Showing papers in "Noise & Health in 2013"

Noise and health in vulnerable groups: A review

Abstract: Vulnerable or susceptible groups are mentioned in most reviews and documents regarding noise and health. But only a few studies address this issue in a concrete and focused way. Groups at risk most often mentioned in the literature are children, the elderly, the chronically ill and people with a hearing impairment. The other categories encountered are those of sensitive persons, shiftworkers, people with mental illness (e.g., schizophrenia or autism), people suffering from tinnitus, and fetuses and neonates. The mechanism for this vulnerability has not been clearly described and relevant research has seldom focused on the health effects of noise in these groups in an integrated manner. This paper summarizes the outcomes and major conclusions of a systematic, qualitative review of studies over the past 5 years. This review was prepared for the 10 th Conference on Noise as a Public Health Problem (ICBEN, 2011). Evidence is reviewed describing effects, groups assumed to be at risk, and mechanisms pertaining to noise sensitivity and learned helplessness.

Does tinnitus "fill in" the silent gaps?

Abstract: In the basic sciences, many researchers now use gap pre-pulse inhibition of the acoustic startle reflex (GPIAS) to determine if an animal has tinnitus after exposure to an ototoxic drug or intense noise. Tinnitus is assumed to be present if the silent gap in an ongoing narrow band noise (NBN) fails to suppress the startle reflex response evoked by an intense noise burst. The lack of gap pre-pulse inhibition presumably occurs because tinnitus fills in the silent intervals in the background noise. To test the perceptual aspects of this hypothesis, we asked hearing impaired subjects with tinnitus if they could perceive 50 ms silent intervals presented in a NBN, which was located above, below or at the subject's tinnitus pitch. The same tests were performed on normal hearing subjects without tinnitus. All subjects, with and without tinnitus, could detect the 50 ms gaps. Thus, using the stimulus parameters similar to those employed in animal and human GPIAS studies, we found that the tinnitus percept does not fill in the silent interval in a perceptual gap detection task; however, these finding do not rule out the possibility that tinnitus interferes with pre-attentive filtering of sensory stimuli in the GPIAS sensorimotor gating paradigm.

Road traffic noise and health-related quality of life: A cross-sectional study

Abstract: Evidence is emerging linking environmental noise to health problems. Noise can affect health directly and indirectly: For example, noise sensitivity moderates the effects of noise annoyance, which in turn mediates the effects of noise exposure. An alternative hypothesis is that noise sensitivity marks the presence of susceptibility to health problems in general, including annoyance from noise. Whether noise sensitivity causes poor health or whether it is a marker of susceptibility to health problems was addressed by comparing the results of a community-based survey of people with similar noise sensitivity profiles but different environmental noise exposures. A questionnaire was delivered to people living in two socio-economically-matched areas: One was within 50 m of a motorway and the other was away from any significant source of environmental noise. The questionnaire contained 58 questions comprised of the World Health Organization health-related quality of life questionnaire (WHOQOL), and questions about amenity, neighborhood issues, environmental annoyances, demographics, and noise sensitivity. Noise sensitivity did not vary with proximity to the motorway but annoyance with traffic noise and fumes was greater in those living close to the motorway than in those who were not. Scores on the four WHOQOL domains (physical, psychological, social, and environmental) were lower in those living close to the motorway, and the WHOQOL domain scores correlated negatively with noise sensitivity in those who lived near motorways but not in those who lived in the quieter areas. This suggests that noise sensitivity is related to poor health outcomes rather than being a trait marker of susceptibility to health problems in general.

Association between sleep disorders, hyperacusis and tinnitus: evaluation with tinnitus questionnaires.

Abstract: Patients with tinnitus are heterogeneous and several factors influence the impact of this symptom on the quality of life. The aim of the study is to evaluate the relationship between age, gender, sleep disorders, hyperacusis and tinnitus annoyance and to demonstrate the utility of tinnitus questionnaires as screening tools for sleep disorders and hyperacusis in patients with tinnitus. 37 consecutive patients (18 males and 19 females) with subjective tinnitus lasting over 3 months were evaluated with a complete interview, otological examination, pure tone audiometry, Italian version of tinnitus sample case history (TSCH) and tinnitus handicap inventory (THI). Statistical analysis was performed with the Wilcoxon's rank sum test, the Spearman's rho non-parametric correlation and the logistic regression analysis. THI grades were slight (16%), mild (32%), moderate (30%), severe (19%) and catastrophic (3%). Based on the answers to TSCH 20 patients reported sleep disorders (54%) and 20 patients reported hyperacusis (54%). 11 patients (30%) reported sleep disorders and hyperacusis. No significant correlation was found between the severity of tinnitus and patients' age and gender. Significant correlation was found between sleep disorders (P = 0.0009) and tinnitus annoyance and between hyperacusis (P = 0.03) and tinnitus annoyance. TSCH and THI may be considered as screening tools in the clinical practice to evidence sleep disorders and hyperacusis in patients with tinnitus.

