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Objective: The purpose of this study was to determine whether the persistent high-frequency noise produced by dental equipment could cause hearing impairment among the dental professionals in the United Arab Emirates (UAE). Method and materials: This cross-sectional study was conducted to evaluate the hearing capacity of 90 randomly selected dental practitioners from different specialties working in the UAE. The participants were approached in their workplace and their hearing capacity was evaluated using the pure tone audiometer. Results: Twenty dental practitioners suffered from hearing impairment, which constitutes 22.2% of the studied sample. At high frequencies, left ears were more affected than right ears, but this was not statistically significant. There was a direct relationship between working hours per week and the hearing capacity, but this did not reach a statistically significant level. The lowest hearing capacity was detected in males at a significantly lower value compared to females. Conclusions: Positive correlation was found between years of experience and reduced hearing capacity among dental practitioners. In addition, males had a significantly higher median count of severely affected hearing frequencies compared to females. Online pure tone audiometric testing is an easy, cost-effective tool that can be used to self-assess the hearing capacity of dental professionals, and it is recommended to perform this test annually. [ABSTRACT FROM AUTHOR]

Hearing loss is a common debilitating complication in nasopharyngeal carcinoma (NPC) survivors. The aim of the present study was to investigate the impact of inner ear/cochlear radiation dose and cisplatin use on early and late sensorineural hearing loss (SNHL) in NPC patients treated with radiotherapy alone, concurrent chemoradiation (cCRT) and induction chemotherapy followed by cCRT (iCRT) in the intensity-modulated radiotherapy era. The study included 81 NPC patients treated with intensity-modulated radiotherapy between 2014 and 2016. Pure tone audiometry was carried out at baseline and follow-up. The effects of cochlear/inner ear radiation and cisplatin doses on early (<12 months) and late (≥24 months) SNHL were analysed using multivariable regression after adjusting for important predictors. In total, 156 ears were examined. In early SNHL (n = 136), cisplatin use predicted the incidence of early high-frequency SHNL (HF-SNHL) (odds ratio 6.4, 95% confidence interval 1.7–23.9, P = 0.005). Ninety ears were analysed for late SNHL (median follow-up 38 months). Inner ear/cochlear radiation and cisplatin doses and better pre-treatment hearing were independent predictors of threshold change at 4 kHz. Every 10 Gy increase in inner ear/cochlear Dmean resulted in 5-dB and 6-dB threshold changes, respectively (cochlear Dmean: B = 0.005, 95% confidence interval 0.0004–0.009, P = 0.031; inner ear Dmean: B = 0.006, 95% confidence interval 0.001–0.010, P = 0.014). Cisplatin use was associated with late HF-SNHL (odds ratio 3.74, 95% confidence interval 1.1–12.3, P = 0.031). In the cCRT and iCRT subgroups, no cisplatin dose-dependent ototoxicity was observed. Severe (≥30 dB) late HF-SNHL occurred in 14% and 25% of the patients when the cochlear dose constraints were 40 Gy and 44 Gy, respectively. The radiotherapy-alone group did not develop severe late HF-SNHL. Cochlear/inner ear radiation dose and cisplatin use showed differential and independent ototoxicity in early and late SNHL. As cochlear/inner ear dose-dependent ototoxicity was demonstrated, the cochlear dose constraint should be as low as reasonably achievable, especially when cisplatin is also administered. • Chemoirradiation-induced sensorineural hearing loss remains prevalent in the modern era. • Cisplatin and cochlear dose had differential and independent ototoxicity in nasopharyngeal carcinoma. • Cochlear radiation dose showed dose-dependent ototoxicity. • Higher cisplatin dose in induction regimes did not confer additional ototoxicity. [ABSTRACT FROM AUTHOR]

Background: Sudden sensorineural hearing loss (SSNHL) is a disease with an unknown etiology; damage to the auditory nerve from inflammation due to viral infection or vascular incidents has been implicated. According to several studies, cytokines, including interleukins, are associated with SSNHL in terms of serum expression and genetic polymorphisms. Interleukin-1 (IL-1) plays a key role in inflammation and may be associated with SSNHL. This study analyzed the association of single nucleotide polymorphisms (SNPs) of IL-1 receptor (IL-1R) genes with SSNHL in Taiwan. Methods: We conducted a case–control study involving 401 patients with SSNHL and 730 healthy controls. Four SNPs (IL-1R type 1 gene [IL1R1] [rs3917225 and rs2234650] and IL-1R type 2 gene [IL1R2] [rs4141134 and rs2071008]) were selected. The genotypes were determined using the TaqMan assay. The Hardy–Weinberg equilibrium (HWE) was tested for each SNP, and genetic effects were evaluated. Results: The TT genotype of rs2234650 had an adjusted odds ratio (OR) of 2.988 (95% confidence interval [95% CI] 1.27–6.82) (P = 0.012) compared with the CC genotype in patients with SSNHL. The SNP rs2234650 was associated with SSNHL in the recessive model (TT vs. CC + CT, P = 0.0206, OR = 2.681). The CT genotype of rs4141134 had an adjusted OR of 3.860 (95% CI 2.01–7.44; P < 0.0001) compared with the TT genotype, in patients with SSNHL. The SNP rs4141134 was associated with SSNHL under the dominant model (CC + CT vs. TT, P < 0.0001, OR = 4.087). Conclusion: These findings suggest that IL1R1 and IL1R2 gene polymorphisms may contribute to an increased risk of SSNHL in Taiwan. [ABSTRACT FROM AUTHOR]

Background: Primary distal renal tubular acidosis (dRTA) is a rare genetic disorder caused by impaired distal mechanisms of urinary acidification. Most cases are secondary to pathogenic variants in ATP6V0A4, ATP6V1B1, and SLC4A1 genes, which encode transporters regulating acid-base balance in the collecting duct. Methods: Retrospective study of molecular and clinical data from diagnosis and long-term follow-up (10, 20, and 40±10 years) of 16 patients with primary dRTA diagnosed in childhood. Results: Molecular analyses revealed nine patients had ATP6V0A4 pathogenic variants, five in ATP6V1B1, and two in SLC4A1. A novel intragenic deletion and a common ATP6V0A4 gene variant (c.1691 + 2dupT) in ATP6V0A4 occurred in two-thirds of these patients, suggesting a founder effect. Median age at diagnosis was 3.25 months (IQR 1, 13.5), which was higher in the SLC4A1 group. Median SDS height at diagnosis was −1.02 (IQR −1.79, 0.14). Delayed clinical diagnosis was significantly related to growth failure (P = 0.01). Median SDS height at 20 years follow-up was −1.23 (IQR −1.71, −0.48), and did not significantly improve from diagnosis (P = 0.76). Kidney function declined over time: at last follow-up, 43% had moderate to severe chronic kidney disease (CKD). Adequate metabolic control was not related to CKD development. Incidence of sensorineural hearing loss (SNHL) was high in ATP6V1B1 patients, though not universal. Patients harboring ATP6V0A4 variants also developed SNHL at a high rate (80%) over time. Conclusions: Patients with dRTA can develop moderate to severe CKD over time with a high frequency despite adequate metabolic control. Early diagnosis ameliorates long-term height prognosis. [ABSTRACT FROM AUTHOR]

The pathogenesis of Idiopathic sudden sensorineural hearing loss (ISSNHL) is ambiguous. Stress is commonly defined as a cause of the disease. Serum levels of stress-related hormone (cortisol, growth hormone, aldosterone, ADH, ACTH) may be elevated in patients with ISSNHL patients. We aimed to determine whether psychological factors and stress hormones in patients are associated with the severity of hearing loss and therapeutic outcomes. We hypothesized that the stress hormone level in the disease sequence is a strong prognostic factor of ISSNHL. Additionally, we investigated whether the subjective degree of psychological stress is likely to contribute to the therapeutic prognosis of ISSNHL, as determined using questionnaires. We conducted a prospective study of patients aged between 19 and 65 years admitted for the treatment of ISSNHL at our hospital. All patients underwent pure tone audiometry (PTA) on day 0, day 5 and 2 weeks after discharge. As an objective indicator of stress, we measured the level of HPA axis-related hormones. So, we measured serum cortisol, adrenocorticotropic hormone (ACTH), aldosterone and dehydroepiandrosterone sulfate (DHEAS) levels in the venous blood sample of patients on day 1 and day 5 after admission. In addition, for subjective stress measurements, depression and anxiety levels were assessed using self-reported questionnaires, Beck Depression Inventory (BDI), and Perceived Stress Scale (PSS) in the revised to Korean versions. Eighteen patients diagnosed with ISSNHL at the Department of Otorhino-laryngology were enrolled. Serum DHEAS level measured on day 1 showed a statistically significant correlation with the hearing threshold in the hearing test performed at the time of diagnosis (p =.037, correlation coefficients(r) = 0.541). Serum ACTH level was measured on day 1, and patients were classified into normal and elevated groups based on a threshold of 1.5 pg/mL; the normal group had better hearing thresholds in the first and second hearing test than the elevated group (p =.040, 0.015, respectively). In the stress-related questionnaires, the BDI score showed a statistically significant correlation with the last hearing test (p =.015, correlation coefficients(r) = 0.613). We demonstrated the possible role of stress-related hormones in the pathogenesis of ISSNHL and suggest that depressive stress response can be a strong predictor of treatment response in patients with ISSNHL. However, the impact of response to stress on the inner ear and endolymph homeostasis remains unknown. Since this is a cross-sectional study, we can only comment on the relationship between stress and ISSNHL, not a causal relationship. Further investigation is necessary to identify the mechanism of interaction between stress and hearing ability in the inner ear. [ABSTRACT FROM AUTHOR]

