de ordenacao temporal (Padrao de Duracao) e verificar se a presenca de perda auditiva influencia no desempenho deste teste. METODOS: 65 idosos foram avaliados (46 mulheres e 19 homens), entre 60 e 79 anos. Os participantes responderam a uma anamnese, realizaram mini-exame do estado mental e avaliacao audiologica basica. Os participantes foram alocados e estudados em um grupo unico e tambem divididos em tres grupos denominados G1, G2 e G3. De acordo com os resultados audiometricos, classificou-se o G1 (audicao normal para as medias de 0,5/1/2 kHz e de 3/4/6 kHz), o G2 (audicao normal ou perda auditiva de grau leve para a media de 0,5/1/2 kHz e grau leve para a media de3/4/6 kHz ) e o G3 (audicao normal ou perda auditiva de grau leve para a media de 0,5/1/2 kHz e grau moderado para a media de3/4/6 kHz). Foi realizado o teste Padrao de Duracao, que avalia a ordenacao temporal, a 50dBNS. Para a analise dos resultados foi utilizado o teste estatistico nao-parametrico de Kruskal-Wallis e o teste do qui-quadrado, sendo considerado como significante um p < 0,05. RESULTADOS: em toda a amostra a media de porcentagem de acertos foi de 63,1%. Nos grupos, as medias de acertos foram de 57,5%, 69% e 63,9% para o G1, G2 e G3, respectivamente. CONCLUSAO: a presenca de perda auditiva nao influenciou nos resultados do teste padrao de duracao.

/pdf/envelhecimento-e-ordenacao-temporal-auditiva-3x1fntetvv.pdf

Envelhecimento e ordenação temporal auditiva

Given that the medial olivocochlear efferent system reduces the amplitude of otoacoustic emissions (OAE), the aim of this study was to establish whether such a pathway is affected in women with migraine and phonophobia by means of OAE suppression testing. In this prospective case–control study, 55 women (29 with migraine and phonophobia and 26 healthy women) were subjected to transient-evoked otoacoustic emission (TEOAE) testing at frequencies from 1 to 4 kHz. The amplitudes of the TEOAE response before and after exposure to contralateral noise and the magnitude of TEOAE suppression were assessed. The average TEOAE amplitudes in conditions with and without exposure to contralateral noise were not significantly different between the groups. However, the magnitude of TEOAE suppression was lower in the group with migraine; that difference was only statistically significant for frequencies 1 and 1.5 kHz (p = 0.042 and p = 0.004, respectively). In this study, women with migraine and phonophobia exhibited deficits in OAE suppression, which points to a disorder affecting the medial olivocochlear efferent system.

Assessment of otoacoustic emission suppression in women with migraine and phonophobia.

O estudo das altas frequencias vem demonstrando sua importância para deteccao de danos na orelha interna Em alguns casos, as frequencias convencionais nao sao sensiveis a alteracoes da orelha interna em seu estagio inicial OBJETIVO: Analisar os resultados dos limiares das altas frequencias de individuos expostos ao ruido com audiometria convencional normal MATERIAL E METODO: Foi realizado um estudo de coorte transversal retrospectivo com 47 combatentes do Corpo de Bombeiros do Rio de Janeiro alocados no aeroporto Santos Dumont e 33 militares sem exposicao ao ruido Os grupos foram divididos em duas faixas etarias: 30-39 anos e 40-49 anos Imediatamente apos a audiometria tonal e vocal eram testadas as altas frequencias RESULTADOS: Os resultados mais significativos ocorreram na faixa de 40 a 49 anos, onde o grupo experimental apresentou limiar significativamente maior que o grupo controle 14000Hz (p = 0,008) e 16000Hz (p = 0,0001) CONCLUSOES: Concluiu-se que o ruido interferiu nos limiares das altas frequencias, onde todas as medias encontradas no grupo experimental foram maiores do que as do grupo controle Sugeriu-se que esses dados reforcariam a importância da pesquisa das altas frequencias, mesmo com a audiometria convencional normal, no diagnostico precoce da perda auditiva induzida pela exposicao ao ruido

http://www.scielo.br/pdf/bjorl/v76n6/en_v76n6a03.pdf

Silvana Frota

Papers

Consciência fonológica e o processo de aprendizagem de leitura e escrita: implicações teóricas para o embasamentoda prática fonoaudiológica

Estudo comparativo de exames audiométricos de metalúrgicos expostos a ruído e ruído associado a produtos químicos

Envelhecimento e ordenação temporal auditiva

Assessment of otoacoustic emission suppression in women with migraine and phonophobia.

High-frequency audiometry in normal hearing military firemen exposed to noise