Effect of cigarette smoking on noise-induced hearing loss in workers exposed to occupational noise in China

Abstract: Excessive exposure to high noise level environments has the potential to cause noise-induced hearing loss (NIHL), and cigarette smoking has also been shown to have a potential adverse effect on hearing. The aim of this study was to determine whether smoking interacts with noise in the development of hearing loss, and if so, the extent of the contribution from smoking on NIHL. A cross-sectional study was designed to assess the effect of smoking on NIHL in 517 male workers (non-smokers: N = 199; smokers: N = 318) exposed to a high-level industrial noise environment in China. Shift-long temporal waveforms of the noise that workers were exposed to for evaluation of noise exposures, and audiometric threshold measures were obtained on all selected subjects. The subjects used hearing protection devices only within the last 1-2 years. The results suggest that smoking has an adverse effect on NIHL in workers exposed to high level industrial noise, i.e., the median high frequency hearing thresholds were significantly greater in smokers than non-smokers exposed to noise for more than 10 years. This effect was observed at 4.0 and 6.0 kHz. Smoking did not have an adverse effect on NIHL in workers exposed to noise less than 10 years. Multivariate regression analysis revealed that the odds ratio (OR) for high frequency hearing loss (i.e., hearing threshold greater than 40 dB at 4.0 kHz) were 1.94 for smokers in comparison to non-smokers. The results suggest that: (1) smokers have a higher risk of developing high frequency hearing loss than non-smokers with a similar occupational noise exposure, and (2) the interaction between cigarette smoking and high-level noise exposure may be additive. There is a need to develop and analyze a larger database of workers with well-documented exposures and smoking histories for better understanding of the effect of smoking on NIHL incurred from high-level industrial noise exposures. A better understanding of the role of smoking may lead to its incorporation into hearing risk assessment for noise exposure.

Road traffic noise, air pollution components and cardiovascular events

Abstract: Traffic noise and air pollution have been associated with cardiovascular health effects. Until date, only a limited amount of prospective epidemiological studies is available on long-term effects of road traffic noise and combustion related air pollution. This study investigates the relationship between road traffic noise and air pollution and hospital admissions for ischemic heart disease (IHD: International Classification of Diseases (ICD9) 410-414) or cerebrovascular disease (cerebrovascular event [CVE]: ICD9 430-438). We linked baseline questionnaire data to 13 years of follow-up on hospital admissions and road traffic noise and air pollution exposure, for a large random sample (N = 18,213) of inhabitants of the Eindhoven region, Netherlands. Subjects with cardiovascular event during follow-up on average had higher road traffic noise day, evening, night level (Lden) and air pollution exposure at the home. After adjustment for confounders (age, sex, body mass index, smoking, education, exercise, marital status, alcohol use, work situation, financial difficulties), increased exposure did not exert a significant increased risk of hospital admission for IHD or cerebrovascular disease. Relative risks (RRs) for a 5th to 95th percentile interval increase were 1.03 (0.88-1.20) for Lden; 1.04 (0.90-1.21) for particulate matter (PM10); 1.05 (0.91-1.20) for elemental carbon (EC); and 1.12 (096-1.32) for nitrogen dioxide (NO2) in the full model. While the risk estimate seemed highest for NO2, for a 5th to 95th percentile interval increase, expressed as RRs per 1 μg/m3 increases, hazard ratios seemed highest for EC (RR 1.04 [0.92-1.18]). In the subgroup of study participants with a history of cardiovascular disease, RR estimates seemed highest for noise exposure (1.19 [0.87-1.64] for Lden); in the subgroup of elderly RR seemed highest for air pollution exposure (RR 1.24 [0.93-1.66] for NO2).

The effects of different styles of musical auditory stimulation on cardiac autonomic regulation in healthy women.

Abstract: The literature investigated the effects of chronic baroque music auditory stimulation on the cardiovascular system. However, it lacks in the literature the acute effects of different styles of music on cardiac autonomic regulation. To evaluate the acute effects of baroque and heavy metal music on heart rate variability (HRV) in women. The study was performed in 21 healthy women between 18 and 30 years old. We excluded persons with previous experience with music instrument and those who had affinity with the song styles. All procedures were performed in the same sound-proof room. We analyzed HRV in the time (standard deviation of normal-to-normal respiratory rate (RR) intervals, root-mean square of differences between adjacent normal RR intervals in a time interval, and the percentage of adjacent RR intervals with a difference of duration greater than 50 ms) and frequency (low frequency [LF], high frequency [HF], and LF/HF ratio) domains. HRV was recorded at rest for 10 min. Subsequently they were exposed to baroque or heavy metal music for 5 min through an earphone. After the first music exposure they remained at rest for more 5 min and them they were exposed again to baroque or heavy metal music. The sequence of songs was randomized for each individual. The power analysis provided a minimal number of 18 subjects. Shapiro-Wilk to verify normality of data and analysis of variance for repeated measures followed by the Bonferroni test for parametric variables and Friedman's followed by the Dunn's post-test for non-parametric distributions. During the analysis of the time-domain indices were not changed. In the frequency-domain analysis, the LF in absolute units was reduced during the heavy metal music stimulation compared to control. Acute exposure to heavy metal music affected the sympathetic activity in healthy women.