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Objective: Worldwide research trends on the prevalence of hearing loss within young rural populations are scarce. Current evidence suggests extended high-frequency audiometry could be a sensitive predictor to detect subclinical hearing loss. This study aimed to determine the prevalence of hearing loss through conventional pure tone (0.25-8 kHz) and extended high-frequency (9-20 kHz) audiometry tests in a group of adolescents aged 13 to 19 years old from two rural areas of Colombia. A sociodemographic and associated factor for hearing loss questionnaire was applied. Design: Cross-sectional study. Study Sample: Three hundred sixty-six adolescents aged 13 to 19 years old from two rural municipalities in Colombia: Soracá, and Palmas del Socorro. Results: Hearing loss prevalence assessed through pure tone audiometry was 3.28% in right ears and 3.83% in left ears while through extended high-frequency audiometry was 14.21% and 13.11%, respectively. Associated factors found by the logistic regression were age (OR: 1.36; CI 95% 1.13-1.64) and obesity (OR: 3.74; CI 95% 1.07-13.11). Conclusions: Using 15 dB as the normal hearing threshold parameter for audiometric frequencies, our results suggest that extended high-frequency hearing loss is already widespread among rural adolescents. This highlights the need for research on extended high-frequency audiometry in rural schoolaged children. [ABSTRACT FROM AUTHOR]

This paper reports a case of spontaneous intralabyrinthine haemorrhage as a cause of sudden sensorineural hearing loss, and discussed the implications that abnormal intralabyrinthine findings may have in the treatment of these cases. A 56-year-old woman with history of anticoagulants intake, was diagnosed with profound right-sided sensorineural hearing loss. Brain/inner ear Magnetic Resonance Imaging showed right-side labyrinthine haemorrhage. Blood tests were within the appropriate range. The patient began treatment with corticosteroids, and on the fifth day of treatment, because there was no improvement, suspend anticoagulation, for being possible and safe. The patient also started hyperbaric oxygen therapy, with mild improvement in hearing function. In fact, there is no consensus in literature that specifies the best management of a proven intralabyrinthine haemorrhage. Further studies with representative samples are needed in order to understand whether the suspension of anticoagulants, when possible, may have real prognostic implications, as noted in the reported case. Our case represents one of the few reported in the literature that shows the possible results of the suspension of oral anticoagulation in the recovery of the audiological and vestibular consequences of intra-labyrinthine haemorrhage. [ABSTRACT FROM AUTHOR]

Objective: Common Variable Immunodeficiency (CVID) is a primary antibody disorder characterized by impaired B cell differentiation. Patients commonly present with acute and chronic sinusitis as well as otitis media, which may lead to hearing loss. Materials and Methods: Thirty-three CVID patients (20 male /13 female) with a mean age of 35 years (range 19-65 years) and 33 healthy individuals as a control group were included. Results: Among CVID patients, 17 (51.5%) had conductive hearing loss (CHL), being unilateral in 4 (12.1%) and bilateral in 13 (39.4%). Unilateral and bilateral sensorineural hearing loss (SNHL) were detected in 2 (6.1%) and 5 (15.2%) respectively. CD4/CD8 cell ratio was significantly lower while CD8+ T lymphocyte ratio was significantly higher in those with CHL than in those without it (p=0.045 and p=0.009). Elevated CD8+ T cell ratio was an independent risk factor for CHL (p=0.015). Patients with SNHL were significantly older than those without it (p=0.040). CD16-56+ cell count was significantly lower in those with SNHL (p=0.031). Conclusion: CVID patients have an increased occurrence of CHL and SNHL, regardless of the cause. They provide evidence for the notion that these two types of hearing loss are not unrelated, immune dysregulation also plays a role in the process, and SNHL is not independent of CHL. [ABSTRACT FROM AUTHOR]

Background: Listening to music through personal listening devices (PLDs) has become more prevalent during last decades. The aim of this study was to evaluate music listening habits through PLDs in adolescents with a smartphone application, and to assess the accuracy of self-reported listening habits. Methods: This study was embedded in the Generation R Study, a population-based prospective birth cohort in Rotterdam, the Netherlands. A smartphone application for Android operating systems was developed to objectively monitor music listening habits for a period of 35 days. A postal questionnaire was used to subjectively assess listening habits. The level of agreement between the objectively measured and self-reported listening habits were evaluated using weighted kappa coefficients. Data were collected from May 2017 to March 2019. Results: A total of 311 adolescents aged 12 to 15 years were included, of whom 237 (76.2%) completed the postal questionnaire. The results of the smartphone application showed that the median listening frequency was 2.1 days a week (IQR 1.0–3.4), the median listening time 21.1 min a day (IQR 9.1–53.7), and the mean listening level 54.5% (SD 18.1%). There was a slight to fair agreement between the objectively measured, and self-reported listening habits according to the weighted kappa coefficients (k = 0.179 to 0.364). Conclusions: The results of the current study suggest that self-reported measures of listening habits are not always accurate. We consider a smartphone application to monitor listening habits of added value in future research investigating the possible damaging effects of PLDs on hearing acuity. [ABSTRACT FROM AUTHOR]

BACKGROUND: Musicians and dancers can be considered an at-risk population for developing noise-induced hearing loss. OBJECTIVES: To determine the audiological profile of members of a folklore-related music group and quantify noise exposure at their rehearsal venue. METHODS: This was a quantitative and descriptive study. The musicians and dancers were evaluated in two stages: an interview about their working life, followed by high frequency tonal audiometry. The sound pressure level in the group's rehearsal venue was measured using a BEK 2270 Noise Analyzer. RESULTS: A total of 7.2% of the subjects had noise-induced hearing loss (NIHL) and 39% of the audiometric tests were notch type. During the interview 31.7% of the subjects mentioned discomfort from loud noise, although none of them used ear protection. The environmental assessment showed inadequate humidity and oscillating temperature. Twenty sound pressure level measurements were performed for Leq (equivalent sound pressure levels) and the results ranged from 88 dB (A) to 99 dB (A) with a mean of 97.05. CONCLUSIONS: Exposure to high levels of sound pressure has led to NIHL in some members of the group. Some of those with normal hearing also presented a notch configuration characteristic of NIHL. Tinnitus, indicating that a change in hearing has occurred, was the most frequent auditory symptom. [ABSTRACT FROM AUTHOR]

The purpose of this study is to estimate the prevalence of hearing loss among noise-exposed U.S. workers within the Services sector. Audiograms for 1.9 million workers (158,436 within Services) from 2006 to 2015 were examined. Prevalence and adjusted risk for hearing loss as compared with a reference industry were estimated for the Services sector/sub-sectors, and all industries combined. The prevalence of hearing loss within Services was 17 compared to 16% for all industries combined. However, many sub-sectors greatly exceeded the overall prevalence (10–33% higher) and/or had adjusted risks significantly higher than the reference industry. Workers in Administration of Urban Planning and Community and Rural Development had the highest prevalence (50%), and workers in Solid Waste Combustors and Incinerators had more than double the risk, the highest of any sub-sector. Some sub-sectors traditionally viewed as 'low-risk' also had high prevalences and risks. Large numbers of workers within Services have an elevated risk of hearing loss and need immediate hearing conservation efforts. Additional research and surveillance are needed for sub-sectors for which there is low awareness of hearing hazards or a lack of hearing data. [ABSTRACT FROM AUTHOR]

Background: Vitiligo is a common chronic disease of pigmentation, which may be accompanied by audiological abnormalities. Material and methods: The aim of this study was to assess vitiligo patients in terms of hearing thresholds using conventional pure tone audiometry (0.25 to 8 kHz), high frequency pure tone audiometry (10 and 12.5 kHz), as well as Transient Evoked Otoacoustic Emissions (TEOAEs). We correlated the audiometric findings with vitiligo duration and severity. The study included 75 subjects with a mean age of 29.7 ± 8.6 years. There were 50 vitiligo patients and 25 age and gender matched healthy controls who had never had any audiological condition or exposed to excessive noise. Results: Only 24% of vitiligo patients had high frequency sensorineural hearing loss (SNHL) using conventional audiometry and the majority (76%) had bilaterally normal hearing. The majority (90%) of vitiligo patients had SNHL in extended high frequency audiometry. There was a statistically significant difference between the cases and controls regarding TEOAE SNR at 5 kHz, and nearly half of the normal hearers had an abnormal TEOAE. Vitiligo patients were found to have subclinical inner ear dysfunction compared with the controls. There was a statistically significant correlation between PTA and age of the patients but not with vitiligo duration or severity. Conclusions: The audiometric findings of the vitiligo group and the statistically significant differences from the control group suggest a subclinical involvement of the cochlea, probably related to the vitiligo condition, but not affected by vitiligo duration or severity. We therefore recommend the use of extended high frequency audiometry and otoacoustic emission tests for early detection of inner ear involvement in vitiligo. [ABSTRACT FROM AUTHOR]

Background: While there is an enormous amount of data on various surgical aspects of total hip arthroplasty (THA), there is only limited literature on the health hazards incurred by the surgical team. Since THA surgery produces noise, exposure over a long period of time may lead to gradual hearing loss which is known as noise-induced hearing loss. Methods: We investigated the noise levels during THA and compared it with the maximum allowed limits at the workplace in the United Kingdom. In collaboration with specialised audio engineers, we analysed the noise levels during various steps of performing 7 uncemented THA. Results: The results showed that the noise levels were close to the allowed limits for a workplace in the UK. Conclusion: Hospitals and staff who work in orthopaedic operating theatres should be aware of this risk and precautions should be put in place. [ABSTRACT FROM AUTHOR]

Background: Noise-induced hearing loss (NIHL) is a common occupational disease that both shipyard and battle cruiser workers may encounter, since they are both exposed to hazardous noise levels. However, both white- and blue-collar workers are simultaneously exposed to possible daily risk-factors of incident tinnitus and subsequent hearing loss (HL), such as caffeine and smoking. The aim of the present prospective study is to investigate the prevalence of HL in these working groups of the Greek Navy and the Hellenic Shipyard SA (HSY) in Skaramanga, Greece, and to look at the correlation between OHL and hazardous noise levels as well as other individual factors. Material and methods: During 2015-17, multiple choice questionnaires including questions referring to socio-demographic information, educational level, and daily habits were administered, and audiograms were performed, to 120 male white- and blue-collar workers, aged 23-30 years old. Statistical analysis was conducted using SPSS v.15. Results: HL in battle cruiser employees was correlated with occupational noise and individual factors such as caffeine, smoking, and educational level. Additionally, HL in shipyard employees was correlated with occupational noise, alcohol and caffeine intake, smoking, and educational level. A higher level of HL appeared to be correlated with higher levels of occupational noise, lower educational level, and larger consumption of caffeine, alcohol, and smoking. Dietary habits were non-significantly statistically correlated with HL in both types of workers. Conclusions: HL is a disease strongly related to the Navy and the shipyard industry. Therefore, constant monitoring of workers, implementation of hearing conservation programs, and using preventive measures are the cornerstone of preventing and treating HL. More research of HL in Navy employees should be conducted. [ABSTRACT FROM AUTHOR]

Objective: To find the overall association of sudden sensorineural hearing loss (SSNHL) and chronic periodontitis (CP) between case and control among the patients with comorbidities like diabetes mellitus, hypertension and obesity. Design: Case-control study comprising 351 subjects with SSNHL and 1101 controls without SSNHL. Both the case and control groups had the individuals with CP and/or CP with diabetes mellitus, hypertension and obesity. Results: We have shown the significant association of SSNHL with CP (p <.05; odd ratio 3.565, 95% confidence interval = 2.566–4.953). The comorbidities stratified analysis revealed a significantly higher risk of SSNHL with CP in the presence or absence of diabetes mellitus, hypertension and obesity (p <.05). Conclusion: We found a significant association of SSNHL with CP. Further, we highlighted the exclusive association of SSNHL and CP, even in cases of CP with or without other comorbidities like diabetes mellitus, hypertension and obesity. More studies must be conducted only with cases having SSNHL and CP for these results to be supported. [ABSTRACT FROM AUTHOR]

Objectives: This study examined the association between pure tone hearing sensitivity and music listening behaviors among traditional college-aged students and sought to determine factors that mediate hearing sensitivity, including health and fitness levels, gender, and personal listening device (PLD) use. Methods: A convenience sample of college students (N = 182; 133 females, 49 males, mean age = 19.8 ± 1.4 year, average PLD use = 1.52 ± 7.1 hours•day−1) completed hearing assessments, music listening behavior questionnaires, and health and fitness tests. Results: Most students listened to music at safe intensity levels (<80 dBA), though 18% had higher hearing levels (≥25 dB HL at one of the measured frequencies). Longer listening duration behavior approached but did not reach a statistical association with compromised hearing sensitivity. Of all variables measured, including cardiovascular health, fitness, and music listening, two variables: total cholesterol: triglycerides (TC:TG) and total cholesterol: high-density lipoproteins (TC:HDL) significantly associated with hearing sensitivity at 2 kHz. The odds hearing loss occurring at 4 kHz was 59% lower in females compared with males. Conclusion: The majority of college students had healthy music listening behavior and fitness, contributing to normal hearing sensitivity in most. In cases where greater hearing threshold levels at one or more frequencies was detected, TC:HDL and TC:TG were statistically related and at 2 kHz, males were more likely to demonstrate higher listening levels compared with females of similar health and fitness level. [ABSTRACT FROM AUTHOR]

Objective: This study was aimed at determining the risk of developing noise-induced hearing loss (NIHL) in middle school band (MSB) and high school band (HSB) members. Method: Between-group comparison of hearing thresholds. Eleven MSB members and 6 MSNB controls, 20 HSB members and 5 HSNB controls. Results: Sixty-four percent of school-age band members presented with 15 dB HL or greater notch at 4,000 or 6,000 Hz in at least one ear. The high school students were slightly more likely to present with a notch. Conclusions: Results indicate that participation in band even as early as middle school increases the risk of developing NIHL, and that the longer the participation the higher the risk. Steps to insure hearing preservation in school-age band members are recommended. [ABSTRACT FROM AUTHOR]

Purpose: A global pandemic, non-occupational noise-induced hearing loss (NIHL) is a completely preventable public health problem, which receives limited air time. This study has dual purposes: to contribute to scholarly literature that puts non-occupational NIHL on the global priority map and to effect change in the City of Vancouver's policies toward noise. Design/methodology/approach: Experts in public health and hearing health were contacted in addition to a scoping literature search on PubMed. Information pertaining to both developed and developing countries was obtained, and comparison was made to Canada where possible. The authors met with elected officials at the City of Vancouver to inform them of the win–win aspects of policies that promoted better hearing. Findings: Non-occupational NIHL is an underappreciated issue in Canada and many other countries, as seen by the lack of epidemiological data and public health initiatives. Other countries, such as Australia, have more robust research and public health programs, but most of the world lags behind. Better hearing health is possible through targeted campaigns addressing root causes of non-occupational, recreational noise – positive associations with loud noise. By redefining social norms so that soft to moderate sounds are associated with positive values and loud sounds are negatively attributed, the societies will prevent leisure NIHL. The authors recommend widespread national all-age campaigns that benefit from successful public health campaigns of the past, such as smoking cessation, safety belts and others. Soft Sounds are Healthy (SSH) is a suggested name for a campaign that would take many years, ample resources and sophisticated understanding of behavior change to be effective. Research limitations/implications: A gap exists in the collection of non-occupational NIHL data. Creating indicators and regularly collecting data is a high priority for most nations. Beyond data collection, prevention of non-occupational NIHL ought to be a high priority. Studies in each region would propel understanding, partly to discern the cultural factors that would predispose the general population to change favorable attitudes toward loud sounds to associations of moderate sounds with positivity. Evaluations of these campaigns would then follow. Practical implications: Everyday life for many people around the world, particularly in cities, is loud. Traffic, construction, loudspeakers, music and other loud sounds abound. Many people have adapted to these loud soundscapes, and others suffer from the lack of peace and quiet. Changing cultural attitudes toward loud sound will improve human and animal health, lessen the burden on healthcare systems and positively impact the economy. Social implications: Industries that create loud technologies and machinery ought to be required to find ways to soften noise. Regulatory mechanisms that are enforced by law and fines ought to be in place. When governments take up the banner of hearing health, they will help to set a new tone toward loud sounds as undesirable, and this will partially address the root causes of the problem of non-occupational NIHL. Originality/value: Very little public health literature addresses NIHL. It is a relatively ignored health problem. This project aims to spurn public health campaigns, offering our own infographic with a possible title of Soft Sounds are Healthy (SSH) or Soft Sounds are Sexy (SSS). The study also aimed to influence city officials in the authors' home, Vancouver, and they were able to do this. [ABSTRACT FROM AUTHOR]