Comparison of anxiety levels associated with noise in the dental clinic among children of age group 6-15 years.

Abstract: Fear or anxiety due to noise produced in the dental clinic is rated third among the reasons to avoid dental visits. The aim of the present study was to determine anxiety levels associated with noise in a dental clinic. The study was done using a survey questionnaire containing 10 questions and was divided into two parts. The first part included demographic information such as name, age, gender, and school; the second half included questions regarding patient's feelings toward noise in the dental clinic and its possible link to dental anxiety. Two-hundred and fifty children and adolescents of age group 6-15 years participated in the study. Results of the study showed that 50% of females, 29% males avoided a visit to the dentist because of anxiety and fear, 38% subjects of age group 6-11 years reported that sound of the drill makes them uncomfortable, followed by having to wait in the reception area. Gender gap was also observed with more females feeling annoyed than males on the 1-10 annoyance level scale. More than 60% felt "annoyed" to "extremely annoyed" by noise in the dental clinic. 45% of subjects preferred watching television to cope with such noise. This study concludes that the noise produced in dental clinic is anxiety provoking and significantly contributes to avoidance of dental treatment and the best way opted by the majority of subjects to overcome this anxiety was audiovisual distraction method.

Adolescents' perceptions of their school's acoustic environment: the development of an evidence based questionnaire.

Abstract: A poor acoustic environment in a school is known to negatively affect pupils' learning and achievement. This paper presents the design and findings of an online questionnaire survey of 11-16 year olds' impressions of their school's acoustic environment. A total of 2588 English secondary school pupils responded to the questionnaire. Factor analysis was used to identify variables which best characterized pupils' impressions of their school's acoustic environment. Four factors, corresponding to ease of hearing in school spaces, sensitivity to noise, the consequences of noise in the classroom, and annoyance to intermittent noise, accounted for 43% of the total variance in pupils' responses to the questionnaire. Analysis of the responses on these factors showed that pupils who reported additional learning needs such as hearing impairment, speaking English as an additional language or receiving learning support reported being significantly more affected by poor school acoustics than pupils reporting no additional learning needs. Older pupils were significantly more sensitive to noise annoyance and to the consequences of poor acoustical conditions on their learning and behaviour than younger pupils. Pupils attending suburban schools featuring cellular classrooms that were not exposed to a nearby noise sources were more positive about their school acoustics than pupils at schools with open plan classroom designs or attending schools that were exposed to external noise sources. The study demonstrates that adolescents are reliable judges of their school's acoustic environment, and have insight into the disruption to teaching and learning caused by poor listening conditions. Furthermore, pupils with additional learning needs are more at risk from the negative effects of poor school acoustics.

Tonic tensor tympani syndrome in tinnitus and hyperacusis patients: a multi-clinic prevalence study.

Abstract: Tonic tensor tympani syndrome (TTTS) is an involuntary, anxiety-based condition where the reflex threshold for tensor tympani muscle activity is reduced, causing a frequent spasm. This can trigger aural symptoms from tympanic membrane tension, middle ear ventilation alterations and trigeminal nerve irritability. TTTS is considered to cause the distinctive symptoms of acoustic shock (AS), which can develop after exposure to an unexpected loud sound perceived as highly threatening. Hyperacusis is a dominant AS symptom. Aural pain/blockage without underlying pathology has been noted in tinnitus and hyperacusis patients, without wide acknowledgment. This multiclinic study investigated the prevalence of TTTS symptoms and AS in tinnitus and hyperacusis patients. This study included consecutive patients with tinnitus and/or hyperacusis seen in multiple clinics. Data collected: Symptoms consistent with TTTS (pain/numbness/burning in and around the ear; aural blockage; mild vertigo/nausea; muffled hearing; tympanic flutter; headache); onset or exacerbation from exposure to loud/intolerable sounds; tinnitus/hyperacusis severity. All patients were medically cleared of underlying pathology, which could cause these symptoms. 60.0% of the total sample (345 patients), 40.6% of tinnitus only patients, 81.1% of hyperacusis patients had ≥1 symptoms (P < 0.001). 68% of severe tinnitus patients, 91.3% of severe hyperacusis patients had ≥1 symptoms (P < 0.001). 19.7% (68/345) of patients in the total sample had AS. 83.8% of AS patients had hyperacusis, 41.2% of non-AS patients had hyperacusis (P < 0.001). The high prevalence of TTTS symptoms suggests they readily develop in tinnitus patients, more particularly with hyperacusis. Along with AS, they should be routinely investigated in history-taking.

Evaluation of the effects of exposure to organic solvents and hazardous noise among US Air Force Reserve personnel.