Introduction Previous research has suggested that hand dryers may operate at dangerously loud levels for adults. No research has explored whether they operate at a safe level for children's hearing. Children's ears are more sensitive to damage from loud sounds than adult ears. Health Canada prohibits the sale of toys with peak loudness greater than 100 dB. This study tested installed dryers in public washrooms to see if they were safe for children's hearing. Methods Forty-four hand dryers in public washrooms were each measured for peak sound levels in a standardized fashion, including at children's ear canal heights. Each dryer was measured at 10 different combinations of heights and distances from the wall, and with and without hands in the air stream coming from the hand dryer, for a total of 20 measurements per dryer. Results Xlerator units performed the loudest, with all being louder than 100 dBA at all measurements whenever hands were in the airstream. Several Dyson Airblade models were also very loud, including the single loudest measurement of 121 dBA. While some other units operated at low sound levels, many units were louder at children's ear heights than at adult ear heights. Discussion Many dryers operated much louder than their manufacturers claimed, usually greater than 100 dBA (the maximum allowable noise level for products/toys meant for children). Conclusion This study suggests that many hand dryers operate at levels far louder than their manufacturers claim and at levels that are clearly dangerous to children's hearing. [ABSTRACT FROM AUTHOR]

Purpose: The aims of this study were to characterize hearing symptoms, habits, and sound pressure levels (SPLs) of personal audio system (PAS) used by young adults; estimate the risk of developing hearing loss and assess whether instructions given to users led to behavioral changes; and propose recommendations for PAS users. Method: A cross-sectional study was performed in 50 subjects with normal hearing. Procedures included questionnaire and measurement of PAS SPLs (real ear and manikin) through the users’ own headphones and devices while they listened to four songs. After 1 year, 30 subjects answered questions about their usage habits. For the statistical analysis, one-way analysis of variance, Tukey’s post hoc test, Lin and Spearman coefficients, the chisquare test, and logistic regression were used. Results: Most subjects listened to music every day, usually in noisy environments. Sixty percent of the subjects reported hearing symptoms after using a PAS. Substantial variability in the equivalent music listening level (Leq) was noted (M = 84.7 dBA; min = 65.1 dBA, max = 97.5 dBA). A significant difference was found only in the 4-kHz band when comparing the real-ear and manikin techniques. Based on the Leq, 38% of the individuals exceeded the maximum daily time allowance. Comparison of the subjects according to the maximum allowed daily exposure time revealed a higher number of hearing complaints from people with greater exposure. After 1 year, 43% of the subjects reduced their usage time, and 70% reduced the volume. A volume not exceeding 80% was recommended, and at this volume, the maximum usage time should be 160 min. Conclusions: The habit of listening to music at high intensities on a daily basis seems to cause hearing symptoms, even in individuals with normal hearing. The real-ear and manikin techniques produced similar results. Providing instructions on this topic combined with measuring PAS SPLs may be an appropriate strategy for raising the awareness of people who are at risk. [ABSTRACT FROM AUTHOR]

Objective: To determine the prevalence and distribution of inner-ear malformations in congenital single-sided deafness cases, as details of malformation type are crucial for disease prognosis and management. Methods: A retrospective study was conducted of 90 patients aged under 16 years with congenital single-sided deafness. Radiological findings were evaluated using computed tomography and magnetic resonance imaging. Inner-ear malformations were identified and cochlear nerve status was determined in affected ears. Results: Out of 90 ears, 42 (46.7 per cent) were found to have inner-ear malformation. Isolated cochlear aperture stenosis was the most common anomaly (n = 18, 20 per cent), followed by isolated cochlear aperture atresia (n = 11, 12.2 per cent) and cochlear hypoplasia (n = 7, 7.8 per cent). Cochlear nerve deficiency was encountered in 41 ears (45.6 per cent). The internal auditory canal was also stenotic in 49 ears (54.4 per cent). Conclusion: Inner-ear malformations, especially cochlear aperture anomalies, are involved in the aetiology of single-sided deafness more than expected. The cause of single-sided deafness differs greatly between congenital and adult-onset cases. All children with single-sided deafness should undergo radiological evaluation, as the prognosis and management, as well as the aetiology, may be significantly influenced by inner-ear malformation type. [ABSTRACT FROM AUTHOR]

Previous research has revealed that firefighters have an increased risk for noise-induced hearing loss; however, firefighters do not reach an 8-hr time-weighted average (TWA) of ≥85 dB. The high variability in occupational tasks and intermittent noise exposure of firefighters offers an explanation for the low 8-hr TWA. Our study evaluated specific occupational tasks, firefighting positions, and fire engine noise during a live fire training exercise. Researchers then identified the tasks and firefighting positions that presented the greatest risk to firefighters' hearing health. Firefighting positions were statistically significantly different (p = .04) in terms of decibel levels; we determined that the firefighter in the position of water pump operator experienced the greatest decibel level (91 dBA). Noise exposure while traveling in a response vehicle varied by the type of vehicle (p = .009), with the newest vehicle having the smallest noise level (81 dBA). Analysis of the data revealed that the occupational tasks with the highest noise levels were cleanup at the scene and cleanup at the fire station (88 dBA each). [ABSTRACT FROM AUTHOR]

Excessive sound levels at events where amplified music is a central element pose a risk to hearing. Whereas noise exposure in the workplace has been recognized as a hazard for over a century, the potential harm resulting from recreational sound exposure has only become apparent in recent years. In occupational settings where sound levels are high, employers are required to implement risk-mitigation strategies to reduce sound exposure and protect employees in accordance with the hierarchy of controls. In principle, this same risk management approach can be applied to entertainment venues. In this paper we discuss how the measures stipulated in various policies and regulations aimed at protecting the hearing of audience members at entertainment venues fit within the hierarchy of controls. We compare the relative likely effectiveness of each of the measures and outline how the particular characteristics of entertainment venues impact on the practical application of these measures. [ABSTRACT FROM AUTHOR]

Purpose: Many children with severe intellectual and developmental disabilities are at a higher risk for hearing loss than their peers who are typically developing. Unfortunately, they do not consistently participate in routine school-based hearing screenings. The current study investigated the feasibility of increasing their participation using an otoacoustic emissions protocol and documented results relative to student educational profiles. Method: A total of 43 students with significant cognitive disabilities enrolled at a public school exclusively serving this population participated in the study. All but 9, who were excluded because of known hearing loss, were screened by a licensed audiologist assisted by audiology doctoral students. The protocol included otoscopy, tympanometry, distortion product otoacoustic emissions (DPOAEs), and teacher surveys. Results: DPOAE screening was attempted on 33 students without previously diagnosed hearing loss and successfully completed for 26 (78.8%). Two students (4.6%) with absent otoacoustic emissions and normal tympanograms were referred for further assessment due to concerns about possible sensorineural hearing loss in one or both ears, and 10 (23.3%) had abnormal tympanograms in one or both ears. Conclusions: Considering the high risk of sensorineural hearing loss for children with significant disabilities, it is important for them to be included in school hearing screenings. The results of this study demonstrate the feasibility of using DPOAEs for school-based hearing screenings with this population with an interprofessional team of licensed audiologists, educators, and speechlanguage pathologists. The results further suggest that students with significant disabilities and hearing loss may be unidentified and underserved. Given the complex needs of this population, an interprofessional practice model for hearing screenings and intervention services is recommended. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the risk of sudden sensorineural hearing loss (SSNHL) in Herpes zoster patients from a representative population cohort. Design: A longitudinal follow-up study Study sample: Data were obtained from the Korean National Health Insurance Service-National Sample Cohort for the period from 2002 to 2013. We matched 61,702 subjects in the Herpes zoster group with subjects in a control group (246,808 subjects with no history of Herpes zoster) based on demographic factors (age, sex, income, and region of residence) and medical history (diabetes, dyslipidemia, and hypertension). The crude (simple) and adjusted hazard ratios (HRs) for Herpes zoster with SSNHL were analysed using the Cox-proportional hazard model. Results: Only 0.5% (338/61,364) of the Herpes zoster group and 0.7% (1664/245,144) of the control group showed SSNHL. The Herpes zoster group did not exhibit a higher rate of SSNHL (adjusted HR = 0.81, 95% CI = 0.72–0.91, p < 0.001) than the control group. In subgroup analyses, no age subgroups showed a significant risk of SSNHL in the Herpes zoster group. Conclusions: After adjusting for confounding factors, the risk of SSNHL did not increase in the Herpes zoster group compared with the control group. [ABSTRACT FROM AUTHOR]