Abstract: Hearing loss affects many workers including those in the military and may be caused by noise, medications, and chemicals. Exposures to some chemicals may lead to an increase in the incidence of hearing loss when combined with hazardous noise. This retrospective study evaluated the risk for hearing loss among Air Force Reserve personnel exposed to occupational noise with and without exposures to toluene, styrene, xylene, benzene, and JP-8 (jet fuel). Risk factors associated with hearing loss were determined using logistic and linear regression. Stratified analysis was used to evaluate potential interaction between solvent and noise exposure. The majority of the subjects were male (94.6%) and 35 years or older on the date of their first study audiogram (66%). Followed for an average of 3.2 years, 9.2% of the study subjects had hearing loss in at least one ear. Increasing age (odds ratio [OR] = 1.03 per year of age) and each year of follow-up time (OR = 1.23) were significantly associated with hearing loss. Low and moderate solvent exposures were not associated with hearing loss. Linear regression demonstrated that hearing loss was significantly associated with age at first study audiogram, length of follow-up time, and exposure to noise. Hearing decreased by 0.04 decibels for every decibel increase in noise level or by almost half a decibel (0.4 dB) for every 10 decibel increase in noise level.

The cost of hypertension-related ill-health attributable to environmental noise

Abstract: Hypertension (HT) is associated with environmental noise exposure and is a risk factor for a range of health outcomes. The study aims were to identify key HT related health outcomes and to quantify and monetize the impact on health outcomes attributable to environmental noise-related HT. A reiterative literature review identified key HT related health outcomes and their quantitative links with HT. The health impact of increases in environmental noise above recommended daytime noise levels (55 dB[A]) were quantified in terms of quality adjusted life years and then monetized. A case study evaluated the cost of environmental noise, using published data on health risks and the number of people exposed to various bands of environmental noise levels in the United Kingdom (UK). Three health outcomes were selected based on the strength of evidence linking them with HT and their current impact on society: Acute myocardial infarction (AMI), stroke and dementia. In the UK population, an additional 542 cases of HT-related AMI, 788 cases of stroke and 1169 cases of dementia were expected per year due to daytime noise levels ≥55 dB(A). The cost of these additional cases was valued at around £1.09 billion, with dementia accounting for 44%. The methodology is dependent on the availability and quality of published data and the resulting valuations reflect these limitations. The estimated intangible cost provides an insight into the scale of the health impacts and conversely the benefits that the implementation of policies to manage environmental noise may confer.

Comparison of sound propagation and perception of three types of backup alarms with regards to worker safety.

Abstract: A technology of backup alarms based on the use of a broadband signal has recently gained popularity in many countries. In this study, the performance of this broadband technology is compared to that of a conventional tonal alarm and a multi-tone alarm from a worker-safety standpoint. Field measurements of sound pressure level patterns behind heavy vehicles were performed in real work environments and psychoacoustic measurements (sound detection thresholds, equal loudness, perceived urgency and sound localization) were carried out in the laboratory with human subjects. Compared with the conventional tonal alarm, the broadband alarm generates a much more uniform sound field behind vehicles, is easier to localize in space and is judged slighter louder at representative alarm levels. Slight advantages were found with the tonal alarm for sound detection and for perceived urgency at low levels, but these benefits observed in laboratory conditions would not overcome the detrimental effects associated with the large and abrupt variations in sound pressure levels (up to 15-20 dB within short distances) observed in the field behind vehicles for this alarm, which are significantly higher than those obtained with the broadband alarm. Performance with the multi-tone alarm generally fell between that of the tonal and broadband alarms on most measures.

Direct effects of music in non-auditory cells in culture

Abstract: The biological effects of electromagnetic waves are widely studied, especially due to their harmful effects, such as radiation-induced cancer and to their application in diagnosis and therapy. However, the biological effects of sound, another physical agent to which we are frequently exposed have been considerably disregarded by the scientific community. Although a number of studies suggest that emotions evoked by music may be useful in medical care, alleviating stress and nociception in patients undergoing surgical procedures as well as in cancer and burned patients, little is known about the mechanisms by which these effects occur. It is generally accepted that the mechanosensory hair cells in the ear transduce the sound-induced mechanical vibrations into neural impulses, which are interpreted by the brain and evoke the emotional effects. In the last decade; however, several studies suggest that the response to music is even more complex. Moreover, recent evidence comes out that cell types other than auditory hair cells could response to audible sound. However, what is actually sensed by the hair cells, and possible by other cells in our organism, are physical differences in fluid pressure induced by the sound waves. Therefore, there is no reasonable impediment for any cell type of our body to respond to a pure sound or to music. Hence, the aim of the present study was to evaluate the response of a human breast cancer cell line, MCF7, to music. The results' obtained suggest that music can alter cellular morpho-functional parameters, such as cell size and granularity in cultured cells. Moreover, our results suggest for the 1 st time that music can directly interfere with hormone binding to their targets, suggesting that music or audible sounds could modulate physiological and pathophysiological processes.