BACKGROUND: Discrepancies between attenuation obtained in the laboratory and the field are caused by several factors associated with hearing protection devices (HPDs). The effects of some factors can be minimized with proper training provided to HPD users. OBJECTIVE: To evaluate the effectiveness of an educational intervention for improving the correct use of earplugs as HPDs in workers exposed to occupational noise by using the F-MIRE method and by comparing pre- and post-training attenuation values and pass/fail rates. METHODOLOGY: The personal attenuation ratings (PARs) of two types of earplugs were obtained (140 individuals) using E-A-Rfit™ equipment. Each HPD was evaluated under two scenarios: first after the user only read the packaging instructions, and then after the user read guidelines and participated in a training program. The results obtained were automatically classified by the software as "Approved" or "Failed". RESULTS: There was a significant post-training increase in the binaural PAR values for both HPDs. The percentages of passes pre- and post-training showed that training users in the proper fit of the HPD was effective; both types had statistically significant differences. CONCLUSION: This study found a statistically significant increase in PARs and the number of workers passing evaluations after HPD fit training, demonstrating the effectiveness of this educational intervention. [ABSTRACT FROM AUTHOR]

Background: Congenital cytomegalovirus (cCMV) infection is the most frequent non-genetic cause of sensorineural hearing-loss (SNHL) (i.e., hearing loss due to a cochlear and/or auditory nerve damage). It is widely accepted that SNHL at birth, when associated to cCMV symptomatic infection involving the central nervous system, benefits from antiviral therapy started in the neonatal period. Conversely, there is no consensus for antiviral treatment in congenitally infected infants diagnosed with isolated SNHL (i.e., SNHL in an otherwise asymptomatic infant) at birth. Our aim was to assess the frequency and the auditory outcome of isolated SNHL at birth due to auditory neuropathy (AN) (i.e., SNHL in a patient with normal cochlear function and auditory nerve dysfunction) in infants with cCMV infection. Methods: We retrospectively reviewed the clinical history of 60 infants, born at term, with cCMV asymptomatic infection, without additional risk factors for SNHL, and exhibiting bilateral "pass" otoacustic emissions (OAE). None of them underwent antiviral therapy. Hearing thresholds were assessed by means of Auditory Brainstem Responses (ABR). AN affected children were followed up until possible normalization of the hearing thresholds or definitive diagnosis of AN. Each infant diagnosed with monolateral or bilateral AN was classified according to the worst ear threshold. Results: In our population, the first ABR was performed at a mean age of 5.00 ± 2.79 (SD) months and AN was diagnosed in 16/60 (26.67%) infants; in 4 infants the AN was defined as mild (4/4 monolateral), moderate in 11 (5/11 bilateral), and severe in 1 (bilateral). The mean age at first ABR was 3.69 ± 2.80 (SD) months in the 16 babies with AN and 5.48 ± 2.66 (SD) months in the 44 infants with normal hearing (p = 0.007). All AN cases spontaneously recovered a normal auditory threshold over time. The mean length of the audiological follow-up was 32.44 ± 17.58 (SD) months (range 5–60 months). Conclusion: A delayed maturation of the auditory pathways should be considered when a mild/moderate isolated AN at birth is detected in cCMV infected infants. Prospective studies conducted on larger populations, and with a longer audiological follow-up, are needed to confirm our findings. [ABSTRACT FROM AUTHOR]

Mutations in apoptosis‐inducing factor mitochondrion‐associated‐1 (AIFM1) cause X‐linked peripheral neuropathy (Cowchock syndrome, CMT4X); however, more recently a cerebellar presentation has been described. We describe a large Irish family with seven affected males. They presented with a variable age of onset, 18 months to 39 years of age. All developed variably present sensorineural deafness, peripheral neuropathy, cerebellar ataxia, and pyramidal involvement. In addition, three had colour vision deficiency. Scale for the assessment and rating of ataxia ranged 2 to 23/40, while Charcot‐Marie‐Tooth neuropathy score 2 varied between 7 and 13/36. All individuals had normal cognitive assessment. Neurophysiology demonstrated length‐dependent large‐fibre sensorimotor axonal neuropathy, with particular involvement of superficial radial sensory responses. Brain imaging, performed in four, revealed varying extent of cerebellar atrophy, and white matter changes in one. Optical coherence tomography was abnormal in one, who had unrelated eye pathology. Four obligate female carriers were assessed clinically, two of them neurophysiologically; all were unaffected. Whole genome sequencing demonstrated a previously reported hemizygous AIFM1 mutation. Analysis for mutations in other genes associated with colour deficiency was negative. AIFM1‐associated phenotype in this family demonstrated significant variability. To our knowledge, this is the first report of AIFM1‐associated colour blindness. Superficial radial nerve was particularly affected neurophysiologically, which could represent a phenotypic marker towards this specific genetic diagnosis. [ABSTRACT FROM AUTHOR]

Noise-induced hearing loss (NIHL) represents the second most common occupational disease in the United States. Although the Occupational Safety and Health Administration (OSHA) has promulgated an occupational noise exposure standard and associated recordkeeping requirements, OSHA inspections increasingly document practices that violate both the noise standard and recordkeeping regulation. This article describes five deviations from good clinical practices masking the true societal costs of NIHL, leading to missed prevention opportunities, and creating burdens for individuals and society. These include attributing NIHL to nonoccupational sources, exculpating the workplace because of audiogram patterns without careful documentation, ignoring symptoms or physical examination findings, and simply denying work-relatedness, leading to employers inappropriately lining out cases from the OSHA 300 log. The practices identified by OSHA suggest that many individuals are not following widely recognized and accepted practices when administering hearing conservation programs. [ABSTRACT FROM AUTHOR]

Wildland firefighters are exposed to numerous noise sources that may be hazardous to their hearing. This study examined the noise exposure profiles for 264 wildland firefighters across 15 job categories. All 264 firefighters completed questionnaires to assess their use of hearing protection devices, enrollment in hearing conservation programs, and their overall perception of their noise exposure. Roughly 54% of firefighters' noise exposures exceeded the National Institute for Occupational Safety and Health recommended exposure limit of 85 decibels, A-weighted, over 8 hr, and 32% exceeded the Occupational Safety and Health Administration permissible exposure limit of 90 decibels, A-weighted, over 8 hr. Questionnaire results indicated good agreement between noise exposures and firefighters' perceptions of the noise hazard. Approximately 65% reported that they used some form of hearing protection; however, only 19% reported receiving any proper training regarding the use of hearing protection devices, with the majority of those firefighters relying on earplugs, including electronic and level-dependent earplugs, over earmuffs or other forms of hearing protectors. The results also suggest that improved communication and situational awareness play a greater role in the consistent use of hearing protection devices than other factors such as risk of developing noise-induced hearing loss. The study highlighted the challenges facing wildland firefighters and their management and the need for a comprehensive wildland fire agencies' hearing conservation program especially for firefighters who were exempt based on their occupational designations. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the sound intensity levels of a university-based wellness center. This research was initiated in response to the explosion of wellness centers being renovated and constructed across the nation at the university level and the need to entertain participants during fitness activities with some type of auditory sound. Measurements were taken in the wellness center under three conditions: quiet, music on, and music on/active. The intensity levels varied depending on the condition. Although the sound intensity was at an acceptable level during the quiet and music on condition, intensity levels reached an unacceptable level during the music on/active condition when not controlled by an administrator. This study provides a heightened awareness of the risks of possible hearing loss and promotes a role for professionals in health and human performance to collaborate with professionals in communication disorders in setting a safe intensity level of all audio systems. [ABSTRACT FROM AUTHOR]

Background: Patients with end-stage renal disease (ESRD) have a higher risk of suffering sudden sensorineural hearing loss (SSNHL), but little is known about this population. Aims and objectives: To investigate the clinical characteristics, treatment and recovery of SSNHL patients with ESRD. Materials and methods: Records of 32 SSNHL patients with ESRD were reviewed, including clinical characteristics and hearing recovery. Patients were divided into intratympanic steroid (ITS) group and oral steroid (OS) group, and hearing recovery was compared between two groups. Results: Twenty-six patients (81.3%) exhibited tinnitus, and 18 patients (56.3%) suffered vertigo. Mean pure-tone threshold at the initial presentation was 73.2 ± 19.4 dB, and the audiogram configuration was ascending in 9.4%, descending in 9.4%, flat in 34.4% and profound in 46.9% cases. At 3-month follow-up, percentages of patients in complete recovery, partial recovery, slight recovery, and no improvement were 18.8%, 31.3%, 21.9% and 28.1%, respectively. Furthermore, the overall recovery rate, complete recovery rate and hearing improvement were significantly higher in the ITS group than those in the OS group. Conclusion: SSNHL patient with ESRD often suffered a severe hearing loss with a high rate of accompanying tinnitus and vertigo. ITS may provide better audiological results for SSNHL with ESRD than OS. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the hearing loss risk in different sectors and subunits in the mining industry and to identify associated occupations, in an attempt to locate gaps between hearing conservation efforts and hearing loss risks.Design: Descriptive statistics and frequency tables were generated by commodity types, subunit operations, and/or occupations. Temporal trends of the incidences of hearing loss were reported by commodity types.Study Sample: The MSHA Accident/Injury/Illness and MSHA Address/Employment databases from 2000 to 2014 were used.Results: Incidence rate of OHL was reported highest in the coal sector compared to other commodity types. Those members of the workforce that entered the mining industry after the year 2000 accounted for 6.5% and 19.0% of the total hearing loss records for coal and non-coal, respectively. High-risk occupations found in all three commodity sectors (coal; stone, sand, and gravel; and metal/non-metal) were electrician/helper/wireman, mechanic/repairman/helper, bulldozer/tractor operator, and truck driver.Conclusion: Hearing loss risks were not uniform across mining sectors, subunit operations, and occupations. In addition to the continuous efforts of implementing engineering controls to reduce machinery sound level exposure for operators, a multi-level approach may benefit those occupations with a more dynamic exposure profile – e.g., labour/utilityman/bullgang, electrician/helper/wireman, and mechanic/repairman/helper. [ABSTRACT FROM AUTHOR]

Background The known relationship between the gestational age at maternal primary infection an the outcome of congenital CMV is based on small, retrospective studies conducted between 1980 and 2011. They reported that 32% and 15% of cases had sequelae following a maternal primary infection in the first and second or the third trimester, respectively. We aimed to revisit this relationship prospectively between 2011 and 2017, using accurate virological tools. Methods We collected data on women with a primary infection and an infected child aged at least 1 year at the time of analysis. An accurate determination of the timing of the primary infection was based upon serial measurements of immunoglobulin (Ig) M and IgG and on IgG avidity in sera collected at each trimester. The case outcome was assessed according to a structured follow-up between birth and 48 months. Results We included 255 women and their 260 fetuses/neonates. The dating of the maternal infection was prospective in 86% of cases and retrospective in 14%. At a median follow-up of 24 months, the proportion of sensorineural hearing loss and/or neurologic sequelae were 32.4% (95% confidence interval [CI] 23.72–42.09) after a maternal primary infection in the first trimester, 0 (95% CI 0–6.49) after an infection in the second trimester, and 0 (95% CI 0–11.95) after an infection in the third trimester (P <.0001). Conclusions These results suggest that a cytomegalovirus infection can be severe only when the virus hits the fetus in the embryonic or early fetal period. Recent guidelines recommend auditory follow-ups for at least 5 years for all infected children. This raises parental anxiety and generates significant costs. We suggest that auditory and specialized neurologic follow-ups may be recommended only in cases of a maternal infection in the first trimester. [ABSTRACT FROM AUTHOR]

Background Personnel assigned to aircraft carriers work and live in environments where hazardous noise areas and hearing recovery spaces such as sleeping areas are in close proximity to one another. Hazardous noise exposure occurring during on-duty time periods and elevated noise levels during off-duty periods in sleeping areas may be prohibiting adequate hearing recovery, thus potentially leading to hearing loss and may lead to adverse effects on sleep, leading to crew-member fatigue. This investigation characterizes Equivalent sound level (Leq) and standardized octave band center frequency noise levels according to berthing (sleeping) area location during flight operation and nonflight operation time periods on a US Navy aircraft carrier. In addition, the investigation compares noise measurements in sleeping areas to noise levels associated with auditory rest and poor sleep quality and quantity. Methods Noise levels were measured in berthing areas aboard a US Navy Nimitz-class aircraft carrier during a routine at-sea period. Sixty noise measurements were taken in eight sleeping locations. Leq in decibels 'A' weighted (dBA) and noise levels from 16 to 16 000 Hz in (dB) were measured during flight operations [Leq (flt ops)] and nonflight operations [Leq (nonflt ops)]. Leq was also measured according to sleep area shipboard locations of forward (FWD) Leq (FWD), middle (MID) Leq (MID), and rear (AFT) Leq (AFT). These data were compared to the 70 dBA American Conference of Governmental Industrial Hygienists (ACGIH) threshold limit value (TLV) for effective quiet areas. In addition, these data were compared to noise levels associated with hearing loss and sleep parameters. Statistical analysis was conducted with R version 3.5.2 using an alpha level of 0.05. Results Leq (flt ops) in sleeping areas was a statistically significant (P < 0.05) 6.4 dBA higher than the Leq (nonflt ops). Leq (FWD) and Leq (MID) in sleeping areas was a statistically significant (P < 0.05) 15.2 and 15.0 dBA higher, respectively, than the Leq (AFT) noise levels. Mean noise levels at standardized center (1/1) octave bands were highest between 500 and 4000 Hz, ranging from 65.2 to 69.8 dB. A total of 72% of all area Leq measurements exceeded the 70 dBA ACGIH TLV classified as effective quiet to allow for temporary threshold shift recovery. All noise measurements exceeded the World Health Organization's noise threshold where adverse effects on sleep begin. Discussion/Conclusions Results suggest that sleeping area location in close proximity to relatively high noise sources and activities occurring on an aircraft carrier (i.e. flight operations) increase noise levels in sleeping areas. These findings raise serious concerns since high noise exposures both on duty and during off-duty/sleeping periods may inhibit auditory recovery from hazardous noise exposures. In addition, results suggest noise levels in sleeping areas are high enough to evoke negative sleep effects. [ABSTRACT FROM AUTHOR]

Purpose: A summary of literature surrounding cortical hearing impairment (cortical deafness, auditory agnosia, and pure word deafness) was studied to identify causes and prognoses of the disorders, in addition to assessment methods and rehabilitation strategies for the multidisciplinary care team setting. Method: A comprehensive review of the literature surrounding cortical hearing impairment with a focus on clinical evaluation and management of patients with these conditions was performed. Results: An extensive literature search resulted in 109 relevant articles discussing cases of cortical hearing impairment. Conclusions: Cortical deafness continues to be the rarest of the cortical hearing impairment spectrum of disorders, with reports of auditory agnosia and pure word deafness appearing more commonly. In order to assess and manage patients with these conditions, audiologists must utilize a comprehensive set of clinical tools. This information must be combined with results of thorough multidisciplinary evaluations in order to better characterize diagnoses and outcomes for these patients. Continued reporting of case studies and summaries of the literature is encouraged, with a specific call for more consistent assessment and reporting formats. [ABSTRACT FROM AUTHOR]