Personal listening devices and the prevention of noise induced hearing loss in children: The cheers for ears pilot program

Abstract: To determine whether the Cheers for Ears Program on noise induced hearing loss prevention was effective in improving current knowledge of noise impact of personal listening devices on hearing, and in changing self-reported listening behavior of primary school students aged between 9 years and 13 years. A survey study was implemented at participating primary schools. Schools represented various levels of socio-economic status. Informed consent (parents and teachers) and informed assent (pupils) were obtained. All pupils participated in two interactive sessions (the second 6 weeks after first) and only those who provided assent and consent were surveyed at three points during the study: Prior to the first session (baseline), directly post-session and at 3 months post-session. A total of 318 pupils were surveyed. The median age of the participants was 11 years (nearly 50% of the total cohort). Significant changes are reported in their knowledge about hearing and in listening behavior of the participants as measured by pre- and post-measurement. The changes in behaviors were stable and sustained at 3 months post-intervention survey point and the success of the program can be attributed to the multimodal interactive nature of the sessions, the spacing of the sessions and the survey points. Wide-ranging support from schools and departments also played a role. The pilot Cheers for Ears Program is effective in increasing knowledge on the harmful effects of noise and therefore, it may prevent future noise-induced hearing loss.

Stress and odor sensitivity in persons with noise sensitivity

Abstract: Previous research has indicated that sensory sensitivity/intolerance to a specific modality may be part of a more general environmental hypersensitivity, and possibly mediated by stress. This study investigated the relationship between noise sensitivity, perceived stress, and odor sensitivity in a group of men. A quasi-experimental design was used. One-hundred and thirty-four male undergraduate students completed Weinstein's noise sensitivity scale from which a low-sensitivity group (n = 16) and a high-sensitivity (n = 16) group were formed. These two groups were screened for loss in auditory and olfactory detection sensitivity, and completed the perceived stress questionnaire (PSQ) and the chemical sensitivity scale (CSS). One-way analysis of variance and Spearman correlational analyses were performed. Significantly higher scores on the PSQ (P < 0.05) and the CSS (P < 0.05) were found in the high noise-sensitivity group compared to the low noise-sensitivity group. These findings raise the question of whether the relation between noise and odor sensitivity reflects a general environmental sensitivity.

Environmental noise and annoyance in adults: research in Central, Eastern and South-Eastern Europe and Newly Independent States.

Abstract: Research work on the adverse effects of noise on annoyance in adults is well documented in Western Europe, but there is a knowledge gap concerning this type of research in Central and Eastern Europe (CEE), South-East Europe (SEE), and Newly Independent States (NIS). The objective of this review was to present findings and to propose future research directions for the studies on the effects of environmental noise on annoyance in adults conducted in these countries. After systematic search in accessible databases, scientific journals, conference proceedings, international and national reports in English and other languages, the authors identified 29 papers to be included to this review: 24 papers related to annoyance due to road traffic noise and 5 papers related to annoyance from other noise sources. In most of the identified studies, a cross-sectional design prevailed and the evaluations were mainly performed subjectively. The lack of recent annoyance studies related to railway and aircraft traffic noise was identified. Only two studies from NIS countries used noise exposure data for the evaluation of population annoyance according to the European Environmental Noise Directive (END). Capacity building in CEE, SEE, and NIS countries is necessary to acquire the "know-how" on how to implement and use the different scenarios for evaluating population annoyance by environmental noise, depending on the availability and suitability of noise exposure data. Particular attention should be given to the possible use of END noise exposure data, where applicable.

Adolescents' reported hearing symptoms and attitudes toward loud music.

Abstract: The aim of the present study was to compare the adolescents' attitudes toward loud music in relation to a set of self-perceived auditory symptoms and psychological variables such as norms, preparedness to take risks and risk-judgment in noisy situations. A questionnaire on hearing and preventive behavior was distributed to 281 upper secondary school students aged 15-19 years. The questionnaire included youth attitude to noise scale, questions about perceived hearing symptoms such as tinnitus and sound sensitivity and finally statements on perceived behavioral norms regarding hearing protection use, risk-taking and risk-judgment in noisy settings. Self-perceived auditory symptoms such as sound sensitivity and permanent tinnitus had a significant relationship with less tolerant attitudes toward loud music. Permanent tinnitus and sound sensitivity together accounted for 15.9% of the variation in attitudes toward loud music. Together with the psychological variables norms, preparedness to take risks and risk-judgment 48.0% of the variation in attitudes could be explained. Although perceived hearing symptoms (sound sensitivity and permanent tinnitus) was associated with less tolerant attitudes toward loud music, psychological variables such as norms, preparedness to take risks and risk-judgment were found to be more strongly associated with attitudes toward loud music and should therefore be considered more in future preventive work. Health promotive strategies should focus on changing not merely individual attitudes, but also societal norms and regulations in order to decrease noise induced auditory symptoms among adolescents.

Qualitative and quantitative assessment of noise at moderate intensities on extra-auditory system in adult rats.

Abstract: Noise has long been realized as an environmental stress causing physiological, psychological and behavioral changes in humans. The aim of the present study was to determinate the effect of chronic noise at moderate intensities on both glandular and cardiac function and oxidative status. Our problem comes from working conditions in call centers where operators are responsible for making simple and repetitive tasks. One wishes to ascertain the effects of moderate sound levels on rats exposed to the same noise levels during similar periods to those experienced by call center operators. Male Wistar rats were exposed to 70 and 85 dB(A) to an octave-band noise (8-16 kHz) 6 h/day for 3 month. Corticosterone levels, oxidative status and functional exploration of adrenal and thyroid glands and cardiac tissue were determined. Exposure to long-term noise for different intensities (70 and 85 dB(A)) resulted in increased corticosterone levels, affected various parameters of the endocrine glands and cardiac function. Markers of oxidative stress (catalase, superoxide dismutase and lipid peroxidation) were increased. These results imply that long-term exposure to noise even at moderate levels may enhance physiological function related to neuroendocrine modulation and oxidative imbalance. In these data, the physiological changes occur during the different sounds suggests the concept of allostatic load or homeostatic response of the body.