Aim: This study was conducted to examine the effect(s) of combined exposure to whole-body vibration (WBV) and noise in railway workers. Methods: In this historical cohort study, train drivers with combined exposure to WBV and impermissible noise as the case group (n = 85) and shunters with just exposure to impermissible noise as the control group (n = 30) were recruited. The hearing threshold at the conventional audiometric frequencies was measured in both the groups, and the standard threshold shift (STS) and hearing threshold shift at higher frequencies were calculated. Data were analyzed by SPSS version 20 using t-test, Chi-square, and paired t-test. Results: There was no significant difference between the groups for age of participants as well as work duration and body mass index. Increased hearing threshold was most frequently observed at 3000, 4000, and 6000 Hz. STS and hearing threshold shift at high frequencies were observed at 6.0% and 3.3%, and 8.2% and 26.7% in train drivers and shunters in the left ear, respectively, but these were not statistically significant. Conclusion: Despite the unauthorized exposure to noise and WBV of train drivers, the STS and hearing threshold shift at higher frequencies were not more prevalent compared with the shunters who were exposed only to impermissible noise levels; hence, no association was found between noise and vibration in this study. [ABSTRACT FROM AUTHOR]

Many studies have been trying to correlate chronic otorrhea, both in children and in adults, with the sensorineural hearing loss in the affected ear, but have been obtaining contradictory results. This loss might be due to the likely toxicity of the bacteria involved, effects of inflammatory cytokines, or constant use of ototoxic antibiotics. All the studies evaluated up to the present date compared the affected ear with the normal contralateral ear. From the digitized archive of otological surgery files of the Department of Otorhinolaryngology, the ears of patients with chronic otorrhea were evaluated visually and compared with the normal contralateral ears. Ears with otorrhea were also compared to ears with dry tympanic perforation of other patients. Ears with suppuration were evaluated for cholesteatoma. The duration of otorrhea was taken into account. The sensorineural hearing threshold was evaluated for the frequencies of 500, 1000, 2000, and 4000 Hz. A total of 98 patients with chronic otorrhea and 60 with dry tympanic membrane perforation were evaluated. From a statistical study, a correlation between sensorineural hearing loss and the chronic otorrhea was observed, in comparison both with contralateral normal ears and with dry perforated ears of other patients. There was no relationship with the duration of suppuration or with whether this was due to cholesteatoma. Sensorineural hearing loss occurs in ears with chronic otorrhea. The duration of otorrhea and the etiology of suppuration did not influence the hearing loss. The great majority of otorrhea cases begin during childhood. [ABSTRACT FROM AUTHOR]

OBJECTIVE: In this study, we determined the prevalence of hearing loss in 157 children with proven congenital cytomegalovirus (cCMV) infection. We looked at possible risk determinants for developing hearing loss and proposed recommendations for screening and follow-up in the newborn. METHODS: In a prospective 22-year study, 157 children with proven cCMV infection were evaluated for sensorineural hearing loss (SNHL). The development of SNHL was correlated with the type of maternal infection (primary versus nonprimary), the gestational age of maternal primary infection, imaging findings at birth, and the presence of symptomatic or asymptomatic infection in the newborn. RESULTS: Of all children, 12.7% had SNHL, and 5.7% needed hearing amplification because of SNHL. Improvement, progression, and fluctuations of hearing thresholds were seen in 45%, 53.8%, and 5.7% of the children, respectively. Hearing loss was more common in the case of a symptomatic infection at birth (P = .017), after a maternal primary infection in the first trimester of pregnancy (P = .029), and in the presence of abnormalities on a neonatal brain ultrasound and/or MRI (P < .001). CONCLUSION SNHL is a common sequela in children with cCMV infection. Risk factors for SNHL were primary maternal infections before the 14th week of pregnancy, the presence of a disseminated infection at birth, and imaging abnormalities in the newborn. These children may benefit from a more thorough investigation for SNHL than children who do not present with those risk factors. [ABSTRACT FROM AUTHOR]

A retrospective review of children with confirmed hearing loss identified through universal newborn hearing screening (UNHS) in Virginia from 2010 to 2014 was conducted in order to compare the incidence of Joint Committee on Infant Hearing (JCIH) risk factors in children with unilateral hearing loss (UHL) to bilateral hearing loss (BHL). Over the 5-year study period, 1004 children (0.20% of all births) developed a confirmed hearing loss, with 544 (51%) children having at least one JCIH risk factor. Overall, 18% of children with confirmed hearing loss initially passed UNHS. Of all children with risk factors, 226 (42%) demonstrated UHL and 318 (58%) had BHL. The most common risk factors for UHL were neonatal indicators (69%), craniofacial anomalies (30%), stigmata of HL syndromes (14%), and family history (14%). The most common risk factors in BHL were neonatal indicators (49%), family history (27%), stigmata of HL syndromes (19%), and craniofacial anomalies (16%). Children with the risk factor for positive family history were more likely to have BHL, while those with craniofacial anomalies were more likely to have UHL (P <.001). Neonatal indicators were the most commonly identified risk factor in both UHL and BHL populations. Children with UHL were significantly more likely to have craniofacial anomalies, while children with BHL were more likely to have a family history of hearing loss. Further studies assessing the etiology underlying the hearing loss and risk factor associations are warranted. [ABSTRACT FROM AUTHOR]

Background: Recreational noise--induced hearing loss (RNIHL) is a major health issue and presents a huge economic burden on society. Exposure to loud music is not considered hazardous in our society because music is thought to be a source of relaxation and entertainment. However, there is evidence that regardless of the sound source, frequent exposure to loud music, including through personal audio systems (PAS), can lead to hearing loss, tinnitus, difficulty processing speech, and increased susceptibility to age-related hearing loss. Purpose: Several studies have documented temporary threshold shifts (TTS) (a risk indicator of future permanent impairment) in subjects that listen to loud music through their PAS. However, there is not enough information regarding volume settings that may be considered to be safe. As a primary step toward quantifying the risk of RNIHL through PAS, we assessed changes in auditory test measures before and after exposure to music through the popular iPod Touch device set at various volume levels. Research Design: This project design incorporated aspects of both between- and within-subjects and used repeated measures to analyze individual groups. Study Sample: A total of 40 adults, aged 18-31 years with normal hearing were recruited and randomly distributed to four groups. Each group consisted of five males and five females. Data Collection and Analysis: Subjects underwent two rounds of testing (pre- and postmusic exposure), with a 30-min interval, where they listened to a playlist consisting of popular songs through an iPod at 100%, 75%, 50%, or 0% volume (no music). Based on our analysis on the Knowles Electronic Manikin for Acoustic Research, with a standardized 711 coupler, it was determined that listening to the playlist for 30 min through standard earbuds resulted in an average level of 97.0 dBC at 100% volume, 83.3 dBC at 75% volume, and 65.6 dBC at 50% volume. Pure-tone thresholds from 500--8000 Hz, extended high-frequency pure tones between 9-12.5 kHz, and distortion product otoacoustic emissions (DPOAE) were obtained before and after the 30-min music exposure. Analysis of variance (ANOVA) was performed with two between-subjects factors (volume and gender) and one within-subjects factor (frequency). Change (shift) in auditory test measures was used as the outcome for the ANOVA. Results: Results indicated significant worsening of pure-tone thresholds following music exposure only in the group that was exposed to 100% volume at the following frequencies: 2, 3, 4, 6 and 8 kHz. DPOAEs showed significant decrease at 2000 and 2822 Hz, also only for the 100% volume condition. No significant changes were found between pre- and postmusic exposure measures in groups exposed to 75%, 50%, or 0% volume conditions. Follow-up evaluations conducted a week later indicated that pure-tone thresholds had returned to the premusic exposure levels. Conclusions: These results provide quantifiable information regarding safe volume control settings on the iPod Touch with standard earbuds. Listening to music using the iPod Touch at 100% volume setting for as little as 30 min leads to TTS and worsening of otoacoustic emissions, a risk for permanent auditory damage. [ABSTRACT FROM AUTHOR]

Background: Several studies have reported that the audiovestibular system is affected in patients with chronic kidney disease. Objective: This study aimed to investigate how the audiovestibular system is affected in patients with various stages of chronic kidney disease. Methods: Sixty participants were divided into three groups: group 1 – controls; group 2 – chronic kidney disease patients receiving conservative treatment; and group 3 – chronic kidney disease patients undergoing regular haemodialysis. Assessments included: standard and high-frequency audiometry and otoacoustic emissions testing, oculomotor tests, and combined vestibular-evoked myogenic potentials testing. Results: Fifty per cent of group 2 and 60 per cent of group 3 had bilateral sensorineural hearing loss. High-frequency pure tone audiometry showed reduced detectability and higher thresholds at 12 kHz and 16 kHz in patients than in controls. Otoacoustic emissions, tracking, optokinetic and combined vestibular-evoked myogenic potential tests showed abnormal results in chronic kidney disease cases. Conclusion: Both the auditory and vestibular pathways are affected in different stages of chronic kidney disease. High-frequency pure tone audiometry, otoacoustic emissions and combined vestibular-evoked myogenic potentials could be performed routinely in patients with chronic kidney disease, regardless of the disease stage. [ABSTRACT FROM AUTHOR]