Recent technological advances in sound-based approaches to tinnitus treatment: a review of efficacy considered against putative physiological mechanisms.

Abstract: The past decade has seen an escalating enthusiasm to comprehend chronic tinnitus from the perspective of both scientific understanding and clinical management. At the same time, there is a significant interest and commercial investment in providing targeted and individualized approaches to care, which incorporate novel sound-based technologies, with standard audiological and psychological strategies. Commercially produced sound-based devices for the tinnitus market include Co-ordinated Reset Neuromodulation ® , Neuromonics © , Serenade ® , and Widex ® Zen. Additionally, experimental interventions such as those based on frequency-discrimination training are of current interest. Many of these interventions overtly claim to target the underlying neurological causes of tinnitus. Here, we briefly summarize current perspectives on the pathophysiology of tinnitus and evaluate claims made by the device supporters from a critical point of view. We provide an opinion on how future research in the field of individualized sound-based interventions might best provide a reliable evidence-base in this growing area of translational medicine.

Auditory risk assessment of college music students in jazz band-based instructional activity.

Abstract: It is well-known that musicians are at risk for music-induced hearing loss, however, systematic evaluation of music exposure and its effects on the auditory system are still difficult to assess. The purpose of the study was to determine if college students in jazz band-based instructional activity are exposed to loud classroom noise and consequently exhibit acute but significant changes in basic auditory measures compared to non-music students in regular classroom sessions. For this we (1) measured and compared personal exposure levels of college students (n = 14) participating in a routine 50 min jazz ensemble-based instructional activity (experimental) to personal exposure levels of non-music students (n = 11) participating in a 50-min regular classroom activity (control), and (2) measured and compared pre- to post-auditory changes associated with these two types of classroom exposures. Results showed that the L eq (equivalent continuous noise level) generated during the 50 min jazz ensemble-based instructional activity ranged from 95 dBA to 105.8 dBA with a mean of 99.5 ± 2.5 dBA. In the regular classroom, the L eq ranged from 46.4 dBA to 67.4 dBA with a mean of 49.9 ± 10.6 dBA. Additionally, significant differences were observed in pre to post-auditory measures between the two groups. The experimental group showed a significant temporary threshold shift bilaterally at 4000 Hz (P < 0.05), and a significant decrease in the amplitude of transient-evoked otoacoustic emission response in both ears (P < 0.05) after exposure to the jazz ensemble-based instructional activity. No significant changes were found in the control group between pre- and post-exposure measures. This study quantified the noise exposure in jazz band-based practice sessions and its effects on basic auditory measures. Temporary, yet significant, auditory changes seen in music students place them at risk for hearing loss compared to their non-music cohorts.

Blood pressure of urban school children in relation to road-traffic noise, traffic density and presence of public transport

Abstract: The aim of the study was to investigate the relationship between noise levels, traffic density and the presence of public transport and children's blood pressure. Another aim was to assess the applicability of public transport as a proxy indicator of noise exposure. A cross-sectional study involved 1113 children aged 7-11 years from a central municipality in Belgrade. Equivalent noise levels were measured in front of all schools and in the middle of all streets. Traffic density was defined as number of light and heavy vehicles per hour. The number of public transport vehicles was calculated from official timetables. Children's addresses were matched with noise levels and transport maps. A physician measured blood pressure with the sphygmomanometer. Children attending schools with public transport running nearby had by 1.3 mmHg higher systolic pressure than did children from schools without public transport. This relationship was independent from children's age, gender, and body mass index, family history of hypertension, some dwelling characteristics, and lifestyle habits. The association between diastolic pressure and public transport was statistically insignificant. The study indicated a possible positive association between the presence of public transport in the vicinity of schools with systolic blood pressure in 7-11 year-old schoolchildren. The presence of public transport may serve as an auxiliary indicator of noise exposure in undeveloped countries with limited capacities for noise measurement or modeling.

The prevalence of audiometric notches in adolescents in Germany: The Ohrkan-study

Abstract: Although there is concern about increasing hearing loss in adolescents caused by leisure noise exposure, prevalence data are scarce. In an US study, about 16-17% of adolescents were affected by audiometric notches. To estimate the prevalence of audiometric notches in adolescents in Germany, baseline data of the cohort study Ohrkan, recruitment during the school years 2009/2010 and 2010/2011 were analyzed. All students in grade 9 visiting any school in the city of Regensburg were eligible for participation. Data was collected via standardized questionnaires from students and their parents. In addition, students were asked to visit the University Clinics of Regensburg for ear examination including a tympanogram and the determination of hearing thresholds in air conduction audiometry. The prevalence of audiometric notches was determined in students with normal tympanogram in both ears and complete audiometry data. Audiometric notches were defined according to criteria used to analyse US data. Overall, 2149 students (1158 girls, 991 boys mainly aged 15-16 years) of the 3846 eligible adolescents (56%) participated. Among the 1843 adolescents with complete audiometry and tympanometry data, the prevalence of audiometric notches was 2.4% (95% confidence interval 1.7-3.1%). We could not confirm the high prevalence of audiometric notches as reported in National Health and Nutrition Examination Surveys for adolescents in the US. Differences in prevalence might be at least partly due to methodical differences in audiometry. Even if empirical evidence is presently ambiguous, it is reasonable to educate young people about the potential risks of high leisure noise exposure.

Rationale for the tinnitus retraining therapy trial

Abstract: The Tinnitus Retraining Therapy Trial (TRTT) is a National Institutes of Health-sponsored, multi-centered, placebo-controlled, randomized trial evaluating the efficacy of tinnitus retraining therapy (TRT) and its component parts, directive counseling and sound therapy, as treatments for subjective debilitating tinnitus in the military. The TRTT will enroll 228 individuals at an allocation ratio of 1:1:1 to: (1) directive counseling and sound therapy using conventional sound generators; (2) directive counseling and placebo sound generators; or (3) standard of care as administered in the military. Study centers include a Study Chair's Office, a Data Coordinating Center, and six Military Clinical Centers with treatment and data collection standardized across all clinics. The primary outcome is change in Tinnitus Questionnaire (TQ) score assessed longitudinally at 3, 6, 12, and 18-month follow-up visits. Secondary outcomes include: Change in TQ sub-scales, Tinnitus Handicap Inventory, Tinnitus Functional Index, and TRT interview visual analog scale; audiometric and psychoacoustic measures; and change in quality of life. The TRTT will evaluate TRT efficacy by comparing TRT (directive counseling and conventional sound generators) with standard of care; directive counseling by comparing directive counseling plus placebo sound generators versus standard of care; and sound therapy by comparing conventional versus placebo sound generators. We hypothesize that full TRT will be more efficacious than standard of care, directive counseling and placebo sound generators more efficacious than standard of care, and conventional more efficacious than placebo sound generators in habituating the tinnitus awareness, annoyance, and impact on the study participant's life.

Intratympanic treatment for tinnitus: a review.

Abstract: Since the 1940s, various attempts have been made to treat peripheral tinnitus by way of intratympanic injection. This administration procedure requires only low concentrations of medication, thanks to the highly targeted delivery to the site of action and comes with minimal systemic exposure. While different compounds have been tested for their effects on tinnitus by intratympanic injection, there has been no breakthrough so far. Accordingly, the clinical use of intratympanic tinnitus treatments has remained limited to date. A more widespread adoption of this approach will require the development of specific medications for peripheral tinnitus, as well as proof of safety and efficacy, which would be determined from randomized controlled clinical trials.

Noise induced hearing loss: research in Central, Eastern and South-Eastern Europe and Newly Independent States.

Abstract: The aim of this review was to summarize the studies on noise-induced hearing loss (NIHL) which were carried out in the countries of Central and Eastern Europe, South-East Europe, and former Soviet Union countries or Newly Independent States in the period from 1970 to 2012. The papers were identified by literature search of all accessible medical and other databases (Scopus, PubMed, Medline, etc.) using the terms "noise; hearing loss, NIHL" as key words and country denomination (in alphabetical order: Armenia, Azerbaijan, Belarus, Bulgaria, Bosnia and Herzegovina, Croatia, Czech Republic, Georgia, Hungary, Montenegro, Poland, Romania, Russian Federation, Serbia, Slovakia, Slovenia, former Yugoslavia, Ukraine). This review comprises both papers published in peer-reviewed international journals and articles from local sources. The main papers' topics included the assessment of the noise hazards in occupational, and very seldom in communal environment, and the prevalence of hearing impairment in employees. Simultaneously, attempts were undertaken to establish the relationship between the degree of hearing impairment and noise exposure. The effect of combined exposures to noise and vibration and/or otoxic chemicals was assessed as well. The influence of environmental, individual, and genetic risk factors on NIHL development was intensively examined. In addition, studies concerning the role of otoacoustic emissions for NIHL monitoring and clinical examinations were conducted. Some animal researches, including molecular genetics, had been also performed. The majority of papers concerned occupational exposures, whereas only a few were dedicated to community noise.

The association between road traffic noise exposure and blood pressure among children in Germany: the GINIplus and LISAplus studies.