Background: Hearing impairment is one of the major health problems under the paradigm of occupational health. Mine workers are vulnerable to hearing impairment due to the nature of work, inadequate knowledge of sound hazards and limited access to protective devices. However, the cause of such health problems in India have rarely been explored. Present study aimed to find out hearing threshold of the study population, the level of noise in the mine areas and the relationship of different concomitants on hearing thresholds of the workers. Methods: Cross-sectional data on audiometric measurements, age and work duration in stone mining work were collected from 189 adult Santal stone mine workers (i.e. Group I= working and residing in stone mines and Group II = working in stone mines but residing outside stone mines) of Birbhum district, West Bengal. Data on noise pollution level were also collected. All the data were collected following standard techniques and instruments. Descriptive statistics, cross-tabulation and multivariate logistic regression analysis were performed. Results: Hearing threshold was higher in Group I than Group II; in aged workers than younger workers and working for long duration than short duration in mines. The level of noise pollution inside the stone mine area was above the recommended limit. The most important concomitants of hearing threshold were residence and work in stone mines. Conclusion: The workers engaged in stone mine work and residing inside mine area were more susceptible to hearing impairment. The intensity of the risk further increases with the advancement of age. [ABSTRACT FROM AUTHOR]

Cisplatin is a highly effective antineoplastic agent used to treat solid tumors. Unfortunately, the administration of this drug leads to significant side effects, including ototoxicity, nephrotoxicity, and neurotoxicity. This review addresses the mechanisms of cisplatin-induced ototoxicity and various strategies tested to prevent this distressing adverse effect. The molecular pathways underlying cisplatin ototoxicity are still being investigated. Cisplatin enters targeted cells in the cochlea through the action of several transporters. Once it enters the cochlea, cisplatin is retained for months to years. It can cause DNA damage, inhibit protein synthesis, and generate reactive oxygen species that can lead to inflammation and apoptosis of outer hair cells, resulting in permanent hearing loss. Strategies to prevent cisplatin ototoxicity have utilized antioxidants, transport inhibitors, G-protein receptor agonists, and anti-inflammatory agents. There are no FDA-approved drugs to prevent cisplatin ototoxicity. It is critical that potential protective agents do not interfere with the antitumor efficacy of cisplatin. [ABSTRACT FROM AUTHOR]

Cisplatin, an effective antineoplastic drug used in the treatment of many cancers, has ototoxic potential, thus placing cancer patients, receiving this treatment, at risk of hearing loss. It is therefore important for health care professionals managing these patients to be aware of cisplatin's ototoxic properties and its clinical signs to identify patients at risk of developing a hearing impairment. Eighty-five English peer-reviewed articles and two books, from January 1975 to July 2015, were identified from PubMed, ScienceDirect, and EBSCOhost. An overview of cisplatin-associated ototoxicity, namely its clinical features, incidence rates, molecular and cellular mechanisms, and risk factors, is presented in this article. This review further highlights the importance of a team-based approach to complement an audiological monitoring program in reducing any further loss in the quality of life of affected patients, as there is currently no otoprotective agent routinely recommended for the prevention of cisplatin-associated ototoxicity. [ABSTRACT FROM AUTHOR]

In the United States, cytomegalovirus is the most common congenital viral infection and the number 1 cause of nonhereditary sensorineural hearing loss. The vast majority of infants may be asymptomatic, especially if cytomegalovirus is contracted later in the pregnancy, and some symptoms may have a delayed onset. Therefore, it is important for the pathologist to identify the common histologic findings to help confirm the diagnosis so the child can be followed for late sequelae. Histologic examination of the placenta is important in live births and in cases of intrauterine fetal demise. Chronic lymphoplasmacytic villitis and fibrotic, avascular villi are the most common findings. When present, Cowdry A intranuclear and basophilic intracytoplasmic inclusions are characteristic. Immunohistochemistry for cytomegalovirus can highlight these inclusions as well as the associated eosinophilic debris. In addition, polymerase chain reaction or viral culture on placental or fetal samples can be performed for confirmation. [ABSTRACT FROM AUTHOR]

Background: Most previous studies are separate dosimetric analyses of conductive or sensorineural hearing loss, and they are not conducive to a comprehensive assessment of auditory radiation damage. Aims/objectives: Our study aimed to evaluate the long-term incidence of sensorineural hearing loss (SNHL) or conductive hearing loss (CHL) in patients with nasopharyngeal carcinoma (NPC) after intensity-modulated radiation therapy (IMRT), and to investigate the relationship between SNHL or CHL and patient factors, treatment-related factors, and radiation dose parameters. Material and methods: Seventy patients (117 ears) with NPC, who were also treated with IMRT in our hospital from 2006 to 2014, were retrospectively analyzed. Radiation doses to the Eustachian tube (ET), middle ear (ME), cochlear (Co), and internal auditory canal (IAC) were assessed. Pure tone audiometry and impedance audiometry were performed before and during the follow-up period. The relationships between low-frequencies (0.5–2 kHz) or high-frequency (4 kHz) SNHL/CHL and radiotherapy dose parameters were analyzed. Results: Of the 117 ears studied, 7.69% had low-frequency SNHL, 35.9% had high-frequency SNHL, 23.93% had low-frequency CHL, and 18.80% had high-frequency CHL. The incidence of high-frequency CHL was higher in the T4 group than in the T (1–3) group (p <.05). When IAC Dmax > 42.13 Gy or IAC Dmean > 32.71 Gy, the risk of high-frequency SNHL increased in NPC patients. When ME Dmax > 44.27 Gy, ME Dmean > 29.28 Gy, or ET Dmax > 57.23 Gy, the risk of high-frequency CHL in NPC patients increased. Conclusions and significance: SNHL and CHL remain common ear complications after IMRT for NPC. IAC Dmax, IAC Dmean, ME Dmax, ME Dmean, and ET Dmax all need to be carefully considered during the IMRT treatment protocol. [ABSTRACT FROM AUTHOR]

To determine if conventional audiometry, EHFA, and pDPOAEs are useful as early indicators of cochlear damage from recreational firearm impulse noise exposure in youth firearm users. Quantitative cross-sectional descriptive pilot study. Descriptive statistics and MANOVA with post hoc Tukey Honestly Significant Difference test were used to compare pDPOAEs (1-10 kHz), conventional audiometry (0.25-8 kHz), and EHFA (10-16 kHz) in YFUs. 25 YFUs (n = 11 7-12 years; n = 14 13-17 years) with self-reported poor compliance with hearing protector device wear. Conventional audiometric thresholds at 2-, 3- and 4 kHz were significantly poorer than normal but did not distinguish between older and younger YFUs or between the GBE and the contralateral ear. EHFA thresholds at 14- and 16 kHz were significantly poorer than for other frequencies, and differentiate between older and younger youths, but do not distinguish the GBE from the contralateral ear. Finally, pDPOAE levels were significantly reduced at 8- and 10 kHz but did not show any differences for the younger versus older YFUs or for the GBE from the contralateral ear. Conclusion: Both EHFA and pDPOAEs provide early evidence of NIHL in YFUs, and may be useful for the early detection of NIHL in YFUs. [ABSTRACT FROM AUTHOR]

Accurate quantification of noise exposure in military environments is challenging due to movement of listeners and noise sources, spectral and temporal noise characteristics, and varied use of hearing protection. This study evaluates a wearable recording device designed to measure on-body and in-ear noise exposure, specifically in an environment with significant impulse noise resulting from firearms. A commercial audio recorder was augmented to obtain simultaneous measurements inside the ear canal behind an integrated hearing protector, and near the outer ear. Validation measurements, conducted with an acoustic test fixture and shock tube, indicated high impulse peak insertion loss with a proper fit of the integrated hearing protector. The recording devices were worn by five subjects during a live-fire data collection at Marine Corps Base Quantico where Marines fired semi-automatic rifles. The field test demonstrated the successful measurement of high-level impulse waveforms with the on-body and in-ear recording system. Dual channels allowed for instantaneous fit estimates for the hearing protection component, and the device worked as intended in terms of hearing protection and noise dosimetry. Accurate measurements of noise exposure and hearing protector fit should improve the ability to model and assess the risks of noise-induced hearing loss. [ABSTRACT FROM AUTHOR]