Abstract: Studies examining the association between road traffic noise and blood pressure in children are scarce. Nighttime noise levels and window orientations have not been considered in most previous studies. Investigate the association between road traffic noise exposure and blood pressure among children, and investigate the impact of bedroom window direction on this association. We measured blood pressure in 605 children aged 10 years from two Munich cohorts. Demographic and health information was collected by parent completed questionnaires. Road traffic noise levels were assessed by day-evening-night noise indicator "Lden" and night noise indicator "Lnight". Minimum and maximum levels within a 50 m buffer around child's home address were derived. Generalized additive models were applied to explore effect of noise levels on systolic and diastolic blood pressure (SBP and DBP). The orientation of child's bedroom window was considered in sensitivity analyses. DBP was significantly associated with the minimum level of noise during 24 h (Lden_min) and nightime (Lnight_min). Specifically, DBP increased by 0.67 and 0.89 mmHg for every 5 A-weighted decibels increase in Lden_min and Lnight_min. After adjusting for Lden_min (Lnight_min), DBP of children whose bedroom window faced the street was 1.37 (1.28) mmHg higher than those whose bedroom window did not, these children showed statistically significant increased SBP for Lden_min (3.05 mmHg) and Lnight_min (3.27 mmHg) compared to children whose bedroom window did not face the street. Higher minimum levels of weighted day-evening-night noise and nighttime noise around the home residence may increase a child's blood pressure.

Environmental noise and sleep disturbance: Research in central, eastern and south-eastern Europe and newly independent states

Abstract: Countries from South-East Europe (SEE), Central and Eastern Europe (CEE) and Newly Independent States (NIS) are in the process of harmonization with European environmental noise legislation. However, research work on noise and health was performed in some countries independently of harmonization process of adoption and implementation of legislation for environmental noise. Aim of this review is to summarize available evidence for noise induced sleep disturbance in population of CEE, SEE and NIS countries and to give directions for further research work in this field. After a systematic search through accessible electronic databases, conference proceedings, PhD thesis, national reports and scientific journals in English and non-English language, we decided to include six papers and one PhD thesis in this review: One paper from former Yugoslavia, one paper from Slovakia, one paper from Lithuania, two papers from Serbia and one paper, as also one PhD thesis from The Former Yugoslav Republic of Macedonia. Noise exposure assessment focused on road traffic noise was mainly performed with objective noise measurements, but also with noise mapping in case of Lithuanian study. Sleep disturbance was assessed with the questionnaire based surveys and was assumed from dose-effect relationship between night-time noise indicator (Lnight ) for road traffic noise and sleep disturbance (for Lithuanian study). Although research evidence on noise and sleep disturbance show to be sufficient for establishing dose response curves for sleep disturbance in countries where studies were performed, further research is needed with particular attention to vulnerable groups, other noise sources, development of laboratory research work and common methodology in assessment of burden of diseases from environmental noise.

Environmental noise and cardiovascular disease in adults: Research in Central, Eastern and South-Eastern Europe and Newly Independent States

Abstract: The adverse effects of noise on health have been intensely explored in the past 50 years. However, the scope of research conducted in the Central and Eastern Europe, South-East Europe, and Newly Independent States is not well-known. The aim of this review was to present studies on cardiovascular effects of environmental noise in adults published since 1965 and to point out the most important issues that need to be addressed in the future. More than 100 papers on noise and health and about 20 papers on cardiovascular effects of environmental noise in adults were identified by literature search. The authors reviewed scientific international and local journals, conference proceedings, and local reports published in national languages. The major endpoints were high blood pressure, ischemic heart disease, and myocardial infarction. The target populations were adults. Experimental and exposure-assessment studies, field, empirical studies, social surveys, and epidemiological studies are presented. The major sources of environmental noise were road and air traffic. The results were presented in tables and the most relevant articles were briefly discussed. The importance of this review is that it refers to some countries that no longer exist in the same political and governmental systems. The strength of this paper is that it includes publications that were not evaluated in earlier systematic reviews. Strategies for future noise-related research on national and global level are proposed.

Effect of administration of vitamins C and E on fertilization capacity of rats exposed to noise stress

Abstract: The aims of this study were to evaluate the effects of administration of Vitamins C and E on fertilization capacity in rats exposed to noise stress. 40 adult male rats were randomly divided into 5 equal groups. Group 1 as controls who were not exposed to noise and groups 2-5 exposed to noise with 90-120 dB intensity and 300-350 Hz frequency from 7 pm to 7 am everyday for 50 days. Group 2 exposed to noise and did not receive Vitamins. Group 3 received vitamin C, Group 4 received Vitamin E. Group 5 received Vitamins C and E concomitantly. After 50 days, serum Follicle-stimulating hormone (FSH), Luteinizing hormone (LH) and testosterone were calculated. Then each rat was left with three female rats for mating. Pregnant females were sacrificed on the 19 th day of pregnancy and evaluated for the presence and number of viable, dead and absorbed fetuses. The level of FSH, LH and testosterone significantly decreased in rats exposed to noise (P < 0.05). By administration of Vitamins in groups 3-5 we observed that the level of hormones significantly increased in compared to group 2 (P < 0.05). The fertilization capacity of male rats in groups 3-5 significantly increased in compared to group 2 (P < 0.05). There was significant difference between groups 1 and 2 in case of fertilization capacity (P = 0.001). The data in this study strongly suggests a negative role for noise stress on level of FSH, LH and testosterone level and also fertilization capacity of male rats. To complement the information it is suggested that this research be done on human samples.